The internally braced removable partial denture clasp--a solution to a common esthetic problem.
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The LeFort I osteotomy is commonly performed to correct maxillary dentofacial deformities. Secondary changes in the nasolabial region that have occurred following this procedure include widening of the alar bases of the nose, upturning of the nasal tip, flattening and thinning of the upper lip, and downturning of the commissures of the mouth. Surgical techniques can modify undesirable secondary changes. Applying these surgical techniques and achieving the desired results require an understanding of the underlying anatomy. This paper will present a thorough review of the nasolabial anatomy (both external and internal) as it pertains to the patient undergoing maxillary surgery.
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The author summarizes the general rules of the facial harmony. These measurements and proportions are an aid to the reader to rapidly evaluate a face and detect any anomaly. No sophisticated devices are necessary. The study of profile photographs following the Charles Baud-principles (circular sectors) is detailed as is a simplified cephalometric study.
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In aesthetic odontology with adhesive materials, a close liaison between manufacturers and dentists is a much-needed prerequisite. Now more than in the past, when restorations were done on nobler materials, techniques and procedures involving composite materials must be performed with extreme precision, since such techniques are very sensitive.
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Metal ceramics and ceramic bridges with aluminum-oxide profile components are optical solutions. The use of silanetreated "Keracetten" (mineral facets) avoids the disadvantages of plastic facing and has stood the test during a 5-year period of observation.
Bleaching discolored teeth must be considered a viable treatment modality. Although it does not offer the predictability of many cosmetic options, its simplicity and economics demands attention. Combining bleaching with selected bonding and contouring can return a smile to the not-so affluent, conservative, or apprehensive patient who does not wish to face tooth reduction and full coverage.
The authors discuss the results of 29 cases of tissue expansion, using 40 expanders, at the head and neck level, in an attempt to achieve a constructive self-criticism. The results have been classified into excellent (18 over 28 cases), good (4/29), fair (3/29) and poor (4/29). Complications were those usually reported: pain, infection, wound dehiscence, reservoir failure. In summary, 23 of 29 patients have definitely gained from tissue expansion. The remaining 6 cases considered as failures are carefully discussed leading to some practical conclusions.