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PubMed2003

In vitro assessment of retention of four esthetic dowels to resin core foundation and teeth.

STATEMENT OF PROBLEM: Several new esthetic dowel systems are currently available for the restoration of endodontically treated teeth. These dowel systems enhance the esthetic quality of all-ceramic restorations better than metallic dowel systems. PURPOSE: The purpose of this study was to evaluate the retentive strength of composite and ceramic endodontic dowel systems to the tooth and to the core foundation. MATERIAL AND METHODS: The following dowel systems were tested: resin dowels (Fibrekor [FR]; Luscent [LU]; Twin Luscent Anchor [TLU]); ceramic dowels (Cerapost [CR]; Cosmopost [CO]); and a titanium dowel (ParaPost XH [Ti]). In Part I of the study, core retention was tested by forming Bis-Core resin (n=12) cores around dowels followed by separation using a universal testing machine. In Part II, 60 (n=12) extracted human canines were endodontically treated, and dowel spaces were prepared using the corresponding drill for each dowel system. Nine-millimeter resin and ceramic dowels were cemented with C & B resin luting agent. Additionally, 2 groups (n=12) of Ti dowels cemented with C & B resin luting agent and zinc phosphate luting agent served as control groups. Retention was tested using a universal testing machine to separate the dowels from teeth. One-way analysis of variance and Student Newman-Keuls tests were conducted for statistical analysis (alpha=.05). Surface texture of all dowel systems tested was examined using SEM at original magnification x25 and x250. RESULTS: Core retention of Ti was higher than all esthetic dowels tested (alpha<.05), but FR had higher core retention than the other esthetic dowels tested. Resin dowels had better retention to teeth than ceramic dowels (alpha<.05). CONCLUSION: The esthetic dowel systems were less retentive for the resin core material than the titanium control. Resin dowel systems were more retentive in the root than the ceramic dowels but were similar to the titanium control.

Analysis of Variance↗
PubMed1991

Ridge contour related to esthetics and function.

Maxillary anterior fixed prostheses may be compromised when pontics are adapted to deficient residual alveolar ridges. This study determined the effect of ridge contour on esthetics and function. Thirteen men and 17 women, 23 to 75 years of age, who had received maxillary anterior fixed prostheses during the period 1976 to 1986 participated. A six-item structured interview was conducted for each subject to determine causes of satisfaction or dissatisfaction with esthetics and function. Pontic esthetics were also determined by examination using a 12-point esthetic index that was developed and pretested for this study. Residual ridge contour was classified according to Siebert as being deficient buccolingually (I), deficient apicocoronally (II), or deficient in both areas in combination (III). The results showed that patients with class I ridges had a higher subjective level of satisfaction with their prosthesis than did those with class II or III ridges. Esthetic index scores were significantly higher (p less than 0.05) for type I (10) than for type II (7.4) or III (7.3) using a post hoc Scheffé comparison. These results suggest that consideration be given to ridge augmentation prior to construction of maxillary anterior fixed prostheses, particularly when class II or III defects are present.

Adult↗
PubMed1994

Remembrance of things past through writing: esthetic patterns of knowing in nursing.

The writing process offers a valuable medium for informing esthetic knowing in nursing. First, characteristics of esthetic patterns of knowing in nursing are described. Esthetic knowing in world literature is then illustrated through the writings of Proust. Next, composition theories and research are used to identify ways in which writing can shape esthetic knowing. Finally, the author presents implications for the use of writing to foster esthetic patterns of knowing in nursing.

Esthetics↗
PubMed2004

Promoting esthetic procedures in the prosthodontic practice.

The demand for esthetic services is large and growing. Emphasis on enhancing personal appearance is demonstrated in patients' increased demands for elective esthetic procedures. The techniques that have fueled this Esthetic Cultural Revolution fall under the expertise of prosthodontists. Prosthodontists, therefore, are in a position to establish themselves as the most qualified providers of these services. Prosthodontists must leverage their technical and treatment planning strengths with effective marketing strategies to address the esthetic expectations of today's patients. Marketing techniques with specific relevance to prosthodontists and esthetic dentistry are detailed.

