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At least 1,531 records · Page 85Linked to original sources
PubMed1999

Photographic imaging for esthetic restorative dentistry.

Patient dental records are the most critical component of every dental practice. Whether these records are maintained in traditional cardboard folders or as digital bytes of information, the completeness of their contents is important to successful patient care. Two trends are expanding the contents of the dental record to include photographs. One of these trends is the widespread interest in esthetic restorative dentistry and the other is the increasing level of expectations by the public. More than ever, patients are seeking dental treatment to alter the appearance of their teeth. Unfortunately, esthetic restorative dentistry often is not part of a formal dental education. In addition, esthetics is a subjective topic, and patient demands and expectations can easily exceed a dentist's skill and expertise. This can ultimately lead to an "unhappy patient syndrome" and cause conflict between the patient and the dental team. Sometimes this conflict can result in litigation, which is another reason that photographs are a valuable addition to the patient record. The information that is contained in a good-quality set of "before" and "after" photographs cannot be duplicated with other components of the dental record. Taking the time to assemble adequate baseline records is always critical before any patient care is initiated. In restorative dentistry, this includes the standard of care elements: a health history, soft-tissue examination, periodontal examination, teeth and restoration examination, study casts, and an adequate radiographic survey. The use of photography in dentistry has historically been limited to the field of orthodontics. It is the standard of care for orthodontic baseline records, but has not been mandated for restorative dentistry. Memories are rarely accurate about subtle details of one's appearance and people can easily forget what their original smiles looked like even though treatment time may only be a matter of days. Baseline photographs provide an irrefutable record of pretreatment conditions in correct context. More importantly, you do not have to be a dentist to interpret the general information that is displayed on a photograph. To gain additional perspective on this issue, we consulted a panel of three dentists who are well recognized for their expertise in dental esthetics and imaging.

Dental Equipment↗
PubMed1999

Surgical crown-lengthening procedure to enhance esthetics.

This article presents the rationale for the use of a preprosthetic surgical crown-lengthening procedure, particularly in the anterior region where esthetics is of great concern. Clinical cases illustrate the procedure and demonstrate how it can be used to provide enough sound tooth structure to restore teeth without impingement on the biologic width, at the same time reducing a "gingival smile" and creating new papillae.

Adult↗
PubMedDate not supplied

Implant-supported removable overdentures in the edentulous maxilla: clinical and technical aspects.

PURPOSE: The aim of this article is to describe the indication criteria and the treatment planning for a maxillary implant-supported removable overdenture. Prostheses are designed according to the requirements of the bar system and the factors influencing the extension of the prosthesis base. MATERIALS AND METHODS: The decisive factors in determining whether a bar-retained overdenture prosthesis is indicated should be evaluated during the initial clinical examination and with the help of a reformatted computed tomographic (CT) scan that is performed with a radiologic template in place. Titanium markers represent the ideal location of the denture teeth in the diagnostic setup so that the implant position can be selected and the available space for the bar system can be assessed vertically and horizontally. RESULTS: For the overdenture prosthesis that is solely implant supported 6 to 8 implants are placed ideally at a distance of about 10 to 14 mm from center to center. A prefabricated bar system that allows the clips to be inserted between the implants can then be used. When the available bone restricts implant placement to adjacent tooth positions an individually milled bar that includes additional frictional pins and/or retentive elements needs to be planned. The prosthesis design, in particular its buccal and palatal flange extension, is determined during setup try-in, taking into account the patient's smile line, their need for facial support, and their phonetic requirements. CONCLUSION: The removable implant-supported overdenture offers flexibility in placing implants in either adjacent tooth positions or with greater distances between them depending on the available bone, as either conventional bar and clip systems or individually milled bars can be used. Adjustment of the buccal prosthesis flange and the palatal prosthesis base is made to fulfill the patient's requirements concerning esthetics, phonetics, comfort, and function.

Dental Implantation, Endosseous↗
PubMed1999

Pain assessment and management.

