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PubMed2004

Functional and esthetic rhinoplasty.

Rhinoplasty is performed to improve the appearance of the nose. However, conventional procedures may result in impairment of nasal breathing. The purpose of this article is to describe a "functional and esthetic" rhinoplasty technique designed to avoid adverse effects on ventilation by preserving the structure of the nasal vault. The main indication for this technique is treatment of cyphotic or tension nose. Since this procedure does not correct nasal obstruction due to septo-turbinal abnormalities and narrow nasal fossa, turbinoplasty must be performed concurrently if necessary. Our series of >1000 cases over a 15-year period demonstrates that this conservative rhinoplasty technique prevents most functional complications associated with conventional procedures and often improves ventilation. Immediate and long-term cosmetic outcome is excellent with a natural-looking appearance and fewer tip revisions.

Cicatrix↗
PubMed2007

Combined effect of staining substances on the discoloration of esthetic Class V dental restorative materials.

The purpose of this study was to determine the combined effect of an organic substance (mucin as a substitute for salivary organic substances), chlorhexidine, and an iron compound/tea solution on the changes in the color of esthetic Class V dental restorative materials. Color of a glass ionomer, resin-modified glass ionomer, compomer and flowable resin composite of A2 shade, respectively, was determined according to the CIELAB color scale relative to the standard illuminant D65. Color was measured at baseline, and after sequential immersion in the following substances: Step-1, mucin in PBS (MCP) for 48 h; Step-2, chlorhexidine (CHX) for 24 h; Step-3, iron compound (IRN) or tea solution (TEA) up to 7 days; and Step-4, ultrasonic cleaning for 1 h. Color change (DeltaE(ab )*) was calculated by the equation: DeltaE(ab)* = [(DeltaL*)(2) + (Deltaa*)(2) + (Deltab*)(2)](1/2), of which DeltaL(*) indicates changes in value, Deltaa(*) indicates changes in red-green parameter and Deltab(*) indicates changes in yellow-blue parameter. DeltaE(ab)* values after immersion in MCP and CHX were compared, and DeltaE(ab)* values after immersion in IRN or TEA, and subsequent ultrasonic cleaning were compared with respect to the restorative material and immersion substance. DeltaE(ab)* and changes in the color parameters (DeltaL(*), DeltaC(ab)* and DeltaH(ab)*) were analyzed by repeated measures, analysis of variance and a post-hoc test at the 0.05 level of significance. Color changes after immersion in MCP were acceptable (DeltaE(ab)* < 3.3), and those after immersion in CHX were generally acceptable. The range of DeltaE(ab)* values after immersion in IRN was 3.1-19.6, and that after ultrasonic cleaning was 2.4-9.6. The range of DeltaE(ab)* values after immersion in TEA was 10.7-21.1, and that after ultrasonic cleaning was 11.9-14.5. Color changes of four Class V restorative materials after combined treatment with mucin, chlorhexidine and an iron compound/tea solution were not acceptable. Colors did not recover to their original values after ultrasonic cleaning. Modifications on the surface of a restoration should be considered to reduce stain accumulation.

Acrylic Resins↗
PubMed1983

An endodontic-orthodontic technique for esthetic stabilization of externally resorbed teeth.

Previous studies reveal that external root resorption is often coincident with orthodontic therapy. Some investigators have reported that root resorption ceases when orthodontic therapy is terminated. However, this is not always the case. The purpose of this article is to present an 11-year history of an unusual case in which root-resorptive processes continued for 3 years after orthodontic treatment had been discontinued. The article also describes and discusses a combined endodontic-orthodontic approach to halt external root resorption and stabilize mobile maxillary anterior teeth. Calcium hydroxide therapy was instituted to inhibit inflammatory apical root resorption. A rectangular orthodontic wire was adapted and inserted intracoronally to splint the teeth esthetically. The advantages and disadvantages of this intracoronal splinting technique are compared with other extracoronal splinting methods. Examination of one-year recall radiographs suggested inhibition of the root resorption. Masticatory function was restored for the patient. Considerations for monitoring patients with this problem are discussed.

Adult↗
PubMed1994

Biomechanical and esthetic considerations for maxillary anterior overdenture abutment selection.

Maxillary canine teeth traditionally have been selected as overdenture abutments. Undesirable aspects associated with the use of maxillary canines as overdenture abutments are described. The use of maxillary lateral incisors as overdenture abutments offers vertical support to the prosthesis, favorable stress distribution, improved esthetics, and preservation of the premaxilla.

