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@#After tooth extraction, labial contour collapses due to inevitable physiologic bone remodeling. To achieve optimal outcomes for pink esthetic treatment at anterior implant sites, bone or soft tissue augmentation has been advocated to maintain or reconstruct the labial tissue contour. When choosing soft tissue augmentation for esthetic restoration, it is necessary to strictly grasp the indications for surgery. Soft tissue augmentation to maintain or reconstruct the labial tissue contour could be considered in patients with healthy soft tissue and no bone defects or only mild horizontal bone defects. In immediate, early and late implant placement, the timing of soft tissue augmentation may vary. In immediate implantation, the labial bone plate is intact, so it is highly recommended to simultaneously manage soft tissue during implant placement. However, patients may have large bone defects with early or late implant placement. The risk of augmenting bone and soft tissue simultaneously is likely too high, and bone augmentation surgery is often performed at the first stage while soft tissue augmentation surgery is performed at the second stage. Therefore, soft tissue surgery is often carried out simultaneously with abutment connection. Currently, soft tissue augmentation is achieved mostly with adjacent autologous soft tissue grafts, such as free gingival grafts, subepithelial connective tissue grafts or pedicle palatal flaps, which are often accompanied by a second surgical area. The replacement of autogenous soft tissue grafting with new biological materials will become an inevitable trend. In this article, we analyze and summarize the indications, timing and different methods of soft tissue augmentation to maintain and reconstruct the labial contour.
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@#It has been traditionally believed that a 1:1 cortical bone remodeling/tooth movement ratio has been preserved during orthodontic treatment for tooth movement, with the alveolar bone on the tension side growing and the alveolar bone on the pressure side resorbing to maintain the balance of the alveolar bone. However, recent studies have shown that alveolar bone loss has been found in patients who have undergone orthodontic treatment, suggesting that the alveolar bone does not change as the teeth change over time. Whether the morphology of the alveolar bone will change when the anterior teeth are moved has been the clinical focus. The changes of anterior alveolar bone in patients who have undergone tooth extraction after orthodontic treatment were summerized by literature review in this paper. The results of the review showed that the alveolar bone at the lingual/palatal root-cervical site of the anterior root is more prone to bone loss after extensive movement of the anterior teeth. With the development of imaging technology, CBCT is now more commonly used for analysis instead of two-dimensional images for measurement, as its results are more accurate. However, there are few multifactorial studies in which CBCT has been used to assess the morphological changes in the alveolar bone. The focus of future research is to compare the long-term changes in the anterior alveolar bone of patients of different ages based on three-dimensional imaging, and to study the correlation between different skeletal features, tooth movement patterns and alveolar bone remodeling.
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@#Introduction: Labial bone with adequate height and width is crucial for an implant to be successfully placed and ensure the stability of treatment outcome in the long term. The objective of this study was to employ cone-beam computed tomography (CBCT) assessment in evaluating the differences in labial alveolar bone morphology among the Kuantan population in Malaysia. Methods: A total of 60 images taken from Kulliyyah of Dentistry, International Islamic University Malaysia, between 2009 and 2019 were analysed. The root diameter, labial and palatal plate thickness, the labial bony curvature angle beneath the root apex, and the distance from the deepest point of labial bony curvature to the root apex were all measured on each of the maxillary anterior teeth. Results: At 3 mm below the cementoenamel junction, the mean (± standard deviation; SD) thickness of the labial plate for maxillary anterior teeth was 1.45 ± 0.62 mm, 1.38 ± 0.50 mm, and 1.61 ± 0.66 mm for the lateral incisor, central incisor, and canine, respectively. Below the root apex, the labial bony curvature angle was 233.63 ± 17.74 for the central incisor, 235.68 ± 17.74 for the lateral incisor and 233.81 ± 11.09 for the canine. Discussion: The result revealed a favourable labial plate in the Kuantan population when implant in the aesthetic zone is planned. Conclusion: Labial alveolar bone thickness of the Kuantan population was thin within 1.5 mm while the palatal plate was thick. Overall, labial alveolar bone was present within 3 mm below the cementoenamel junction. The labial bony curvature was highest and most curved for the central incisor compared to the lateral incisor and canine.
