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PubMed1998

Effect of esthetic illusions on rhinoplasty assessment.

OBJECTIVE: Esthetic assessment in rhinoplasty represents a balance between art and science. The result of surgical maneuvres in creating esthetic illusions has been alluded to, but has never been scientifically reported. This project analyzed the effect of optical illusions in esthetic assessment. METHOD: Eight rhinoplasty case studies were designed using computer imaging. Two hundred and ten judges analyzed the apparent differences in one parameter, such as tip projection, tip rotation, dorsal hump, and nasal size, when a different parameter was altered. RESULTS: This study confirms the validity of nasal esthetic illusions. These results indicate how surgical maneuvres that vary one parameter can create the illusion of a variation in tip projection or tip rotation. CONCLUSIONS: The surgeon can exploit esthetic illusions to provide greater control over rhinoplasty dynamics.

Chi-Square Distribution↗
PubMed1995

Esthetic refinements in forehead flap nasal reconstruction.

OBJECTIVE: To identify refinements in forehead flap nasal reconstruction that consistently provide better esthetic and functional results. DESIGN: Case series of patients undergoing forehead flap nasal reconstruction from July 1, 1987, to May 31, 1994. SETTING: University hospital ambulatory surgery department. PATIENTS: Thirty-two patients with various nasal defects. INTERVENTIONS: Modifications of currently accepted techniques of paramedian forehead flap nasal reconstruction, namely, flap harvest and contouring, W-plasty closure of the superior forehead donor site, and creation of soft-tissue triangles. The principles of open-structure rhinoplasty are incorporated into cartilaginous reconstruction of the nasal tip and columella. The alar rim is reconstructed with cartilage grafts placed at the nasal rim. MAIN OUTCOME MEASURES: Esthetic and functional results of nasal reconstruction were subjectively graded by three otolaryngologists (V.C.Q., D.A.S., and M.F.R.) and the patients. RESULTS: Improved esthetic and functional nasal reconstruction. The most common nasal subunits reconstructed were as follows: ala, 27 patients (84%); side-wall, 22 patients (69%); dorsum, 18 patients (56%), and tip, 15 patients (47%). The esthetic results ranged from average to excellent (3 to 5 on a scale of 5), the functional results ranged from improved to much improved over preoperative breathing (4 to 5). Two patients required unplanned surgical revisions. Forty-seven percent of patients chose to undergo dermabrasion. Five patients required postoperative intradermal injection of triamcinolone acetonide (Kenalog). Three patients required preoperative tissue expansion. Flap or graft loss, infection, or hematoma did not occur. CONCLUSIONS: The predictability of the techniques in providing excellent results in patients undergoing nasal reconstruction decreases the need for revision procedures and helps the patient and the surgeon achieve the desired outcome.

Aged↗
PubMed2002

Esthetic aspects of orthodontic-surgical treatment of sagittal-vertical anomalies: the example of the short face syndrome.

BACKGROUND: Psycho-esthetic aspects play an important role in motivating patients to undergo combined orthodontic-surgical treatment as well as in the subjective appraisal of treatment outcome. The facial soft tissues are the crucial interlink between the underlying skeletal and dental structures and their perception by the patient and his social environment. TREATMENT OF SHORT FACE SYNDROME: In the therapy of Class II malocclusions with skeletal deep bite and short lower face (short face syndrome), the soft tissues and the psycho-esthetic treatment expectations of the patient are taken systematically and appropriately into account during treatment planning and evaluation. PATIENTS AND METHOD: The respective elements of the treatment concept are outlined and explained in this article. Based on the empirical evaluation of 15 patients treated according to this concept, the soft tissue changes in patients with short face syndrome and the changes in esthetic and psychosocial self-perception are reported. RESULTS: The results demonstrate the efficiency of the treatment concept in improving facial soft tissues, especially in the vertical dimension, and the resulting psycho-esthetic benefit to the patient.

Adult↗
PubMed1977

Factors mediating against excellence in dental esthetics.

Factors mediating against excellence in dental esthetics have been classified and enumerated in this article. A formula for producing unesthetic prostheses can be hypothesized as follows: Educational de-emphasis + Lack of research + Technical orientation + Technical tradition + Delegation (abdication) + Poor economics + Fatique + Poor office design + Convention + Conditioning + Schemata leads to POOR DENTAL ESTHETICS. It is postulated that a formula for excellent dental esthetics can be produced by reversing these factors: Altered schemata + Deconditioning + Altered convention + Adequate office design + Elimination of fatique + Favorable economics + Personal participation + Research + Educational emphasis leads to ESTHETIC EXCELLENCE.