Biomechanical Phenomena↗
PubMed1994

The effect of esthetic fibers on the flow properties of an acrylic resin denture base material.

OBJECTIVES: This study was conducted to measure the effect of viscose rayon esthetic fibers on the flow properties of an acrylic resin denture base material. METHODS: Two testing methods using a needle penetrometer and an oscillating rheometer were employed on weighed proportions (0.1%, 0.2%, 0.8%, and 0.3%) of fiber. RESULTS: The results show that the fibers affect the flow properties of the polymer/monomer mix. Increasing the percentage of fibers decreases the flow of the material and reduces the doughing time. With increasing amounts of fiber, a rapid increase in the viscosity occurs with a corresponding adverse effect on flow properties. SIGNIFICANCE: It is concluded that these properties are important for the successful handling of acrylic materials since they can influence the accuracy and quality of the molded denture.

Acrylic Resins↗
PubMed1992

Soft-tissue cephalometric norms in Chinese adults with esthetic facial profiles.

Using a double selection process comprised of professional and lay judges, the cephalometric tracings on a final sample of 48 Chinese adults with esthetically pleasing profiles were analyzed. The soft-tissue cephalometric norms and standard deviations of two widely accepted soft-tissue analyses, the Legan and Burstone analysis and the Holdaway analysis, were determined. In comparison with white norms, the Chinese nose was less prominent (P < .01), the nasolabial angle was less obtuse (P < .01), both the upper and lower lips were more protrusive (P < .05), the upper lip curvature was greater (P < .01), and the soft-tissue chin thickness was less (P < .05). This variance between racial types emphasizes the need to recognize that soft-tissue lateral cephalometric norms are specific for the racial group and cannot always be applied across different racial types.

Adolescent↗
PubMed2006

Effect of esthetic core shades on the final color of IPS Empress all-ceramic crowns.

STATEMENT OF PROBLEM: Clinically relevant assessment of all-ceramic crowns supported by esthetic composite resin foundations has not been evaluated with regard to color reproducibility. PURPOSE: This in vitro study quantitatively evaluated the influence of different shades of composite resin foundations and resin cement on the final color of a leucite-reinforced all-ceramic material. MATERIAL AND METHODS: A total of 128 disks were fabricated; 64 (20 x 1 mm) were made of all-ceramic material (IPS Empress) and 64 (20 x 4 mm) of 4 different shades composite resin (Tetric Ceram). The ceramic and composite resin disks were luted using 2 shades (A3 and Transparent) of resin cement (Variolink II). Color was measured using a colorimeter configured with a diffuse illumination/0-degree viewing geometry, and Commission Internationale de l'Eclairage (CIE) L( *)a( *)b( *) values were directly calculated. Descriptive statistical analysis was performed, and color differences (DeltaE) for the average L( *), a( *) and b( *) color parameters were calculated. Repeated measures analysis of variance (ANOVA) was used to compare mean values and SDs between the different color combinations (alpha=.05). RESULTS: The CIE L( *)a( *)b( *) color coordinate values showed no significant differences for variation in color parameters due to the effect of the different composite resin shades (P=.24) or cement shades (P=.12). The mean color difference (DeltaE) value between the groups was 0.8. CONCLUSION: Within the limitations of this study, the use of different shades for composite resin cores and resin cements presented no statistically significant effect on the final color of IPS Empress all-ceramic material.

Acrylic Resins↗
PubMed1984

Direct bonding of orthodontic brackets to esthetic restorative materials using a silane.

Along with adult orthodontics comes a concern for direct-bonding techniques with esthetic anterior restorative materials. Two such materials available today are porcelain and a heat-cured composite resin. The ability to bond orthodontic brackets to these materials was tested with a normal direct-bonding technique. In addition, silane was used to theoretically enhance the bond to porcelain and the glass component of the composite. A normal acid-etch procedure to enamel served as a comparison. Bonding equivalent to the enamel acid-etch procedure was achieved with the heat-cured composite, whether silane was used or not. Silane enhanced the bond to porcelain, but the bond might not be adequate for clinical effectiveness.

Acid Etching, Dental↗
PubMed1998

An esthetic and hygienic approach to the use of intracoronal attachments as interlocks in fixed prosthodontics.

This article describes a procedure that uses the Ney MS (Minimal Space) intracoronal attachment as an interlock in a pontic. This procedure overcomes the disadvantages associated with the use of the intracoronal attachments, which are (1) excessive tooth reduction often required to place the attachment within the contour of the crown; (2) compromised embrasures, which result in oral hygiene and periodontal problems; and (3) poor esthetics.

