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Progress in esthetic surgery.

Esthetic surgery is now widely accepted by the public and produces results that look more natural than in its early years. Rhinoplasties tend to be undetectable, remodeling of the face includes bone work when useful and treats the soft tissues at the right levels, breast reductions leave minimal scarring, abdominoplasty and liposuction are better adapted to individual deformities. However, so many new techniques are presented that it is sometimes difficult to have a clear opinion about their value before they are widely diffused by the media, and it is mandatory to be careful before proposing a new procedure to our patients.

Abdomen↗

Transferring the occlusal and esthetic anatomy of the provisional to the final restoration in full-arch oral rehabilitations.

Provisional restorations are an excellent diagnostic instrument, especially in full-arch oral rehabilitations where no normal occluding contacts remain. Esthetics, phonetics, function, parafunction, and dysfunction after evaluation and acceptance through clinical trial with the provisional restorations should be accurately transferred to the final restorations to ensure the same clinical success. This article presents a sequence of clinical procedures that enables a methodical and controlled transfer of the morphology of the provisional restorations to the final ones in full-arch oral rehabilitations.

Dental Occlusion, Centric↗

Retention of esthetic veneers on primary stainless steel crowns.

The purpose of this study was to ascertain the amount of shearing force necessary to fracture, dislodge or deform the esthetic veneer facings of four commercially available veneered primary incisor stainless steel crowns. The four types tested were: Cheng Crowns, [Peter Cheng Orthodontic Laboratory]; Whiter Biter Crown II, [White Bite Inc.]; Kinder Krowns, [Mayclin Dental Studio, Inc]; and NuSmile Primary Crowns, [Orthodontic Technologies, Inc]. The crowns (#4 right central incisor) from each manufacturer were obtained with the facings attached. The crowns were soaked for ninety days and thermocycled at 4 degrees C and 55 degrees C for 500 45-second cycles. The crowns were cemented to standardized chromium cobalt metal dies. Each die was placed in to a custom holder on the Instron Universal testing machine. A force was applied at the incisal edge of the veneer at 148 degrees, (the primary interincisal angle), with a crosshead speed of 0.05 inches/minute until the veneer either fractured, dislodged or deformed. The mean force (Ibs) required +/- SD to produce failure, in descending order, was as follows: Cheng (107.8 +/- 17.3); NuSmile (100.2 +/- 18.2); KinderKrown (91.3 +/- 27.4)d Whiter Biter (81.5 +/- 21.7). To test the hypothesis of no difference among the four manufacturers, an analysis of variance was performed using PROC GLM. The resultant F statistic was 2.79 (p < 0.0543), indicating a marginally statistically significant difference in the response variable "pressure" among the four groups. A posthoc test was then performed to ascertain where these differences occurred. These results, using Turkey's studentized range test for pairwise comparisons, suggested that the only difference was between the Cheng and Whiter Biter manufacturers.

Analysis of Variance↗

Localized cerebritis following an esthetic rhinoplasty.

We report a case of Wernicke's sensory aphasia, caused by a localized cerebritis of the left temporal lobe. The condition developed in the second week after an esthetic rhinoplasty. There was an associated small abscess in the right inner canthal area.

Adult↗

[Functional and esthetic blepharoplasty].

Functional blepharoplasty is characterized by both esthetic and functional impairment. Proper management requires a meticulous preoperative analysis with special regard to brow position, lid crease and lid fold, levator function, tightness of the canthal ligaments, tarsal plate and orbital septum, because these factors will determine the kind and extent of the operation. In the upper lid the incision depends on the individual situation, while in the lower lid it is routinely done subciliarly. Symmetry should be achieved in each case with regard to several safety guidelines in order to prevent complications.

Adult↗

Conservative concepts for achieving anterior esthetics.

The options in conservative approaches to anterior esthetics include several that are often forgotten in favor of more complicated procedures. This article explores many of those treatments, including recontouring, abrasion and veneers.

Dental Enamel↗

The effect of three finishing systems on four esthetic restorative materials.

Previous studies have investigated the finishing and smoothness of composite and traditional glass-ionomer restorations, but few have included resin-modified glass-ionomer cements or more recent finishing systems. The results of using three different finishing systems (Sof-Lex, Enhance, finishing burs) on two composites (Silux, Prisma TPH), a traditional glass ionomer (Ketac-Fil), and a resin-modified glass ionomer (Fuji II LC) were studied. Sixty samples were condensed into sectioned acrylic tubes, covered with a Mylar matrix plus a glass slide at each surface, then cured as per the manufacturers' instructions. Samples were randomized to three groups of five for each material and testing with a Surfanalyzer 4000 of unfinished samples (cured with Mylar matrix) was done to obtain baseline average surface roughness (Ra). Samples were then finished as per the manufacturers' instructions using polishing disks, abrasive impregnated disks, and finishing burs before further surface testing. Samples finished with burs and with abrasive impregnated disks were further polished using polishing paste (Prisma Gloss) and again tested. Data were analyzed with ANOVA testing and Tukey's HSD pairwise comparison. Initial testing after randomization to groups showed no significant difference in surface roughness (P = 0.24). Two-factor analysis revealed no significant difference between materials (P = 0.34), a significant difference in method of finish (P < or = 0.00), with no significant interaction between type of material and method of finish (P = 0.11). Aluminum oxide disk and impregnated disk systems provided the best finish for microfilled composite and both glass-ionomer materials (P < or = 0.00). No significant difference in method of finish existed with the hybrid composite (P = 0.07). Overall, esthetic restorative material finishing is best accomplished using abrasive impregnated disks or aluminum oxide disks. Finishing burs gave a significantly rougher surface than the former methods.

Aluminum Oxide↗