Review - Golden proportion in denture esthetics
REVIEW
GOLDEN PROPORTION IN DENTURE
ESTHETICS
MEENU MERRY C. PAUL 1 AND SANU TOM ABRAHAM 2
1
Department of Prosthodontics and 2Department of Orthodontics
Indira Gandhi Institute of Dental Sciences, Nellikuzhi PO
Kothamangalam, Ernakulam, Kerala – 686691, India
Correspondence to : [email protected]; [email protected]
Abstract
Esthetic dental treatment involves artistic and subjective components designed to
create the illusion of beauty. Scientific analysis of beautiful smiles has shown that
the principle of golden proportion can be systematically applied to evaluate and
improve dental esthetics in predictable ways.The golden proportion
mathematically denotes that the ratio of a smaller to a larger length is equal to the
ratio of the larger length to the total length. This ratio has been used for centuries
by artists, mathematicians, architects and engineers to study and design
proportion in art and nature. This review article describes the application of the
Golden Proportion in dentistry, as a tool for the initial evaluation of symmetry,
dominance and proportion for esthetic treatment planning.
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An Open Access Peer Reviewed E-Journal
Review - Golden proportion in denture esthetics
Introduction
One of the important features, predicting
the attractiveness of the face is the ‘smile’
and most often the need for ‘esthetics’
motivates the patient to seek
dental
1,2,3
treatment.
“Beauty is power, a
smile is its sword”- Charles Reade. 4 But, what
is beauty? Is it something that can be
produced by taking some measurements, or
is it based purely upon the perception and
realization of the beholder?
In the study of nature, art and life
itself, we discover the existence of a common
principle running throughout with a
pleasant, magical proportion - The Golden
Proportion. Why ‘Golden’? because it seems
to be so noble and perfect with many
amazing properties. The first feature to
understand is that the beauty of nature
shows not just one simple Golden
proportion, but a multiple of relationships
in the Golden Proportion. Can we do
exactly the same when making our dentures?
History of golden proportion
The term golden proportion (GP) has been
used for centuries by artists (Leonardo Da
Vinci,
“Sectio Aurea” The Golden
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section), mathematicians (Pythagorus, Luca
Paccioli-“Da Divine Propportine” -The
Divine Proportion, Fibonacci -Fibonacci
numbers), architects and engineers to study
and design proportion in art and nature.
Golden Proportion was used in the ancient
Greek architecture, Parthenon, considered
the most beautiful architectural creation in
history, has all its parts laid out in GP. One
cannot talk about Golden Proportion
without referring to its counterpoint, which
is the Fibonacci Series.
The concept of golden proportion
The ancient Greeks believed that there was a
constant proportion between a large and a
small in the beauty of nature.Whilst the
concept of golden proportion is easy to
understand, attempts at its application have
proved to be complex and difficult to
explain.5 The golden ratio is the number you
get when you compare the lengths of certain
parts of perfectly beautiful things. The
peacock feather has 12 discreet Golden
proportions, which are all interrelated
(Figure 1). Nature is abundant with
examples of golden proportion. From the
double helical form of our DNA to flowers
and insects; the golden proportion is evident
all around us.
An Open Access Peer Reviewed E-Journal
Review - Golden proportion in denture esthetics
Golden Rectangle, whose sides are having a
golden relationship to each other. The
Golden Rectangle is said to be one of the
most visually appealing of all geometric
forms.8
The Golden Proportion Caliper (The Golden
Mean Gauge)-The GP Calipers were
developed by Ricketts. 9 These Calipers
always open to a constant Golden
Proportion between the larger and smaller
portions (Figure 2). The use of the gauge
makes it easy to assess the golden
proportion.
Figure 1. Peacock feather having 12 discreet
golden proportions
The Golden Proportion mathematically
denotes the ratio of a smaller to a larger.
Length is equal to the ratio of the larger
length to the total length. The ratio is equal
to 0.618 or 1.618.6 It is mathematically
depicted as Greek letter ‘phi-ϕ’ (studied by
Greek sculptor, Phidias)7 This ratio is also
referred to as the Fibonacci Ratio or Divine
Ratio. The symbol of golden proportion is
the pentagon, which was the symbol of the
Pythagorean School, which was deeply
involved in the study of golden proportion.
Golden Proportion occurs in triangles,
circles and spirals…but notably in the
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Figure 2.
Golden Proportion Calipers
always opens in GP
GP in dental esthetics
Application of GP to dental esthetics was
first documented by Levin in 1978.10 He
explained the association of proportion with
an esthetically pleasing dentition and smile.
A proportion between 2 adjacent parts
which is repeated across enhances the unity
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Review - Golden proportion in denture esthetics
within the diverse parts of a composition. 11
Lombardi stated that when this repeated
ratio is equal to the Golden Mean, the
composition is said to be esthetic. Chiche
published a prosthodontic book with
references
to
Golden
proportion.12
Shoemaker wrote a series of articles relating
to GP and aesthetics.13
Tooth to tooth proportion
Levin advocated the use of the golden
proportion for establishing tooth size and
stated that the width of the central incisor is
in golden proportion to the lateral incisor, as
is the lateral to canine and the canine to first
premolar, when viewed from the front
(Figure 3 and 4).14
Figure 3. Central incisor, lateral incisor & canine are not in golden proportion
Figure 4. Central incisor,lateral incisor and canine are in golden proportion
This phenomenon has been combined in a
grid (developed by Lewin) called the
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diagnostic grid or golden proportion grids
which can be used to assist in perfecting the
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Review - Golden proportion in denture esthetics
esthetics of anterior teeth (Figure 5). 15These
grids are templates for spaces in the GP,
between the teeth, from central incisor, to
first bicuspid, based on the widths of the
central incisor, with 4 grids varying from
7.5 to 9.0mm.16 It also shows that the width
of teeth is in Golden Proportion to the
width of smile(from lips at one corner of the
mouth, to the other corner) as seen in Figure
5. But the common errors due to parallax
should be avoided while using the gauge at
chairside. These errors can be avoided by
using the accurate paper grids in the
mouth.16 Levin also states that when doing
facings for teeth, it is necessary to remove
tooth substance mesially and distally on
central and lateral and buccally on the
canine and premolar.
