[Esthetic dentistry. The 10th Scientific Meeting of the European Academy of Esthetic Dentistry (EAED) of 10 to 16 March 1996 in St. Moritz].
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Dental Implantation↗
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[Pink esthetics. Surgical periodontology as prerequisite for esthetic tooth reconstruction].
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Adult↗
[Esthetics in implantology. "Esthetic Perfection in Oral Implantology"--the course of 17 to 18 October 1997 in Zurich].
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Dental Implantation↗
[Study of stomatology from the viewpoints of esthetics and cosmesis: Summary of the first national symposia on esthetic and cosmetic stomatology of the Chinese Medical Association.].
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Journal Article↗
Evaluation of the esthetic results of a 40-patient group treated surgically for dentoskeletal class III malocclusion.
A dentoskeletal Class III malocclusion results in unesthetic alterations of the soft tissues, which may cause psychologic and interpersonal problems. Surgical treatment, if based on cephalometric evaluations alone, can result in inadequate correction of facial esthetics. The aim of this paper is to discuss the esthetic needs observed in surgical planning of a group of 40 Class III patients and to compare the presurgical esthetic parameters with those recorded in the sixth month of follow-up. To obtain the proper esthetic result and to restore proper stomatognathic functionality, surgical treatment planning required the integration and correction of skeletal cephalometric planning. In 24 of the 40 patients, the skeletal and esthetic planning were in agreement with each other. In the remaining 16 patients, the correction of skeletal planning with the esthetic planning was necessary to obtain the correct esthetic and functional restoration. In all patients, esthetic, radiographic, and functional analysis at the sixth month of follow-up revealed the restoration of correct facial esthetics in the vertical, transverse, and sagittal planes; no temporomandibular joint problems; and a high degree of personal satisfaction regarding the esthetic and functional result obtained, including improvements in social life and in masticatory function. Cephalometric indications should always be compared with esthetic clinical indications and, possibly, the skeletal planning must be corrected by the esthetic needs, so that esthetic and functional success can be reached at the same time.
Adult↗
Esthetic dentistry in North American dental schools.
OBJECTIVES: Esthetic dentistry is among the most dynamic areas of contemporary clinical dentistry. Teaching programs in dental schools have a strong effect on the practice of dentistry, not only for recent graduates, but also for established clinicians, especially with respect to new techniques and concepts. The purpose of the study reported here was to assess the frequency and extent of the teaching of esthetic dentistry in North American dental schools and to report how it differs among the various schools. MATERIALS AND METHODS: A 19-question survey was mailed to 64 North American dental schools. The questions inquired about the priority given to the teaching of esthetic dentistry in the school; how the subject was taught (through regular curricular courses; through a multidisciplinary approach or through elective classes); the duration of the esthetic dentistry course; the nature of the course content (theoretical or practical); the esthetic procedures taught to undergraduate students; the level of interaction among different disciplines in the teaching of esthetic dentistry; and the techniques and commercial materials used. The responses were summarized as percentages based on the number of schools that responded to each question. RESULTS: Fifty-two (81%) of the 64 dental schools completed and returned the questionnaire. Twenty-five of these schools (48%; designated group A) reported having a course exclusively for the teaching of esthetic dentistry. Twenty-seven schools (52%; designated group B) reported that esthetic dentistry was addressed in multiple courses, i.e., no specific course was available. Four schools in group B (15%) were in the process of developing a separate course for esthetic dentistry. In group A schools, esthetic dentistry was taught mainly in the operative dentistry department or division. The most frequent course duration was 4 to 6 months, but there were marked variations. Thirteen (52%) of these 25 schools had didactic and practical teaching at both the preclinical and the clinical levels. The schools in group B reported that only clinical instruction in esthetic dentistry was provided. Several concerns were addressed in the courses offered in group A schools: extrinsic and intrinsic discoloration, bleaching, diastemas, malformation and malpositioning (the latter including rotation, intrusion and labio-linguoversion), and replacement of amalgam and gold restorations. Only 7 (28%) of the group A schools reported having the support of an inhouse laboratory. The esthetic procedures taught were similar for schools in group A and group B. The use of direct posterior composite restorations, all-ceramic crowns and nonvital bleaching was more common among group B schools. Ceramic inlays, onlays and indirect posterior composite restorations were not taught by 4 (16%) of the schools in group A and 7 (26%) of the schools in group B. CONCLUSIONS: The teaching of esthetic dentistry in North American dental schools is highly variable and in many schools is shared among different disciplines. Dental schools should work together to establish the parameters for teaching this subject and should formulate the necessary standards for education and research in this new field.
Canada↗
Nasal morphology and shape parameters as predictors of nasal esthetics in individuals with complete unilateral cleft lip and palate.
