Getting it down to a fine art.

Daniel Ziskind D.M.D., Hebrew University, Israel

www.lingualnews.com Vol 2 No 2 November 2004

Alignment of the dental arch as well as the shapes of the teeth are not the only aspects contributing to an esthetic orthodontic result. In addition, the fine details must be considered when judging any esthetic improvement desired. For example, the surface and microstructure of any dental restoration provide the illusion of a natural appearance. Light reflected from its surface gives it its unique individual tooth appearance. (Fig. 1). This may be considered as the ''tooth signature'' or ''tooth print'' of an individual smile.
 

Fig 1: Tooth restoration with a crown.
Light reflection provides a natural appearance.

After completing the orthodontic treatment and removing the brackets, a microscopic almost invisible resin layer remains on the tooth surface. This layer is removed using fine dental burs. However, the typical tooth surface might not be reconstructed properly. Understanding and recognizing the possible typical appearance of a tooth might be helpful for the clinician achieving superior aesthetic results. Analysis of tooth micro structure is recommended during the gathering of pre-treatment diagnostic information. Removal to bonding agents following treatment may wipe off reference points noted prior to their placement, therefore, it is advantageous to record the details in the patient file prior to bracket placement. In addition, I highly recommend that dring the removal of the resin rests to utilize magnification glasses in order to improve  the effectiveness of this procedure. It should be remembered that there are specific microstructures within enamel, some of which are age, habit, and tooth form dependent. For example, attention should be paid to the existence of the typical groove and transverse ridge pattern of the teeth. (Fig. 2).

Fig 2: A summary of three typical tooth characteristics of a tooth. The clinician should recognize these structures prior to brackets cementation.  

When needed the structure should be re-established in order to regain the light reflectance characteristics of the tooth. (Fig. 3). Awareness and attention to the finer details of the aspects which provide more than just straight teeth is part of the "art" of orthodontics and must be included as part of the final stage of treatment. This represents the orientation of our professional effort towards excellence - getting it down to a fine art.

Fig 3: An illustration of re-producing the "Transverse ridge".

www.lingualnews.com 
Adult and Lingual Orthodontics
EDITORS:
Dr. Silvia Geron D.M.D., M.Sc
Dr. Rafi Romano D.M.D., M.Sc
Dr. Pablo Echarri D.M.D., M.Sc