Smile Analysis The Photoshop Edward A. McLaren, DDS Lee ... · techniques for incorporating digital technology into the smile design process that can be accomplished in approximately

94 Spring 2013 • Volume 29 • Number 1

Abstract

Computer design software will become the main communication technology

between dentists and ceramists and a useful tool for showing patients the

possibilities for enhancing their smiles. Despite the modern age of smile

design, which enables the use of technology to create and design an ideal

smile, ceramists involved with the fabrication process still rely on sound

concepts and principles of facial and dentofacial esthetics. By understanding

the elements of esthetics and learning how to incorporate technology

applications into clinical dentistry, clinicians can predictably plan smile

design cases and communicate anticipated results to patients and ceramists

alike. This article, the first in a two-part series, introduces elements of smile

design and reviews some timeless concepts. It discusses new, step-by-step

techniques for incorporating digital technology into the smile design process

that can be accomplished in approximately three to four minutes. The second

article will address tooth anatomy, morphology, and the various laboratory

applications for digital design.

Key Words: esthetic dentistry, smile design, digital technology

Smile AnalysisThe Photoshop® Smile Design Technique: Part I

Edward A. McLaren, DDSLee Culp, CDT, AAACD

e d m c l a r e n . c o m

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1.Full face cheeks retracted 1:8 or at f16 or 22 (for DIP) iso 4002.Full face smiling 1:8 at f16 or 22 iso 400 3.Full face lips relaxed 1:8 at f16 or 22 or iso 224.optional : profileALL IDEAL BUT OPTIONAL5.cheeks retracted optional 1:2 at f32 (f22 ok)6.Lower 1/3 smiling 1:2 at f32 (f22 ok)7.Contrastor 1:1 at f32 (f22 ok)

P h o t o s h o p S m i l e D e s i g n I m a g e s

1 . C h e e k s r e t r a c t e d f u l l f a c e

3 . L i p s R e l a x e d f u l l f a c e

2 . N o r m a l S m i l e f u l l f a c e

f 2 2 ( f 1 6 )

a p p r o x : 1 : 5 t o 8 m a g

S h o o t i n g P o s i t i o n

S t a r t T r e a t m e n t P l a n n i n g F r o m

M a x i l l a r y C e n t r a l I n c i s a l E d g e

1. WHERE IN THE FACE TO PLACE THE MAXILLARY INCISAL EDGES ?

2. WHAT IS THE PROPER TOOTH DISPLAY STATICALLY AND DYNAMICALLY?

5. CAN I DO IT WITH RESTORATIVE DENTISTRY ALONE? (do the root position, soft tissue, and bone support the desired tooth shape and position

4. WHAT IS THE PROPER INTER AND INTRA TOOTH RELATIONSHIPS ?

3. WHAT IS THE PROPER GINGIVAL DISPLAY AND FORM STATICALLY AND DYNAMICALLY?

RULE OF 42.2the 4 MAXIMUM OF 4MM OF

MAXILLARY CENTRAL DISPLAY WHEN LIPS AT REST (MIN 2MM)

the 2 MAXIMUM OF 2MM OF GINGIVAL DISPLAY DURING NORMAL SMILE

the .2 2 mm or less from lower lip during smiling

Smile Design Session 3:

• facial esthetics

• measuring faces in Photoshop and Keynote

• setting incisal and gingival lines

• i n t e r - t o o t h p r o p o r t i o n s

• i n t r a - t o o t h p r o p o r t i o n s

T O O T H P R O P O R T I O N S ( I N T R A A N D I N T E R - T O O T H R E L A T I O N S H I P S )h o w d o e s f a c e f o r m e f f e c t o u r c h o i c e f o r t o o t h f o r m a n d s i z e ?

