1 Journal of Interdisciplinary Clinical Dentistry Feb.25.2021,(5)4 Introduction The essence of aesthetics, from my point of view, constantly connects the underlying three qualities: beauty, strength, and unpredictability, which are all quite different in every aspect. Beauty is just beautiful; strength and unpredictability are qualities that render 'miracles' possible. This is the conclusion I have reached after exploring other aspects of aesthetics -different from dentistry- in various dimensions, such as art, architecture, gastronomy, fashion, among other small or big man-made wonders in the East and the West. From the aesthetics point of view, such theory can be applied to nature, for example, a rose has the beauty in its colors, and in the uneven distribution of its delicate petals; the strength of its stem is found in its rigidity, and its unpredictability lies in the unsuspected shape of its thorns. In the case of trees, beauty is given by the color and shape of their leaves, flowers, or fruits; strength is yielded by its stem’s hardness, and unpredictability is presented by the direction each branch takes. The beauty of the sea is in the water and its colors; however, what pleases us the most is the strength provided by the sea waves, which in turn, unpredictably disintegrate into foams. The beauty of the sky is highlighted by its varied shades, its strength emanates from the clouds, in the most hidden layer of the masses; their unpredictable textures, shapes, and sizes generate a continuous changing lighting effect, depending on the lights and the shadows. If we analyze what brings fascination and pleasure to the sight (from the most sublime heavenly creations -men, women, nature, animals, and plants) we will always find the essence of aesthetics being repeated relentlessly with no exception: beauty, strength, and unpredictability. From the dental aesthetics perspective, I can also claim that taste is subjective and personal, while aesthetics is absolute and unique. Therefore, the beauty of a smile is given by the central incisors, the strength of the canines, and the unpredictability of the lateral incisors, the shape of which may not fit into the so-called beauty ideal. It is true that every tooth may be symmetrical, with perfectly rounded and defined angles; but if the strength of the canines, and the unpredictability of the lateral incisors are lost, all the magic of the smile would be erased, deviating from the real sense of aesthetics. Case Report A 24y.o female was referred to the dentist. She wanted to replace her composite aesthetic restorations, made 6 years ago, with porcelain veneers, because she didn’t feel comfortable with the appearance, color, width, shape, size, and shine of her teeth. Clinical examination revealed that every tooth was excessively white, symmetrical, with rounded and rough gingival shapes (Fig. 2 and 3); every tooth was short and wide (Fig. 4), mainly on the lateral incisors. The canines were smooth and rounded. Even though aesthetics, art, and creativity do not require measurements, the following table was developed with the purpose to provide a guideline -not an absolute specification- to determine teeth sizes and shapes for each case. First, we will use the initial composite restorations to make a mock-up that leads us to our goal. Then, we will modify the gingival height and shape, and accurately locate the zenith points. (Fig. 5). Case Report Aesthetics with beauty, strength, and unpredictability By Dr. Marlon Becerra. Dentist from Colegio Odontológico Colombiano; Completed his aesthetics certificate program at New York University. Creator and director of 'Odontología de Marlon Becerra', a 25 clinics network specialized in dental aesthetics in Colombia. E-mail: [email protected]Summery What is intended with this case is to show how symmetry and perfection of dental shapes lead us away from the real essence of aesthetics; by the other hand, the proper management of measurements and imperfections will lead us close to such essence. Key words:Aesthetics, Art, Smile design
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Journal of Interdisciplinary Clinical Dentistry Feb.25.2021,(5)4
Introduction
The essence of aesthetics, from my point of view, constantly connects the underlying three qualities: beauty, strength, and unpredictability, which are all quite different in every aspect. Beauty is just beautiful; strength and unpredictability are qualities that render 'miracles' possible. This is the conclusion I have reached after exploring other aspects of aesthetics -different from dentistry- in various dimensions, such as art, architecture, gastronomy, fashion, among other small or big man-made wonders in the East and the West. From the aesthetics point of view, such theory can be applied to nature, for example, a rose has the beauty in its colors, and in the uneven distribution of its delicate petals; the strength of its stem is found in its rigidity, and its unpredictability lies in the unsuspected shape of its thorns. In the case of trees, beauty is given by the color and shape of their leaves, flowers, or fruits; strength is yielded by its stem’s hardness, and unpredictability is presented by the direction each branch takes. The beauty of the sea is in the water and its colors; however, what pleases us the most is the strength provided by the sea waves, which in turn, unpredictably disintegrate into foams. The beauty of the sky is highlighted by its varied shades, its strength emanates from the clouds, in the most hidden layer of the masses; their unpredictable textures, shapes, and sizes generate a continuous changing lighting effect, depending on the lights and the shadows. If we analyze what brings fascination and pleasure to the sight (from the most sublime heavenly creations -men, women, nature, animals, and plants) we will always find the essence of aesthetics being repeated relentlessly with no exception: beauty, strength, and unpredictability. From the dental aesthetics perspective, I can also claim that taste is subjective and personal, while aesthetics is absolute and unique. Therefore, the beauty of a smile is given by the central incisors, the strength of the canines, and the unpredictability of the lateral incisors, the shape of which may not fit into the so-called beauty ideal. It is true that every tooth may be symmetrical, with perfectly rounded and defined angles; but if the strength of the canines, and the unpredictability of the lateral incisors are lost, all the magic of the smile would be erased, deviating from the real sense of aesthetics.
