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Dental esthetics.

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Dentistry↗

Psychologic facets of esthetic dental health care: a developmental perspective.

A developmental perspective is presented to explore dental health and esthetics in dentistry and to describe the specific ways human behavior and various aspects of esthetic health care interrelate. An investigation of the fascinating links between mind and mouth over the life cycle are elucidated to explain how and why the oral cavity is so psychologically important. Clinical examples of how personality factors can influence dental treatment and its outcome are illustrated.

Adult↗

Classification of altered dental esthetics.

Clinical procedures designed to reestablish the idealized framework for the achievement of optimal esthetic restorative results have been frequently reported. Yet complex cases, where remarkable improvements of esthetic appearance are achievable in spite of preoperative conditions, are infrequently presented because the presentation standards appear to be set for idealized situations. If a classification system that reflects dental esthetic compromises and ideals existed, cases could be categorized accordingly, and realistic expectations could be applied to assess the effectiveness and results of a course of therapy. Considering that there is not currently a published classification system to this end, it is the purpose of this article to tender a classification of altered dental esthetics.

Classification↗

Dental esthetic satisfaction in adults.

This study determined the influence of teeth, mouth, and face on self-image and personal esthetic satisfaction in adults. A random sample of 125 patients completed a five-item questionnaire about personal esthetic satisfaction and oral self-image. As a group, general dental variables were stronger predictors of esthetic satisfaction than orthodontic variables (P less than .01). Discrepancies between clinical findings and patterns of self-perception and satisfaction suggest the dentist and patient should plan together for esthetic dental treatment.

Adolescent↗

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↗

The effect of axial midline angulation on dental esthetics.

The purpose of this study was to analyze the effect of various degrees of axial midline angulation on the attractiveness of a smile. We explored the influence of age, race, sex, direction of midline deviation, education, occupation, and dominant hand on each evaluator's perception of dental esthetics. Photographs of smiling subjects--one man and one woman--were altered to produce both left and right axial midline angulations in 5 degree increments. Fifty orthodontists and 50 laypeople evaluated these altered photographs by assigning both a numerical attractiveness rating and an acceptable or unacceptable rating to each. The results showed that attractiveness scores and acceptability ratings declined consistently as axial midline angulation increased. Statistical analysis showed that both sex of the subject and occupation of the judge were significant variables (P < .05) in the evaluation of the subjects. Age, race, sex of the judge, education level, direction of midline deviation, and dominant hand were not statistically significant. The mean acceptable midline angulation for the male subject was 6.6 +/- 4.5 degrees for orthodontists and 10.7 +/- 6.2 degrees for laypeople. For the female subject, the mean acceptable threshold was 6.4 +/- 4.0 degrees for orthodontists and 10.0 +/- 6.1 degrees for laypeople (P < .001). Discrepancies of 10 degrees were unacceptable by 68% of orthodontists and 41% of laypeople.

Adult↗

Dental esthetics and the golden proportion.

A system of esthetic predictions is described that has been used since antiquity. The naturalness of the system is emphasized by showing examples from nature and how artists and designers use it. The application of this system to dental esthetics is facilitated by the description and inclusion of a dental grid for the anterior esthetic segment.

Bicuspid↗

Effect of in-office tooth bleaching on the microhardness of six dental esthetic restorative materials.

OBJECTIVES: The aim of this in vitro study was to evaluate the effect of the in-office bleaching technique on the microhardness of six dental esthetic restorative materials. METHODS: Four composite resins (a hybrid, a flowable, a micro-hybrid and a nano-hybrid), an ormocer and a ceramic were tested, after the use of an in-office bleaching product. Fourteen specimens of each composite and the ormocer were fabricated and randomly divided into two groups of seven samples each. One group was polished and the other group remained unpolished. For the ceramic, seven polished samples were fabricated. Two samples of each group were used as negative controls. The specimens were bleached for 15, 30 and 45min. Five Knoop microhardness measurements were made on each sample, for each of the following periods tested: before bleaching, after 15, 30 and 45min of bleaching, 24h and 1 month after the bleaching procedure. Data were analyzed by the repeated measures analysis of variance with three between factors and one within. RESULTS: The differences in the microhardness values between the bleached and the control samples for the composites and the ceramic, were not statistically significant (hybrid: p=0.264; flow: p=0.584; micro-hybrid: p=0.278; nano-hybrid: p=0.405; ceramic: p=0.819). For the ormocer, although bleaching did not have any significant effect on the unpolished samples (p=0.115), it caused an increase on microhardness of the polished samples. SIGNIFICANCE: Bleaching with 38% hydrogen peroxide does not reduce the microhardness of the restorative materials tested. Therefore, no replacement of restorations is required after bleaching.

Ceramics↗

Restoring soft and hard dental tissues using a removable implant prosthesis with digital imaging for optimum dental esthetics: a clinical report.

Currently, most dental implants are placed in the esthetic zone with a delayed surgical protocol. This delay can result in loss of both soft and hard oral tissues following the healing period, necessitating guided tissue regeneration, distraction osteogenesis, or bone expansion and grafting procedures either prior to or at the time of implant placement. If a delayed placement protocol is used, or if grafting procedures are ineffectual, the prosthetic phase of implant dentistry must restore the missing structures artistically and functionally to integrate with the patient's existing dentition. This article presents the option of using a removable implant prosthesis for an esthetic anterior restoration of soft and hard tissues. A computer-assisted camera was used to record speaking, smiling, and active facial positions, with digital imaging to achieve realism for tooth position during the prosthetic phase. The captured patient images with the esthetic setups were transmitted by e-mail for direct viewing by both dentist and dental technician prior to case completion. These images were viewed as reference files during laboratory construction of the prosthesis to achieve the desired esthetic and functional results.

Adult↗

The esthetic dental implant: letting restoration be the guide.

Dental implants originally were placed according to the availability of supportive bone structures. This article describes a new way of approaching implant placement: envisioning the ideal ultimate restoration and developing the treatment plan--and the implant site--to achieve that goal.

Alveolar Bone Loss↗