Are Golden Proportions necessary?

Golden Proportions are one way to reference a smile design. Many aspects of nature, art, and architecture can be described with attention to Golden Proportions. While it is helpful to analyze the elements of a structure and compare them with each other, Golden proportions are not required to create a well-balanced composition. Like any grid on the background of an architectural sketchboard, lines, numbers, and matrices help to relate designs in progress.

We already described dental and facial proportions elsewhere. They are a useful tool for the cosmetic dentist to get a better grasp on existing proportions to make cosmetic dentistry more predictable.

The consideration of Golden Proportions on teeth and the face sharpens the perception of current and desired dental conditions:


Dental Golden Proportions

Many cosmetic dental publications have talked about Golden Proportions as a measure to evaluate the aesthetic appearance of a smile. However, they should only be a reference to facilitate communication between the dental lab, the patient, and the cosmetic dentist. Many other factors determine to optimum smile design for a particular patient. You will find them throughout this website.

See also:

Stephen J Chu. A biometric approach to predictable treatment of clinical crown discrepancies. Pract Proced Aesthetic Dentistry. 2007 vol. 19 (7) pp. 401-9.

Ufuk Hasanreisoglu. An analysis of maxillary anterior teeth: facial and dental proportions. J Prosthetic Dentistry. 2005 vol. 94 (6) pp. 530-8.

E I Levin. Dental esthetics and the golden proportion. J Prosthetic Dentistry. 1978 vol. 40 (3) pp. 244-52.

R E Lombardi. The principles of visual perception and their clinical application to denture esthetics. 1973 vol. 29 (4) pp. 358-82.

Michael R Sesemann. Utilizing diagnostic tracing analysis for smile design. AACD Monograph. 2010 pp. 1-4.

J D Sterrett. Width/length ratios of normal clinical crowns of the maxillary anterior dentition in man. J Clin Periodontology. 1999 vol. 26 (3) pp. 153-7.

S Wolfart. Subjective and objective perception of upper incisors. J Oral Rehabilitation. 2006 vol. 33 (7) pp. 489-95.


Facial Proportions

Even the face has been divided into areas that approach Golden Proportions. They are not written in stone nor should they be attained by all means. They are helpful to discover and understand facial relationships and their deviations from person to person. In addition, as we all know, most faces are slightly asymmetric and the proportions of one side of a face do not entirely correlate to the proportions of the other side. However, facial symmetry is desirable, since it is related to health and facial beauty.

See also:

Rhodes, G., Proffitt, F., Grady, J. M., & Sumich, A. (1998). Facial symmetry and the perception of beauty. Psychonomic Bulletin & Review. 5(4), 659–669.

Kowner, R. (1996). Facial asymmetry and attractiveness judgment in developmental perspective. Journal of Experimental Psychology. Human perception and performance. 22(3), 662–75.

Perrett, D. I., Burt, D. M., Penton-Voak, I. S., Lee, K. J., Rowland, D. a, & Edwards, R. (1999). Symmetry and Human Facial Attractiveness. Evolution and Human Behavior. 20(5), 295–307.

Penton-Voak, I. S., Jones, B. C., Little, a C., Baker, S., Tiddeman, B., Burt, D. M., & Perrett, D. I. (2001). Symmetry, sexual dimorphism in facial proportions and male facial attractiveness. Proceedings. Biological sciences / The Royal Society. 268(1476), 1617–23.

Farhad B Naini. The enigma of facial beauty: esthetics, proportions, deformity, and controversy. Am J Orthod Dentofacial Orthop. 2006 vol. 130 (3) pp. 277-82.


Facial Lines of Reference

Plastic surgeons and orthodontists use many lines of reference to establish norms, deviations, and the goals of their treatments. The facial lines of reference sharpen the perception of facial relationship and their nuances, which facilitates the gradation of the deviation from the "norm" and the formulation of an appropriate treatment plan. Facial lines of reference also help the cosmetic dentist to relate the dental framework to the entire face to to integrate the new smile harmoniously into the face.

See also:

E L Miller.A study of the relationship of the dental midline to the facial median line. J Prosthetic Dentistry. 1979 vol. 41 (6) pp. 657-60.

G William Arnett. Facial analysis: The key to successful dental treatment planning. J Cosmetic Dentistry. 2005 vol. 21 (3) pp. 19-34.


Progressions of Dental Axial Alignment

A beautiful smile is characterized by a progression of the alignment of the dental axes from the front to the back. This is how nature created our dentition, and any failure to observe this natural principle will lead to an artificial-looking and unattractive smile.

See also:

Thomas M Graber. Diagnosis and Treatment Planning. In "Orthodontics - Current Principles and Techniques;" 1985 (1. Edition) pp. 1-10.

V F Ferrario. Three-dimensional inclination of the dental axes in healthy permanent dentitions--A cross-sectional study in a normal population. Angle Orthod. 2001 vol. 71 (4) pp. 257-64.


Gingival Architecture: Gingival Zeniths in Relationship to their Dental Axes

Prior to preparing the teeth of the aesthetic zone for a smile design, it is important to establish two goals: the incisal edge position of the future upper central incisors and the position and degree of scalloping of the gingival margins next to the teeth. A beautiful smile starts with healthy gums, a harmonious balance between "red" and "white," and a correct position of the gingival zeniths.

See also:

Nitzan Bichacho. Cervical contouring concepts: enhancing the dentogingival complex. Pract Periodontics Aesthetic Dentistry. 1996 vol. 8 (3) pp. 241-54.

Chu SJ. Gingival zenith positions and levels of the maxillary anterior dentition. J Esthetic Restorative Dentistry. 2009;21(2):113-20.


Emergence Angles of Occlusal Embrasures and Reverse Progression of Cusp Heights

A youthful and playful smile does not have tightly packed teeth without the element of "open space." This is created by the development of sufficiently sized incisal embrasure, the triangular spaces that are created by the slopes of the adjacent tooth cusps. Their size and their emergence angle increase at each successive tooth contact from the front of the mouth towards the back

See also:

George E Kirtley. The art of a beautiful smile. J Cosmetic Dentistry. 2008 vol. 24 (3) pp. 122-131.

Ken M Hamlett. Steps in creating a beautiful smile. J Cosmetic Dentistry. 2008 vol. 34 (4) pp. 92-96