Case Report
A 24y.o female was referred to the dentist. She wanted to replace her composite aesthetic restorations, made 6 years ago, with porcelain veneers, because she didn’t feel comfortable with the appearance, color, width, shape, size, and shine of her teeth. Clinical examination revealed that every tooth was excessively white, symmetrical, with rounded and rough gingival shapes (Fig. 2 and 3); every tooth was short and wide (Fig. 4), mainly on the lateral incisors. The canines were smooth and rounded. Even though aesthetics, art, and creativity do not require measurements, the following table was developed with the purpose to provide a guideline -not an absolute specification- to determine teeth sizes and shapes for each case. First, we will use the initial composite restorations to make a mock-up that leads us to our goal. Then, we will modify the gingival height and shape, and accurately locate the zenith points. (Fig. 5).
Case Report
Aesthetics with beauty, strength, and unpredictability
By Dr. Marlon Becerra.
Dentist from Colegio Odontológico Colombiano; Completed his aesthetics certificate program at New York University. Creator and director of 'Odontología de Marlon Becerra', a 25 clinics network specialized in dental aesthetics in Colombia.E-mail: [email protected]
SummeryWhat is intended with this case is to show how symmetry and perfection of dental shapes lead us away from the real essence of aesthetics; by the other hand, the proper management of measurements and imperfections will lead us close to such essence.
Key words:Aesthetics, Art, Smile design
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Journal of Interdisciplinary Clinical Dentistry Feb.25.2021,(5)4
(Fig. 1) (a) Baseline appearance of the patient's smile in frontal view, (b) lateral view, and (c) lips at rest view. Note the rounded appearance of the arch, and broad exposure of the gingiva while smiling.
(c)
(a) (b)
(Fig. 2) (a) Plane of six anterior teeth in frontal view, (b) right lateral, left lateral, no angles, no proper textures are shown; the beauty of the central incisors is lost in the whole picture.
(a)
(b) (c)
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(Fig. 3) Measurement table
(Fig. 4) Based on the table of measurements, each tooth is not at the ideal length and width.
(Fig. 5) Mock-up without removal of the previous composite restorations, only modeling to improve appearance.
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(Fig. 6) minimally-invasive teeth preparations for veneers.
(Fig. 7) (a) Frontal view of the plane of the anterior teeth, (b) right lateral view, and (c) left lateral view.
(a)
(b) (c)
(Fig. 8) (a) Upper view of the plane of the anterior teeth where we can see polychrome, shapes and translucency; (b) beauty, strength and unpredictability, which are three distinct qualities, can be seen on the same plane.
(a) (b)
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After the gums have healed, we removed composites, and prepared the teeth for veneers (Fig. 6). Finally, along with a dental technician and the patient, during an appointment solely for this purpose, we determined the colors, translucency of the ceramic, light effects, shapes, imperfections, angles, among other details i.e., arts and creativity (Fig. 7, 8 and 9).
