Smile, Lip Line and Filler
The smile is one of the most important facial expressions and should be carefully analyzed as a whole before the accomplishment of dental treatment, aiming to establish the harmony between the teeth and adjacent soft tissues, achieving an esthetic and pleasant smile.
Evaluation of the face should be conducted together with the intraoral examination for the establishment of treatment goals that may meet the patient’s expectations and reestablish the most esthetic conditions as possible.
The esthetic analysis of smile by the visual perception should consider it as a unique composition, in which some elements act in combination to make the smile harmonious and pleasant for the observer.
Significant disruptions in the composition deviate the attention to the undesired element; alterations in the gingival component, lip shape, and filling of the gingival papillae call the attention due to their distinguished role in the composition of smile.
Concerning the position of the upper lip, the smile may be classified as high, average, and low, which is very important in the indication of periodontal plastic surgeries and restorative procedures performed in esthetic areas. The high smile reveals the entire cervicoincisal length of maxillary anterior teeth and the adjacent gingiva; in the average smile, 75% to 100% of the maxillary anterior teeth and the interproximal gingiva are observed; in the low smile, less than 75% of the anterior teeth are visible. Higher smiles usually expose the gingival margin and restorations in esthetic areas, and any imbalance may affect the esthetics.
The thickness of lips should also be observed, since individuals with thinner upper lip usually present greater exposure of teeth and higher smile compared to individuals with thicker lips.
Analysis of the symmetry of smile is very important, yet the curve of the upper lip should also be considered, based on the position of the mouth angle in relation to the center of the lower border of the upper lip, according to the following three categories: ascendant, descendant, or straight, being that the ascendant and straight patterns are considered more esthetic.