In the field of oral aesthetics, the final vision should be perceived before treatment techniques commence. The final vision or perception is tempered with several technical factors. One is the vision of the practitioner, which could be influenced by the individual’s desires, the culture where he or she practices, or the availability of materials.
In aesthetic dentistry, we should see the desired result before we commence. Patients’ input is vital, and as we listen to them, we note these concerns and desires first. While they are not always practical, the patient’s desires are tempered by cultural, family, and economic influences. The dentist’s professional input should be combined with the patient’s desires. The dentist’s input is tempered by (1) experience, (2) educational exposure (how many continuing education courses have assisted his or her growth, confidence, experience, and comfort using available materials), (3) laboratory technique interchange, and (4) communication with labs. So many variables. We are in need of consistency with such variability.
Coordinating the periodontium and its colors and shapes to emphasize the teeth and desired smile using available restorative materials is technically paramount. Plus, imagination is needed. The preventive maintenance of the treatment result is also part of picture.
The natural color of the patient’s surrounding periodontal tissue should blend into and direct one’s focus to the desired aesthetic illusion. In other words, the background elucidates the foreground “illusion.” If the periodontal background is unhealthy or asymmetrical in height and/or length, it will distract from the desired focus.The periodontal tissues that form the background can and should be manipulated to gain health as well as a symmetrical background color. This may minimize or even avoid unnecessary mechanical correction of the hard tooth structures.
We need to know the desired anatomy before initiating treatment plus the effort it takes to achieve it. In the periodontal oral tissues, there are 2 colors that stand out—the reddish-blue alveolar mucosa and the pinkish-white keratinized attached gingiva.The line of demarcation is the mucogingival junction. If we can acquire a symmetrical healthy zone of attached gingiva around the teeth, we can accentuate desired aesthetic features and diminish undesirable ones more easily yet facilitate and maintain the results.
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