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At least 307 records · Page 17Linked to original sources
PubMed2006

Dental aesthetics and the aging patient.

Those over the age of 65 years old and the "baby boomers" regard oral health, including oral/dental/facial aesthetics, as part of their overall health and wellness. Over 65% of discretionary wealth in the United States belongs to those over the age of 50. In many instances, they have had to deny their own needs for those of their families and are now at a point where their dental issues can finally be addressed. Aesthetic dentistry offers the opportunity to reverse the signs of aging and restore a youthful appearance. A smile can be the most eye-catching feature of a face and therefore should blend in or harmonize with facial appearance. Advances in aesthetic dentistry, such as porcelain veneers, bonding, periodontal surgery, and dental implants, have shown great efficacy and reliability when used properly. Aesthetic dentistry offers the opportunity for the aged population to have a more youthful, harmonious smile with improved function and optimum oral health.

Aged↗
PubMed1999

Current concepts in aesthetic orthognathic surgery.

While orthognathic surgery provides a significant improvement in masticatory, dentofacial, and airway function, proper and considered preoperative planning can significantly enhance facial harmony and balance as well. Also, orthognathic procedures to correct underlying skeletal discrepancies in concert with, or prior to, other cosmetic procedures can greatly enhance the patient's final result. This paper reviews the use of the occlusal plane angle as a guide for improved aesthetic results with bimaxillary orthognathic surgery. It also provides several examples of facial cosmetic procedures performed as an adjunct to dentofacial surgery. A rationale of timing of these procedures is offered.

Adult↗
PubMed2000

Treatment of a Class II Division 1 malocclusion with a severe unilateral lingual crossbite with combined orthodontic/orthognathic surgery.

A 24-year-old woman had a Class II Division 1 malocclusion with a severe unilateral crossbite. The crossbite was due partially to the maxilla being much wider than the mandible, allowing the mandibular left canine and first and second premolars to overerupt, impinging on the palatal tissue in habitual occlusion. The maxillary left segment from the lateral incisor to the first molar also overerupted producing 2 planes of occlusion. The malocclusion was treated successfully with comprehensive orthodontics, combined with a 2 piece Lefort I osteotomy procedure, a 3 tooth mandibular segmental osteotomy procedure, and a bilateral sagittal split osteotomy procedure.

Adult↗
PubMed2003

Long-term follow-up of Class II adults treated with orthodontic camouflage: a comparison with orthognathic surgery outcomes.

Thirty-one adults who had been treated with orthodontics alone for Class II malocclusions were recalled at least 5 years posttreatment to evaluate cephalometric and occlusal stability and also their satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in patients with more severe Class II problems who had surgical correction with mandibular advancement, maxillary impaction, or a combination of those. In the camouflage patients, small mean changes in skeletal landmark positions occurred in the long term, but the changes were generally much smaller than in the surgery patients. The percentages of patients with a long-term increase in overbite were almost identical in the orthodontic and surgery groups, but the surgery patients were nearly twice as likely to have a long-term increase in overjet. The patients' perceptions of outcomes were highly positive in both the orthodontic and the surgical groups. The orthodontics-only (camouflage) patients reported fewer functional or temporomandibular joint problems than did the surgery patients and had similar reports of overall satisfaction with treatment, but patients who had their mandibles advanced were significantly more positive about their dentofacial images.

Adolescent↗
PubMed1993

Concern for dental appearance among young adults in a region with non-specialist orthodontic treatment.

With limited orthodontic manpower in an area, treatment resources may be allocated to deal with a restricted number of patients, e.g. those with the most severe malocclusions, or to treat a greater number of patients by letting the specialist supervised treatment delivered by non-specialists. The purpose of the present study was to examine orthodontic concern among young adults in a region where orthodontic treatment was mainly delivered by non-specialists. The material comprised 100 individuals born in 1971 and 1972 (mean age 18.0 years) who were consecutively examined and interviewed during their annual routine dental visits. Forty subjects (19 females, 21 males) had previous orthodontic treatment. In all but four individuals treatment was delivered by general dental practitioners. Impressions for dental study casts and standardized photographs (Polaroids) were taken. The individual's occlusion was classified according to two methods: the Need for Orthodontic Treatment Index (NOTI) and Anterior Occlusal Traits (AOT). Interviews concerning the subjects' perception of their occlusion were performed with the use of questionnaires. From the answers a composite measure representing orthodontic concern was constructed. Awareness of their own dental arrangement was assessed by comparing the respondents' reports with occlusal recordings from the study casts, and by a photo-identification test. Frequencies of NOTI and AOT scores demonstrated that more than 50 per cent of the treated individuals were still assessed to be in need of treatment and exhibited deviations in the anterior region. Furthermore, 30 per cent of the treated subjects expressed concern about their occlusal appearance, and dissatisfaction was generally based on a realistic perception of their own dental appearance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1998

The validation of an orthodontic expert system rule-base for fixed appliance treatment planning.