Details and imperfections to analyze
Besides obtaining proper measurements, imperfections and creativity are also of paramount importance to approach the essence of Aesthetics. There are several imperfections and details that could be found as described below: - Although the central incisors are the most symmetrical teeth, the distal surface is more convex than the mesial
surface. - The mesio-incisal angle of the central incisorsias less rounded than that of the disto-incisal angle; the distal contact
point is in a more cervical position than that of the mesial contact point. - The incisal edges are not straight on any tooth. - The distal contact point at the lateral incisor is the highest, creating a real ‘void’ between the lateral incisor and the
canine. - The incisal edge of the lateral incisor is the steepest among all teeth. - The width of the lateral incisor did not exceed 6.6 millimeters to enhance the beauty of the central incisor. - A canine is a canine, and its shape is neither rounded nor rhomboid; also, its incisal edge has cuts and notches (at
least five and is possibly distributed randomly). - The zenith points of the central incisors are located distally, in order to provide a much more stylized shape than the
other teeth; the zenith points of the canines are located at the center to increase their strength; the zenith points of lateral incisors are more distally located than those of the central incisors, which gave them a narrow and asymmetric appearance.
- The gingival margin of the canine is more rounded in shape at the distal area. - Every tooth angle is different, with random cuts. - The central incisors that showed, while the lips were at rest, is higher than 5mm. - Every contact point is located at different heights.
Conclusion
Neither can we deny that perfect and white teeth stand out more than others, nor can we deny they might overshadow
(Fig. 9) The frontal view of the final smile (a, c), and the lateral view (b, d).
(c)
(a)
(d)
(c)
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Journal of Interdisciplinary Clinical Dentistry Feb.25.2021,(5)4
other parts of the face. By the same token, it might be absurd to remove the waves and the movement from the sea, even if its water is aquamarine blue, or the most beautiful sea in the world. Isn't it enough that a sky full of white clouds make the infinite color range of blue more prominent? The same analogy could be made with viewing a completely dark sky, which enhances the beauty of the dark reflections of moonlight and the unpredictable shine of the stars, and in turn the strength of the infinite void of the black sky. Moreover, if we focus on the aesthetics of the simple, it might be also comparable to eating some tuna chunks with just bare hands, depriving us from the appreciation of a beautiful bowl decorated with some green Shiso leaves.
“Art is the artists, not techniques or materials.”
References- Rickne C. Scheid – Gabriela Weiss. Woelfel. Anatomía Dental.- Galip Gurel. The Science and Art of Porcelain Laminate Veneers.- Stephen Chu, Devigus and Mieleszko. Fundamentals of Color.- Philip Ball. La Invención del Color.- Kassia St Clair. Las Vidas Secretas del Color.
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Journal of Interdisciplinary Clinical Dentistry Feb.25.2021,(5)4
Colegio Odontológico Colombiano 出身歯科医,ニューヨーク大学で審美歯科プログラムを修了. コロンビアで審美歯科を専門とするクリニック数 25 施設のネットワークから成る Creator and director of 'Odontología de Marlon Becerra の創設者・理事長 E-mail: [email protected]
“Art is the artists, not techniques or materials.”
参考文献
- Rickne C. Scheid – Gabriela Weiss. Woelfel. Anatomía Dental.- Galip Gurel. The Science and Art of Porcelain Laminate Veneers.- Stephen Chu, Devigus and Mieleszko. Fundamentals of Color.- Philip Ball. La Invención del Color.- Kassia St Clair. Las Vidas Secretas del Color.
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Journal of Interdisciplinary Clinical Dentistry Feb.25.2021,(5)4
兼具美观,力量和不确定性的美学 Aesthetics with beauty, strength, and unpredictability
By Dr. Marlon Becerra.
Dentist from Colegio Odontológico Colombiano; Completed his aesthetics certificate program at New York University. Creator and director of 'Odontología de Marlon Becerra', a 25 clinics network specialized in dental aesthetics in Colombia.E-mail: [email protected]
- Rickne C. Scheid – Gabriela Weiss. Woelfel. Anatomía Dental.- Galip Gurel. The Science and Art of Porcelain Laminate Veneers.- Stephen Chu, Devigus and Mieleszko. Fundamentals of Color.- Philip Ball. La Invención del Color.- Kassia St Clair. Las Vidas Secretas del Color.
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Journal of Interdisciplinary Clinical Dentistry Feb.25.2021,(5)4
Case Report
Una estética con belleza, fuerza e impredecibilidad
Por Dr. Marlon Becerra.
Odontólogo del Colegio Odontológico Colombiano con especialidad en Estética Dental en New York University. Creador y director de ‘Odontología de Marlon Becerra’, red con 25 clínicas de Estética Dental en Colombia.E-mail: [email protected]
Un resumenLo que se pretende demostrar con este caso es cómo la simetría y la perfección de las formas dentales nos alejan de la verdadera esencia de la Estética; al contrario, el manejo adecuado de justas medidas e imperfecciones es lo que precisamente nos acercará a dicha esencia.