Advertising↗
PubMed1999

Esthetic smile analysis of maxillary anterior tooth width: the golden percentage.

UNLABELLED: With increasing application of cosmetic dental treatment comes the need for a greater understanding of esthetic principles. Scientific analysis of beautiful smiles has revealed repeatable, objective principles that can be systematically applied to evaluate and improve dental esthetics in predictable ways. Symmetry across the midline, anterior or central dominance, and regressive proportion are three composition elements required to create utility and esthetics in a smile. The Golden Proportion has been suggested as one possible mathematic analysis tool for assessing dominance and proportion in the frontal view of the arrangement of maxillary teeth. It has proven to be controversial in developing esthetically beautiful smiles and cumbersome for evaluating symmetry. CLINICAL SIGNIFICANCE: This article considers a bilateral analysis of apparent individual tooth width as a percentage of the total apparent width of the anterior segment and proposes the concept of the Golden Percentage as a more useful application in diagnosing and developing symmetry, dominance, and proportion for esthetically pleasing smiles.

Cuspid↗
PubMed2002

Esthetic treatment planning: the grid analysis system.

UNLABELLED: It is sometimes difficult to identify esthetic problems let alone pre-visualize an esthetic end-result. The Esthetic Grid Analysis is a system for analyzing the basic problems that detract from the concept of an attractive smile. A photograph is taken of the anterior teeth with the lips retracted. The upper and lower frame of the photograph is aligned parallel with the interpupillary line, assuming that the interpupillary line is parallel with the horizon. Where this is not the case, the vertical margins of the photograph are aligned parallel with the facial midline. Through orienting the photograph to the facial guidelines and incorporating the idealized positions of the incisal plane, highest lipline, midline axis, and proportionate contact areas, a grid is formed. The grid built from these components provides a method of demonstrating deviations from an esthetic arrangement of anterior teeth. CLINICAL SIGNIFICANCE: Integrating facial guidelines with the dental composition using a grid highlights deviations from the ideal. It thereby assists in the treatment planning process by communicating esthetic problems to the patient, laboratory personnel, and other specialists.

Adult↗
PubMed2004

Evaluation of "golden proportion" in individuals with an esthetic smile.

BACKGROUND: One of the most important tasks in esthetic dentistry is creating harmonious proportions between the widths of maxillary anterior teeth when restoring or replacing these teeth. The "golden proportion" is a main guideline introduced in this field. PURPOSE: This study aimed to investigate the existence of the golden proportion between the widths of the maxillary anterior teeth in individuals with an esthetic smile. MATERIALS AND METHODS: This study was conducted with 157 dental students (75 women and 82 men), with ages ranging from 18 to 30 years. Students whose natural smile did not develop any visual tension with regard to the study's and their own criteria were selected as having esthetic smile. An image measurement program was used to measure the apparent mesiodistal widths of six maxillary anterior teeth on the scanned photographs of these subjects. The existence of the golden proportion was investigated in the width ratios of maxillary anterior teeth. RESULTS: The golden proportion was not found to exist between perceived maxillary anterior teeth widths of individuals with an esthetic smile. CONCLUSION: The golden proportion is not a common factor in esthetic smiles. CLINICAL SIGNIFICANCE: This article suggests considering the dentofacial specificities of each individual and also the wide variety of natural teeth proportions when restoring or replacing the maxillary anterior teeth. However, individual cultural characteristics and perception of beauty must be considered.

Adolescent↗
PubMed2004

Single-tooth implant restorations in the esthetic zone with PureForm ceramic crowns: 3 case reports.