Figure 5. Golden Proportion Grid illustrating how well the teeth fit into the golden proportion
spaces. Note that the neutral buccal space is in golden proportion to the teeth showing in the
smile
Bukhary et al conducted an interesting study
in which six photographs with different
widths of lateral incisor were used.When
people were asked to choose the best; not
surprisingly, the lateral incisor closest to the
golden proportion was selected.17
Indian population).18 The results of the
study revealed that the golden percentage
was rather inconstant in terms of relative
tooth width.18
However, in a recent study, golden
proportion was not found between the
width of the right central and lateral incisors
in 53% of women and 47% of men (in
The anterior aesthetic segment (8 teethcentral incisor,lateral incisor,canine and 1 st
premolar is in Golden Proportion to the
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Anterior teeth and width of smile
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Review - Golden proportion in denture esthetics
width of smile) is in golden proportion to
the width of the smile.19
The Golden rectangle of the central incisors:
Stephen Marquardt found that the height of
the central incisors is in the Golden
Proportion to the width of the two centrals
(Figure 6).
Figure 6. The width of both central incisors is in golden proportion to their height (The Golden
Rectangle)
The golden rectangle defined by the incisal
edge of the maxillary central incisors, if they
are of normal length, to the superior tip of
the eyebrow and the pupillary width can be
used as a guide in determining incisal edge
position.20,21,22 Another guide to assess the
incisal edge of the maxillary central incisors
is the golden proportion between subnasale
to the incisal edge and that to the menton.
The incisal edge of the incisors divides the
distance from the bottom of the nose to the
bottom of chin into golden proportion. Still,
one can also assess incisal edge position with
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the golden proportion that exists between
the eyes, the incisal edge of the maxillary
incisors (if ideal in length), and the chin.22
The Golden Proportion gives good guidance
for the position of the height of the incisors
but this only applies in about 75% of the
population.23 The maxillary central incisors,
because of their position in the front of the
arch, should appear to be the widest,
whitest,
and
therefore,
the
most
predominant teeth when viewed from front.
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Height of lip line: In the relaxed face, where
the teeth are not touching together (when
the lower jaw is in the rest position with free
way space present) the lip line divides the
lower third of the face into the GP.
9.
The midline between the eyes to the
inner canthus of the eye
Golden proportion exists between (Figure
7)
11.
The height of the gingival papillae to
the incisal edge of a tooth.
10.
The cervical apex of a tooth to the
height of the gingival papillae
1.
The central incisor and lateral
incisor, lateral incisor and canine, canine
and 1st premolar (8 teeth of the anterior
aesthetic segment are in GP to each other)
2.
The 2 central incisors(width of
centrals is in GP to their height)
3.
The anterior teeth and width of
smile (8 teeth of the anterior aesthetic
segment is in GP to the width of smile)
4.
The lower edge of the nose to the
incisal edge of the maxillary incisors
5.
The incisal edge of the maxillary
incisors to the bottom of the chin
6.
The inner canthus to the outer
canthus of each eye
7.
The inner canthus of the right eye to
the inner canthus of the left eye.
8.
The pupil of the eye to the inner
canthus of the eye
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Figure 7. Various golden proportions seen
in the face (explained in detail in the text)
At times, the GP of maxillary anterior teeth
may have a larger ratio on one side of the
arch relative to the other side (eg., when a
peg lateral is present unilaterally). Therefore
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Review - Golden proportion in denture esthetics
it is clear that for golden proportion to be
useful in esthetic dentistry, it must be
adapted for easy bilateral analysis of the
teeth. Snow advocates the use of the
‘Golden Percentage’ as a means of applying
the golden proportion across the midline to
encompass the total canine-to-canine width
(six anterior teeth).24 According to him, the
proportional width of each tooth should be:
canine 10%, lateral 15%, central 25%,
central 25%, lateral 15% and canine 10% of
the total distance across the anterior
segment. The principle of the golden
percentage in evaluation and treatment
planning appears to be of significant benefit
in esthetic smile design.
What’s the latest? A new dental software has
been developed to determine the dental
golden proportions digitally (PhiDental). In
addition to the clinical grids used in mouth
and the golden gauge we can do a GP
analyses and manipulation with a digital
camera.
Conclusion
In today's health and esthetic conscious
world, the smile is considered an important
component of an individual's overall
appearance and well being. Golden
Proportion is considered as the “Starting
Point” in designing the relative width of
teeth in a beautiful smile. Esthetic dental
treatment involves artistic and subjective
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components designed to create the illusion
of beauty. Scientific analysis of beautiful
smiles has shown that the principle of
golden proportion can be systematically
applied to evaluate and improve denture
esthetics in predictable ways. Golden
Proportion is undoubtedly a useful tool in
the initial evaluation of proportion in tooth
arrangement and cosmetic dental treatment
planning.
Acknowledgement: We thank Dr. Sanu
Tom Abraham for providing photographs
and pencil drawing for the publication of
this article.
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