Little research is currently available related to pain management by neuroscience nurses. However, due to concerns about the potential for altering neurological status, some neurosurgery patients may not receive optimal pain management. This paper describes findings from a pain related survey which was distributed during the Canadian Association of Neuroscience Nurses June 1998 national conference. The survey was intended to assess Canadian neuroscience nurses pain management knowledge and to explore pain management techniques after intracranial surgery. While 60% of respondents answered four pain assessment and management case study related questions correctly, some respondents rated pain differently when it was expressed by a smiling or grimacing patient. The most common methods for pain control after intracranial surgery included intermittent codeine and/or morphine, often by intramuscular injection. Findings from this study suggest that some neuroscience nurses require further education about pain management and that many patients do not receive optimal pain management after intracranial surgery.

Adult↗
PubMed1998

Conservative tooth-colored restorations for the 21st century.

Within the past 5 years, the development of tooth-colored restorative materials has allowed dentists to restore teeth to proper form and function, while achieving great aesthetics (Figures 8 through 11). Adhesive resins enable dentists to strengthen teeth, while providing the patient with strong, long-lasting restorations. Dentists should become comfortable with placing these types of restorations and offer them as alternatives to patients who are looking for brighter, healthier smiles.

Adult↗
PubMed1998

Aesthetics in implantology.

A young man presented himself with a missing maxillary central incisor and a depressed defect due to a trauma. The trauma caused the loss of No. 8 and its surrounding supportive structure. The defective results were seen by the labial bone loss in the area and a depression. The depression became a food-and-plaque trap and an unaesthetic eyesore. Before the tooth loss, iatrogenic factors from a root canal or retrograde amalgam caused a permanent gingival tattoo. The bonded temporary pontic was larger mesio-distally than the adjacent teeth, and this was very noticeable. It was dull in its finish and poor aesthetically. The patient requested an implant to avoid excess drilling of natural teeth. A combined effort was used to achieve the pleasing final result. To correct the area and improve the physiology and aesthetics, several techniques had to be understood. These techniques also need to be mastered, recalled, and used almost instinctively, and done in a proper team-like sequence. In this case we performed an aesthetic ridge augmentation and tissue surgical manipulation to acquire the form, shape, and correct color background. Deciding upon which implant and material involved choosing the size, type, and shape for the area involved. The techniques used included implant insertion, surgical second stage abutment, mucosal periosteal flap design, various suturing and gingival grafting techniques, ridge buildup augmentation, and GTR. Other choices included which resorbable membrane to use, what bone graft materials, and what oral hygiene to recommend to maintain final health. The restorative technique included full crown coverage, laminate veneers, provisional pontic design and bonding, control of porcelain materials, computer imaging, occlusion, cementing, smile designs, and implant prosthodontics.

Adult↗
PubMed1999

Head and neck cancer and reconstruction revisited.

People are known by their faces and voices. Wide resection of intraoral tumors leaves faces that are unrecognizable and socially unacceptable, speech that may be unintelligible, dietary needs not met in any restaurant, and isolation from a society that puts a priority on smiles and meaningful communication.

Head and Neck Neoplasms↗
PubMed2000

[The modiolus. Comparative anatomy, embryological and physiological review, surgical importance].

Monkeys, imitators of man's gesture never shared smile with him and their facial expressions only result in grimaces. Study of animal anatomy may explain why subtle expressions of the lips are a more man's special gift than laughter. These fine movements are related to a subcutaneous muscular structure termed modiolus, which is the meeting point of muscles involved in the motion of mouth and comparative anatomy shows this structure to be better defined in Man than in other primates. Embryologically, muscles that form the modiolus derive from a cellular concentration in the region of the second branchial arch. It is then logical to see these muscles converge to the corner of the mouth to form the modiolus, as they emerge from a common area. Functioning of the modiolus is complex, as its position may change many times in a minute to allow the orbicularis oris muscle to take any position and do any movement as if it was inserted on bone. With its complex physiology, the modiolus is of critical importance in the subtle expressions of the lips and must be preserved or reconstructed when performing repair of full-thickness tissue defects of lips.