L A T E R A L 1 . 0 M M T O M A X I M U M 2 M M S H O R T E R T H A N T H E C E N T R A L

9.5MM

C A N I N E 1 0 T O 1 1 M M B U T S L I G H T L Y S H O R T E R T H A N T H E C E N T R A L

10.5 MM

1 1 MM

ASPECT RATIO75% to 80% ideal

70% to 75% 80% to 85%acceptable

LENGTH10.5 to 12 mm

71%



LENGTH10.5 to 12 mm

75%



LENGTH10.5 to 12 mm

80%

3/4 to 4/5 2/3 1 1 65% 75 to 80%

60 to 70% 70 to 90%

rule : can ine and all teeth d istal has to be perce ived to occupy less v isual

space

rule: you can move the contact area restoratively up to the root of the adjacent tooth

2.5 mm display at rest

2 0 0 4

3 mm gingival display

3 mm incisal edge to lower lip

2.5/ 3/.3

RULE OF 42.2

6.7 mm1 to 1 aspect ratio

CENTRAL

VIDEO : open image i n PSD

V IDEO : s elect ing , mask ing ,

and l iqu i fy tool

VIDEO: Digital Bleaching

u s ing the DODGE tool

4 . D E N T O-G I N G I V A L E S T H E T I C S

MIDLINE BALANCE

1. You only move midline to establish esthetic inter and intra-tooth proportions

2. midline should be vertical when the head is in the postural rest position: NEVER ANGLE AWAY FROM MIDLINE

Quick Photoshop Smile Design

i m p o r t i n g t e e t h f r o m l i b r a r y

q u i c k P h o t o s h o p S M I L E D E S I G N : i m p o r t i n g t e e t h f r o m l i b r a r y

Open ideaLLy fuLL resolution Pre-Op fuLL face image

with image open in Photoshop> click command (control PC) J this will duplicate the background layer which is image of full face

Quick P SD

open image of teeth you like


using the move tool drag the image of the teeth on top of the full face


use Free Transform to size image initially: >shift/option (alt pc) to scale proportionally and from the center


drag the layer of the teeth underneath the duplicate layer of the face image


zoom in on the teeth

Quick P SD

activate the polygon lasso tool

Quick P S D

select the space between (teeth)the lips-make sure layer on top of face is activated: important to included 1 to 2 pixels of lips

Quick P S D

select> modify> smooth> 2 to 4 pixels- this smooths the edge of the selection

Quick P S D

click the delete key with the full face layer activated and whatever was selected disappears

Quick P S D

zoom out to view full face

Quick P S D

activate the free transform functionedit > free transform or command (control pc) T

Quick P S D

grab one corner- hold down the shift and option (alt pc) key and scale up or down the teeth to fit the face

Quick P S D

use up/ down or left / right arrows to make slight movements to image. You can also use the move tool

Quick P S D

if a rotation is necessary place the cursor next to corner until the curved double arrow appears: move mouse left or right to rotate

Quick P S D

zoom out> command (control pc) - to view full image

Quick P S D

in layers palette: change opacity of layer to about 60% to “see through” to the existing teeth: can give an idea of other necessary interdisciplinary treatment

Quick P S D

zoom in to show patient: command (control pc) +

Quick P S D

To make adjustments to the teeth layer go to image> Adjustments and choose adjustment

it is common to adjust the brightness:

Quick P S D

adjust brightness as necessary by using the sliding adjustment

Quick P S D

Quick P S D viewing position of new teeth relative to position of existing teeth

zoom in> turn off visibility of top layer of face> make layer of teeth about 65% opaque

VIDEO : us ing l i brary t eeth

Redesigning With

Individual Library Teeth Or Tracings

o p e n i m a g e a n d i m a g e w i t h l i b r a r y t e e t h a n d t r a c i n g s

