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PubMed2006

An overview of treatment considerations for esthetic restorations: a review of the literature.

Controversy persists regarding the treatment planning criteria for esthetic restorations. This article reviews the literature regarding the biocompatibility, marginal adaptation, color matching, patient selection, technique sensitivity, and mode and rate of failure of tooth-colored restorations. A Medline search was completed for the period from 1986 to 2006, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks. The key words used were amalgam, posterior composite resin, ceramic inlays/onlays, CEREC, porcelain laminate veneers, all-ceramic crowns, and all-ceramic fixed partial dentures.

Acrylic Resins↗
PubMed2006

Esthetic considerations for ethnic skin.

The initial assessment of ethnic skin needs to be culturally sensitive. A clear discussion about expectations, number of treatment sessions required for a likely result, limitations of a particular cosmetic modality, or product as well as a discussion of the potential side effects must be carefully explained during a consultation. As the skin of color market continues to grow, the long-term cosmetic concerns of the individuals that comprise this market should be comprehensively evaluated. Esthetic considerations for ethnic skin presently include cosmeceuticals, laser treatments, injections with Botox, chemical peels, Restylane, Sculptra, fitness, hair loss, and sun protection.

Cosmetic Techniques↗
PubMed1984

Some esthetic factors in a smile.

A survey of the characteristics of an open smile was conducted with 454 full-face photographs of randomly selected dental and dental hygiene students. Findings show that an average smile exhibits approximately the full length of the maxillary anterior teeth, has the incisal curve of the teeth parallel to the inner curvature of the lower lip, has the incisal curve of the maxillary anterior teeth touching slightly or missing slightly the lower lip, and displays the six upper anterior teeth and premolars. Consideration of the characteristics may be useful in improving the esthetics of restorations.

Adult↗
PubMed1997

A review of esthetic alternatives for the restoration of anterior teeth.

PURPOSE: This article describes different options for the esthetic treatment of anterior teeth, starting with minimally invasive procedures, such as facial surface bleaching and bonding with composites. METHODS: The importance of metal ceramic restorations, porcelain shoulder techniques, and metal free ceramics are also emphasized. The options are carefully demonstrated to identify advantages and limitations of each technique.

Composite Resins↗
PubMed1998

An esthetically attractive twin-flex clasp for removable partial dentures.

The cosmetic appearance of a removable partial denture is of great importance to both the patient and the dentist. Traditional facial clasp arms are usually unsightly. Other options are expensive and/or technically difficult, and may require time-consuming maintenance. Furthermore, when these clasps are broken, replacement of the entire removable partial denture may be required. This article describes a procedure for making a simple but effective twin-flex clasp. The clasp has excellent esthetics and can be readily adjusted or replaced.

Dental Clasps↗
PubMed1999

Shear bond strength of techniques for bonding esthetic veneers to metal.

STATEMENT OF PROBLEM: New composites with improved qualities have been introduced to the dental profession as alternatives to porcelain. There is concern about the strength and reliability of new metal-resin bonding systems when these composites are used as esthetic veneers over metal frameworks. PURPOSE: This in vitro study compared the shear bond strength of 2 metal-resin bonding techniques with the bond strength of conventional porcelain fused-to-metal (PFM). Effects of water storage and thermocycling were also evaluated. MATERIAL AND METHODS: Ninety disks, cast in a medium gold, high noble PFM alloy, were divided equally into 6 groups, and received 3 treatments for veneering: conventional feldspathic porcelain on 1 group, and a composite (Artglass) bonded to the metal, using 2 metal-resin bonding techniques. Specimens were tested in shear, half of them after a 24-hour dry storage at room temperature and the rest after 10-day storage in normal saline solution at 37 degrees C and thermocycling. Fractured specimens were evaluated under x10 magnification to determine the nature of failure. Statistical analysis was performed with 2-factor analysis of variance (ANOVA). RESULTS: Mean shear bond strength values before and after wet storage and thermocycling were 29.66 and 22.91 MPa for the PFM group; 21.43 and 17.92 MPa for the Siloc group; and 19.34 and 15.64 for the etched group, respectively. The PFM group exhibited significantly higher bond strength values compared with the other 2 groups (P<.001). All groups showed a significant decrease in bond strength values after wet storage and thermocycling (P<.001). CONCLUSION: Wet storage and thermocycling caused a significant decrease in shear bond strength of all specimens. Shear bond strength of conventional feldspathic PFM was significantly higher than that of the 2 metal-resin bonding techniques tested. The 2 latter techniques did not reveal any statistically significant differences.

Analysis of Variance↗
PubMed2004

An interdisciplinary approach for restoring function and esthetics in a patient with amelogenesis imperfecta and malocclusion: a clinical report.

This clinical report describes an interdisciplinary approach for the coordinated treatment of a patient diagnosed with amelogenesis imperfecta and malocclusion. The patient's functional and esthetic expectations were successfully met with interdisciplinary treatments, including orthodontics, porcelain laminate veneers, metal-ceramic fixed partial dentures, and direct composite restorations.

