New developments in dental bonding and esthetic dentistry.
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Acid Etching, Dental↗
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Results for “ESTHETICS, DENTAL”
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Dental implants in the esthetic zone. Considerations for form and function.
Successful esthetic results of dental implant placement in the esthetic zone require knowledge of various concepts and techniques. Careful preoperative treatment planning, augmentation of hard and soft tissues, and attention to the details of implant surgical and prosthetic techniques are areas that must be addressed when treating the anterior maxilla. This article will address the fundamental considerations related to implant treatment in the anterior maxillary esthetic zone, using both theory and case examples.
Bone Transplantation↗
15 esthetic solutions to dental problems.
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Adult↗
Congenital erythropoietic porphyria--oral manifestations and dental treatment in childhood: a case report.
Congenital erythropoietic porphyria is a rare condition resulting from an inborn error in prophyrin metabolism. This deficiency leads to hemolytic anemia, photosensitivity, blistering of the skin, and deposition of red-brown pigments in the bones and teeth. The literature regarding the dental aspects of this disorder is briefly reviewed and the preventive, restorative, and esthetic dental management of a 4-year-old child with congenital erythropoietic porphyria is described.
Child, Preschool↗
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↗
Optimal dental and facial esthetics in orthodontics--a multifaceted challenge.
The role of the orthodontist in resolving the patient's dental and facial esthetic concerns is a challenge due to the number of factors to be evaluated. The effect of growth and aging, and the existing dental, gingival, dentoalveolar, skeletal, and facial soft tissue components mandate a thorough investigation into all treatment options and modalities available to reach optimal esthetic goals. The orthodontist is further challenged with professional bias and patient bias and desires. Mounted study models, facial and intraoral photographs, cephalometric evaluation of dentoskeletal relationships, VTOs and STOs for trial treatment, computerized imaging, and clinical soft tissue evaluation are essential in proper diagnosis, treatment planning, execution of treatment, and assessment of post treatment results. With proper planning, the challenge of reaching dental and facial esthetic goals can be met without compromising the functional occlusal goals, periodontal health, TMJ health, and long term stability.
Aging↗
[Esthetic problems in dental prosthesis].
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Denture Design↗
Teaching nightguard bleaching and other tooth-whitening procedures in North American dental schools.
Tooth-whitening using carbamide peroxide delivered in a custom-fitted tray (nightguard bleaching) is a relatively new procedure, yet it is currently one of the most commonly used types of esthetic dental treatment in private practice. This study determined the extent that nightguard bleaching (NGB) has been included in dental school curricula. All sixty-five dental schools in North America were surveyed about curriculum content and treatment protocol for the use of nightguard and other bleaching procedures, generating an 82 percent response. The survey covered eighteen subject areas related to NGB ranging from clinical requirements and indications to products and recall intervals used. The most commonly taught tooth-whitening procedure was NGB, which was most often taught by operative and restorative faculty. Although no schools had clinical requirements for NGB, 92 percent taught it. The most common indications for NGB were esthetic shade change and pre-restorative lightening of teeth. Unrestored caries, defective restorations, and pre-existing sensitivity were common contraindications. Most schools do not use a specific NGB consent form, but most use written patient instructions. Most schools use at least two different NGB products, bleach for two to four weeks, and use reservoired and scalloped trays. An average of 25 percent of NGB patients were estimated to develop sensitivity, for which treatment recommendations include fluoride, desensitizing toothpaste, and reduced exposure time. Curriculum time and safety concerns were reasons for not teaching NGB (8 percent schools). Most schools indicated that the relative importance of NGB in the curriculum was increasing.
Canada↗
Immediate placement and implant loading for expedited patient care: a patient report.
This patient report concerns etiologic factors leading to a failed natural dentition, masticatory function, and poor dental esthetics in a 30-year-old woman. The surgical and restorative treatment provided for the patient was designed to address her dental phobia, location of residence, and debilitated oral condition. While the following case report details an example of the clinical success that can be achieved through advances in dental implant treatment, the most satisfying event was not necessarily the procedure itself, but the profound change that the generosity of the osseointegration community has made on the life of a needy individual. Through the active leadership of the Osseointegration Foundation Charitable Grant Program, the patient, whose complex treatment is described here, was able to take advantage of treatment that otherwise would not have been available to her. This complex treatment was enabled by the Osseointegration Foundation and other caring donors.
Adult↗
Reinforcement of bonded crown fractured incisors with porcelain veneers.
A method is described by which porcelain laminate veneers are used to reinforce crown-fractured incisors which have been restored by reattachment of enamel-dentin fragments using enamel etching and a dentin bonding system. In an experimental model using sheep incisors, it was found that fracture strength equal to that of intact incisors could be achieved by employing this method. This is in contrast to fracture strengths of reattached enamel-dentin tooth fragments without porcelain laminates which were only 50% of intact incisors. It is suggested that porcelain laminate veneers may be used to supplement fragment bonding, thereby enhancing dental esthetics and function.
Acid Etching, Dental↗
A pilot study of esthetic perceptions of dental fluorosis vs. selected other dental conditions.
The prevalence of fluorosis has increased over the past fifty years, and with this increase, esthetic concerns pertaining to fluorosis should also be taken into consideration. Canadian, Australian, and British studies have explored perceptions concerning enamel fluorosis, but no studies in this area have been published from the United States. In the previous studies, esthetic concerns resulting from fluorosis generally were not compared with the esthetic perceptions of other conditions such as isolated opacities, tetracycline staining, or various types of malocclusion. In the present investigation, respondents answered written questions about paired photographs, one of fluorotic teeth and the other with one of the other conditions. Results show that not only is fluorosis noticeable, but it may be more of an esthetic concern than the other conditions.
Adolescent↗
[Esthetic problems in dental prosthesis].
