Emergence Profile and Labial Contour/Anatomy

The emergence profile of a tooth refers to the angle at which the tooth emerges from the gums. This must mimic the silhouette of the natural tooth, in the one third of the tooth closest to the gums, when viewed from both the facial and lateral views. A proper emergence profile will help avoid swelling and inflammation of soft tissue and conversely will prevent the unsightly dark spaces in the area near the gums and between the teeth. The emergence profile must reproduce, in ceramic, the idealized, natural eruption of enamel from healthy gums.

This is an issue I see currently with all the advertising of “no-prep veneers”. In most situations this will lead to excessive emergence profile (not to mention bulkier-looking teeth) and exactly the kind of gum situations we should try to avoid. The ideal situation for no-prep veneers is where the enamel has been worn down to where the thickness it would take to restore the tooth to a normal emergence profile is the thickness you would make the veneers.

Labial anatomy refers to the surface texture of the teeth and should mimic that of the person’s natural teeth. That is to say, copy what nature has put in unless you desire it differently. Although the surface of the teeth can be completely flat the presence of lobes, however how subtle, is very important because it allows a more natural and varied pattern of reflected light. The proper placement of these lobes can also influence the perception of width.

The texture of the surface of the tooth can also be anything from from perfectly smooth to a heavier texture. Sample of a characterization guide. (pdf)

The labial contour should exhibit three (gingival, middle and incisal) planes, as evaluated from a lateral view (see picture below). The absence of distinct planes will result in a flat incisor profile. The most common error is to keep the incisal third angled too far toward the inside of the lip. The above picture demonstrates the ideal position.