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At least 109 records · Page 6Linked to original sources
PubMed2003

Anatomic crown width/length ratios of unworn and worn maxillary teeth in white subjects.

STATEMENT OF PROBLEM: Dimensions of teeth have been available for a century. Some significant and clinically relevant aspects of dental esthetics, however, such as the crown width/length ratios, have not been presented in tooth morphology sources until recently. PURPOSE: The purpose of this study was to analyze the anatomic crowns of 4 tooth groups (central incisors, lateral incisors, canines, and first premolars) of the maxillary dentition with respect to width, length and width/length ratios and determine how these parameters are influenced by the incisal edge wear. MATERIAL AND METHODS: Standardized digital images of 146 extracted human maxillary anterior teeth from white subjects (44 central incisors, 41 lateral incisors, 38 canines, 23 first premolars) were used to measure the widest mesiodistal portion "W" (in millimeters) and the longest inciso-cervical/occluso-cervical distance "L" (in millimeters). The width/length ratio "R" (%) was calculated for each tooth. A 1-way analysis of variance was used to compare the mean values of W, L, and R for the different groups ("unworn" and "worn" subgroups, except for premolars). Multiple least significant difference range tests (confidence level 95%) were then applied to determine which means differed statistically from others. RESULTS: There was no influence of the incisal wear on the average value of W (width) within the same tooth group. The widest crowns were those of central incisors (9.10 to 9.24 mm) > canines (7.90 to 8.06 mm) > lateral incisors (7.07 to 7.38 mm). Premolars (7.84 mm) had similar width as canines and worn lateral incisors. The L-value was logically influenced by incisal wear (worn teeth were shorter than unworn teeth) except for lateral incisors. The longest crowns were those of unworn central incisors (11.69 mm) > unworn canines (10.83 mm) and worn central incisors (10.67 mm) > worn canines (9.90), worn and unworn lateral incisors (9.34 to 9.55 mm), and premolars (9.33 mm). Width/length ratios also showed significant differences. The highest values were found for worn central incisors (87%) and premolars (84%). The latter were also similar to worn canines (81%), which constituted a homogeneous group with worn lateral incisors (79%) and unworn central incisors (78%). The lowest ratios were found for unworn canines and unworn lateral incisors (both showing 73%). CONCLUSIONS: Along with other specific and objective parameters related to dental esthetics, average values for W (mesiodistal crown dimension), L (inciso-cervical crown dimension), and R (width/length ratio) given in this study for white subjects may serve as guidelines for treatment planning in restorative dentistry and periodontal surgery.

Analysis of Variance↗
PubMed1989

Esthetic principles; concepts, and practices in pediatric and adolescent dentistry.

The foundation of all dental esthetics is health. A beautiful dentition only occurs in supporting structures free of disease and inflammatory responses. Beyond health, the desire for manipulation of the oral cavity for esthetics in pedodontics is guided by the expectations of the dentist and the parents. When treatment planning for young children and adolescents, it is imperative that the dentist helps to distinguish procedures performed for the health and functional needs of the child from techniques performed to meet cultural standards of esthetics.

Adolescent↗
PubMed1998

Achieving natural looking restorations.

Early in my career, I realized that to achieve lifelike restorations, one needed to introduce the same excellence into the laboratory that exists in a high-end esthetic dental practice. I discovered that the foundation for excellent esthetics begins with good communication between the dental technician and the dentist. To establish good communication, one should acquire knowledge of the requirements and limitations encountered by both the technician and the dentist. Once meaningful communication is established between the two disciplines, esthetic excellence will follow.

Communication↗
PubMedDate not supplied

Management of periodontal tissues for restorative dentistry.

Proper management of periodontal tissues is required to achieve predictable long-term success with restorative dental procedures. Forced eruption as well as several surgical techniques may be used to achieve and maintain adequate biologic width during restorative and esthetic dental procedures. The technique that will yield optimal results depends on the relationship between the restoration's margins and the surrounding periodontium. A classification system that describes these interrelationships and provides treatment recommendations is included.