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Adult↗
Postorthodontic dental changes: a longitudinal study.
The conventional adolescent orthodontic patient is treated during a phase of active growth, but growth of the skeletodental complex continues after treatment and into adulthood at a much slower pace. Selection of orthodontic diagnostic and treatment regimens that produce stable and esthetic dental relationships is a continual endeavor for the orthodontic specialist. Patients should be recalled for long periods of time and the results evaluated. The present longitudinal study was completed on 36 individuals, all of whom had received comprehensive orthodontic treatment. Dental changes were assessed from cephalograms for the in-treatment period (ca. 12 to 15 years of age), posttreatment to first recall (0 = 22 years of age), and first to second recall period (0 = 30 years of age). There was considerable change in the absolute locations of the teeth, but, in reality, these changes are almost wholly attributable to growth of the bony reference structures, not dental changes per se. Growth proceeded at a very slow pace after the first recall (ca. 22 to 30 years of age ). Dental relationships, eg., FMIA, IMPA, 6L angulation, exhibited no systematic change after treatment.
Adolescent↗
Clinical application and effective assessment of cerinate porcelain laminate veneers.
OBJECTIVE: To study the esthetic and long-term effectiveness of cerinate porcelain laminate veneers. METHODS: A total of 736 front teeth were restored with cerinate porcelain laminate veneers, which were then tested at different time points by clinical tracking observation and appraisal. RESULTS: The short and long term rates of effectiveness were 96.6% and 96.2%, respectively. There was no relationship between clinical effectiveness and the length of restoration time. The failure rate was higher in 18 - 30 years old patients and those with discolored teeth. The major clinical performance was fold fissure and deciduous of porcelain laminate veneers. CONCLUSIONS: Cerinate porcelain laminate veneers are an ideal choice for dental esthetic restorations because they are unnoticeable, stable, strong and require no excessive dental preparation.
Adolescent↗
Changes in scattering and absorption properties of esthetic filling materials after aging.
OBJECTIVES: Assuming that color changes after aging are related to changes in translucency of materials, the purpose of the present study was to determine the correlation between the changes in color and the changes in scattering and absorption properties after accelerated aging with representative dental esthetic restorative materials: glass ionomer, resin-modified glass ionomer, compomer, and resin composite. METHODS: Color was measured according to the CIELAB color scale in the transmittance and reflectance modes and used to calculate changes in color (deltaE*(ab)), color coordinates (deltaL*, delta a*, and delta b*), translucency parameter (deltaTP), scattering coefficient (deltaS), absorption coefficient (deltaK), and light reflectivity (deltaRI) after accelerated aging. Simple correlations between each pair of the changes in optical values were calculated, and multiple regression analysis was used to determine the parameters influencing the changes in color and color coordinates (p = 0.05). RESULTS: In the resin composite and compomer, deltaS, deltaK, and deltaRI values were approximately zero, whereas deltaS was as high as 8.9 in the glass ionomer. For most comparisons, correlation coefficient (r) was between 0.700 and 0.997. DeltaL* was found to have a major influence on color changes, and deltaS, deltaTP, and deltaRI influenced deltaL*. Therefore, changes in scattering and absorption properties, after aging, were closely correlated with changes in color and color coordinates, especially in glass ionomer-based filling materials.
Acrylic Resins↗
Dental characteristics in Williams syndrome: a clinical and radiographic evaluation.
Williams syndrome is a rare congenital syndrome with distinctive craniofacial features, cardiovascular abnormalities, and behavior characteristics including mental retardation. The dental abnormalities have received scant attention in previous literature. The aim of this study was to describe dental characteristics in individuals with Williams syndrome. In a group of 41 individuals more than 10 years of age, 40.5% had agenesis of one or more permanent teeth and 11.9% had agenesis of 6 permanent teeth or more. The mesio-distal and labio-lingual dimensions of permanent tooth crowns were measured on 31 dental study casts from individuals older than 12 years. The mesio-distal and labio-lingual dimensions were significantly smaller compared with a reference sample. An analysis of tooth morphology was performed on the same dental study casts revealing altered tooth morphology. A high proportion of maxillary and mandibular incisors was tapered or screwdriver shaped. An evaluation of taurodontism on mandibular permanent molars was performed using a metric crown-body/root ratio. However, most of the molars rated as being taurodontic had short or extremely short total tooth lengths and could thus be rated taurodontic without meeting the classical definition. The results of this study indicate that although there is variation in dental development in individuals with Williams syndrome, agenesis of permanent teeth in combination with aberrations in tooth size and morphology may affect dental esthetics and complicate orthodontic and prosthodontic treatment.
Adolescent↗
A new metal-free alternative for single- and multiunit restorations.
More than 40 years after their development, porcelain-fused-to-metal (PFM) restorations remain the clinical standard against which other esthetic dental materials are measured. One of the challenges of PFM restorations, as with many indirect restorations, is the task of making them appear lifelike when viewed adjacent to natural teeth. All-ceramic restorations have become a welcome addition to the restorative armamentarium because their lack of a metal substructure allows them to blend well with surrounding natural dentition. While all-ceramic materials were initially used to veneer teeth and improve esthetics, they began to be used for full-coverage crowns and, more recently, to replace missing teeth as well.
Computer-Aided Design↗
Management of rampant caries in children.
Because research has resulted in a better understanding of the etiology of dental caries as well as the introduction of new techniques and materials in the practice of dentistry, approaches toward the management of rampant caries should be reevaluated. The development of the acid-etching technique and the improvements in the physical properties and clinical performance of composite resins and glass-ionomer cements have completely changed the concepts of prevention, conservative dentistry, and dental esthetics. Several methods for the treatment of rampant caries are described and management of two cases is documented.
Acute Disease↗