Optimal dental and facial esthetics in orthodontics--a multifaceted challenge.

The role of the orthodontist in resolving the patient's dental and facial esthetic concerns is a challenge due to the number of factors to be evaluated. The effect of growth and aging, and the existing dental, gingival, dentoalveolar, skeletal, and facial soft tissue components mandate a thorough investigation into all treatment options and modalities available to reach optimal esthetic goals. The orthodontist is further challenged with professional bias and patient bias and desires. Mounted study models, facial and intraoral photographs, cephalometric evaluation of dentoskeletal relationships, VTOs and STOs for trial treatment, computerized imaging, and clinical soft tissue evaluation are essential in proper diagnosis, treatment planning, execution of treatment, and assessment of post treatment results. With proper planning, the challenge of reaching dental and facial esthetic goals can be met without compromising the functional occlusal goals, periodontal health, TMJ health, and long term stability.