Palabras clave: estética, arte, diseño de sonrisas
Introducción
La esencia de la Estética, en mi concepto, implica conectar siempre tres cualidades: Belleza, Fuerza e impredecibilidad, cualidades bien distintas en todos los aspectos. Lo bello simplemente es bello, la fuerza y la impredecibilidad son las que en realidad generan el ‘milagro’. Y es esta la conclusión a la que he llegado después de adentrarme en otros contextos de la Estética -ajenos a la odontología-, en otras dimensiones como el arte, la arquitectura, la gastronomía, la moda, y muchas otras pequeñas o grandes maravillas echas por el hombre, tanto en Oriente como Occidente. Desde el punto de vista netamente de la Estética, dicha teoría también la podría relacionar con la naturaleza, donde encontramos que, por ejemplo, una rosa tiene la belleza en los colores y la distribución desordenada de sus delicados pétalos, la fuerza en la rigidez del tallo, y la impredecibilidad en la forma insospechada de las espinas. En el caso de los árboles la belleza está dada por el colorido y las formas de las hojas, las flores o los frutos, la fuerza por la dureza del tronco, y la impredecibilidad por la dirección que toman cada una de las ramas. En cambio, la belleza del mar está en el agua y en sus colores; sin embargo, lo que nos produce un placer aún mayor es la fuerza dada por las olas, que, a su vez, se desintegran de manera impredecible para transformarse en suave espuma. Así como la belleza del cielo está dada por sus variadas tonalidades, la fuerza por las nubes, en lo más oculto de esas masas cuyas texturas, formas y tamaños impredecibles, van generando un efecto lumínico que cambia cada segundo, dependiendo de luces y sombras. El caso es que, si analizamos todo lo que nos produce fascinación y placer a la vista (desde las más sublimes creaciones divinas -el hombre, la mujer, la naturaleza, cada uno de los animales o plantas-) siempre encontraremos que la esencia de la Estética se repite inexorablemente: Belleza, Fuerza e Impredecibilidad, tres cualidades implícitas, sin excepción alguna. En lo referente a la estética dental, podría también asegurar que el gusto es una cuestión personal y subjetiva, mientras la Estética es absoluta y única. Así pues, la belleza de una sonrisa está dada por los dientes centrales, la fuerza por los caninos, y la impredecibilidad por los dientes laterales, cuya forma no puede encajar dentro de lo que llamamos belleza. Es cierto que todos los dientes podrían estar simétricos, con ángulos delimitados y perfectos, pero al perderse la fortaleza del canino y la impredecibilidad del lateral, toda la magia de la sonrisa queda borrada, malogrando el verdadero sentido de la Estética.
Reporte de caso
Mujer de 24 años que consulta porque quiere cambiar sus restauraciones estéticas hechas en resina -seis años atrás- por láminas veneers en porcelana, ya que no se siente contenta con la apariencia, color, grosor, forma, tamaño y brillo de sus dientes. Al examen clínico determinamos que todos los dientes son excesivamente blancos, simétricos, con formas gingivales redondeadas y bruscas (Fig. 2 y 3); también es importante analizar que todos los dientes son cortos y anchos (Fig. 4), especialmente los dientes laterales, además de que la forma de los caninos es suave y redonda. Aunque la estética, el arte y la creatividad no precisan de medidas, es mejor tener algunos parámetros. La siguiente es una table de medidas que desarrollamos con el propósito de tener una guía -no es una especificación absoluta- antes de definir tamaños y formas en cada uno de los casos.
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(Fig. 1) Apariencia inicial de la sonrisa de la paciente vista de frente (a), vista de lado (b), y vista con los labios en reposo (c). Nótese que el aspecto del arco es muy redondeado y la encía se expone demasiado en el momento de sonreír.
(c)
(a) (b)
(Fig. 2) Plano de los seis dientes anteriores de frente (a), lado derecho (b), y lado izquierdo (c), donde observamos que no existen ángulos ni texturas adecuadas, aparte de que la belleza de los dientes centrales se pierde dentro de todo el conjunto.
(a)
(b) (c)
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(Fig. 3) Tabla de medidas
(Fig. 4) Al revisar nuestra tabla guía de medidas, vemos que la longitud y el ancho de todos los dientes no son ideales.
(Fig. 5) Mock-up realizado sin quitar las restauraciones en resina, simplemente moldeándolas para mejorar el aspecto.