OBJECTIVE: The purpose of this study was to assess the ability of shape parameters of nasal morphology to predict esthetics in individuals with complete unilateral cleft lip and palate (CUCLP). METHODS: This retrospective study involved 28 patients with repaired CUCLP. Nostril morphology was analyzed using nose casts and a video-imaging technique. Calculated shape parameters included area, perimeter, centroid, angle of the principal axis, major and minor moments of area, anisometry, bulkiness, lateral offset, and three-dimensional internostril angles. Esthetics was assessed using a panel of six orthodontists who rated nasal esthetics from frontal, lateral, basal, and three-quarters view slides and from nose casts. Correlations between esthetics and the shape parameters were completed using the entire group as well as using two statistically determined subsets: those with the best and those with the worst esthetics. RESULTS: Nasal esthetics was related to only the perimeter and bulkiness parameter ratios. Symmetry of the perimeters between the right and left nostrils positively correlated with better esthetics using the entire sample group while symmetry of bulkiness between the right and left nostrils positively correlated with better esthetics using both the entire sample group and the best and worst subsets. CONCLUSIONS: Only perimeter and bulkiness showed positive correlations with nasal esthetics. The group of parameters used to assess nostril morphology had neither significant correlation with-nor predictive power for-esthetics. Thus, an assessment of the entire nasal surface topography in three dimensions needs to be completed and assessed with respect to predictability of nasal esthetics.
Adolescent↗
[Medical esthetics in the works of Polish doctors on the turn of the XIXth century].
The paper determines the objects of medical esthetics and the use of what is esthetic in doctor's practice and in medicine. The thesis of the paper is the assumption that medicine emerges out of esthetic distance. It is created by culture forms due to which biologicality of human body is restrained and subordinated. Medical esthetics examines these forms as well as their esthetic expressions in the art of therapy. The above assumption is documented by presenting the esthetic ideas of Polish doctors on the turn of the XIXth century. These ideas are represented first of all by: Zygmunt Kramsztyk, Henryk Nusbaum, Edmund Biernacki, Wladyslaw Bieganski, Heliodor Swiecicki and Wladyslaw Szumowski. The esthetic concepts and statement of the Polish doctors determine the limits of the objects of medical esthetics in which the doctor becomes the esthetic subject - creator of esthetic beauty, where as the medical art becomes esthetic form of medical practice.
Esthetics↗
Smile esthetics: perception and comparison of treated and untreated smiles.
INTRODUCTION: Although orthodontic treatment is based primarily on occlusal relationships, greater attention is now paid to enhancing dentofacial characteristics to produce optimal facial esthetics. The purposes of this study were to compare smile esthetics among extraction and nonextraction patients and a control group, assess certain dentofacial characteristics in those groups, and discuss how these features relate to smile esthetics. METHODS: Panels of orthodontists, plastic surgeons, artists, general dentists, dental professionals, and parents used a 5-point scale to rate smiling photographs of 25 extraction, 25 nonextraction, and 25 untreated control subjects. Dentofacial characteristics of the 3 groups were obtained from lateral cephalometric analyses, direct biometric measurements, and frontal photographs. Smile esthetics and differences among the 3 groups were subjected to 1-way analysis of variance (ANOVA), and Pearson correlation coefficients were calculated to determine the relationship of the variables to the esthetic score. RESULTS: The mean esthetic scores for the extraction, nonextraction, and control groups were 3.15, 3.12, and 3.26, respectively. Visible dentition width relative to the smile width ratio and intercanine distance relative to smile width ratio were significantly different among the groups, with extraction patients showing a slightly wider dental arch relative to the soft tissue (P < .05). There was also a significant difference in the U1-SN angle among the groups (P < .05), and this variable showed a strong correlation with the esthetic score as did maxillary gingival display (P < .05). However, our study groups could not be differentiated in smile esthetics.
Adult↗
Malocclusion: esthetic impact and quality of life among Brazilian schoolchildren.
INTRODUCTION: The objectives of this study were to assess the esthetic impact of malocclusion on the daily life of Brazilian schoolchildren and to test the association between esthetic impact due to malocclusion and biopsychosocial variables. METHODS: The sample comprised 333 randomly selected subjects aged 10 to 14 years. The oral impact on daily performance (OIDP) instrument was used to assess the esthetic impact, and the dental aesthetic index (DAI) was used for clinical assessment. The subjects were further evaluated as to their self-esteem (global self-evaluation) and self-perception of oral esthetics (oral aesthetic subjective impact scale). Other variables were assessed through questionnaires. Multiple logistic regression was used in the data analysis. RESULTS: Twenty-seven percent of the children reported an esthetic impact on their daily lives due to malocclusion. The following variables were independent risk factors for an esthetic impact: female sex, maxillary anterior crowding of 2 mm or more, normative need for treatment considered elective and highly desirable, negative self-perception of oral esthetics, low self-esteem, and intermediate economic level. CONCLUSIONS: The esthetic impact of malocclusion significantly affects the quality of life of schoolchildren in Belo Horizonte.