Denture Design↗
PubMed1979

Conservative alternative to full esthetic crowns.

Several alternatives to full esthetic crowns have been presented. Preparation techniques and factors to be used in patient selection have been discussed for using all-metal esthetic retainers. Problems that arise from the indiscriminate use of full-coverage crowns must not be overlooked. Adjunctive esthetic retainers such as pinledges, three-quarter crowns, and inlays can be used to provide a functional, conservative alternative to full crowns while maintaining maximum esthetics.

Crowns↗
PubMed1988

Margin design for esthetic posterior metal ceramic crowns.

Variations in margin designs for ceramic metal restorations have been used to fulfill the many requirements for such restorations. The trend in our population toward greater esthetic awareness places increased emphasis on esthetics. This trend necessitates a high level of esthetics in posterior restorations. Commonly used posterior margin designs have been described and their inherent weaknesses and strengths have been reviewed. An alternative design has been proposed with its advantages in esthetics, tissue compatibility, cleansibility, and versatility. The clinical and laboratory procedures for this design have been described.

Crowns↗
PubMed2005

The effects of buccal corridor spaces and arch form on smile esthetics.

PURPOSE: An attractive, well-balanced smile is a paramount treatment objective of modern orthodontic therapy. The purpose of this study was to determine the effects of buccal corridor spaces (BCS) and arch form on smile esthetics as perceived by laypeople, general dentists, and orthodontists. MATERIAL: Photographs of 20 women treated by 2 orthodontists were collected: 1 group had narrow tapered or tapered arch forms, and the other had normal to broad arch forms. Photographs of 10 untreated women served as a control sample. All photographs showed the subjects smiling. The photographs were digitized and evaluated for BCS. Then, photographs with BCS were altered to eliminate the dark triangular areas, and those without BCS were altered by the addition of dark triangular areas at the lateral aspects of the smile. The altered photographs were randomized into a survey with the 30 original photographs. Three groups of raters (dentists, orthodontists, and laypeople) used a visual analogue scale to rate the photographs. RESULTS: There was no significant difference in smile scores related to BCS for all samples and for all viewers. Dentists rated broader arch forms as more esthetic than untreated arch forms. Orthodontists rated broader arch forms as more esthetic than narrow tapered arch forms and untreated arch forms. Lay people showed no preference of arch form. CONCLUSIONS: This study demonstrates that the presence of BCS does not influence smile esthetics. However, there are differences in how dentists, orthodontists, and laypeople evaluate smiles and in what arch form each group prefers.

Adolescent↗
PubMed2005

A comparative assessment of the perception of Chinese facial profile esthetics.

INTRODUCTION: The aim of this study was to compare the perception of male and female Chinese facial profile esthetics between dental professionals, dental students, and laypersons. MATERIAL: The sample comprised 31 dental professionals (20 orthodontists, 11 oral surgeons), 92 dental students, and 152 laypersons in an Asian community. The facial profile photographs and lateral cephalometric radiographs of a Chinese man and a woman, each with a normal profile, a Class I incisor relationship, and a Class I skeletal pattern, were digitized. The digital images were modified to obtain 7 facial profiles for each sex. The images were constructed by altering cephalometric skeletal and dental hard tissue Chinese normative values by 2 standard deviations in the anteroposterior plane only. The 7 profiles were (1) bimaxillary protrusion, (2) protrusive mandible, (3) retrusive mandible, (4) normal profile (Class I incisor with Class I skeletal pattern), (5) retrusive maxilla, (6) protrusive maxilla, and (7) bimaxillary retrusion. RESULTS: Normal and bimaxillary retrusion Chinese male and female profiles were perceived to be highly attractive by all 3 groups. Profiles with a protrusive mandible were perceived to be the least attractive. Dental professionals, dental students, and laypersons were highly correlated for the perception of male (r > 0.67) and female (r > 0.93) profile esthetics. All correlation coefficients were found to be significant for the perception of female profiles, but, for male profiles, only the correlation coefficient between dental students and laypersons was significant. CONCLUSIONS: Chinese male and female profiles that were normal or had bimaxillary retrusion were perceived to be highly attractive by dental professionals, dental students, and laypersons, and profiles with a protrusive mandible were perceived to be the least attractive. Dental students and laypersons were more tolerant of a male profile with a retrusive mandible than were dental professionals, and all groups were more tolerant of bimaxillary protrusion in women than in men. Dental professionals, dental students, and laypersons had a similar trend in male and female esthetic preferences. The perception of female profiles by all 3 groups was highly and significantly correlated. Only the perception of male esthetics by dental students and laypersons was not significantly correlated with dental professionals.