The anterior maxillary jaw is frequently called the "esthetic zone" because of its high visibility and influence on facial appearance. Implant placement and single-tooth restoration in this region can present some esthetic challenges for the clinician. The underlying titanium abutment, for example, can diminish porcelain translucency and result in a darkened prosthesis. Subsequent changes in soft-tissue margins can also result in the visibility of titanium at the gingival crevice. In recent years, all-ceramic restorations have gained popularity in response to increasing patient demands for improved esthetics. This article describes the clinical use of a new, tooth-shaped, ceramic coping system in the restoration of single teeth in the esthetic zones of 3 patients. Four tapered screw implants were placed in the locations of the central incisors (n = 3) and bicuspid (n = 1). Conventional ceramic protocols were used to fabricate all-ceramic crowns that were cemented onto small core abutments attached to the implants. All prostheses restored the biomechanical needs of the patients and achieved excellent esthetic results.

Adult↗
PubMedDate not supplied

The esthetics of the smile: a review of some recent studies.

PURPOSE: This article reviews recent research on the esthetics of the smile, covering the attractiveness of the smile, the effect of aging on the smile, oral condition and the smile, personality and smile, and smile exercises. MATERIAL AND METHODS: The subjects were Koreans with normal occlusion. Photographs of a full smile were taken and the esthetic quality of the subjects' smiles was estimated. Smile scores were correlated with oral condition, personality, the practice of smile exercises, and elements of the smile, such as the position of the lip in a smile. The personality of the subjects was assessed by means of a Sixteen Personality Factor Questionnaire. Gibson's smile exercises were used to investigate the effect of smile exercise. RESULTS: In an attractive smile, the full shape of the maxillary anterior teeth was shown between the upper and lower lip, the upper lip curved upward or was straight, the maxillary anterior incisal curve was parallel to the lower lip, and teeth were displayed to the first molar. The amount of maxillary incisal exposure gradually decreased with age, accompanied by a gradual increase in mandibular incisal exposure. Personality traits such as warmth, calmness, extroversion, and low anxiety were closely related to an attractive smile. Smile exercises were an effective means of improving the esthetic level of the smile if patients exercised continuously. CONCLUSION: An attractive smile is important for esthetic treatment. The lip position, oral condition, personality traits, and smile exercise affect the esthetics of the smile.

Aging↗
PubMedDate not supplied

Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists.

PURPOSE: The objective of this study was to assess and compare patients' and clinicians' judgments of the esthetic outcome of implant-supported single-tooth replacements. MATERIALS AND METHODS: In all, 29 patients with 41 single implant-supported crowns in the maxillary anterior region participated in the study. The esthetic outcome of the implant-supported crowns was assessed by the patients and by 5 prosthodontists by means of a questionnaire in which various esthetics-related variables were addressed and responded to using visual analogue scales. Multiple regression analyses were used to evaluate the influence of the variables on the "overall satisfaction" with the implant-supported crown. RESULTS: Most variables in the patients' assessments revealed mean values above 90% and median values close to 100%. No single factor used in the multiple regression analysis was found to influence a patient's satisfaction with appearance of the crown at a statistically significant level. The clinicians' degree of satisfaction was for all variables lower than that of the patients. In 89% of the cases the clinicians could correctly locate the single implant-supported crown. Among the variables assessed, surrounding soft tissue appearance and form of the crown had the strongest influence on the clinician's overall satisfaction with the appearance of the crown. CONCLUSION: Appreciation of the esthetic outcome of the single implant-supported crowns was rated higher by the patients than by the prosthodontists. Furthermore, factors considered by professionals to be of significance for the esthetic result of the restorative treatment may not be of decisive importance for the patient's satisfaction.

Adolescent↗
PubMed2002

Maxillary anterior esthetic extractions with delayed single-stage implant placement.

