27 October 2022

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The course of esthetic dentistry

Lorenzo Breschi

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Introduction

Currently, during the formulation of a treatment plan it is necessary to refer to aesthetic considerations and to involve the patient's needs and expectations in the process. The aesthetic reference parameter has evolved over time, and we are increasingly talking about aesthetic dentistry that reflects the passage of time. More than a branch of its own, cosmetic dentistry represents a confluence of preventive and restorative dentistry to prosthodontics, orthodontics, periodontics, and oral and maxillofacial surgery. In a recent literature review, Blatz and his research team analyzed the past 100 years of cosmetic dentistry to assess the evolution of dental research and clinical interventions that have contributed to the art and science of adhesive dentistry. 

Materials & methods

The evaluations were based on esthetic guidelines, tooth color, tooth whitening, adhesive restorations, prosthodontics, dental implants, oral surgery and CAD/CAM technology.

Results

Starting from a mainly subjective aesthetic definition, reference guidelines have been drawn up since the mid-90s to set scientific aesthetic canons. This made it possible to identify the shapes of the face (oval, square, triangular), the shapes of the teeth (allowing for a distinction between male and female gender) and the arrangement of the facial and dental midline. The color of teeth can be influenced by various factors both intrinsic and extrinsic, thus making it difficult to obtain a precise combination between natural tooth and restorative materials. The recent spectrophotometer, colorimeter and digital image analysis techniques simplified and standardized color assessment and matching. Dental bleaching has allowed for cost-effective and non-invasive procedures to improve dental esthetics. Beginning in the late 1800s, tooth-whitening has become a daily clinical practice, allowing for tooth lightening of one to two shades. When greater whitening is desired, restorative procedures can be implemented, with restorative and prosthodontic treatments that have been simplified and strengthened with the advent and amelioration of adhesive systems. Bonding restorations have allowed for more and more procedures within the limit of minimally invasive dentistry. The last few decades have seen the advent of dental implants. The use of CAD/CAM technologies has made it possible to simplify and accelerate dental therapies in all branches of dentistry.

Conclusions

The advent of new technologies has allowed an interdisciplinary approach aimed at offering increasingly simplified and performing aesthetic solutions.

Blatz MB, Chiche G, Bahat O, Roblee R, Coachman C, Heymann HO. “Evolution of aesthetic dentistry.” Nov. 2019. J Dent Res; 98(12):1294-1304. doi: 10.1177/0022034519875450.