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Background: Partial pulpotomy is a procedural intervention that can maintain the vitality of pulp during the management of traumatized permanent teeth with pulpal involvement. Aim: To evaluate whether partial pulpotomy can be considered a reliable conservative treatment option for treating traumatized permanent anterior teeth with pulpal involvement. Methodology: A computerized systematic search was performed in PubMed, Science Direct, Cochrane, and LILACS databases from 1980 to May 2021. Five studies were included in the final analysis. Quality assessment, Meta?analysis, and Publication bias of the studies were evaluated. This systematic review was registered in PROSPERO (ID – CRD42021262031). Result: The comprehensive Meta?Analysis Software was used. The test of the heterogeneity was analysed using Cochran’s Q statistics. The Q value was 7.186 (df = 6) with a P value of 0.3 and I2 as 16.5%. The studies were considered homogenous, and the fixed?effect model showed an overall point estimate of 0.89 with a 95% confidence interval (0.86–0.91). The Begg and Egger funnel plot indicated that there was no publication bias in the included studies. Conclusion: Evidence indicates that partial pulpotomy may be considered a reliable definitive treatment option in asymptomatic traumatized permanent anterior teeth with exposed pulp rather than total pulpotomy.
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@#Root fracture is a kind of dental trauma involving dentin, cementum, pulp tissue, periodontal membrane ligament and even the surrounding alveolar bone. It occurs frequently between the ages of 10-20, mostly in the area of the maxillary anterior teeth with high aesthetic requirements. The treatment goal for root fracture in permanent teeth is to maintain the physiological and functional integrity of the tooth as much as possible and to reduce the incidence of complications. Clinicians usually classify the affected teeth according to the position of the root fracture, including the apical, mid-root, cervical-mid-root and cervical segments, since it determines the treatment plan and the prognosis of the affected teeth. CBCT examination can avoid misdiagnosis and missed diagnosis of root fracture to the greatest extent. The sequential treatment plan of root fracture after permanent anterior tooth trauma includes initial emergency treatment, pulp vitality monitoring and complication management during follow-up. Emergency treatment mainly includes local anesthesia and repositioning, if displaced, the coronal segment of the tooth as soon as possible. Then, after checking its position radiographically, adjustment occlusion and flexible splinting for 4 weeks (4 months for cervical root fracture). The process of root fracture repair includes many tissues and is affected by many clinical factors. Timely and standardized treatment and close follow-up according to the Dental Trauma Guideline guarantee a good prognosis of root fracture. The closer the root fracture line is to the apex, the higher the survival rate is. In addition to the location of the root fracture line, the prognosis is affected by many other clinical factors, such as the displacement of the coronal fragment of the root fracture, the pathological state of the dental pulp, patient age, developmental stage of the root, timely and good replacement of the root fracture, splinting method, and the presence of other dental trauma complications. Pulp vitality should be monitored regularly, and root canal therapy of the coronal segment should be carried out only when infection of the pulp is established. This article reviews the classification, diagnosis, emergency treatment, sequential follow-up treatment, and prognostic assessment of root fracture trauma to provide suggestions for clinicians to manage root fracture trauma in permanent teeth.
