WHO IS THE FACIAL SPECIALIST ? HYALURONIC ACID FILLERS : OPTIMISATION OF AESTHETIC DENTISTRY AND PATIENT LOYALTY
Figure 3 . Facial proportion analyses . Frontal view ( A ). The face is divided into three thirds ( black lines ): the upper third ( in between the hairline and the line which links the upper points of the eyebrows ); the middle third ( in between the line which links the upper points of the eyebrows and the inter-alar line ); and the lower third ( from the inter-alar line to the chin ). The three thirds should have similar dimensions . More several planes ( red lines ) should be used as reference points to evaluate the shape ( bitemporal , bipupillare , bizygomatic , bigoniale , and inter-commissural line ), and the vertical symmetry ( vertical median line , intercantal line , and inter-commissural line ). Oblique view ( B ). The face is focused at about 45 ° to highlight the angle formed by the buttress of the zygomatic bone on the external profile ( red lines ). From the internal profile , we will examine the look of the temporal area , of the periorbital area , of the cheek and the definition of mandibular angle . Profile view ( C ). Several angles can be analysed : the fronto-nasal ( red ); the naso-labial ( blu ), it shows if the tip of the nose is facing down and it gives us information on the form of the upper lip ; the labio-mental ( green ) it describes the direction of the labiomental sulcus and allows us to evaluate the form of the lower lip . Drawn by Aldo Zupi using ZygoteBody™ 3D Anatomy Viewer . Zygote Media Group Inc ., American Forks , UT
clusively as a mouth with teeth and gum . Nothing else . He will most certainly do an excellent job . The patient will definitely be satisfied ( Fig . 1B ). If the patient went to an aesthetic doctor or plastic surgeon , the evaluation would be very different . Any other doctor , not an odontologist , would not evaluate the mouth . Teeth would be excluded from any kind of evaluation immediately . The exam would concentrate on the skin and face . In this case , too , the plastic surgeon would do a great job and the patient will be satisfied ( Fig . 1C ). What is the difference you can give to the patient ? The difference is a complete exam of the face and the smile and a global and harmonious solution ( Fig . 1D ). Face and smile are indivisible units . No aesthetic treatment would be completely satisfactory if it did not involve the care of the teeth and smile . Surely , two or three different specialists can do this separately : dentist and aesthetic doctor ; or dentist , aesthetic doctor and plastic surgeon . This is how it used to happen , until now . However , a new kind of dentist with aesthetic sensibility , can finally become the specialist who treats face and smile in a coherent and harmonious way . To be able to do so , a correct and targeted assessment of the patient and serious dermal filler training is required . 4 . Patient ’ s assessment The traditional dentistry approach to the solution of cases with aesthetics problems basically consists in the assessment of the beauty of the face based on the personal work experience of each dentist . The main element to assess it is the smile . For the construction of a correct aesthetic plan the face has to be considered in its entirety and it is necessary to have a detailed knowledge of anatomic and functional characteristic of the soft tissue of the face and therapeutically available options for the soft tissue treatment , with a particular reference to possibilities and limits of not surgical techniques 14 . In the approach to the facial aesthetic rehabilitation , we need to start from the evaluation of several facial parameters : face ’ s form ; aspect and position of soft tissue ( nose , lips , chin , etc .) and supporting structures ( bones , cartilages , and teeth ); muscles ’ activity ; and aging , meaning the way in which these tissues aged or will age 14 . Leaving out any of these aspects can only take us to a partial aesthetic success without a harmony of the whole face 14 . The integration of perioral soft tissue treatment ex-
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