Adult↗
PubMed2004

[Functional and esthetic cephalometric analysis of the profile].

We report a new cephalometric method for profile analysis, which uses strictly exobasicranial landmarks: 13 anatomic points, 9 bone points and 4 skin points. The analysis is based on phylogenetic, ontogenetic, anatomic and biomechanical data. The face is comprised between a new exobasicranial plane represented by the Nasion-Glenion (Na-Gl) and the classical mandibular plane. These two planes form the angle of facial divergence. Orthogonal projection of the axis of the maxillary incisors and the axis of facial growth on the new basicranial plane is then performed. The upper and lower levels of the facial mass are divided sagittally by four vertical anatomic planes perpendicular to the Francfort plane, accounting for the facial skin profile (cutaneous facial plane), the anterior and posterior facial pillars (premaxillary and postmaxillary planes), and the craniospinal postural plane. The ideal occlusion plane is undistinguishable from the curve of Spee. This new cephalometric method for functional and esthetic profile analysis enables simple rapid and efficient study of the main facial and cervical structures.

Adult↗
PubMed1994

Occlusal plane alteration in orthognathic surgery--Part I: Effects on function and esthetics.

The angular relationship of the occlusal plane and Frankfort horizontal (occlusal plane angle, normal value 8 degrees +/- 4 degrees) is very important, in both diagnosis and treatment planning, but is usually ignored. Surgical alteration of the occlusal plane may influence presurgical orthodontic mechanics and surgical technique and design, but may offer significant benefits relative to the patient's functional and esthetic results. Candidates for surgical alteration of the occlusal plane angulation include the low occlusal plane (LOP) facial type and the high occlusal plane (HOP) facial type. Correction of the LOP facial type by downward and backward (clockwise) rotation of the maxillomandibular complex has been a well accepted technique. Upward and forward (counter-clockwise) rotations of the maxillomandibular complex for correction of the HOP facial type has not been supported as an acceptable treatment modality. However, we have demonstrated that upward and forward rotations are stable with proper treatment planning, appropriate presurgical orthodontics, proper execution of the surgery, and in the presence of healthy and stable temporomandibular joints. This article will discuss the clinical characteristics of the LOP and HOP facial types, the specific anatomic changes with alteration of the occlusal plane, the presurgical orthodontic goals, and the surgical techniques for downward and backward and upward and forward repositioning of the maxillomandibular complex. Cases are presented to demonstrate the application of this treatment approach.

Adolescent↗
PubMed1999

Effects of water immersion on mechanical properties of new esthetic orthodontic wire.

New fiber-reinforced plastic orthodontic wire (FRP wire) was fabricated with polymethyl methacrylate (PMMA) for the matrix and biocompatible CaO-P(2)O(5)-SiO(2)-Al(2)O(3) (CPSA) glass fibers for fibers that have not only high esthetics but also mechanical properties similar to those of metal wires. The purpose of this study was to evaluate the effects of water immersion on the mechanical properties of this new wire. The fiber-reinforced plastic orthodontic wire specimens were 0.5 mm in diameter with 29.1% to 60. 4% volume fraction of fibers that were 20 microm in diameter. A three-point flexural test was performed to obtain the elastic modulus and flexural load at the deflection of 1 mm under dry and wet conditions. Stress relaxation of the wires was tested under dry and wet conditions, and the wire diameters were measured before and at 20 days after immersion. The results showed that there were changes in the elastic modulus up until 10 days and in flexural load up until 20 days after immersion. The values of these two at 30 days after immersion were 93% and 87%, respectively, of those before immersion. Stress relaxation occurred rapidly from the start of immersion until about 60 minutes under dry conditions and about 120 minutes under wet conditions and then approached saturation. The swelling of hydrated fiber-reinforced plastic orthodontic wires affected the wire diameter, although this effect was not significant. The results of this study therefore suggest that the mechanical properties of fiber-reinforced plastic orthodontic wires are reduced by water immersion in the initial stage.

Dental Materials↗
PubMed1976

The maxillary cuspid and missing lateral incisors: esthetics and occlusion.

When maxillary cuspids are moved mesially or if they are absent, it may be safe to assume: 1. There is no apparent change in facial contour. 2. The first premolar can serve as an adequate substitute for the cuspid, both functionally and esthetically. 3. If all spaces are closed, occlusal equilibration will usually be necessary to effect acceptable posterior occlusion. Mesiodistal contouring of the cuspids probably accentuates the problem since it seems to exaggerate any tooth size discrepancy which may exist between maxillary and mandibular teeth. 4. Unilateral space closure displays functional deficiencies more frequently on the side of closure. 5. Varying degrees of shade imbalance between the cuspid and central incisor can be expected, and the degree of contrast can be accurately predicted by using the mandibular cuspid as a guide. This is particularly important when the maxillary canines are impacted or unerupted.

Adolescent↗
PubMed1980

Posttreatment stability and esthetics of orthognathic surgery.

