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Anterior esthetic rehabilitation on teeth and dental implants optimized with Procera technology: a case report.

With the latest developments of the Procera system, all-ceramic crowns have become an attractive solution to provide functional and esthetic rehabilitation on teeth and dental implants. The Procera AllCeram crown and Procera Abutment embrace the concept of computer-assisted design and computer-assisted machining (CAD/CAM) and can be used together for optimal esthetic result. The purpose of this case report was to illustrate the advantages of these new components for complex anterior rehabilitation. Three natural teeth and a Procera Abutment were restored using four Procera AllCeram crowns. Treatment planning and esthetic benefits are discussed.

Aluminum Oxide↗

Esthetic soft tissue ridge augmentation using an acellular dermal connective tissue allograft.

UNLABELLED: Residual ridge defects present significant limitations to the esthetic restoration of edentulous tooth sites. Augmentation techniques can aid in the re-establishment of natural ridge contours. This article describes a technique in which an acellular dermal connective tissue allograft is used to augment a buccolingual residual ridge defect. A single vertical incision enables the allograft to be placed laterally into a buccal pouch. Augmentation of this edentulous site permitted a three-unit bridge to be placed with a highly esthetic pontic. CLINICAL SIGNIFICANCE: This article presents a simplified method of esthetic ridge augmentation that reduces patient discomfort.

Aged↗

Achieving optimal esthetics in a patient with severe trauma: using a multidisciplinary approach and an all-ceramic fixed partial denture.

UNLABELLED: The treatment of traumatic injuries can be difficult, especially when the patient's expectations are too high or unreasonable. Such cases require extremely clear communication with the patient before beginning the case, including an explanation of the final results, based on the patient's goals. Taking over a case from another colleague adds more complications and requires that close attention is paid to the reason for the original dissatisfaction between the former dentist and patient to avoid repeating the same mistakes. Clinically, patients with thin, fragile gingiva are extremely challenging if they require a fixed partial denture in the esthetic zone since the most common material, a ceramometal bridge, requires infragingival margins; if any recession occurs, a catastrophic esthetic failure will result. The case presented here underscores all these special issues. Proper multidisciplinary management, good patient communication, and the use of an all-ceramic fixed partial denture system can provide an excellent final result. CLINICAL SIGNIFICANCE: Replacing teeth in the esthetic zone is complicated, especially when trauma has caused severe damage to the surrounding bone and gingiva. Satisfying a demanding patient requires a multidisciplinary approach and psychological management, as are exemplified in this article.

Adult↗

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↗

Modern dentistry and the esthetically aware patient.

With esthetic dentistry, the profession derives excitement and satisfaction from providing service patients want, not just need. The new materials and techniques rest on a firm foundation of sound restorative and diagnostic principles. Patients who seek esthetic dentistry today are informed consumers who have specific objectives. Esthetic care, more than any other treatment, has psychological aspects, the consideration of which is crucial to treatment success.

Attitude to Health↗

The state of the art in esthetic restorative dentistry.

Esthetic restorative procedures are routine in most dental practices. The procedures considered to be standard and acceptable by practitioners are bleaching teeth outside the dental office; bonding; intracoronal direct resin restorations; tooth-colored inlays and onlays; porcelain veneers; all-ceramic crowns; and PFM crowns. Unfortunately, some third-party payment organizations do not pay adequately for numerous esthetic restorative procedures, and continued education of these groups about the reliability of esthetic restorative procedures is necessary.

Crowns↗

The challenge of esthetic dentistry and elective services.

Many dentists would like to increase the number of esthetic and elective procedures they perform. What may be holding them back is the ability to communicate with, educate and motivate patients in the area of esthetic and elective dentistry. While implants, esthetic dentistry or elective dentistry is not for every patient, each of these areas has improved the quality of many people's lives, allowing the dental profession to continue to serve the public in the broadest possible way.

Communication↗

Esthetic evaluation of immediate breast reconstruction after nipple-sparing or skin-sparing mastectomy.