Denture Design↗
PubMed2000

Esthetic management of an unerupted maxillary central incisor with a closed eruption technique.

In cases of orthodontic traction of unerupted teeth, gingival recession and long clinical crowns are often seen. Satisfactory esthetic demands are not always met. A case of an unerupted maxillary central incisor is presented, in which traction was used, with emphasis on the surgical technique and the direction of the pull. The result was clinically favorable. The appearance of gingival margin was restored.

Child↗
PubMed2006

Optimizing resin cement removal around esthetic crown margins.

OBJECTIVE: To quantify luting cement at the crown-tooth interface of esthetic crowns fabricated using four different techniques and two methods of excess cement removal. MATERIAL AND METHODS: Four methods of crown fabrication were used: the feldspathic porcelain and platinum foil technique, the feldspathic porcelain and refractory die technique, the resin composite crown and CAD/CAM technique, and the feldspathic porcelain crown and CAD/CAM technique. Half of the cemented crowns were allocated to Group A: removal of excess cement by flicking-off with a plastic instrument 3 min after initial polymerization, or Group B: removal of excess cement using a wiping action with cotton pellets. Morphologic measurements, using non-destructive digital profilometry, were made of the volume of excess cement (mm(3)), mean maximum and mean depth of excess cement (microm), and surface area of excess cement (mm(2)). RESULTS: ANOVA and Duncan post-hoc tests revealed no statistical differences (p<0.05) between the four types of crown fabrication with respect to volume and mean depth of retained luting cement. There was a significantly greater volume, mean depth, and mean maximum depth of luting cement retained using the "flick off" method compared to the cotton pellet "wiping" method for excess cement removal, but no statistical differences in mean surface area between the two methods. CONCLUSIONS: Following removal of excess luting cement, as judged clinically, using two methods, subclinical amounts of cement remained adherent to the tooth surface of all specimens at the crown-tooth interface.

Analysis of Variance↗
PubMed2003

Immediate tooth extraction, placement of a Tapered Screw-Vent implant, and provisionalization in the esthetic zone: a case report.

PURPOSE: This clinical report describes an immediate tooth extraction, followed by placement and provisional restoration of a dental implant in the prepared socket of a right maxillary central incisor. MATERIALS AND METHODS: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. A flapless, transmucosal surgical approach was used to prepare the socket and insert a tapered implant. The implant was immediately restored with a provisional abutment and crown without occlusal contacts. An impression was made 22 days after implant insertion, and a definitive, all-ceramic restoration was placed 3 days later. RESULTS: During the period of provisional progressive loading, no significant soft tissue contraction was observed related to noninvasive operating techniques and the immediate insertion of the provisional restoration. The patient exhibited no clinical or radiologic complications through 8 months of clinical monitoring after loading. CONCLUSION: The Tapered Screw-Vent implant and all-ceramic restoration provided the patient with immediate esthetics, function, and comfort without any complications during the postloading follow-up period.

Adult↗
PubMed1992

Esthetic arch bar for maxillomandibular fixation in orthognathic surgery.

Arch bars are well-known dental appliances for the management of fractures and orthognathic surgery. Traditionally both the commercially available, prefabricated arch bars as well as the custom-made arch bars are made of metal so as to provide good rigidity. Each of these types of arch bars has its own advantages as well as drawbacks. This article looks at a type of custom-made arch bar that is easy to construct and use. At the same time, it provides good rigidity, fit, and esthetics.

Acrylic Resins↗
PubMed1999

Esthetic compomer restorations in posterior teeth using a new all-in-one adhesive: case presentation.

UNLABELLED: Compomers have continually gained in importance since their introduction in 1993, especially because of their ease of handling. The main indications are cervical lesions, Class III restorations, and restorations in the primary dentition. To extend the indications of compomers to esthetic Class I and II restorations in the permanent dentition, improvements in wear resistance and bond strength need to be accomplished. Studies have shown an improved bond strength and less marginal gap formation between compomers and enamel and dentin with acid etching of the tooth before application of conventional mild self-etching adhesives. Newly formulated, improved self-etching adhesives with a higher demineralization potential recently have been developed. The objective of this case presentation is to demonstrate step-by-step the clinical procedure for the application of a newly developed self-etching adhesive with high demineralization potential in combination with a compomer material in occlusal cavities. CLINICAL SIGNIFICANCE: Improved self-etching adhesives provide a faster and simplified application technique and allow effective conditioning and priming of enamel and dentin in one step, without waiving sufficient bond strengths. With limited indications, compomers are used in combination with these self-etching primers to restore occlusal cavities in posterior teeth. Evidence-based dentistry requires exact scientific data to evaluate whether this new trend results in benefits for patients. However, until clear evidence from controlled clinical studies supports the use of improved compomer systems in Class I and II cavities in the permanent dentition, dentists should be careful with this indication.