Animals↗
PubMed1999

Developing confidence and competence in cosmetic dentistry.

When it comes to cosmetic or esthetic dentistry the old adage "beauty is in the eye of the beholder" should be a guiding principal when developing an outline of treatment for our patients. Frequently our patients come to us with requests for improving their smiles but uncertain as to exactly what they want or even worse that have expectations that we are unable to deliver. The path traveled from initial interviewing of the patient to completing each case can be fraught with pitfalls of disappointment unless a careful process of educating the patient and constant communication is followed.

Clinical Competence↗
PubMed1999

Evaluation of a curriculum for dental health in 3rd grade school children in Mumbai, India.

Utilising the Bright Smiles, Bright Future curriculum as modified for India, a trial on its effectiveness was carried out at the Raja Shivaji School in Mumbai, India. Students from the third standard English medium were selected. The teacher training programme utilised a professional educator from the U.S.A. plus other international representatives including India. Prior to the beginning of any classroom instruction, all experimental and control students were scored for plaque. A pretest was also given to both the experimental and control students to measure their knowledge of dental health. At the end of the two month test period all measurements were repeated. The curriculum was evaluated by the teachers. Parents were also interviewed. Results showed significant (P < .0001) difference between the two groups in reducing plaque, which demonstrated the improvement in oral hygiene in the experimental group.

Child↗
PubMed2000

Comparison of two-dimensional and three-dimensional techniques for determination of facial motion--absolute movement in a local face frame.

BACKGROUND AND PURPOSE: Few studies have used motion analysis in the study of facial animation. A facial animation model using an expert vision motion analysis system was developed in this study to quantitatively evaluate absolute movement during five facial animations. METHODS: Skin markers were adhered to the face of each subject at 16 anatomic landmarks selected to represent the functional movement of the facial muscles. Three of the 16 skin markers were used to establish a local face frame with the origin in the mid-point of the face. All of the coordinates measured in the laboratory frame were rotated and translated to the local face frame for analysis. The trajectory of the facial markers was evaluated from the local face frame when comparing two-dimensional (2-D) displacement of skin markers (frontal plane) with three-dimensional (3-D) values by paired Student's t-test. RESULTS: Although the correlation of 2-D and 3-D displacements of skin markers was high (r > 0.69), the differences between 2-D and 3-D motion were significant (p < 0.001). The 2-D displacement of skin markers underestimated the 3-D facial animation in each marker and animation. There were no significant differences in the movement of both mouth angles or of the eyes. Thirty repeated measurements of a subject revealed good concentration in 3-D displacement, velocity, and angle of movement in smiling. The measurement error was less than 0.06 mm. The normative displacement of individual anatomic landmarks was evaluated to avoid size differences of individual faces. CONCLUSIONS: We suggest that the expert vision motion analysis technique is feasible for quantitative evaluation of absolute facial movement and would be useful for further clinical evaluation of patients with facial palsy.

Adult↗
PubMed2000

[Two siblings with adult-type metachromatic leukodystrophy: correlation between clinical symptoms and neuroimaging].

We reported two siblings with adult-type metachromatic leukodystrophy (MLD). Patient 1 was a 19-year-old male, and patient 2 was a 20-year-old female. Their initial symptoms were similar. They developed abnormal behavior and personality changes, poor concentration, and inappropriate smiling. In patient 1, his condition deteriorated and he developed incontinence. His attention span and verbal expression severely decreased. He had an inability to engage in meaningful conversation. The siblings were diagnosed as having MLD by marked reduced leukocyte arylsulfatase A activity. T2-weighted MRI of these two cases showed a high intensity area in the cerebral white matter. The high intensity areas of the cerebral white matter gradually spread over one year. However, SPECT of these cases showed only a few abnormal findings in the initial stage. Using SPECT, a reduction of regional cerebral blood flow (rCBF) spreading to the cerebral cortex was seen over one year after it was seen using MRI. The discrepancy between MRI and SPECT findings in the initial stage was characteristic. MLD is an important disease that involves white matter dementia. The discrepancy between MRI and SPECT is helpful to diagnose white matter dementia.