BACKGROUND: It has been reported that immediate autologous tissue breast reconstruction after nipple-sparing mastectomy (NSM) or skin-sparing mastectomy (SSM) is esthetically superior to autologous tissue reconstruction after conventional mastectomy (CM). We evaluated reconstructed breasts to determine whether these methods contribute to breast appearance other than skin texture. METHODS: Between April 1992 and September 2001, forty-two patients underwent immediate breast reconstruction using autologous tissue. Mastectomy options were NSM, SSM and CM. Postoperative photographs were evaluated using a subscale (volume, contour, placement, and inframammary fold) on a 0-2 point scale. Sternal notch to nipple distances of the affected and normal sides were measured with photographs to estimate nipple-areola complex (NAC) position. No corrective procedure was performed in a later phase before evaluation. RESULTS: NSM was performed in 22, SSM in 6 and CM in 14 cases. On esthetic evaluation, the NSM and SSM groups received 4.96 and the CM group received 4.63. There were no significant differences. In the NSM and SSM group, the NAC position rose in cases with partial necrosis or fat lysis compared with the no complication group (p = 0,004). CONCLUSIONS: Autologous tissue breast reconstruction after NSM or SSM is esthetically equal to autologous tissue reconstruction after CM with regard to parameters other than skin texture. Preserved or simultaneously reconstructed NAC sometimes emphasizes nipple-areola asymmetry when breast deformity has occurred.

Adult↗

Cosmetic or esthetic dentistry?

This article, through presentation of case studies, defines differences and suggests separate definitions for the terms cosmetic dentistry and esthetic dentistry. Dentistry strives to emulate harmonious form and function for therapy, and modification of appearance is an integral part of dental treatment. Cosmetic dentistry suggests a certain accommodation and is a compromise of current technology. Cosmetic dentistry is commonly selected as an interim procedure that does not necessarily function ideally and does not always emulate the pristine state of a natural dentition. Esthetic dentistry requires less accommodation, incorporates acceptable biologic technology for long-term survival, functions suitably, and mimics the pristine state of the natural dentition. Cosmetic and esthetic dentistry are different in definition, concept, and execution.

Esthetics, Dental↗

Esthetic principles in prosthetic dentistry.

Dento-facial esthetics represents today the fourth clinical dimension in our activity. Together with morphological, functional and biomechanical factors, aesthetics contribute to a successful clinical result in prosthodontics. Dento-facial esthetics takes over the visual perception principles adapting them to dental requirements. Continuously assimilating esthetics information, being a good observer and training visual perception is important for the final complete result in prosthetic dentistry.

Adult↗

Location of incisal edge position for esthetic restorative dentistry.

Restorative dentistry means just that--changing the position and morphology of teeth (when indicated) to restore the patient to a functional and esthetic occlusion. The first step considers the mandibular incisal edge position. Following that choice, the maxillary anterior teeth are evaluated for position against the lips and with the rest of the dentition, particularly the mandibular incisors and canines. When the three major determinants of incisal edge position (occlusion, phonetics, and esthetics) are used to place the anterior teeth where they will function best, all cases have the potential for a more enduring esthetic success.

Cuspid↗

Amelogenesis imperfecta: functional and esthetic restoration of a severely compromised dentition.

The treatment of patients with severe forms of amelogenesis imperfecta presents an interesting challenge to the dental team. A 16-year-old girl presented with a severely compromised occlusion and poor esthetics that had lowered her self-esteem. Preoperative investigations included the determination of completion of growth, an accurate diagnostic waxup, and an evaluation of clinical crown lengths. Periodontal full-flap surgery was planned to lengthen clinical crowns and create gingival harmony. This was to be followed by placement of 28 complete crowns to restore occlusal function and gain a pleasing esthetic result. All-porcelain crowns were placed from premolar to premolar in each arch (20 crowns), and porcelain-fused-to-metal crowns were placed on each molar tooth in each arch (8 crowns). The final treatment result provided this patient with a mutually protective occlusion and with esthetics that greatly enhanced her self-image.