Bicuspid↗
PubMed2003

Fracture resistance of endodontically treated teeth restored with three different prefabricated esthetic posts.

PURPOSE: This study was undertaken to evaluate the role of composition of prefabricated esthetic posts in fracture resistance of endodontically treated teeth in vitro. MATERIALS AND METHODS: Thirty human, single-rooted teeth (maxillary central incisors and canines) with similar root dimensions, extracted for therapeutic reasons, were used in this study. The crowns were removed below the cementoenamel junction to obtain a standard root length of 17 mm. The roots were endodontically treated following the conventional manual technique and randomly assigned to three groups (n = 10) according to the post used: Aestheti-Post, Bisco, Schaumberg, Illinois; FibreKor Post, Jeneric/Pentron, Wallingford, Connecticut; and CosmoPost, Ivoclar Vivadent, Schaan, Liechtenstein. The root canals were rendered patent, and the root preparations were standardized through flaring with the manufacturers' drills included in the respective kits. The posts were cemented with an adhesive system and a resin cement (All-Bond 2 and C&B, Bisco, respectively), according to the manufacturers' directions. Composite resin (Tetric Ceram, Ivoclar Vivadent) crowns were built up using a preformed polyester matrix, and the specimens were mounted in metallic rings with cold-cure acrylic resin and kept in saline solution at 4 degrees C for 24 hours. Fracture resistance was then determined using an EMIC DL-2000 universal testing machine. The crosshead speed was 0.5 mm/min with the 45-degree compressing load at the middle third of the crown. Data were analyzed using one-way analysis of variance and Tukey's test (p < or = .001). RESULTS: Mean fracture resistance was as follows: Aestheti-Post, 83.5 kgf; FibreKor Post, 85.7 kgf; and CosmoPost, 36.5 kgf. The fracture strength of CosmoPost was significantly lower than that of the other posts. Teeth restored with CosmoPost had post fractures, and in three specimens, those were associated with root fractures. Teeth restored with the other two posts presented fractures on the composite crowns.

Analysis of Variance↗
PubMed1990

An esthetic approach to vertical root extrusion in a patient with an anterior open bite: report of case.

A previous attempt to locate the root canal system in the maxillary left central incisor with a bur created a perforating root defect at the level of the alveolar crest. The patient received root canal therapy. Next, vertical root extrusion was chosen to expose sound tooth structure apical to the defect so that a crown could be constructed. With an anterior open bite, the natural crown was left intact and it was possible to position the anchor bar in an incisal and lingual position, maintaining esthetics for the patient during both the extrusive and stabilization phases of treatment.

Adult↗
PubMed2000

Treatment of gingival hyperpigmentation for esthetic purposes by Nd:YAG laser: report of 4 cases.

Gingival hyperpigmentation may cause esthetic problems and embarrassment, especially in patients with a gummy smile. This report presents the use of the Nd:YAG laser for gingival depigmentation. Four cases, 3 females and 1 male, ages between 24 to 28 years old, presented with the same chief complaint of unesthetic gingiva caused by melanin hyperpigmentation. The Nd:YAG laser was set at 6 watts, 60 millijoules per pulse, and 100 pulses per second. The procedures were performed with contact mode in all pigmented areas by using a handpiece with a 320 microm diameter fiber optic. Ablation of the gingival hyperpigmented areas were accomplished without any bleeding complications or significant postoperative pain. Three to 4 weeks after the procedures, the hyperpigmented gingiva appeared healthy, pink, and firm. No recurrence of hyperpigmentation had been found in 11 to 13 months of follow-up. However, in delicate areas such as the marginal gingiva, the Nd:YAG laser should be used cautiously.

Adult↗
PubMed2006

Esthetic management of fused carious teeth: a case report.

UNLABELLED: A rare case of a carious supernumerary tooth fused to the labial surface of a maxillary right central incisor is reported. Root canal therapy on the maxillary right central incisor was performed owing to the pulpal communication between the supernumerary tooth and the maxillary right central incisor after removing the carious supernumerary tooth structure. The defect was then restored with anterior resin composite and the esthetics reestablished. CLINICAL SIGNIFICANCE: Clinical significance lies in identifying a rare case of fusion of supernumerary tooth to a permanent tooth and treating the anomaly in the most conservative way.

Adult↗