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PubMed1995

Determinants of dental esthetics: a rational for smile analysis and treatment.

An attractive smile has always been the focal point of a person's attention to improving esthetic appearance and thus self-esteem. It is the contrasts of shape, color, line, and texture that enable us to differentiate one tooth from another, the teeth from the gums, and the smile from the face To understand why a smile with dentition in harmony is considered beautiful, clinical examples are presented to illustrate how to apply visual perception to the dental environment. These simple principles of visualization and treatment can be successfully applied to enhance the smile of any patient.

Adolescent↗
PubMed1992

Computerized design and manufacturing of esthetic dental restorations.

The "high-tech race" in restorative and esthetic dentistry is underway. The Cerec System, which currently leads the race, is reviewed. Other systems, which soon will be available, are discussed briefly. New and innovative technologies are sure to become a significant part of dentistry, both today and in the future. Many traditional methodologies and materials will be replaced by these new developments.

Ceramics↗
PubMed1999

Prosthodontic considerations in complicated restorative and esthetic dental problems.

An axiom of prosthetic dentistry has always been that the restoration of esthetics, speech and function requires the successful arrangement of teeth in space. The road to this success often requires the restorative dentist be a visionary who can coordinate multidisciplined planning in the presence of such obstacles as deficient alveolar bone and gingival tissues, poor occlusal plane, and jaw malrelations. Dr. Cook would like to thank the many Albuquerque generalists and specialists whose experienced hands contributed to the successful treatment of these patients.

Adult↗
PubMed1998

Thermal stability of direct dental esthetic restorative materials at elevated temperatures.

With increasing use of direct esthetic restorative materials, the identity of a body may rely upon knowledge of temperature effects on this class of dental restorations. This research examined the effect of atmospheric gas on thermal decomposition and color change of a wide variety of direct esthetic restorative materials. Cured discs (4 x 1 and 8 x 1 mm) were made using manufacturer's directions: traditional glass ionomer (Fuji II), light-curable resonomer (Fuji II LC), compomer (Geristore), and three types of resin composites--highly filled, urethane-based (Occlusin), and two Bis-GMA/TEGDMA resins: hybrid (Herculite XRV) and microfill (Silux Plus). Three replications of each material were heated at 5 degrees C/min in a thermogravimetric analysis unit using either room air or nitrogen purge to simulate different thermal environments. First derivative values of percent weight loss with respect to temperature were obtained to determine temperatures associated with increased decomposition rates. Room-air heating showed greater numbers of decomposition events than did nitrogen-heated discs. The only material decomposing less than 200 degrees C in either atmosphere was traditional glass ionomer. The majority of decomposition occurred between 200 degrees and 500 degrees C for all materials. Only products containing glass ionomer components decomposed between 600 degrees and 800 degrees C. Room-air heating resulted in ash white discs at 800 degrees C and higher. Specimens heated in nitrogen were gray to black at 600 degrees C and higher. Heating atmosphere greatly affected color, and some products demonstrated distinguishing color changes: glass ionomers, in particular, showed characteristic color features. An atlas was constructed from color change of specimens recovered after 200 degrees, 400 degrees, 600 degrees, 800 degrees, and 1000 degrees C compared with non-heated controls.

Composite Resins↗
PubMed2006

Influence of salivary organic substances on the discoloration of esthetic dental materials-a review.

The objective of this article was to review the articles on the interaction of salivary organic substances with resin-based dental materials and on the interaction of these organic substances with exogenous chemical agents, which results in discoloration. Original scientific articles or reviews on the saliva, acquired pellicle, and the interaction with pellicle and chemical agents related to dental resin-based materials were reviewed. Salivary esterases can increase or decrease the internal and external discoloration. The formation of acquired pellicle on the surface of a material varies by the properties of material, and the pellicle interacts with denaturation agents, such as tannin and chlorhexidine, to form stains and also adsorbs staining substances. Therefore, for the quality and longevity of restorations, protocols for the evaluation of the influence of organic substances on the extrinsic staining of restorative materials should be included in the evaluation of aesthetic restorative materials.

Dental Materials↗
PubMed2002

Follow-up study of dental students' esthetic perceptions of mild dental fluorosis.