A peer review clinical trial was undertaken to assess the appropriateness of the advice produced by an expert system designed to plan orthodontic treatment in which the pre-adjusted bracket appliance was to be used. The results showed that the expert system's treatment plans were as reliable as those produced by a group of orthodontists. Two members of the panel actually ranked the expert system's plans more highly than their own.

Adolescent↗
PubMed1999

Motivation for and satisfaction with orthodontic-surgical treatment: a retrospective study of 28 patients.

Motivation for starting treatment and satisfaction with treatment results were evaluated on the basis of replies to a 14-item questionnaire and clinical examination of 28 orthognathic patients from 6 months to 2 years after treatment. The most common reasons for seeking professional help were problems in biting and chewing (68 per cent). Another major reason was dissatisfaction with facial appearance (36 per cent). Many patients also complained of temporomandibular joint symptoms (32 per cent) and headache (32 per cent). Women (8/19) were more often dissatisfied with their facial appearance than men (2/9), but the difference was not statistically significant. In agreement with earlier studies, the results of orthognathic treatment fulfilled the expectations of almost every patient. Nearly 100 per cent of the patients (27/28) were satisfied with treatment results, although 40 per cent experienced some degree of numbness in the lips and/or jaw 1 year post-operatively. The most satisfied patients were those who stated temporomandibular disorders as the main reason for seeking treatment and whose PAR-index had improved greatly. The majority of the patients experienced the orthodontic treatment as painful and as the most unpleasant part of the whole treatment, but all the patients were satisfied with the pre-treatment information they were given on orthodontics. Orthodontic-surgical therapy should be of a high professional standard technically, but the psychological aspects are equally important in the treatment protocol. The professionals should make efforts to understand the patient's motivations for and expectations of treatment. Patients should be well prepared for surgery and supported for a long time after to help them to adjust to post-surgical changes.

Adolescent↗
PubMed2003

An aesthetic index for evaluation of cleft repair.

The aim of this study was to develop an aesthetic index for the evaluation of complete unilateral cleft lip and palate (UCLP) repair. The reproducibility and validity of this index were evaluated. A pilot study was devised, in which photographic slides of 50 subjects with UCLP were evaluated by seven orthodontic examiners on two separate occasions. After determining levels of agreement, the original index was modified for use in a clinical study. A field study was undertaken during an audit of cleft repair outcome in Perth, Western Australia. The subjects were graded using direct observation by two trained examiners. Standardized photographs of these subjects were taken at the same time. These were later graded by the same examiners independently on two separate occasions. Direct and indirect patient gradings could therefore be compared. A further field study involved the evaluation of the photographic slides of the original 50 subjects by 22 cleft surgeons. Reproducibility was determined by calculation of weighted kappa statistics. The intra-examiner agreement ranged from moderate to good and inter-examiner agreement from fair to good. Comparison of direct and indirect aesthetic evaluation revealed that the agreement was moderate to good, and no significant systematic bias existed. The new index offers advantages in simplicity and flexibility. Its reproducibility compares favourably with other aesthetic indices, and is not affected by the subject's age.

Child↗
PubMed2005

Attractiveness ratings of anterior open bites and reverse overjets using the aesthetic component of the Index of Orthodontic Treatment Need.

This study was carried out to determine the level of attractiveness of anterior open bites (AOB) and reverse overjets of varying severity. A sample of 180 non-dental students (101 females and 79 males; average age 20 +/- 0.75 years) and 45 dental professionals (12 females and 33 males; average age 35.5 +/- 5.07 years) was asked to complete a questionnaire to rate the level of attractiveness of AOB and reverse overjets of varying severity using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). Photographs of mild and severe AOB and reverse overjets were projected onto a white screen in a lecture theatre (15 seconds each with a 5 second interval between images). The participants were asked to record the AC grade at which they thought the projected picture of the AOB or reverse overjets had similar attractiveness. Dental awareness of non-dental students was determined by asking them their opinion on how important it was to have straight teeth (very unimportant, unimportant, important, very important), about their personal or close family members' orthodontic experiences and if they thought they were in need of any orthodontic treatment. A chi-square test was applied to record any differences between sexes and between the different groups. Backward stepwise linear regression analysis was used to determine the relationship between the students' ratings of the photographs and their dental awareness. The majority of non-dental students rated a mild AOB (93 per cent) and mild reverse overjet (96 per cent) to be aesthetically acceptable. A mild AOB and mild reverse overjet were found to be acceptable by 40 and 58 per cent of dental professionals, respectively. The differences in the ratings between dental professionals and non-dental students were significant at P < 0.001.A severe AOB was considered unattractive by both students and dental professionals. However, dental professionals rated it at the more unattractive end of the scale (P < 0.001). A severe reverse overjet was rated by the majority of the subjects as aesthetically unacceptable (85 per cent of the non-dental students and 78 per cent of the dental professionals).

Adult↗
PubMed1997

Comparison of the changes in facial profile after orthodontic treatment, with and without extractions.