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(Fig. 6) Dientes con preparaciones mínimamente invasivas para láminas veneers.
(Fig. 7) Plano de los dientes anteriores de frente (a), lado derecho (b), y lado izquierdo (c).
(a)
(b) (c)
(Fig. 8) Plano de los dientes anteriores vistos desde arriba donde observamos policromías, formas y translucidos (a); el mismo plano para observar la diferencia entre Belleza, Fuerza e Impredecibilidad (b).
(a) (b)
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Inicialmente utilizaremos las mismas restauraciones en resina con las que llegó la paciente para realizar un mock-up que nos aproxime a lo que buscamos. Después modificamos la altura y las formas gingivales, ubicando con exactitud los puntos cenit (Fig. 5). Luego del tiempo de cicatrización de la encía, procedimos a quitar lo que quedaba de las resinas iniciales y realizamos preparaciones para láminas veneers (Fig. 6). Finalmente -junto con el técnico dental y la paciente, en una cita dedicada solo con ese propósito- determinamos colores, translucidos, efectos, formas, detalles, imperfecciones, ángulos, en fin, arte y creatividad (Fig. 7, 8 y 9).
Detalles e imperfecciones a analizar:
Aparte de conseguir justas medidas, las imperfecciones y la creatividad son también indispensables para acercarnos a la esencia de la Estética. Si observan con atención este caso, encontrarán decenas de detalles e imperfecciones: - Aunque los dientes centrales son los dientes más simétricos, la superficie distal es más convexa que la superficie
mesial. - Los ángulos mesio-incisales de los dientes centrales son menos redondeados que los disto-incisales, y el punto de
contacto distal es mas cervical que el mesial. - Los bordes incisales no son rectos en ninguno de los dientes. - En todo el conjunto, el punto de contacto distal del diente lateral es el mas alto, de manera que se crea un verdadero
‘vacío’ entre este diente y el canino. - El borde incisal del diente lateral es el mas inclinado de todos los dientes. - El ancho del diente lateral no sobrepasa los 6,6 milímetros para que la belleza del diente central sea todavía más
evidente. - El canino es canino y su forma nunca es redondeada ni romboidal, además de que su borde incisal tiene cortes y
muescas (mínimo cinco, ojalá dadas al azar). - El punto cenit de los dientes centrales está ubicado en distal, para darle una forma mucho más estilizada que la de
los otros dientes; el punto cenit de los caninos está en el centro para aumentar su fortaleza, mientras el punto cenit de los dientes laterales está mucho más en distal que el de los centrales, lo que le da una apariencia angosta y asimétrica.
- La forma del margen gingival del canino es más curva en el área distal. - Absolutamente todos los ángulos de los dientes son distintos y con cortes dados al azar. - La visualización de los dientes centrales -con los labios en posición de reposo- es mayor a cinco milímetros. - Todos los puntos de contacto están situados en alturas diferentes.
(Fig. 9) Sonrisa final de la paciente vista de frente (a, c), y de perfil (b, d).
(c)
(a)
(d)
(c)
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Conclusiones
Aunque no podemos negar que unos dientes blancos y perfectos sobresalen más que otros, tampoco podemos negar que, indiscutiblemente, opacan la importancia de las otras partes del rostro. Del mismo modo que sería absurdo quitar las olas y el movimiento del mar, aunque sus aguas fueran azules aguamarinas, aunque se tratara del mar más hermoso del mundo. ¿O es que acaso no nos basta con un cielo repleto de nubes blancas para que la infinita gama de colores azules sea aún más evidente? Sería comparable con que no nos bastara con detenernos a contemplar un cielo completamente oscuro, lo que nos impediría disfrutar de la belleza dada por los reflejos profundos de la luz de la luna, del brillo impredecible de una que otra estrella, y de la fuerza generada por el inmenso vacío del color negro del cielo. Incluso, si nos vamos a la estética de lo simple, sería también comparable con el hecho de comernos unos trozos de atún en la mano, así nada más, privándonos del placer de apreciar un bello tazón adornado con unas cuantas hojas de shiso verdes.
“El Arte son artistas, no técnicas ni materiales.”
References- Rickne C. Scheid – Gabriela Weiss. Woelfel. Anatomía Dental.- Galip Gurel. The Science and Art of Porcelain Laminate Veneers.- Stephen Chu, Devigus and Mieleszko. Fundamentals of Color.- Philip Ball. La Invención del Color.- Kassia St Clair. Las Vidas Secretas del Color.