OBJECTIVES: Several studies have assessed people's esthetic perceptions of dental fluorosis, suggesting that concerns may be greater than believed previously. Few studies have assessed dental students' perceptions and none has done so over time. The purpose of this paper is to report on changes in dental students' esthetic perceptions of dental fluorosis and other conditions. METHODS: Fourth-year dental students (n=45) completed questionnaires about computer-generated photographs of fluorosis and other conditions, using the same protocol as when they were entering dental students. Results were compared for each of the eight images at the individual level using paired statistical tests. RESULTS: Although many patterns were generally consistent, there were a substantial number of differences in results over time, concerning both the mild fluorosis and non-fluorosis images. In general, students tended to score both fluorosis and non-fluorosis images more favorably as fourth-year students. When rating images from very pleased (1) to very embarrassed (10), fourth-year students rated the images significantly more favorably than they had done as first-year students for normal/control, incisal third only dental fluorosis, and a more generalized, mild fluorosis. Similarly, with a visual analog scale from satisfactory (0) to unsatisfactory (69), fourth-year students reported significantly lower (more favorable) scores than they had done as first-year students for the normal/control, diastema/no fluorosis, more involved mild fluorosis, and incisal third only mild fluorosis. There were no obvious changes in the relative levels of favorable evaluation of fluorosis vs. the other conditions. CONCLUSIONS: Fourth-year dental students generally had more favorable esthetic perceptions of mild dental fluorosis and other conditions than they had reported as entering students.

Adult↗
PubMed2003

Effect of three bleaching agents on the surface properties of three different esthetic restorative materials.

STATEMENT OF PROBLEM: Information related to the effect of night-guard vital bleaching procedure on the surface properties of esthetic dental restorative materials is incomplete. PURPOSE: The aim of this study was to examine the effects of 3 proprietary carbamide peroxide bleaching agents on the surface properties of 3 dental esthetic restorative materials. MATERIAL AND METHODS: Three bleaching products (Nite White, Opalescence, and Rembrandt Lighten Gel) and 3 restorative materials (Duceram, Fuji II LC, and Silux Plus) were studied. A stainless steel mold and a 6-mm-thick polytetrafluoroethylene plate with a 1-cm-diameter hole were used to prepare 30 standardized specimens for each of the 3 restorative materials tested. Each group was divided into 3 subgroups (n=10). Two specimens from each subgroup were selected to form a control group. Three different carbamide peroxide bleaching agents were applied to each restorative material group for 8 hours per day for 30 days, respectively. Initial roughness measurements (Ra measured in microm) were made by use of a profilometer, at repeated intervals of 24 hours, 48 hours, 1, 2, 3, and 4 weeks (30 days). Surface topography of the specimens was assessed by scanning electron microscopy, and results were compared with the control group graphically. Surface structure and alterations of atomic weight percentages of element were made by use of energy-dispersive x-ray microanalysis. One-way analysis of variance was used to evaluate the surface roughness measurements. Significant results were evaluated with Fisher and Duncan's multiple range test (P<.005) RESULT: Surface roughness values for all restorative materials increased during the bleaching procedure. The only significant increase was found with the effect of Rembrandt bleaching gel on modified glass ionomer cement (mean Ra was 0.48 microm initially, 0.5 microm at 24 hours, 0.75 microm at 2 weeks, and 0.83 microm at 30 days). Surface roughness values increased significantly during the first 2 weeks (P<.005) for all bleaching groups of each restorative material, and no significant changes were seen in the following periods. SEM micrographs of the feldspathic porcelain specimens for each bleaching agent appeared to be similar to the control group. All of the modified glass ionomer specimens revealed serious cracking areas, whereas microfilled composite specimens showed increased surface porosity and cracks in certain areas when compared with control specimens. Surface spectral analyses results indicated a decrease in the SiO(2) content in the feldspathic porcelain and the microfilled composite groups for all bleaching agents. Modified glass ionomer specimens bleached with Nite White and Rembrandt showed an increase in mass percentage of SiO(2), whereas Opalescence specimens showed a decrease. However, there were no significant differences between the groups. CONCLUSION: Within the limitations of this study, no significant difference was found between bleaching agents. Most changes occurred in the first 2 weeks; the products tested were relatively stable in the following test periods. No significant change in the surface roughness of feldspathic porcelain was observed. On the other hand, the microfilled composite tested showed slight changes in the surface roughness. Significant changes were found for the modified glass ionomer cement (P>.005).

Aluminum Silicates↗
PubMed1994

Dental implant esthetics.

As dental implants have become an increasingly popular restorative therapy and their stability and functional benefits have become widely acknowledged, newly applied surgical and prosthetic techniques are enabling dentists to approach patients' esthetic expectations. Esthetic results of implant-supported fixed bridges, retrievable bridges, and overdentures are influenced by the amount of soft and bone tissue as well as by the placement of the implants themselves. Tissue augmentation procedures that restore normal tissue contour and allow more ideal implant placement help minimize esthetic compromises. The use of modified abutments that are angulated and placed directly in the implant can offset weak implant placement. Finally, overdentures should be constructed if these techniques cannot be used or if their use still results in compromised esthetic results.