Activities of Daily Living↗
Evaluation of profile esthetic change with mandibular advancement surgery.
Our purpose was to investigate the impact of mandibular advancement surgery on profile esthetics and to attempt to define guidelines that could be of value to the clinician in predicting profile esthetic change. The sample consisted of 34 patients who had been treated with a combination of orthodontics and mandibular advancement surgery without genioplasty. Initial (pretreatment) and final (posttreatment) cephalometric radiographs of each patient were used to produce silhouette images and to quantify skeletal changes that occurred with surgery. The images were displayed randomly to lay persons and orthodontic residents who were asked to score the esthetics of each profile. On average, after mandibular advancement surgery, B point moved forward 5.0 mm (SD = 2.6 mm) and downward 4.7 mm (SD = 3.1 mm), and the ANB angle decreased 3.0 degrees (SD = 1.6 degrees ) Graphical analysis and results of paired t tests revealed that for patients with an initial ANB angle >/= 6 degrees, a consistent improvement in profile esthetics was seen following surgery (P </=.001). This represented, on average, about a 45% improvement in esthetics. For patients with an initial ANB angle < 6 degrees, an improvement in profile esthetics after surgery was seen about half the time but poorer esthetics were equally likely. These results underscore the importance of using the ANB angle as a skeletal guideline when deciding whether to treat patients with mandibular advancement surgery. If improved profile esthetics are a desired outcome, an initial ANB angle of at least 6 degrees is recommended.
Adult↗
Dental esthetics, orthodontic treatment, and oral-health attitudes in young adults.
INTRODUCTION: The aim of this study was to investigate whether young adults with varying dental esthetics and histories of orthodontic treatment also differ in oral-health attitudes, preventive behaviors, and self-perceived oral health. METHODS: The sample comprised 298 young adults, 18 to 30 years old, with at least 13 years of primary and secondary school education. The subjects were asked to complete questionnaires dealing with various measures related to oral-health attitudes, preventive behaviors, and perceptions of oral health. Dental esthetics were assessed by means of the aesthetic component of the index of orthodontic treatment need. Dental plaque accumulation was assessed in a subsample of respondents. RESULTS: Subjects with high dental-esthetics scores reported more favorable oral-health attitudes, such as internal control, dental awareness, value of occlusion, and preventive behavior expectations than subjects with lower scores. Subjects with previous orthodontic treatment showed greater internal control and dental awareness than those who had not previously been treated. Subjects ranking high in dental esthetics and those with previous orthodontic treatment reported stricter oral-hygiene adherence than others. Self-perceived oral health was better in high scorers on dental esthetics. Less plaque accumulation was found in subjects with higher dental esthetic scores and in those with previous orthodontic treatment. CONCLUSIONS: These findings suggest that favorable dental esthetics and previous orthodontic treatment might be important variables in explaining individual differences in oral-health attitudes and behaviors.
Adolescent↗
Perception of facial esthetics: a comparison of similar class II cases treated with attempted growth modification or later orthognathic surgery.
In recent years, there has been considerable interest in the esthetic outcomes of various types of Class II treatment. In this study, it was the authors' intent to determine the esthetic outcomes for 60 Class II division 1 patients: 28 patients treated during the active growth phase with an activator and fixed appliances and 32 patients treated at the completion of growth with fixed appliances and by orthognathic surgery. Using a visual analogue scale, a mixed panel of 14 judges scored the pre- and posttreatment attractiveness of these patients from frontal and lateral facial photographs. Statistical analysis by two-sample t-tests indicated that, on average, esthetic scores improved with treatment, regardless of the treatment modality. There was, however, considerable individual variation in the degree of improvement, even to the point that there was a decline in esthetics for some patients. Despite somewhat different modes of treatment, it was found that neither the average pre- and posttreatment esthetic scores nor the change in esthetic score with treatment was significantly different for the two groups. Although clinical planning decisions should still be made on an individual basis, the findings of this study suggest that the perceived esthetic outcome in many Class II division 1 patients may well be just as favorable, regardless of whether they are managed early during the growth phase or later, at the completion of growth by orthognathic surgery.
Activator Appliances↗
The influence of various fluoride exposures on the prevalence of esthetic problems resulting from dental fluorosis.