Adult↗
PubMed1999

Tissue sculpturing: an alternative method for improving esthetics of anterior fixed prosthodontics.

Esthetics associated with health of surrounding tissues in fixed prosthodontics is arduous, especially when treating the maxillary anterior region. An unfavorable relationship between residual ridge, pontic, and gingival papilla commonly compromises the final result. Alternative procedures based on biologic procedures can be developed to improve relationships and provide esthetic and functionally acceptable fixed partial dentures. This article describes a technique for the improvement of esthetics with conditioning of the tissue beneath the pontics, by displacing tissue with a treatment restoration. Lateral displacement of tissue under gradual, controlled pressure enhances the interdental papilla, which improves esthetics. The role of plaque control is also discussed in this article.

Alveolar Process↗
PubMed1995

Selected aspects of the art and science of facial esthetics.

The historical aspects of facial esthetics and its role in orthodontic teachings and practice are traced to their origins in classical art. Related discussions include the failure of "divine proportions," the ascent of the Class II facies, and the influence of 19th century pseudoscience. Today, the treatment of facial form for a diverse society requires a tolerant sense of esthetic pluralism. Moreover, advances in neuroscience and psychology have extended understanding of the biological basis of variation in facial expression and judgment. The nature of oral esthetics was examined through quantitative studies of the smile line. Significant sexual dimorphism was found, ie, the gingival smile line (GSL) appears to be a female lineament and the low smile line seems to be a male lineament. Further results indicated that the GSL is associated with several facial characteristics, including anterior vertical maxillary excess, and the muscular capacity to raise the upper lip significantly higher than average on smiling. Other variables associated with GSL are statistically significant increases in overjet, interlabial gap at rest, and overbite. The gingival smile line is not necessarily objectionable esthetically and it will normally diminish with age. However, the treatment of choice for the GSL patient with an uncoached complaint is orthognathic surgery and orthodontics.

Adolescent↗
PubMed1976

Twin resemblances in creativity and in esthetic and emotional expression.

Three sources of observation relevant to the measurement of individual differences in emotional and esthetic expressiveness were employed to study their heritability by application to a sample of some 60 pairs of young adult like-sexed twins, approximately evenly divided between male and female and MZ and DZ pairs. The sources of observation were objective test performances, trait ascription using a standard list of adjectives, and videotaped enactments of mood and esthetic performances. Perceptual and esthetic abilities do appear to have substantial heritability, although esthetic preferences do not. Heritability is also indicated for such adjectives as artistic, inventive, original, and independent. Ratings of the videotape performances yielded somewhat ambiguous results, due to the presence of a marked halo effect; the most likely interpretation congruent with earlier results is that greater MZ twin resemblances in social extroversion generated greater resemblances in the videotape situation on such other trait-rating variables as creativity, naturalness, and dominance.

Adolescent↗
PubMed2002

The esthetic outcome of autotransplanted premolars replacing maxillary incisors.

Autotransplantation of developing premolars to replace maxillary incisors has been documented to provide physiologically sound results, but comprehensive studies of the esthetic outcome have not been made previously. In order to assess the applicability of this approach and to identify factors important for planning of treatment, 22 autotransplanted premolars reshaped to incisor morphology were compared to their natural, contralateral maxillary incisors by scoring of features considered important for esthetics (color, soft tissue appearance, tooth morphology, and position). The sum of scores for each feature was used to place the reshaped transplant in one of three categories - Match, Deviate, Mismatch. The 22 patients were asked to fill in a questionnaire which addressed the same features that were examined professionally, and the responses were categorized as either Satisfied, Acceptable, or Dissatisfied. Eleven of the 22 patients had received orthodontic treatment with fixed appliances following the transplantation. Most of the transplanted premolars matched the contralateral incisor, and the majority of patients were satisfied with the appearance of the transplant. Fourteen percentage of the transplants were categorized as Mismatch and 18% of patients reported dissatisfaction. The distribution in categories assessed professionally and by the patients was not significantly different. The color and gingival width of the transplanted tooth were scored as different from the natural incisor in about half of the bilateral comparisons. For those teeth categorized professionally as Mismatch and by patients as Dissatisfied, a potential for esthetic improvement could be identified, as allocation to these categories was primarily due to suboptimal positioning and restorative build-up of the transplant. Inter-disciplinary planning is important for successful esthetic results.