As a result of the high predictability of dental implantology, successful osseointegration is no longer the primary challenge. Rather, esthetics has emerged as the primary challenge. Hard and soft tissue ridge augmentation, performed either in preparation for later implant placement or concurrently with implant placement, has been described in the literature for the esthetic zone. These procedures are still evolving. If, however, ridge collapse can be prevented or minimized after tooth extraction, more predictable outcomes with better esthetics can be accomplished, along with fewer surgical procedures. This article describes a technique for esthetic extraction, as well as delayed esthetic single-stage implant placement, in the maxillary anterior sextant.

Aged↗
PubMed2004

Ethics of esthetic dentistry.

Patient demand for esthetics has increased globally, and often for reasons of patient self-esteem. However, important ethical issues encompass treatment for purely esthetic reasons. Also, perceptions of what is esthetic differ among patients and clinicians. Therefore, the aim of this article is to make suggestions regarding some of the issues surrounding the ethical, esthetic treatment of patients, as well as present three cases illustrating the different meanings of esthetic health to different people.

Adult↗
PubMed1991

[Lateral cephalometry in Chinese population with esthetic face].

According to selections of both the public and the orthognathic surgeons, 100 lateral cephalograms were taken on the male and the female young adults with esthetic face and normal occlusion. Each X-Y coordinate value of 18 landmarks, 10 angular and 10 linear measurements, and 5 linear ratios were analysed. The features of the craniofacial structure of the hard tissue profile in the Chinese group with esthetic face were emphasized as follows. 1. The craniofacial structure of the esthetic group presents its typicality, which is accord with the basic principles of esthetics. 2. Great individual variation was found in the lower third of the face. 3. The profile patterns of the lower third face in the esthetic group become well-developed and chubby convexity which looks relatively straight. 4. The differences exist in the craniofacial skeleton structure between male and female.

Adult↗
PubMed1988

Reliability of esthetic ratings of cleft impairment.

The decision to seek secondary treatment for facial clefts is often the result of concerns about the esthetic acceptability of appearance. There are no standard techniques to assess cleft impairment for esthetic acceptability. Therefore, it is not possible to evaluate objectively either the need for or the benefits of treatment. If it could be shown that people agree closely on how they rate the esthetic appearance of cleft impairments that vary in severity, then esthetic measures of cleft impairment could be developed with human judgment as the yardstick. The goals of this study were: (1) to examine the reliability with which children express their preferences for cleft impairments that vary in severity, (2) to determine if other facial characteristics influence the reliability of children's preferences for cleft impairments, and (3) to evaluate if age and gender of children influence preferences for cleft impairments. Based on preratings, eight types of photographic slides were created that varied in severity of cleft impairment and global facial attractiveness. A second sample of subjects then rated the slides on the esthetic acceptability of appearance. Children ranked the photographic types consistently. They least preferred the photographic types depicting severe impairment or low facial attractiveness, or both, and most preferred faces with no impairment or moderate attractiveness, or both. There were also developmental effects in that younger children tended to have less consensus in their ratings of appearance than older children. Finally, boys displayed greater consensus than girls.

Adolescent↗
PubMed1995

Esthetic diagnosis.

To ensure esthetic success, dental practitioners must respond to patient inquiries with a codiagnostic approach, allowing the clear identification of esthetic problems and the visualization of solutions. This structured approach involves a therapeutic mind set whereby a common esthetic language is established, and a communication triangle is formed between the patient, the dentist, and the technicians. The problem is clearly identified through the use of the esthetic evaluation form, diagnostic casts, and computer imaging. The solutions are visualized and treatment methods established through a diagnostic wax-up and computer imaging. This approach works by building a high-energy, high-trust relationship between the doctor and the patient, which serves to increase the probability of successful and consistent treatment and improves the dentist's general understanding of esthetic concepts.

Communication↗
PubMedDate not supplied

Esthetic veneering of amalgam restorations with composite resin--combining the best of both worlds?