Photoshop SMILE DESIGN

c a n u s e l i b r a r y o f s a v e d t r a c i n g s o r t e e t h

d r a g i n t r a c i n g f r o m f i l e : s i z e w i t h f r e e t r a n s f o r m


c a n u s e l i b r a r y o f s a v e d t r a c i n g s o r t e e t h

“ d r a g ” i n i m a g e o f t o o t h : u s e f r e e t r a n s f o r m a s n e c e s s a r y t o f i t d e s i g n


i f n e c e s s a r y u s e “ w a r p ” t o o l


h a l f m o u t h f i n i s h e d


w h o l e m o u t h f i n i s h e d


4th generation

all-bond 3

Creat ing Custom

Tooth Gr ids , Teeth , and Measur ing

TEETH/GRID/LINES

o p e n i mage o f r e t ra c t ed v i ew o f t e e t h y o u l i k e a nd a p p ea r s t o h a v e g o o d e s t h e t i c p r o p o r t i o n s

act ivate the po lygon lasso too l : trace the desired tooth

set a point by clicking on edge of central (usually at papilla tip)- trace the outline of the central- set points every few pixels- close the loop by double clicking at the starting point

creat a new b lank layer for each traceing

h igh l ight b lank layer in layers palette

go to Edit menu then c l ick on Stroke

for width 2 to 3 p ixe ls, co lor b lack, l ocat ion center- then c l ick OK

central tracing on its own layer

to see the tracing c l ick on the “eye” of other layers to make them inv is ib le

c l ick eyes back on-- then h igh l ight layer of teeth- se lect ion wi l l st i l l be act ive--Cl ick Command (Contro l PC) J to set tooth on its own layer

to see the teeth c l ick on the “eye” of other layers to make them inv is ib le

trace the lateral

create a new b lank layer- then with layer h igh l ighted-- Edit menu then “Stroke” 2 to 3 p ixe ls with b lack co lor

v isual iz ing tracing

then h igh l ight image layer : and c l ick on Command J to put lateral tooth on its own layer

visual iz ing tooth

naming layers

completed f i le with teeth, tracings, l ines

click on eye of background layer to make invisible: command J to duplicate layer

you can alter the aspect ratio from say 80% W/L to 75% W/L using the free transform tool. FIRST MAKE COPY OF LAYER : COMMAND J then save name and save both versions

Digital Measurements

high l i ght the ru l er t o o l

put the cursor on the most ap ica l pos it ion of the central inc isor and ho ld down the sh ift key and re lease when at the inc isa l edge

note: the “H” value- in this case 205 pixels

put the cursor on the widest pos it ion of the central inc isor and ho ld down the sh ift key and re lease when at the contact mesia l ly

note: the “W” value- in this case 164 pixels

divide the “W” by the “H” to get the aspect ratio in this case it is 80.5%

measure the width of the lateral

inc isornote: the “W” value in this case 108 pixels

divide the “W” value of the lateral by the “W” value of the central : th is gives the optical v isual percentage of lateral to central : in this case 65%

I w o u l d n a m e t h i s i m a g e 8 0 / 6 5 / 8 2 80 for the 80% W/L central65 for the 65% lateral to central82 for the 82% canine to lateral

To create a d ig i ta l equ iva lent of 1-mm d iv ide the actua l t o oth l ength (e .g 1 1 mm) by the measured he ight i n p ixe ls e.g. 205 divided by 11 is 18.6

in this image 18.6 pixels represents 1 mm (at least on the 4 incisors)

119

8.5 mmF i r s t m e a s u r e t h e t o o t h

e s t a b l i s h d i g i t a l l e n g t h s

Act i vate the r u l e r t o o l t o measure the d i g i ta l l ength

e s t a b l i s h d i g i t a l l e n g t h s

P SD

c l ick at the apex of tooth #8 -- ho ld down sh ift key and drag down to inc isa l edge and stop

note the H (height) in this case it is 172 pixels. you can divide the 172 by the exact measured height to get how many pixels equal 1-mm

P SD

for example h is tooth was 8.5 mm. d iv ide 172 by 8.5-- which g ives 20.2 p ixe ls (round to 20) in th is image represents 1-mm

P SD

if it is determined the length to be added at the incisal edge is 2.5 mm - the dig ital equivalent of 2.5 mm is 50 pixels : so the new dig ital length would be 222 pixels.