Bicuspid↗
PubMed2006

Esthetic influence of negative space in the buccal corridor during smiling.

The purpose of this study was to measure and verify the esthetic influence of the bilateral spaces between maxillary teeth and lip corners, called negative space (NS), during smile. The sample was comprised of 60 smile photographs obtained from 60 individuals (30 men and 30 women) aged 18 to 25 years old. Two orthodontists and two lay people evaluated these pictures regarding esthetics by a visual analogue scale. In each picture, the right and left NS were measured in millimeters and in proportion to the smile width (SW). Data were analyzed for statistical significance (P = .05). The mean NS of the sample was 6.68 +/- 1.99 mm, and the NS proportion in relation to the SW was 9.6 +/- 2.56%, for both sides of the arch. No significant asymmetries were observed between the right and left sides. The NS was significantly larger in men than in women when measured in millimeters (P = .028) (7.08 +/- 2.24 mm in men vs 6.28 +/- 1.62 mm in women), but the NS proportion to the SW was similar (9.94 +/- 2.24% in men vs 9.26 +/- 1.61% in women). When the 12 individuals with the smallest NS in proportion to SW were compared with the 12 individuals with the largest NS in proportion to SW, there was no statistical difference regarding the esthetic evaluation (P = .11). It was concluded that the NS did not influence the esthetic evaluation of smile photographs in the sample in this study, for both orthodontists and lay people.

Adolescent↗
PubMedDate not supplied

Evaluating students' esthetic knowing.

Few references in education are made to evaluating students' performance in the art of nursing (esthetic knowing). To address this rarity, a client-based clinical evaluation modality was developed using clients as the "critics" of students' esthetic knowing. The findings suggest that having clients evaluate students' esthetic knowing is an appropriate evaluation modality and is especially important as empirically based cirricula shift to include esthetics as a central element.

Curriculum↗
PubMed2001

Multifaceted aspects of implant esthetics: the anterior maxilla.

Presurgical planning, implant positioning, soft tissue management, esthetic bone grafting, provisionalization, and prosthetic management are the treatment considerations that affect the treatment outcomes that are associated with dental implants in the anterior maxillary area of the oral cavity. Each should be approached with caution to help avoid postoperative esthetic complications and to maximize the esthetic outcome. This article reviews most of the current techniques that help to maximize the esthetic results and introduces a new classification for soft tissue management according to the time of clinical intervention.

Alveolar Bone Loss↗
PubMed2004

Multidisciplinary approach to the immediate esthetic repair and long-term treatment of an oblique crown-root fracture.

This case report describes the esthetic management of a dental trauma at the first visit and its subsequent treatments to restore the esthetics and function. Today, patients expect adequate esthetics and the ability to confidently smile immediately after the first appointment. In addition, they require that esthetics is maintained throughout the definitive treatment phase as well. After the use of the fractured crown as a temporary replacement crown, an orthodontic extrusion was undertaken to restore the physiological periodontal attachment. The tooth was then splinted for 6 months and at completion of this orthodontic stage, the permanent restoration was fabricated.

Adult↗
PubMedDate not supplied

Periodontal and other soft tissue considerations in esthetic dentistry.

Esthetic considerations are playing a greater role in the treatment planning of dental care, especially in the restoration of anterior teeth. Much attention has been paid to both operative and prosthodontic techniques that are available in esthetic restorative dentistry. Less attention has been given to soft tissue esthetics, the shape of the face and position of the lips, and the contours, color, and overall appearance of the gingiva and associated soft tissues. This article reviews a basic approach to soft tissue esthetics, the appearance of the gingiva, the interrelationship of the gingiva, teeth, and restorations, and outlines several common soft tissue problems and their management.

Alveolar Ridge Augmentation↗
PubMed1997

Esthetic preference of the frontal and profile views of the same smile.

This study has shown that orthodontists and their patients share a common pool of diffuse esthetic values of the same smile. Profile and frontal views of the same smile were not similarly rated for esthetic pleasantness: the profile views were rated higher than the frontal views of the same smile. This finding suggests that orthodontists should consider both frontal and lateral views during evaluation of their patient when planning and assessing orthodontic treatment. More research is needed to determine the generalizability of the finding that orthodontists and patients have similar facial esthetic preferences. Future studies should expand the range of smiles that are evaluated by including both genders, people of different ethnic backgrounds, and people of a variety of ages. Research is also needed to evaluate facial esthetics and smiles in dynamic motion.

Adolescent↗