Patients are becoming more and more aware of the esthetic alternatives to dental amalgam and are asking dentists to offer solutions that are more esthetically pleasing. However, the difficulties in inserting clinically durable composite resin restorations in the posterior area are numerous. With the high-copper amalgam systems, the dental profession has had an excellent restorative material. In the past there have been attempts to combine amalgam with the esthetic qualities of composite resin. The introduction of an adhesive and opaque light-curing glass-ionomer liner has created new opportunities to bond composite resin to existing amalgam restorations on esthetically disturbing surfaces. This paper describes a simple and quick way in which unesthetic buccal and occlusal extensions of amalgam restorations can be veneered with composite resin. Preliminary six-month results of about 100 restorations are presented. This method may prevent the premature replacement of good functioning amalgam restorations with porcelain-fused-to-metal crowns or composite resin restorations for only esthetic reasons.

Color↗
PubMed1994

Advanced marketing strategies to build the esthetic dental practice.

Esthetic dentistry is truly a major part of the future of the fee-for-service practice. There are still many patients who seek high-quality elective care and these individuals need to be swayed to make an initial appointment with you. Whether you reach them through your present patients or through outreach to the community, the important key is your method of handling each of these patients as they join your practice. Customer service needs to be stronger and more obvious than ever before in order to differentiate your practice from others and to attract more referrals. The days of waiting for patients to arrive have clearly come to an end. Managed care and a decline in the need for traditional services has eroded a significant component of the dental market. When you combine that with the realization that only 50% of the population visits the dentist even once a year (and far less in many countries outside the United States), then it becomes obvious that the total available market for the elective services of esthetic dentistry has declined. Esthetic dentistry programs must be better defined, with an ongoing focus to educate present patients and to attract new patients. As I state in my seminars, I firmly believe that any practice today can still be highly successful. I do not feel that I will be making that statement three to five years from now. The time to begin positioning your practice for future growth of esthetic dentistry is now. As managed-care programs increase, it will become more difficult to turn around a declining practice. Having a quality marketing program already in place will make the difference for your esthetic practice. The new patient phone call is critical. It is there that you will begin to help patients understand fully the overall attitude and policies of your office. Successful management of new patients is to win their trust by giving them ultimate customer service while convincing them to fit your present system and schedule. When a new patient calls the practice, you want to get them scheduled within a reasonable time frame while their motivation is still positive. Remember, you only get one first chance to make a great impression. Each office should decide which questions are appropriate to ask. The front desk coordinator should ask these questions calmly and clearly so that the new patient has an opportunity to answer them without feeling that they are going through the inquisition. At the same time, the more information you have about this patient, the easier it will be to gain treatment acceptance because of your understanding of the new patient's needs. Many offices will ask new patients how they came to choose their particular office. Since many practices gain new patients from existing patients, it is appropriate to know when this has occurred and properly thank the referral patient. By thanking the patient who referred the new patient, you will encourage further referrals.

Appointments and Schedules↗
PubMed1998

A retrospective look at esthetic resin composite and glass-ionomer Class III restorations: a 2-year clinical evaluation.

OBJECTIVE: A restorative material for Class III cavities must, besides being functional, be esthetically satisfactory, providing good working conditions and several shade and color options. A clinical evaluation was initiated to compare the suitability of resin composite and glass-ionomer cement materials for such restorations. METHOD AND MATERIALS: Forty-two Class III conservative cavities, esthetically important because of facial extensions, were selected. Resin composite restorations were placed in 21 cavities, and the remaining 21 were restored with glass-ionomer cement. The following characteristics were studied: color or esthetics, anatomic shape, surface texture, staining, marginal infiltration, dental plaque retention, and occurrence of fracture. After 24 months, the restorations were evaluated. RESULTS: The only statistically significant difference between the resin composite and glass-ionomer cement restorations in the experimental period involved color or esthetics. CONCLUSION: Resin composites and glass-ionomer materials provide excellent functional and esthetic results in Class III cavities when properly indicated.

Color↗