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Objective@#To explore the application effect of a four-dimensional smile design as the leading and facial streamline as the reference system in the aesthetic restoration of anterior teeth.@*Methods@# A case of scattered space in anterior teeth was treated with a four-dimensional smile design and digital aesthetic restoration with ultrathin porcelain veneer. The digital information of the patients was obtained through oral and facial scanning, and a four-dimensional smile design and prediction were carried out. After the treatment plan was jointly determined by doctors and patients, minimally invasive abutment preparation was carried out, and ultrathin porcelain veneer was made and bonded in place. After the operation, the esthetic degree and marginal fit were observed and reexamined one year after the repair.@* Results @#The edges of the ultrathin ceramic veneers were naturally tight, and the color was coordinated, with satisfying pink and white esthetics. The face was more harmonious and natural when smiling. One year after the restoration, the facial aesthetics were wonderful, the abutment teeth and periodontal tissues were healthy, and the patients were satisfied. The results of the literature review showed that the fitting of temporal facial scanning and intraoral scanning data can accurately predict four-dimensional smile aesthetics, simulate the real state of the dynamic smile and pronunciation process, and combine it with facial streamlines to design a natural and coordinated personalized smile for patients with asymmetric faces. However, for patients with occlusal changes, unstable occlusion or temporomandibular joint disorder, it is necessary to add data fitting, such as electronic facial arch and cone beam CT, to more accurately simulate postoperative mandibular movement.@*Conclusion@# With a four-dimensional smile design as the leading and facial streamline as the reference system, the whole process digital design assisted the restoration of asymmetric anterior teeth with ultrathin porcelain veneer and had a good effect. The postoperative smiling of patients is harmonious and beautiful, which is in line with the expected effect. Patient participation and satisfaction are high; thus, this method is worthy of clinical promotion.
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ABSTRACT Objective: To determine the discrepancy of crown-root morphology of anterior teeth, using cone-beam computed tomography (CBCT), and to provide a guidance for proper torque expression. Methods: A total of eligible 200 CBCT were imported into Invivo v. 5.4 software, to obtain the middle labio-lingual sections of anterior teeth. AutoCAD 2007 software was applied to measure the crown-root angulation (Collum angle) and the angle formed by a tangent to the center of the labial surface and the long axis of the crown (labial surface angle). SPSS 18.0 was used for statistical comparisons of the two measurements, at the level of p< 0.05, and the Pearson correlation analysis was applied to investigate the association between the two measurements. Results: The value of Collum angle in maxillary central incisor was close to 0°. Significantly negative Collum angle in lateral incisors and maxillary canine, and positive value in mandibular canine were detected (p < 0.001). The labial surface angle in canine was significantly greater than the intra-arch incisors (p< 0.001), and no significant difference was detected between the central and lateral incisors (p > 0.05). Notably, there was also a significant positive correlation between the two measurements. Conclusions: The crown-root angulations were greatly different among anterior teeth. Accompanying the obvious crown-root angulations, the canines both in maxillary and mandibular arches presented considerable labial surface curvatures. Hence, equivalent deviation during bracket bonding might cause greater torque expression error and increase the risk of alveolar fenestration and dehiscence.
RESUMO Objetivo: Determinar a discrepância na morfologia coroa-raiz de dentes anteriores, utilizando tomografia computadorizada de feixe cônico (TCFC), e fornecer parâmetros para a expressão apropriada do torque. Método: No total, 200 tomografias elegíveis foram importadas para o software Invivo 5.4 para obtenção das secções médias vestibulolinguais dos dentes anteriores. Osoftware AutoCAD 2007 foi usado para medir a angulação coroa-raiz (ângulo Collum) e o ângulo formado por uma tangente ao centro da superfície vestibular da coroa e o longo eixo da coroa (ângulo da superfície vestibular). O software SPSS 18.0 foi utilizado para as comparações estatísticas das duas medições, com nível de significância de p< 0,05, e a análise de correlação de Pearson foi aplicada para investigar a associação entre as duas medições. Resultados: O valor do ângulo Collum do incisivo central superior foi próximo a 0°. Foram detectados valores significativamente negativos para o ângulo Collum nos incisivos laterais e caninos superiores, mas valores positivos nos caninos inferiores (p< 0,001). O ângulo da superfície vestibular no canino foi significativamente maior do que nos incisivos intra-arcada (p< 0,001), e nenhuma diferença significativa foi detectada entre incisivos centrais e laterais (p> 0,05). Também foi observada uma correlação positiva significativa entre as duas medições. Conclusões: As angulações coroa-raiz foram muito diferentes entre os dentes anteriores. Os caninos superiores e inferiores apresentaram considerável curvatura na superfície vestibular, associada a uma evidente angulação coroa-raiz. Consequentemente, desvios durante a colagem de braquetes podem desencadear maior erro na expressão de torque e aumentar o risco de fenestração alveolar e deiscência, sendo necessária uma avaliação antes da colagem.