Several procedures were identified as important adjuncts to successful orthognathic results. Among these were the use of laminagraphic X-rays to monitor condyle displacement, condyle resorption and fibrous union problems. Other aspects involve gnathological errors in splint and positioner design, misdiagnosis because of a lack of soft-tissue analysis, differential treatment planning in deciding if surgery is needed, and understanding surgical effects on proportionality of the nose and lip esthetics.

Bone Resorption↗
PubMed2000

Perception of facial esthetics by native Chinese participants by using manipulated digital imagery techniques.

This investigation utilized a manipulated digital video imaging model to elicit profile facial esthetics preferences in a lay population of native Chinese participants from Beijing. A series of 4 distinct digitized distortions were constructed from an initial lateral cephalogram. These images represented skeletal or dental changes that differed by 2 standard deviations from the normative values for Chinese adults. Video morphing then created soft-tissue profiles. A series of nonparametric tests validated the digitized distortion model. The native Chinese participants in this sample found that the profile distortions most acceptable were the "flatter", or bimaxillary retrusive distortion, in the male stimulus face and the "anterior divergent", or maxillary deficiency, in the female stimulus face.

Adult↗
PubMed2003

The effect of axial midline angulation on dental esthetics.

The purpose of this study was to analyze the effect of various degrees of axial midline angulation on the attractiveness of a smile. We explored the influence of age, race, sex, direction of midline deviation, education, occupation, and dominant hand on each evaluator's perception of dental esthetics. Photographs of smiling subjects--one man and one woman--were altered to produce both left and right axial midline angulations in 5 degree increments. Fifty orthodontists and 50 laypeople evaluated these altered photographs by assigning both a numerical attractiveness rating and an acceptable or unacceptable rating to each. The results showed that attractiveness scores and acceptability ratings declined consistently as axial midline angulation increased. Statistical analysis showed that both sex of the subject and occupation of the judge were significant variables (P < .05) in the evaluation of the subjects. Age, race, sex of the judge, education level, direction of midline deviation, and dominant hand were not statistically significant. The mean acceptable midline angulation for the male subject was 6.6 +/- 4.5 degrees for orthodontists and 10.7 +/- 6.2 degrees for laypeople. For the female subject, the mean acceptable threshold was 6.4 +/- 4.0 degrees for orthodontists and 10.0 +/- 6.1 degrees for laypeople (P < .001). Discrepancies of 10 degrees were unacceptable by 68% of orthodontists and 41% of laypeople.

Adult↗
PubMed2005

An interdisciplinary approach for improved functional and esthetic results in a periodontally compromised adult patient.

In contemporary dental care, an increasing number of adult patients are seeking orthodontic treatment. In such adult patients, a combined orthodontic and other specialized therapy often offers the best option for achieving a predictable outcome to solve complex clinical problems. This case report demonstrates a combined therapy with orthodontic, periodontic, and implant-prosthodontic treatments in a 56-year six-month-old female patient with mild diastemata in the maxillary anterior region and a missing left maxillary second premolar caused by a periodontal disease with medium bone loss. The patient had improved her oral hygiene condition through periodontal treatment before orthodontic treatment. The patient was orthodontically treated with a maxillary lingual arch and a maxillary edgewise orthodontic appliance. Active orthodontic treatment was completed in 18 months, and an implant-supported prosthesis was placed with a single crown in the region of the left maxillary second premolar. The treatment outcomes, including the periodontal condition and the dental implant treatment, were stable at two years after the active orthodontic treatment. We demonstrate that combined orthodontic-periodontic-implant-prosthodontic treatment can achieve an improved masticatory function, esthetics, occlusion, and periodontal condition.

Alveolar Bone Loss↗
PubMed2001

The importance of incisor positioning in the esthetic smile: the smile arc.

The smile arc is defined as the relationship of the curvature of the incisal edges of the maxillary incisors and canines to the curvature of the lower lip in the posed smile. The ideal smile arc has the maxillary incisal edge curvature parallel to the curvature of the lower lip. Evaluation of anterior smile esthetics must include both static and dynamic evaluations of profile, frontal, and 45 degrees views to optimize both dental and facial appearance in orthodontic planning and treatment. This article presents the concept of the smile arc and how it relates to orthodontics-from the recognition of its importance, to its impact on orthodontic treatment planning, to how procedures and mechanics are adapted to optimize the appearance of the smile. Three cases are used to illustrate how treatment is directed, emphasizing how facial and smile goal setting go hand in hand.

Adult↗
PubMed2001

Implant repositioning for esthetic reasons: a clinical report.

This article describes the correction of an unesthetic implant position that resulted from unexpected postpubertal growth. Surgical implant repositioning, a technique similar to single-tooth osteotomies, was used. The implant and surrounding bone were mobilized, and a green stick fracture was made on the buccal plate. With pivoting on the buccal plate, the implant was moved to a more palatal position and restored. Although some degree of asymmetry could still be detected, a satisfactory esthetic result was achieved.

Adolescent↗