Dental Implants↗
PubMed2004

Esthetic alternative for fluorosis blemishes with the usage of a dual bleaching system based on hydrogen peroxide at 35%.

Esthetic dental procedures in pediatric dentistry represent sources of satisfaction and realization, as much for the patient as for the professional. Lack of dental esthetics may develop psychological problems in infant as well as in adolescent patients. Blemishes produced by fluorosis appear as a challenge to the pediatric dentist and alternatives for treatment are desired. The scope of this present paper is to relate a clinical case with esthetic solution for blemishes in teeth enamel due to fluorosis. A dual system of bleaching was used (photo/chemically activated) based on hydrogen peroxide at 35% (Hi-Lite-Shofu) in a male eight-year-old patient with white fluorosis blemishes on teeth 11 and 21. The bleaching system used was efficient in bleaching teeth with white blemishes due to fluorosis, thus masking the blemishes and providing a more uniform appearance.

Child↗
PubMed1999

A pilot study of dental students' esthetic perceptions of computer-generated mild dental fluorosis compared to other conditions.

OBJECTIVES: Few studies have considered people's opinions about the esthetics of dental fluorosis. Assessments of fluorosis esthetics can be confounded by differences in a number of clinical factors, including tooth shape, color, contour, and gingival status. This pilot study compared esthetic perceptions of mild fluorosis and other conditions using computer-generated images made from a base set of normal appearing teeth. METHODS: Entering dental students (n = 61) completed questionnaires about four sets of paired photographs. Three sets consisted of fluorotic teeth (very mild to mild) versus other conditions (diastema, isolated enamel opacity, "normal"/control) and the other pair compared two presentations of mild fluorosis (generalized versus limited to incisal one-third). Six questions, both qualitative and quantitative, were asked about each pair of photographs. RESULTS: Mild fluorosis was assessed less favorably than normal/control, midline diastema was less favorable than mild fluorosis, and mild fluorosis was less favorable than isolated opacity. CONCLUSIONS: This approach allows fluorosis to be better compared with other oral conditions because the images are standardized. Additional research with this method is warranted, including more variations in conditions, more comparisons, and other study populations.

Adult↗
PubMedDate not supplied

Surgical templates for function and esthetics in dental implants.

The functional and esthetic importance of surgical templates associated with dental implants has been discussed. The design of the stent and proposed location of the fixtures basically determine the dentist's "wish list." Although ideal placement of an implant fixture often is achieved, it can be aided through use of a surgical template. Particularly useful in larger partially edentulous cases as described above, the ideal template is made of hard acrylic with holes slightly larger than the 3.0 mm drill often used during surgery. Construction of a template requires the dentist and surgeon to think about the case, create a wax-up, and decide on location before constructing the appliance. This process will benefit all, particularly the patient, and provide a foundation for a long-lasting prosthetic result.

Acrylic Resins↗
PubMed2003

Extraction vs nonextraction: arch widths and smile esthetics.

Dental casts of 30 patients treated with extraction and 30 patients without extraction of four first premolars were randomly selected to determine changes in arch width as a result of treatment. Arch widths were measured from the cusp tips of the canines, premolars, and molars. Posttreatment arch widths were also measured in the midline at a constant arch depth from the most labial surfaces of the incisors. Standardized frontal photographs of the face taken during smiling of 12 extraction- and 12 nonextraction-treated subjects were evaluated. Fifty laypersons judged the esthetics of the smiles. Intercanine width increased less than one mm in both groups, and there was no difference between the two groups. The interpremolar and intermolar distance in both arches decreased significantly from 0.53 to 0.95 mm in the extraction sample, whereas the interpremolar and intermolar widths increased significantly from 0.81 to 2.10 mm in the nonextraction sample. When arch widths of both groups were measured from the most labial surfaces of the teeth at a constant depth, the average arch width of both arches was significantly wider in the extraction sample (1.8 mm wider in the mandible and 1.7 mm wider in the maxilla). The mean esthetic score and the number of teeth displayed during a smile did not differ between the groups. The results indicate that arch width is not decreased at a constant arch depth because of extraction treatment, and smile esthetics are the same in both groups of patients.

Adolescent↗
PubMed2002

Survey of undergraduate esthetic courses in U.S. and Canadian dental schools.