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Abstract Restoration of fractured anterior teeth presents a challenge to dental clinicians owing to its esthetic requirements and, more importantly, because of the young age of the patients. Thus, it is important to follow the most conservative protocol. Many professionals face the dilemma of whether or not to perform enamel beveling. This article briefly discusses the clinical perspective and evidence regarding this type of operative restoration procedure.
Resumen: La restauración de dientes anteriores fracturados representa un desafío para los odontólogos debido a sus requisitos estéticos y, lo que es más importante, debido a la corta edad de los pacientes que generalmente necesitan del tratamiento. Por lo tanto, es importante seguir el protocolo más conservador. Muchos profesionales enfrentan el dilema de si realizar o no el biselado del esmalte. Este artículo discute brevemente la perspectiva clínica y la evidencia con respecto a este tipo de procedimiento de restauración quirúrgica.
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Dentin-Bonding Agents , Dental Restoration, Permanent/methodsABSTRACT
OBJECTIVES@#A study was conducted to investigate the clinical effects of oral digital design on the aesthetic restoration of anterior teeth of cleft lip/palate patients.@*METHODS@#Nine adult cleft lip/palate patients who need aesthetic restoration of anterior teeth were recruited. Digital information of patients' dental arches, the surrounding soft tissue and face were captured by digital camera and scanner. The aesthetic analysis and design were conducted using keynote and 3shape software and were demonstrated to the patients. The optimized treatment plan was ensured by communicating with the patients. Digital wax-up models were exported and printed into resin diagnostic models, which were then utilized in the treatment process to guide the doctors and the technicians in tooth preparation and in making the final restorations, respectively. The adhesive procedure was completed after satisfactory try-in. Aesthetics assessment was conducted in accordance with the anterior esthetic evaluation form. The scores of patient's satisfaction were recorded on a questionnaire containing six items of aesthetic index and doctor-patient communication. Patients were interviewed and examined after 1, 3, 6, and 12 months, respectively, and the clinical effects of restorations were evaluated.@*RESULTS@#All nine patients had satisfactory clinical results. The aesthetic defects of the patients were effectively addressed. All treatments met the requirements of the preoperative digital designs. The patients' scores were all above 90 on the satisfaction scale. At 12 months after the operation, the clinical effects of restorations of all cases achieved A class in each evaluation indicator.@*CONCLUSIONS@#For cleft lip/palate patients with esthetic defect in the anterior teeth, the digital design plays an important role in optimizing the treatment plan and guides the whole treatment process. This design can help clinicians achieve predictable satisfactory aesthetic results.
Subject(s)
Adult , Humans , Cleft Lip , Cleft Palate , Esthetics , ToothABSTRACT
Objective: The purpose of this study was to assess patient satisfaction, gross fracture and marginal adaptation of e.max press endocrowns versus e.max press crowns retained with Fiber reinforced composite post (FRCP) and core in upper anterior teeth. Material and methods: The present study included 24 patients seeking root canal treatment in anterior upper arch. The patients received root canal treatment (RCT) then they were randomly assigned into two groups (n=12). The first group received preparation for the IPS e.max crowns retained with FRCP and core and the second group received preparation for the IPS e.max endocrowns. Press technique was used for the fabrication of both restorations using IPS e.max press ingots. Marginal integrity and gross fracture were evaluated using USPHS criteria and a questionnaire was conducted to evaluate patient satisfaction. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. Results: There was no statistical significant difference regarding gross fracture of both groups after 12 months (p-value = 0.093, Effect size = 0.447), meanwhile; group 1 was statistically significantly higher than group 2 regarding marginal integrity (p-value = 0.037, Effect size = 0.513). Regarding patient satisfaction FRCP and core group showed statistical significant higher satisfaction than endocrown group (p-value = 0.047, Effect size = 0.447). Conclusion: E.max press endocrowns revealed successful performance similar to e.max press crowns retained with FRCP in terms of gross fracture, however better marginal adaptation and patient satisfaction was obtained with e.max press crowns retained with FRC post and core group. (AU)