OBJECTIVES: This study sought to determine the prevalence of esthetic problems due to dental fluorosis, and determine the relationship of different fluoride exposure histories to the occurrence of these problems. METHODS: In 1993-94 2,715 children in grades 2 and 3 and 3,297 adolescents in grades 8 and 9 were examined by four dentists. Questionnaires detailing exposures to various fluoride technologies were collected from 3,022 of these study participants. Esthetic ratings of the participants' maxillary anterior teeth were made by the examiners, the participants themselves, and their parents using questionnaires designed for this purpose. RESULTS: Data indicate that 46 percent of the participants had dental fluorosis. Only 40 percent had fluorosis on anterior maxillary teeth. The prevalence of esthetic problems ranged from about 1 percent to 4 percent, depending on how an esthetic problem was defined. Esthetic problems as defined by the participant were more prevalent for the "over 11" age group. Logistic regression results demonstrated significant associations between several of the classifications of esthetic problems and the use of fluoride supplements and dentifrices, and exposure to fluoridated water during the third year of life. CONCLUSIONS: Results suggest that the prevalence of esthetic problems is low in the communities surveyed, and that exposure to any number of fluoride technologies in the third year of life can increase a child's risk for this problem.
Adolescent↗
Simulated shape design. Helping patients decide their esthetic ideal.
BACKGROUND: Esthetic care is changing dentistry from a need-based to a want-based practice. Patients are asking for esthetic treatment, and clinicians are retooling their practices to satisfy this need. One important part of providing esthetic dentistry is ensuring that the patient is as well-informed as possible about treatment outcomes. DESCRIPTION OF TECHNIQUE: This article describes a tool dentists can use to show patients potential tooth sizes, shapes and arrangements before carrying out treatment. Simulated shape design, or SSD, is a reversible method of demonstrating potential esthetic outcomes that involves creating trial restoration shapes and placing them over a patient's teeth. SSD is a simple technique that any dentist can perform. In essence, the technician makes new tooth shapes in wax, the dentist places these in the patient's mouth and the patient evaluates them. The dentist then makes modifications in the SSD, which he or she reports to the technician. CLINICAL IMPLICATIONS: With the decisions of shape, arrangement and size made at chairside, the whole flow of esthetic treatment can be handled smoothly. Preparations can be cut more accurately to better support the restorative material; decisions can be made to open or not open the contacts; and shapes can be agreed on in the earliest stage of evaluation, then duplicated faithfully in the provisional and final restorations. There are no surprises for the patient, the dentist or the technician. Both the esthetic (smile design) and functional elements (anterior guidance) of the restoration can be checked with SSD. SSD could become the standard in determining whether or not to proceed with esthetic treatment.
Cuspid↗
Achieving gingival esthetics.
INTRODUCTION: Dentists traditionally have thought of periodontal treatment as a means of saving the teeth while leaving the patient with an esthetic problem. This no longer is true. The goal of this article is to show how esthetic crown-lengthening procedures, papillary regeneration and root coverage may enhance the overall esthetic results of periodontal treatment. METHODS AND RESULTS: Esthetic crown lengthening aims not only to provide biological width for the healthy restoration of teeth, but also to permit esthetic gingival and prosthetic contours. Papillary regeneration aims to fill the dark spaces that may occur interproximally with the progression of periodontitis or as a result of tooth alignment. Finally, root coverage procedures now can provide predictable results with the application of connective-tissue periodontal grafts and plastic surgery techniques. This article presents a case report for each type of procedure, each of which resulted in improved esthetics and cosmetic appearance. CLINICAL IMPLICATIONS: Periodontal treatment now is part of the solution for certain esthetic problems. While technically demanding, these procedures, in the hands of an appropriately trained and experienced clinician, can improve the overall results of patient treatment.
Connective Tissue↗
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↗
Clinical performance of esthetic posterior crowns in primary molars: a pilot study.
PURPOSE: The aim of this pilot study was to assess the clinical performance of esthetic crowns and to compare these to conventional stainless steel crowns (SSC). METHODS: Twenty two crowns (11 conventional and 11 esthetic) were placed in mandibular primary molars obeying the following criteria: the tooth was not mobile; no fistulae were present; the tooth had at least one caries free or properly restored antagonist and had to be in contact with one adjacent tooth mesially, in the case of the primary second molars or distally in the case of the primary first molars. Crown preparation was done in a conventional manner, but reduction was more extensive for the thicker esthetic crowns, to allow for proper occlusion. The crowns were evaluated clinically and radiographically after 6 months and the following parameters were assessed: gingival health, marginal extension, crown adequacy, proper position or occlusion, proximal contact, chipping of the facing (for esthetic crowns) and cement removal. RESULTS: At the 6 month evaluation all esthetic crowns were intact, without chipping of the facing, and no excess of cement was observed in both groups. No difference was found for marginal extension, occlusion, proximal contact, crown adequacy, and bone resorption, but a significant difference was found for periodontal health between esthetic crowns and conventional SSC (P < 0.001 McNemar test). CONCLUSIONS: The esthetic crowns assessed had several inconveniences, as they resulted in poor gingival health, are very expensive, and, although not measured, are bulky and without a natural appearance.
Cementation↗