Choosing an esthetic dental material in 1997.
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The aim of this study was to evaluate the importance of the dental aesthetic for the patients, the dental surgeon and the dental teachers by the study of the consultation reason, the complaints, the post-university congress program, the practical program of the dental students and the programs of the IADR congress. It appears that in odontology, patients ask strongly for aesthetic care, in consultation and litigation. The content of congress and professional literature shows that dental surgeons answer to that request. Only the practical teaching was a bit less but it was recently modify. The research workers are also very interesting for aesthetic care.
PURPOSE: This study was designed to determine the perceptions of lay people and dental professionals with respect to minor variations in anterior tooth size and alignment and their relation to the surrounding soft tissues. MATERIALS AND METHODS: Smiling photographs were intentionally altered with one of eight common anterior esthetic discrepancies in varying degrees of deviation, including variations in crown length, crown width, incisor crown angulation, midline, open gingival embrasure, gingival margin, incisal plane, and gingiva-to-lip distance. Forty images were randomized in a questionnaire and rated according to attractiveness by three groups: orthodontists, general dentists, and lay people; 300 questionnaires were distributed. RESULTS: The response rate was 88.2% for orthodontists, 51.8% for general dentists, and 60.6% for lay people. The results demonstrated threshold levels of noticeable difference between the varying levels of discrepancy. A maxillary midline deviation of 4 mm was necessary before orthodontists rated it significantly less esthetic than the others. However, general dentists and lay people were unable to detect even a 4-mm midline deviation. All three groups were able to distinguish a 2-mm discrepancy in incisor crown angulation. An incisal plane cant of 1 mm as well as a 3-mm narrowing in maxillary lateral incisor crown width were required by orthodontists and general dentists to be rated significantly less esthetic. Lay people were unable to detect an incisal plane asymmetry until it was 3 mm, or a lateral incisor narrowing until it reached 4 mm. Threshold levels for open gingival embrasure and gingiva-to-lip distance were both at 2 mm for the orthodontic group. Open gingival embrasure became detectable by the general dentists and lay people at 3 mm, whereas gingiva-to-lip distance was classified by these groups as noticeably unattractive at 4 mm. CLINICAL SIGNIFICANCE: The results of this study show that orthodontists, general dentists, and lay people detect specific dental esthetic discrepancies at varying levels of deviation, which may aid the dental professional in making specific treatment recommendations.
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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.
OBJECTIVES: A range of esthetic restorative dental materials are now available to dental clinicians. The aim of this study was to evaluate the relative fluoride recharge potential of a number of these materials in vitro over two years. METHODS: Disc samples (12 mm x 2 mm) of each of the materials were placed into artificial saliva at neutral pH. The materials tested were: two glass ionomers (Chemfil; Ketac-Fil), two resin-modified glass ionomers (Photac-Fil Aplicap; Vitremer), two compomers (Dyract; Compoglass) and two composites (Heliomolar; Concise). At 13 intervals over a two years period the discs were subjected to a 2 min fluoride recharge by exposure to sodium fluoride (500 ppm F). The pre- and post-recharge fluoride release values were determined using an ion sensitive electrode. RESULTS: At all time intervals the post-recharge fluoride release of the materials was significantly different (MANOVA p<0.0001). The mean values for post-recharge fluoride release after two years were: Chemfil 10.3, Ketac 3.0, Vitremer 9.0, Photac-Fil Aplicap 12.1, Compoglass 5.0, Dyract 3.6, Concise 0.3, Heliomolar 0.2 (units = microgF/cm(2)/h). SIGNIFICANCE: Esthetic fillings vary significantly in their capacity to absorb and re-release fluoride. The glass ionomer-based materials displayed a far greater potential for fluoride recharge than the composites, in which the recharge was virtually negligible. Whilst it cannot be assumed that fluoride release is directly proportional to cariostatic potential, these results suggest that, where possible, glass ionomer-based materials should be used in patients who have a high caries rate.