Objetivo: O objetivo deste estudo foi avaliar a satisfação do paciente, grau de fratura grosseira e adaptação marginal de endocrowns e.max versus coroas de e.max retidas com pino de compósito reforçado com fibra (FRCP) e núcleo nos dentes anteriores superiores. Material e métodos: O presente estudo incluiu 24 pacientes que buscavam tratamento endodôntico na arcada superior anterior. Os pacientes receberam tratamento de canal radicular (RCT) e foram divididos aleatoriamente em dois grupos (n = 12). O primeiro grupo recebeu preparação para as coroas IPS e.max retidas com FRCP e núcleo e o segundo grupo recebeu preparos para as endocrowns IPS e.max. A técnica de prensagem foi usada para a fabricação de ambas as restaurações usando os lingotes de prensagem IPS e.max. A integridade marginal e a fratura macroscópica foram avaliadas usando os critérios da USPHS e um questionário foi realizado para avaliar a satisfação do paciente. Os dados foram analisados usando IBM SPSS Statistics for Windows, versão 23.0. Armonk, NY: IBM Corp. Resultados: Não houve diferença estatisticamente significativa em relação à fratura bruta de ambos os grupos após 12 meses (p-valor = 0,093, tamanho do efeito = 0,447), entretanto; o grupo 1 foi estatisticamente significativamente maior do que o grupo 2 em relação à integridade marginal (p-valor = 0,037, tamanho do efeito = 0,513). Em relação à satisfação do paciente, o FRCP e o grupo principal mostraram maior satisfação estatisticamente significativa do que o grupo endocrown (p-valor = 0,047, tamanho do efeito = 0,447). Conclusão: as endocrowns E.max press revelaram um desempenho bem-sucedido semelhante às coroas e.max press retidas com FRCP em termos de fratura bruta, no entanto, melhor adaptação marginal e satisfação do paciente foram obtidas com as coroas e.max press retidas com pilar FRC e núcleo de preenchimento (AU)
Subject(s)
Humans , Adult , Middle Aged , Root Canal Therapy , Dental Marginal Adaptation , Tooth, Nonvital , Dental PinsABSTRACT
Objective@#To investigate the clinical effect of concentrated growth factor (CGF) applied in guided bone regeneration (GBR) for severe bone deficiency in the anterior maxilla.@*Methods @#Forty patients with bone defects in the anterior maxilla were chosen to be treated with GBR, 20 patients were treated with CGF applied in GBR as the observation group, and the other 20 patients were treated only with GBR as the control group. The evaluation of wound healing was performed after the operation, and bone augmentation was evaluated half a year after the operation.@*Results@#The first-stage healing rate of soft tissue wounds in the observation group was 100% and 75% in the control group, and the primary healing rate in the observation group was better than that in the control group (P=0.017). The changes in bone width of the observation group were （3.70 ± 0.28） mm, and those of the control group were （2.96 ± 0.16） mm. The bone augmentation in the observation group was higher than that in the control group (P=0.000). @*Conclusion@#CGF applied in GBR has a good effect on bone augmentation for severe bone deficiency in the anterior maxilla.
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Objective@# Through a pain study of buccal gingival mucosa sensitivity of the mandible, the corresponding sensitive area of pain was determined, which provided the basis for reducing the pain and discomfort of oral diagnosis and treatment.@*Methods@#400 patients with mandibular tooth extraction in the outpatient department of stomatology were selected. During tooth extraction, articaine epinephrine injection was used for infiltration anesthesia. The injection needle size was 0.3 mm × 21 mm, and the injection site was about 5 mm away from the buccal gingival margin. The pain degree of the patients was recorded. The data were statistically analyzed using the modified International pain classification method.@*Results @#Among the 400 patients who underwent mandible extraction, 75% (300 patients) graded their pain from painless to moderate, and 25% (100 patients) reported moderate to severe and severe pain. Of those in the moderate to severe and severe groups, 50% and 42% reported pain in the central and lateral incisors, respectively, and 38% were in the canine group. When comparing the moderate to severe and the severe groups, 16% and 10% were in the bicuspid group, 16% and 12% and 16% were in the molar group, respectively . There were significant differences in the pain sensitivity of different teeth positions (χ2=54.203, P < 0.001). The proportion of moderate to severe and severe pain in the anterior teeth group was higher than it was in the posterior teeth group (χ2=55.555, P < 0.001). There were significant differences in the pain sensitivity of different ages (χ2=96.501, P=0.000), and there was a positive correlation between pain and age (r=0.465, P < 0.001). The proportion of women with at least a moderate degree of pain was higher than that of men (χ2=12.298, P=0.031). @*Conclusion@# The sensitivity of the buccal gingival mucosa to pain is different in different positions of the mandible. The sensitivity of the anterior gingiva is higher than that of the posterior gingiva. Age is positively correlated with the degree of pain. Further, compared with men, women are more sensitive to pain.