Crown Lengthening↗
PubMed1977

Management of cases with upper incisors missing.

A problem often confronting the orthodontist is that of missing upper incisors. In evaluation of the individual case, the dicision as to space closure or space regaining and eventual prosthetic reconstruction can be perplexing. Various diagnostic criteria, such as skeletal relation, arch-length analysis, inclination of teeth, and dental esthetics, must be evaluated. On the basis of this diagnostic information, treatment alternative is chosen to correct the malocclusion. The solution may be found in maintaining space, necessitating postorthodontic prosthetic replacement, or closing space and thus avoiding the need for artificial teeth. Four cases are shown to illustrate different approaches to the treatment of patients with upper incisors missing. Other solutions are possible anc correct. Each case must be weighed on its own merits.

Adolescent↗
PubMed1998

International comparisons of professional assessments in orthodontics: Part 2--treatment outcome.

The opinion of 97 orthodontists in 9 countries has been surveyed with respect to the judgment of treatment outcome. Ninety-eight pretreatment and posttreatment study casts were examined by each orthodontist who gave a judgment of the degree of improvement and whether they thought the result was acceptable. It was found that there was at least 80% agreement on the acceptability of the outcome for only 45.5% of the sample. Logistic regression was used to identify predictive indicators for the judgment of acceptance. It was found that the posttreatment scores for dental esthetics, crossbite, buccal segment sagittal relation, lower arch crowding, centerline, and left and right buccal segment vertical relationship were most important predictor variables. These six traits correctly assigned the decision with 70% accuracy. The judgment of outcome did not seem to take account of the treatment complexity as judged by the practitioners. It was also found that judgments are significantly affected by the country and payment methods, practice environment, and experience of the practitioner. The occlusal traits identified can be usefully incorporated into a index for assessing both treatment need and outcome, and may serve the purposes for audit and research in orthodontics.

Attitude of Health Personnel↗
PubMedDate not supplied

Esthetic designs of removable partial dentures.

The increased emphasis on physical appearance in contemporary society has increased the demand for esthetic dental restorations. Although the success of implant dentistry has expanded the scope of esthetic fixed prostheses, many patients demand a removable partial denture (RPD) for health, anatomic, psychological, or financial reasons. Fabricating an esthetically pleasing RPD while avoiding the unsightly display associated with conventional clasp assemblies often presents a challenge to dentists. This article examines using lingual clasps, proximal undercuts (also known as rotational path insertion), and acetal resin clasps as simple and effective means of improving RPD esthetics.

Adult↗
PubMed2000

Treatment of a patient with a Class II malocclusion, impacted canine, and severe malalignment.

A case report of the orthodontic treatment of a male adolescent with a unilateral dental Class II malocclusion, an impacted canine, severe maxillary malalignment, and a canted maxillary anterior occlusal plane. Treatment consisted of full fixed appliances, extraction of the maxillary right first premolar, and surgical exposure of the impacted canine. Treatment vastly improved the patient's facial and dental esthetics. A Class I skeletal and dental relationship was established, along with a functional anterior guidance. The dental arches were coordinated and the dental midlines coincident with the midsagittal plane. This case report was presented to the American Board of Orthodontics in partial fulfillment of the requirements for the certification process conducted by the Board.

Cephalometry↗
PubMed1991

Esthetics in fixed and removable prosthodontics: the composition of a smile.

The composition of an esthetic smile can be an elusive goal. The purpose of this paper is to present and clarify the principles of perception and the common errors in dental esthetics. A review of the literature is distilled into basic building blocks for composing the esthetic smile. Utilization of the principles presented here will allow the practitioner+ to improve the appearance of fixed and removable restorations.

Denture Design↗
PubMed2004

Comprehensive clinical evaluation as an outcome assessment for a graduate orthodontics program.