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OBJECTIVES: The purpose of this study was to determine the esthetic importance of different types of developmental enamel defect. METHODS: In the first method used, individual subjects from three different populations with less than 0.1, 0.7, and 0.9 ppm fluoride in their drinking water, were asked about the appearance of their teeth and results compared to assessments of clinical photographs made by a single examiner. In the second method used, dentist and lay observers were asked to assess the appearance of the dentition of selected individuals who had a range of enamel defects. RESULTS: According to the first method, both the size of demarcated opacities and the degree of enamel hypomineralization (TF index) were related to satisfaction with appearance. However, there was no difference in satisfaction with the appearance of the teeth among the three areas included in this study. In the second method, similar types of enamel defects were found to be esthetic stimuli as with the first study, but the dentists responded more strongly to the stimulus of enamel hypomineralization than the lay examiners. CONCLUSIONS: Both demarcated opacities and enamel hypomineralization may be important when assessing differences between populations. Further, esthetic ratings by dentists may not be a suitable means of assessing the esthetic importance of different types of enamel defects.
Dentists have needed an objective way in which to evaluate a smile. A method for determining the ideal size and position of the anterior teeth has been presented here. Use of the FIVE to evaluate the RED proportion and the width-to-height ratio, tempered with sound clinical judgment, gives pleasing and consistent results. With the diversity that exists in nature, rarely does the final result follow all the mathematical rules of proportional smile design. This approach may serve as a foundation on which to base initial smile design, however. When one begins to understand the relationship between beauty, mathematics, and the surrounding world, one begins to appreciate their interdependence.
The surge of interest in the use of tooth-colored restorative materials and systems in recent years has been attributed partly to rapid developments in dental materials science and also to patient demand and operator interest. When overall dental appearance is considered, several factors are of significance, including tooth color, shape, and position; restoration quality; and the general arrangement of the dentition, especially of the anterior teeth. Each factor may be considered individually, but all components together act in concert to produce the final esthetic effect. However, although the clinician must be mindful of the patient's desires for a favorable cosmetic result, materials and techniques must be carefully selected, and restorations should be sufficient to withstand the forces of occlusion and mastication and provide long-term function.
Traditionally, dentistry has focused on biomedical and mechanotechnical approaches to patients' dental health care. Objective and quantifiable measurements, such as tooth form, occlusal function, color, and biological compatibility, are conventional indicators of success or failure. However, unlike most facets of dental practice, the attainment of an enhanced facial and dental appearance is influenced and measured by more abstract, psychological factors such as perception, ideal body image, self-image, and personal motivation. These complex concepts are affected by emotional and personality factors that develop during the life cycle. This article will explore a psychodynamic perspective of patients who are dissatisfied with the esthetics of their dental treatment, although the result may be functionally and esthetically acceptable.
Four hundred eighty-one 10- to 13-year-old children answered questions to determine their skill at self-evaluation and their level of self-satisfaction with their own dental appearance. Their answers were correlated to dental-orthodontic variables measured for each child. Findings indicate that while subjects were objective in self-evaluation, there were sex-specific correlates between particular dental variables and self-satisfaction.
This article reviews plastic surgery literature to help identify and manage the risk presented by patients interested in elective esthetic dentistry whose physiologic profile would compromise the success of the procedure. A questionnaire, designed to help identify patients with problematic physiologic profiles, is presented. In addition, risk management techniques adapted from the plastic surgery literature are reviewed.
Esthetic dentistry was once a specialty of the family dentist and the orthodontist. Today it is a field for the prosthodontist, periodontist, oral and maxillofacial surgeon, and others. When jawbones are malpositioned, unesthetic facial contours can result, and dental compensations occur that can be additionally unattractive. Orthodontic attempts to correct malocclusion or other disharmonies of the dentition in affected individuals without surgical intervention can cause tooth instability and result in less than satisfactory cosmetic results. The treatment of orthognathic surgeons is especially well suited for full-face esthetic appearance--the picture the patient views each day in the mirror.