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An injury to the anterior teeth can affect a perfect smile and thus have an adverse effect on the psychology of the individual. Traumatic injuries to the anterior teeth among the young children are tragic but often an ignored problem. The aim of the study is to determine the impact of traumatic dental injuries to permanent anterior teeth on the quality of life of children of 7–14years of age and their parents. A cross sectional survey was conducted in 25 schools in and around Mangalore South. The study participants included parents of children with age group of 7–14 years. Participants will be informed about the purpose of the study and a questionnaire will be distributed to the children who have undergone traumatic dental injury. The results of this study showed that 94.6% children did not miss school due to traumatic injury but 5.4% children missed the school. Similarly, on evaluating the impact on the parents, 99.1% parents did not leave from work for this same reason. This study shows that there is no impact on the quality of life of the children and their parents. The parents and children should be given awareness on the importance of trauma to the teeth and its management.
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Introduction: Dental trauma is an irreversible pathologyand it is a commonly encountered problem in school childrenwhich after occurrence is characterized by lifelong debilitatingeffects because of physical, psychological discomfort andpain. Thus a study was conducted to assess the prevalence ofthe traumatic dental injuries to the permanent anterior teeth inrelation to occlusal relationship among 7-14 years old schoolchildren in Chitradurga townMaterial and Methods: Descriptive cross sectional studywas conducted among 3,363, 7-14 years old school childrenof Chitradurga Town. WHO (ICD-DA) 1995 Classificationwas used for assessing traumatic dental injuries and Angle’sclassification with Dewey’s Modification was used forrecording occlusal relationship. Fifteen Primary and HigherPrimary Schools and Five High schools were selected usingsimple random sampling procedure. Children aged 7-14 yearswere included in the study. Data was recorded using speciallydesigned proforma. The collected data was subjected tostatistical analysis.Results: Among 3,363 children examined prevalence rate was5.5% with higher prevalence in boys than girls. Prevalenceof traumatic dental injuries was more in the age group of10-12 years. Traumatic injuries of permanent anterior teethinvolved both maxillary and mandibular teeth with the higherprevalence in Maxillary anterior’s. Enamel fracture was thehighest (87.8%). Children with Class I type 2 and class IIdivision 1 occlusal relation exhibited very highly significantnumber of dental injuries.Conclusion: Prevalence of traumatic dental injuries wasmore in the age group of 10-12 years. Children with ClassI and class II division 1 occlusal relation exhibited veryhighly significant number of dental injuries than other type ofocclusal relationship
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PURPOSE: This research is to investigate factors that affect dental aesthetics and analyze whether individual perception affects and difference of genders affects the esthetic factors. MATERIALS AND METHODS: Seventy dental students of Chonnam University aged from 25 to 35 years old without periodontal problems were included. Maxillary dental cast for participants were made, and standardized photo was taken with a digital camera. Maximum visual width and the position of gingival zenith of maxillary anterior teeth and maximum height of the maxillary central incisors were measured by a measurement program and the shape of central incisor was categorized. Questionnaire was conducted to evaluate esthetic perception. SPSS program was used to perform statistical analysis. RESULTS: The average visual width ratio of right maxillary anteriors was 1.38:1:0.78 and 1.41:1:0.81 for the left which differ from the golden ratio. The width to height ratio for right and left central incisor was 0.84 and 0.83 respectively. The gingival zenith position was determined to be: mostly, central incisors and canines were located in the distal side, lateral incisors were located in the center. The visual width ratio of right maxillary anterior teeth, ratio of width to height of central incisor, gingival zenith position, crown morphology and amounts of gingival exposure upon smiling were not significantly different between genders, and facial patterns and these dental esthetic factors were not related to aesthetic perception. CONCLUSION: Even though participants had the visual width ratio of maxillary anteriors or ideal width to ideal height of central incisors that did not agree with the golden ratio, they had high satisfaction for dental esthetics. Esthetic perception depends more on subjective judgements of participants than objective indices.