U.S. and Canadian dental schools were surveyed regarding curriculum issues related to undergraduate dental esthetic restorative courses. A one-page survey instrument was sent to deans of academic affairs (n=59) of dental schools to complete or forward to the most appropriate faculty at their respective schools who would be knowledgeable about the esthetic restorative curriculum. Responses were received from forty-two dental schools (42/59) for a response rate of 72.9 percent. The first part of the survey asked if a specific esthetic restorative course was offered at their school, if it was mandatory or elective, and details of the course length and content. The second part of the survey asked whether selected esthetic restorative procedures were included in the curriculum. Respondents to this survey indicated that most types of esthetic restorative procedures are taught whether or not an esthetic course is included in the curriculum.

Canada↗
PubMed2000

Factors associated with dental anxiety and attendance in middle-aged and elderly women.

The aim of this study was to analyze the association between dental anxiety, dental attendance, health status and social factors. Our previous studies have shown that dental anxiety declines with age and is associated with poor oral health. In addition, correlations between dental anxiety, dental utilization and dental status have been revealed. However, the association of these factors with general health and social factors has not been analyzed in our previous studies. In a study of women's health in Göteborg, Sweden in 1992, 1.017 urban women aged 38 to 84 years took part in a series of investigations including clinical examinations, interviews and questionnaires. In addition to descriptive and simple inference statistics, a two-part multiple logistic regression model was utilized to investigate dental anxiety and dental utilization. Dental fear was less prevalent among older women, dentate or not, although 10% of females 62 years of age and older still reported high dental anxiety (DAS > or = 12). 94% of the younger (< or = 62 yr) and 76% of the older (> or = 70 yr) women reported regular dental attendance. When separating all women into dentate and edentulous groups, 94% of the dentate and 11% of the edentulous respondents reported regular dental care. Due to the large difference in dental attendance between dentate and edentulous women, these groups were analyzed separately. Multiple logistic regression analyses showed that the following factors were associated with irregular dental utilization among dentate women: high dental anxiety, fewer teeth and restorations, more caries, poorer chewing ability and dissatisfaction with dental esthetics. In the multiple regression for dental anxiety, high fear was shown to be associated with irregular dental care, age (younger), fewer teeth, dissatisfaction with dental esthetics and lower scores on the SF-36 mental health scale. A separate analysis showed that individuals with high fear and regular, as opposed to irregular, dental attendance had more teeth at a statistically significant level, which were less often decayed and more often restored. In spite of the group with high fear and irregular attendance having fewer teeth, their level of decay was seven times higher. Overall, the results indicate a strong association between dental fear and dental attendance. Weak associations were found among socio-economic, dental health and general health factors.

Adult↗
PubMed1991

Attitude variables of dentofacial deformity patients: demographic characteristics and associations.

For patients to obtain satisfaction from surgical orthodontic treatment, a concordance needs to exist between the patients' concerns and expectations and the clinician's outcome measures of success. In this study, 231 patients 16 years or older were analyzed to define attributes of treatment that relate to patient satisfaction with outcome. The most prevalent patient concerns were related to facial and dental esthetics, and the effect of the dentofacial deformity on the quality of life was associated with a significantly higher motivation for surgical treatment.

Adolescent↗
PubMed1996

Orthodontic concern among 11-year-old children and their parents compared with orthodontic treatment need assessed by index of orthodontic treatment need.

The aims of the study were to compare the opinions of both the children and the parents with an orthodontist's assessment of treatment need, to investigate the children's self-esteem, and parents' opinion of treatment results. The study group of 359 children (51% girls, 49% boys, mean age 10.6 years) and their parents were asked about their opinions in separate questionnaires. The self-esteem of the children was measured by the global negative self-evaluation scale (GSE). An orthodontist assessed the children's dental casts with the index of Orthodontic Treatment Need (IOTN). Allocated to the dental health component (DHC) of IOTN, 53.2% children had very great to moderate need and 46.8% had little to no need. No sex difference was noted. The children's own assessments of the aesthetic component (AC) of IOTN were closer to the attractive end of the scale than the orthodontist's (p < 0.05). Desire for treatment was more frequent than dissatisfaction with children's occlusion (p < 0.001). The patients' orthodontic concern correlated significantly with both DHC and AC grades (p < 0.001). The children's GSE scores were not correlated to components of IOTN. For children with very great need, high self-esteem was related to orthodontic concern. The parents (90.8%) perceived dental esthetics to be equally important for girls and boys. Most parents (93.0%) thought the results of orthodontic treatment were good. The results indicate meaningful association between orthodontic concern and orthodontic treatment need assessed by IOTN. However, some patients with great need do not express orthodontic concern, whereas others with near ideal occlusion express concern.

Attitude to Health↗