To supplement the American Board of Orthodontics (ABO) objective grading system (OGS) for posttreatment dental casts and panoramic radiographs, a comprehensive clinical assessment (CCA) method was developed to assess facial form, dental esthetics, vertical dimension, arch form, periodontium preservation, root resorption, and treatment efficiency. The sum of the CCA and the ABO OGS scores was defined as the clinical outcome. To determine a 3-year baseline for treatment outcomes in a graduate orthodontic program, the posttreatment records of 521 consecutive patients were evaluated. The mean ABO OGS score for the entire sample was 34.4 points: 32.4, 33.1, and 37.8 points for 1998, 1999, and 2000, respectively. The mean CCA score for the entire sample was 4.67 points: 2.96, 5.13, and 6.15 points for 1998, 1999, and 2000, respectively. Corresponding ABO OGS and CCA scores showed a progressive decrease in the quality of finished cases that was associated with a treatment time increase from 28.9 to 39.3 months. Overall, longer active treatment times resulted in a diminished clinical outcome, primarily due to "patient burn-out." Scoring of all finished cases is an effective means for determining clinical outcomes. However, the data suggest that, in initiating a clinical grading program, it is important to establish a multiyear baseline. Patients who are progressing well in treatment tend to be finished by the time the current class graduates, and the problem patients are transferred. Because long treatment times are associated with diminished clinical outcomes, it is often in the best interest of the uncooperative patient to terminate treatment rather than extend active mechanics in an attempt to achieve a better result.

Adolescent↗
PubMed1987

The beauty of the face: an orthodontic perspective.

In esthetic dentistry, the practitioner needs to consider more than just tooth shade and contour. All too often, attention is directed toward reconstructing the dentition for function and esthetic appearance without regard for an existing malocclusion and facial imbalance. When an individual accepts esthetic dental reconstruction, it can be assumed that he or she is attempting to improve a self-image. Dentofacial balance must be considered to truly enhance a patient's potential to achieve the optimal dentofacial esthetic appearance and enhance self-image. Optimal care in the area of esthetics, therefore, requires that esthetic dentistry be considered a multidisciplined service encouraging cooperation among the patient's family dentist, orthodontist, oral and maxillofacial surgeon, prosthodontist, plastic surgeon, periodontist, and possibly others.

Esthetics, Dental↗
PubMed1995

Orthodontic camouflage versus orthognathic surgery in the treatment of mandibular deficiency.

Clearly, there are postpubertal patients with Class II malocclusions for whom orthognathic surgery combined with orthodontics is the "best" option, but epidemiologic information suggests they are a relatively small percentage of the potential patient pool. The majority of patients fall into either an orthodontic treatment group or a borderline category. Many of these can be treated successfully with orthodontic camouflage. Research has shown psychosocial factors play a major role in determining the patient's selection of a treatment option. This emphasizes the need for careful attention to global psychologic factors, with special emphasis on patient concerns regarding body image. Morphometric criteria have been offered describing appropriate candidates for orthodontic camouflage. These are supported by a combination of research and clinical experience. Patients who do not fit these criteria should not automatically be considered candidates for surgery. Psychosocial research suggests a percentage of these individuals place less importance on facial change and are content to improve dental esthetics and function to the degree possible. To assist in the decision-making process, patients should be given the best information available regarding potential outcome. Currently this may involve treatment simulation using a combination of computer images and dental models. Caution has been suggested, given the variability associated with predicting soft tissue change. There are additional legal concerns regarding the implied guarantee of treatment outcome. Correspondingly, the influence of this technology must be kept in perspective. Recent research on the decision-making process found computer imaging to be an important factor in only 24% of the patients studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Decision Making↗
PubMed2003

The use of periodontal plastic surgery procedures in aiding esthetic restorative results.

The creation of an esthetic dental restoration with gingival harmony can provide a reconstructive challenge. The use of periodontal plastic surgical procedures can aid in evening-out the gingival margins and in creating ovate pontics that improve not only the overall esthetic result but also the phonetic result for the patients. Working closely with an esthetic-driven periodontal office using evidence-based procedures can set the stage for a truly esthetic restoration.

Adult↗