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Factors mediating against excellence in dental esthetics.

Factors mediating against excellence in dental esthetics have been classified and enumerated in this article. A formula for producing unesthetic prostheses can be hypothesized as follows: Educational de-emphasis + Lack of research + Technical orientation + Technical tradition + Delegation (abdication) + Poor economics + Fatique + Poor office design + Convention + Conditioning + Schemata leads to POOR DENTAL ESTHETICS. It is postulated that a formula for excellent dental esthetics can be produced by reversing these factors: Altered schemata + Deconditioning + Altered convention + Adequate office design + Elimination of fatique + Favorable economics + Personal participation + Research + Educational emphasis leads to ESTHETIC EXCELLENCE.

Denture Design

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

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

Tweed triangle and soft-tissue consideration of Japanese with normal occlusion and good facial profile.

A total of thirty-six Japanese adult subjects (consisting of eighteen men and eighteen women) with normal occlusion and harmonious facial features were subjected to cephalographic examination for the purpose of studying their soft tissues. Out of this group, twenty were selected and compared with twenty Class II, Division 1 and twenty Class III patients for the purpose of establishing an appropriate diagnostic guide for the Tweed triangle. These are our conclusions: 1. The Z angle of the Japanese subjects with normal occlusion was 69.70 degrees for the men and 71.75 degrees for the women. There is no significant difference between the sexes. 2. Although there are no significant differences between the sexes for the integumental and total chins, there is slight sexual difference for the upper lip measurement. 3. As compared to the subjects with normal occlusion, there is a significant difference for the Z angle of Class II, Division 1 and Class III patients. 4. In this study, the measurements of the Tweed triangle were FMA 27.28 degrees, IMPA 95.50 degrees, and FMIA 57.22 degrees. On the basis of this study and the reports of other Japanese investigators, we would like to suggest an FMIA of 57 degrees as being the most suitable basis for the diagnosis of Japanese patients, but this should be modified according to the FMA value.

Adult

Bioblock therapy.

An orthopedic treatment philosophy has been presented. Attention is drawn to the fact that the facial bones of both experimental animals and human beings respond extensively to physiologic and pathologic forces, and it is suggested that these could be mimicked to advantage. A system of appliances designed to achieve this is described. Some case reports which appear to show induced skeletal change are presented, but it will be some time before the real contribution of bioblock therapy can be assessed scientifically. Meanwhile, we should perhaps look more closely at our patients' faces and consider treating them at an earlier age.

Adolescent

The surgical-orthodontic correction of maxillary deficiency.

To date surgeons have primarily emphasized advancement of the retrusive or retodisplaced maxilla. There has been no emphasis on combined surgical-orthodontic treatment sequencing in this deformity. Moreover, the maxilla may be deficient not only anteroposteriorly but also vertically and/or transversely. Frequently, when the maxilla is deficient, two or three of these spatial components of the deformities coexist to various degrees. Thus, the term maxillary deficiency is used here to describe the general nature of the skeletal deformity.

Adolescent

The anatomy of a smile.

The anatomy of the smile is an integral part of dentistry. Its understanding involves close scrutiny of all elements of the oral region. It is not enough to establish the size of teeth based on the high and low lip lines, size of the mouth, and a shade to blend with the age and complexion. To create a harmonious smile the dentist must maintain or create the normal curvature of the lips, proper exposure of the red zone of the lips, an undistorted philtrum, and undisturbed nasolabial grooves. These entities, maintained in harmony with the exposed teeth, constitute the anatomy of a smile. In order that patients may be served properly, the smile must be understood, recorded, and analyzed so that desirable aspects may be preserved and graceless components returned to attractiveness.

Age Factors

[Gold plating].

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Crowns