A study was made of 31 patients with Angle Class II malocclusion. Fifteen patients did not undergo extraction of teeth (Group A), while 16 underwent extractions of four premolars (Group B). Data was obtained from the corresponding lateral radiographs of the head taken both before and after orthodontic treatment. The main aim of the study was to compare the response of the soft and hard tissues of the facial profile in Class II malocclusion treated with the extraction of four premolars and the response of borderline cases presenting with similar malocclusions, but not subjected to extraction. In this latter group reasonable doubt existed as to whether or not to remove teeth in order to solve the occlusal and aesthetic problems. It is concluded that significant hard tissue differences between the groups at the end of treatment were limited to a more retruded position of the incisors and a reduced overbite amongst those patients subjected to extraction. The main soft tissue differences between the groups at the end of treatment were a more retruded lower lip and a more pronounced lower labial sulcus in those patients subjected to extraction.

Adolescent↗
PubMed2003

Measurement of the profile angle and the aesthetic analysis of the facial profile.

Cephalometric measurement of the face in terms of aesthetics can be difficult and misleading due to the variability of the intra-cranial reference lines. Extra-cranial references are more accurate, but can be time-consuming to apply. The Aesthetic Horizontal is an intuitive datum line related to the 'photographic position' of the head, which is expedient in use and clinically relevant. A new and straightforward technique is presented for transferring the Aesthetic Horizontal directly from the patient to any recent radiograph, which can then be used as the reference line for an aesthetic analysis of the facial profile. The instrument used for measuring the profile angle and the transfer is readily constructed from a protractor and small weight. The technique can also be used to transfer any other orientation (e.g. Natural Head Position or Natural Head Posture) from the patient to a recent radiograph.

Cephalometry↗
PubMed1997

Midline mandibular osteotomy: an analysis of functional outcomes.

Although the oncologic validity and perioperative complications of midline mandibular osteotomy are well described, little attention has been directed toward the long-term functional problems that may be associated with its use. Thirty-one patients who had undergone this procedure were examined to assess postoperative sensation, temporomandibular joint (TMJ) function, occlusion, and cosmesis. The majority (27 of 31) patients had some sequelae but these were minor in nature. Twenty of 31 patients had abnormal sensation, 24 of 31 noted a changed occlusion, and 15 of 31 had signs or symptoms of TMJ myofascial pain. Although patients should be advised of the potential for functional problems with this procedure, they can be reassured that these are likely to be relatively minor in significance. If technically feasible and if an exact restoration of occlusion is a priority, a prefabricated lingual splint should be used.

Dental Occlusion↗
PubMed2006

Cosmetic dentistry.

PURPOSE OF REVIEW: Patients seeking the expertise of facial plastic surgeons for facial aesthetic improvement may also desire or benefit from dental aesthetic procedures. This paper reviews current treatment options available in cosmetic dentistry. RECENT FINDINGS: Many techniques exist to improve dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Although orthodontic therapy is still an important modality for smile aesthetics, some simpler procedures can provide acceptable aesthetic results. Comparison of external dental bleaching techniques reveals similar long-term results for in-office and at-home bleaching; in-office treatments, however, may provide the benefit of faster results. Internal dental bleaching is an effective method for correcting nonvital teeth coloration. Enamel shaping via either direct tooth contouring or the application of resins or veneers to tooth surfaces can correct defects, asymmetries and shape or rotation problems. Veneers or crowns are also options to correct intrinsic dental stains not amenable to bleaching techniques. Treatments to refine gingival margins and borders are another proven beneficial cosmetic procedure. SUMMARY: A myriad of techniques exist to correct a patient's particular concerns. Correction of discoloration is usually feasible as is the improvement of a patient's smile and overall dental aesthetics.

Crowns↗
PubMed1991

A clinical study of a microfilled composite resin for labial veneers.

Two-hundred and eighty-nine composite resin-full labial veneers were placed after labial enamel reduction in children and adolescents and reviewed after periods of up to 3 years. The median (+/- S.E.) survival time was 35.6 +/- 0.8 months with 42 (14%) of the veneers considered to have failed. There was a small incidence of marginal staining, no deterioration in gingival health, and patient satisfaction was high.

Acrylic Resins↗
PubMed2005

The aesthetics of all-ceramic veneered and monolithic CAD/CAM crowns.

The aim of this study was to examine whether crowns fabricated from machinable blocks would achieve acceptable aesthetics and whether these could compete with the aesthetics of restorations obtained by individual layering technique. Fourteen patients, who were to receive single anterior crown restorations, participated in this study. For each person two kinds of crowns were provided: one crown was made with the Cergogold system. The second one was produced in a Cerec machine and was additionally stained. Three independent examiners assessed the aesthetic appearance of crowns fabricated to match each subject's anterior shade. A scale of 1-6 was used to assess the aesthetic adaptation of each crown, with 1 representing excellent characteristics and 3.5 marking the threshold for clinical acceptability. The examiners' scores were averaged, and the mean values were analysed with the Wilcoxon signed rank test (P<or=0.05). Regardless of the fabrication method the crowns were aesthetically acceptable in all 14 patients. The mean values for the layering technique and for the machined restorations did not differ significantly. Within the limits of this study it was documented, that machinable blocks could attain aesthetically satisfying results.

Ceramics↗