Adolescent↗

Soft tissue management in oral implantology: a review of surgical techniques for shaping an esthetic and functional peri-implant soft tissue structure.

Along with osseointegration and restoration of function, the patient's subjective satisfaction with the esthetic result is a touchstone of the success of implant therapy. Although esthetic restoration of natural teeth can be achieved routinely through appropriate tooth preparation and a natural-looking design on the part of the dental laboratory, the road to success is much more complicated with implants, because of atrophy of bone and mucosa. Surgical techniques, paths of incision, and useful instruments for implant therapy are described, from implant placement to exposure. These methods help to provide durable, functional, and esthetic results.

Alveolar Process↗

[Traditional esthetic concepts of Akan women in Ivory Coast].

Akan is a linguistic group living in the Middle-East and South-East parts of Ivory Coast. This group has its particular esthetic concept: esthetic should produce first, a general harmony. The most beautiful young girl is a very important personality in the society. She should wear the most beautiful jewels and clothes of the family to represent the village everywhere. Akan esthetic concept concerns both physical features and moral characteristics.

Clothing↗

Esthetic blepharoplasty.

Esthetic blepharoplasty is the operation designed to correct excess skin and/or pseudoherniation of fat in the eyelids. These eyelid changes give the pateint a tired look and make him or her look (prematurely) old. The indications and contraindications for the procedure are reviewed. The possibilites and the limitations of the operation must be thoroughly discussed with the patient preoperatively. A psychological evaluation of the patient must be carried out by the surgeon in order to discard unsuitable candidates for the operation. The esthetic blepharoplasty is performed under local anesthesia, completed by intravenous sedation. The operative technique is outlined and consists of judicious skin excisions and resection of fat from the differenct orbital compartments. Atraumatic technique is of utmost importance. Complications are rare in experienced hands but are almost unavoidable in inexperienced hands. Ectropion of the lower eyelid is the most common complication. The cause, prevention and treatment of possible complications are discussed. If carried out properly in a well selected patient by a competent plastic surgeon, the esthetic blepharoplasty gives very satisfying results.

Anesthesia, Local↗

Enhanced resilience and esthetics in a Class IV restoration.

The purpose of this article is to give the reader a better understanding of the complex restorative challenge in achieving true harmonization of the primary parameters in esthetics (i.e., color, shape, and texture) represented by the replacement of a single anterior tooth. The case presented demonstrates the restoration of a Class IV fracture taking esthetic consideration of the anatomic variations of the adjacent teeth to produce a direct composite resin in harmony with the surrounding dentition. The basic procedure includes tooth preparation, development of the body layer, internal characterization with tints, development of the artificial enamel layers, shaping and contouring, and polishing. In understanding the total morphology of a tooth and using natural teeth as the basis for morphological thinking, the clinician possesses the knowledge to create restorations with a more natural appearance. Use of a recently developed optimized-particle composite and this morphological thinking allowed the author to achieve a restoration in harmony with the surrounding dentition. Continuing technological breakthroughs allow the clinician to implement and maximize new products to attain more predictable and esthetic results as demonstrated by this methodological protocol of incremental application of composite resins and modifiers to transform the Class IV fracture into a final restoration that mimics nature.

Adult↗

Achieving ultimate anterior esthetics with a new microhybrid composite.

Direct bonding is one of the most commonly used forms of restoration for the conservative esthetic improvement of anterior teeth. The major challenges involve selecting composites that have adequate strength as well as provide lifelike optical properties that render the restoration functionally sound and esthetically pleasing. Properties such as high sculptability, wide shade range, varying opacities and translucency, as well as high polishability are essential for gaining absolute control over the restorative process and the attainment of natural-looking results. This article discusses a new composite restorative system and its application in the direct esthetic and functional rehabilitation of the anterior dentition.

Adult↗