P SD

using Photoshop Grid

P SD

turning on Grid

P SD

you can make marks on transparent layer

P SD

then you can drag new tooth in and s ize tooth

with free transform adjust opacity of layer to see through as necessary

P SD

w h o l e m o u t h f i n i s h e d


Alternative ly you cou ld use a ru ler and adjust s ize of ru ler to known measurement on tooth

o p e n i m a g e o f r u l e r

“ C H R I S T I A N C O A C H M A N ”

P h o t o s h o p S M I L E D E S I G N

o p e n i m a g e o f t e e t h d r a g i m a g e o f r u l e r o n t o p o f t e e t h

Alternative ly you cou ld use a ru ler and adjust s ize of ru ler to known measurement on tooth


A D J U S T T H E S I Z E O R T H E R U L E R T O A K N O W N D I M E N S I O N

B Y U S I N G F R E E T R A N S F O R M


e . g . A d j u s t t h e R u l e t o 8 . 5 m m b y l e n g t h e n i n g o r s h o r t e n i n g r u l e r a g a i n s t t h e C e n t r a l


e d m c l a r e n . c o m w w w . f a c e b o o k . c o m / e d w a r d . m c l a r e n

This DVD will cover: Photography and necessary images for Photoshop Smile Design Setting up Photoshop interface on your computer Opening images into and using Camera Raw How to make selections and how to use a mask How to create and work with layers How to use the Liquefy filter to do simple smile alterations How to do digital bleaching How to use the various transform functions in Photoshop to create custom shapes How to make and use “Library” teeth to do a Quick Photoshop smile design How to fix Rotations in images, objects, and layers How to align and size incorrectly composed images How to measure in Photoshop and create a digital to analog (real world) conversion How to create “grids” to measure tooth proportions How to create “grids” the shade of real teeth and use in a smile design How to use all these digital tools to create a “Full PSD” smile design How to present to the Patient using Photoshop Also included with DVD are templates of teeth, and tracings you can immediately use

English | Johan Figueira, DDS Spanish Versionfor more dvds, visit our website: www.edmclaren.com

“DUAL LAYER DVD”

Over 4

hours of

high impact c

ontent.

Edward A. McLaren, DDS, MDCDr. McLaren is a Prosthodontist, Professor of clinical dentistry, and director of Post Graduate Esthetic Dentistry at the UCLA school of Dentistry. He is the director of the UCLA Center for Esthetic Dentistry, a full time didactic and clinical program for graduate dentists. He is also the founder and direc-tor of the UCLA/LACC Master Dental Ceramist program. The post-graduate program is a full time master ceramist program for dental technicians fea-turing extensive experience with the newest esthetic restorative systems. Dr. McLaren maintains a private practice limited to prosthodontics and esthetic dentistry in which he does all of his own ceramics.

Johan Figueira, DDSDr. Johan Figueira graduated from School of Dentistry at the Central University of Venezuela in 2009. In 2010 Dr. Johan received acceptance into the Esthetic Restorative Program at the U.C.L.A. Center for Esthetic Dentistry where he continues his studies under leadership of preeminent Prosthodontic and Master Ceramicist, Dr. Edward McLaren. Dr. Johan graduated in “Advanced Esthetic Dentistry” / Center for Esthetic Dentistry in 2013. Dr. Figueira is a member of the American Academy of Cosmetic Dentistry. Currently, Dr. Johan is faculty at “Center for Esthetic Dentistry” at UCLA. He presents numerous lectures & hands-on clinics internationally.

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Smile Analysis The Photoshop Edward A. McLaren, DDS Lee ... · techniques for incorporating digital technology into the smile design process that can be accomplished in approximately