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Vincent G Kokich

Publications and source records attributed to Vincent G Kokich.

12 recordsLinked to original sources
PubMed2006

Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations.

INTRODUCTION: Previous studies evaluated the perception of laypersons to symmetric alteration of anterior dental esthetics. However, no studies have evaluated the perception of asymmetric esthetic alterations. This investigation will determine whether asymmetric and symmetric anterior dental discrepancies are detectable by dental professionals and laypersons. METHODS: Seven images of women's smiles were intentionally altered with a software-imaging program. The alterations involved crown length, crown width, midline diastema, papilla height, and gingiva-to-lip relationship of the maxillary anterior teeth. These altered images were rated by groups of general dentists, orthodontists, and laypersons using a visual analog scale. Statistical analysis of the responses resulted in the establishment of threshold levels of attractiveness for each group. RESULTS: Orthodontists were more critical than dentists and laypeople when evaluating asymmetric crown length discrepancies. All 3 groups could identify a unilateral crown width discrepancy of 2.0 mm. A small midline diastema was not rated as unattractive by any group. Unilateral reduction of papillary height was generally rated less attractive than bilateral alteration. Orthodontists and laypeople rated a 3-mm distance from gingiva to lip as unattractive. CONCLUSIONS: Asymmetric alterations make teeth more unattractive to not only dental professionals but also the lay public.

Adult↗
PubMed2006

Congenitally missing mandibular second premolars: clinical options.

INTRODUCTION: Congenital absence of mandibular second premolars affects many orthodontic patients. The orthodontist must make the proper decision at the appropriate time regarding management of the edentulous space. These spaces can be closed or left open. IMPLICATIONS: If the space will be left open for an eventual restoration, the keys during orthodontic treatment are to create the correct amount of space and to leave the alveolar ridge in an ideal condition for a future restoration. If the space will be closed, the clinician must avoid any detrimental alterations to the occlusion and the facial profile. SIGNIFICANCE: Some early decisions that the orthodontist makes for a patient whose mandibular second premolars are congenitally missing will affect his or her dental health for a lifetime. Therefore, the correct decision must be made at the appropriate time. PURPOSE: In this article, we present and discuss various treatment alternatives for managing orthodontic patients with at least 1 congenitally missing mandibular second premolar.

Adolescent↗
PubMed2006

Interdisciplinary management of anterior dental esthetics.

BACKGROUND: Dental esthetics has become a popular topic among all disciplines in dentistry. When a makeover is planned for the esthetic appearance of a patient's teeth, the clinician must have a logical diagnostic approach that results in the appropriate treatment plan. With some patients, the restorative dentist cannot accomplish the correction alone but may require the assistance of other dental disciplines. APPROACH: This article describes an interdisciplinary approach to the diagnosis and management of anterior dental esthetics. The authors practice different disciplines in dentistry: restorative care, orthodontics and periodontics. However, for more than 20 years, this team has participated in an interdisciplinary dental study group that focuses on a wide variety of dental problems. One such area has been the analysis of anterior dental esthetic problems requiring interdisciplinary correction. This article will describe a unique approach to interdisciplinary dental diagnosis, beginning with esthetics but encompassing structure, function and biology to achieve an optimal result. CLINICAL IMPLICATIONS: If a clinician uses an esthetically based approach to the diagnosis of anterior dental problems, then the outcome of the esthetic treatment plan will be enhanced without sacrificing the structural, functional and biological aspects of the patient's dentition.

Adult↗
PubMed2004

Maxillary lateral incisor implants: planning with the aid of orthodontics.

Implants are commonly used to replace congenitally missing lateral incisors in adolescent orthodontic patients. However, these restorations are often challenging for the orthodontist, surgeon, and restorative dentist. In some patients the space across the alveolar crest is too narrow to permit the surgeon to place the implant. Occasionally the root apices of the adjacent central incisor and canine are in close proximity. In other cases the ridge thickness could be inadequate and require augmentation. When the orthodontist opens the space, the papilla heights are adversely affected. Some adolescent patients have altered passive eruption after orthodontic treatment, which affects the level of the gingival margins. Finally, questions commonly arise regarding the appropriate age for implant placement in these young patients. If not addressed, these issues could compromise the aesthetics of the implant restoration. This article will use several clinical examples to discuss each of these 6 potential problems and provide guidelines for their solutions.

Adolescent↗
PubMed2002

Restoration and retention of maxillary anteriors with severe root resorption.

BACKGROUND: The authors describe the treatment of three patients who had severe apical root resorption of maxillary lateral incisors caused by ectopically erupting canines. Ectopically erupting canines derive from a normal path of eruption and may cause resorption of the adjacent teeth. CASE DESCRIPTION: The authors present the three cases of severe root resorption caused by ectopically erupting canines. They then discuss various prosthetic options; the indications, advantages and disadvantages of various treatment modalities; the long-term retention and esthetic concerns of the patients; and the inherent limitations of restorative treatment. CLINICAL IMPLICATIONS: Increased tooth mobility and long-term retention are significant concerns in cases of patients who have severe root resorption. Attaining stability with lingual splinting can cause esthetic problems. An interdisciplinary approach is necessary to provide optimal care for the patient.

Child↗
PubMedDate not supplied

Facial development, continuous tooth eruption, and mesial drift as compromising factors for implant placement.

The replacement of teeth lost by children because of trauma can be an important indication for early implant therapy. Osseointegrated dental implants, like ankylosed teeth, alter position as growth-related changes occur within the jawbones (displacement, remodeling, mesial drift). Facial growth of the child and even of the adolescent, as well as the continuous eruption of the adjacent anterior teeth, create significant risk of a less favorable esthetic and/or functional outcome. For patients with a normal facial profile, the placement of an implant should be postponed until growth is complete. For patients with a short or long face type, further growth, especially the continuous eruption of adjacent teeth, creates a serious risk even after the age of 20 years, as illustrated by some recent clinical studies. This review aims to explain these phenomena and provides some recommendations for implant placement.

Adolescent↗