Adult↗
PubMed1999

Bimaxillary orthognathic surgery in a patient with long face: a case report.

The primary characteristics of long face patients are gummy smile and/or anterior open bite. Consequently, correction of esthetic and functional problems are especially important for long face patients. Since orthodontic therapy alone is not sufficient to solve the problem, orthognathic surgical approach is indicated for these patients. In this report, orthognathic surgical therapy of a severe long face patient with similar findings was presented. Following clinical and cephalometric examination and preoperative orthodontic therapy, a Le Fort I osteotomy, a bilateral sagittal split osteotomy, and vertical and horizontal reduction genioplasties were performed. Alternative surgical therapies, complications, and the effects on the upper respiratory tract are also discussed.

Adult↗
PubMed1999

The nasal frame osteotomy: technical note.

In the practice of orthognathic surgery, a patient presenting with a gummy smile and lip incompetence is readily diagnosed as having vertical maxillary excess, and a maxillary impaction osteotomy is usually the proposed treatment. If a short nose, an arched and upwardly displaced upper lip, and a broad face accompany these 2 features, nasal lengthening and caudal repositioning of the central portion of the upper lip by a nasal frame osteotomy should be considered instead. The technique of the nasal "frame" osteotomy, which was used in 1 patient with a 4-year follow-up, is described.

Adolescent↗
PubMed2000

The role of lasers in cosmetic dentistry.

Dental lasers contribute significantly to the field of cosmetic dentistry, providing an invaluable resource for clinicians who perform different types of esthetic procedures. Practitioners in this specialized field not only help patients acquire beautiful and ideal smiles and dental health, but also they assist patients in benefiting from tremendous clinical advantages, such as sterile surgical sites and increased comfort levels. Tooth whitening will always be an important component of cosmetic dentistry. Developing the most efficient and safe method of tooth whitening is the goal of power bleaching. Currently the argon laser has proved to be the most valuable energy source for power bleaching. Clinicians need to learn more about constantly updated technology and apply newly discovered methods and protocols to clinical situations to benefit patients and clinicians.

Adolescent↗
PubMedDate not supplied

Use of Markush structure analysis techniques for descriptor generation and clustering of large combinatorial libraries.

This article outlines a system in which a Markush structure representation is used for analysis of a combinatorial library, giving savings in terms of storage and processing requirements when compared with an enumerated library. The Markush representation used is described, along with the way in which it can be built from a reaction- and precursor-based description of a library. The process used to generate SMILES, and structure fingerprint and calculated property descriptors for each specific molecule in the library is discussed. Comparative performance figures are given for the Markush approach and various standard fingerprint generation programs based on the enumerated members of the library; the former shows time savings of a couple of orders of magnitude. The use of these rapidly generated fingerprints for clustering of large combinatorial libraries is described.

Cluster Analysis↗
PubMedDate not supplied

Esthetic and functional reconstruction of the geriatric patient.

Esthetics is not only for the young. People at every age want to look their best and have a confident and beautiful smile. Generally speaking, restored senior citizens become very appreciative of the care they receive, refer others like themselves, and, most importantly, have a renewed self-worth and can continue to interact socially for many years.

Aged↗
PubMedDate not supplied

The orthodontic shift towards functional jaw orthopedics.

FJO treatment is exceptionally unique and differs dramatically from traditional orthodontics. Parents are demanding earlier treatment, less bicuspid extractions, and broader smiles. A national trend towards FJO treatment methods will continue because FJO treatment has been shown to be medically effective for a number of common human disorders. Progressive dentists who provide cutting edge FJO therapy are uniquely positioned to impact human development and general health starting at birth, in ways yet to be charted. Early FJO treatment fulfills the ADA Code of Ethics which "calls upon dentists to follow high ethical standards which have the benefit of the patient as their primary goal: Do No Harm and Do Good."

Humans↗