Subject(s)
Humans , Crowns , Esthetics , Esthetics, Dental , Incisor , Smiling , Students, Dental , ToothABSTRACT
The anterior guidance is one of the important factors in prosthodontic treatment of anterior teeth. The lingual surface shape of anterior restorations is so critical that small errors of treatment procedure can cause discomfort of the patient and disharmony of the dentition. If the anterior restorations are achieved harmonious anterior guidance through the fabrication and adjustment of provisional restorations, it is important to accurately reproduce the lingual surface shape of provisional restorations as the final prosthesis. In this case report, it was used the modified Dahl principle and copy-milled technique of computer-aided design/computer-aided manufacturing (CAD/CAM) system for systematic diagnosis and treatment. Therefore, we tried to reconstruct the restoration shape more precisely by setting the appropriate anterior guidance and superimposing the digital image of the abutment teeth and the provisional restorations. Thus, by promoting functional and esthetic recovery, this case report demonstrates satisfying results to both the patients and dentist.
Subject(s)
Humans , Dentists , Dentition , Diagnosis , Prostheses and Implants , ToothABSTRACT
The purpose of this study was to obtain instructions for size selection of prefabricated crown and tooth reduction by 3-dimensional analysis of the size and shape of the maxillary primary central and lateral incisors and prefabricated crowns (celluloid strip, resin veneered stainless steel, and zirconia crowns).The maxillary primary central and lateral incisors of 300 Korean children was scanned with three types of prefabricated crown to create standard three-dimensional tooth models and prefabricated crowns. The shapes of the prefabricated crowns and natural teeth were compared according to four parameters (mesio-distal width, height, labio-palatal width, and labial surface curvature coefficient) and calculated the amount of tooth reduction required for each prefabricated crown.The size 2 resin veneered stainless steel crown, size 1 zirconia crown, and size 2 celluloid strip crown were most similar in shape to the primary central incisor. The size 3 rein veneered stainless steel crown, size 2 zirconia crown, and size 3 celluloid strip crown were most similar to the primary lateral incisor.The amount of tooth reduction was similar in both maxillary primary central and lateral incisors. The incisal reduction was greatest for the zirconia crown. At the proximal surface, the zirconia and celluloid strip crowns required a similar amount of tooth reduction, but more than the resin veneered stainless steel crown. The labial surface reduction was greatest for the zirconia crown. The degree of lingual surface reduction was not significant among the three prefabricated crowns.Among the assessment parameters, mesio-distal crown width was the most important for choosing a prefabricated crown closest to the actual size of the natural crown.
Subject(s)
Child , Humans , Crowns , Incisor , Stainless Steel , ToothABSTRACT
Objective: To analyze the postoperative satisfaction and repair effect of prosthesis of the patients who received digital smile design(DSD) combined with porcelain veneers in the anterior teeth, and to illustrate the their application in anterior teeth aesthetic restoration. Methods: A total of 91 anterior teeth of 32 patients whose clinical diagnosis conformed to the indications of porcelain veneers and aesthetic restoration because of tetracycline pigmentation teeth, dental fluorosis, color stained teeth, enamel defects and anterior teeth space were selected. DSD software was used to design the preoperative aesthetic analysis of the teeth morphology and to show the virtual effect of restoration. The preparation of tooth under the guidance of the design results was finished. The IPS e-max porcelain veneers were prepared after the conventional impression preparation. At last, the permanent restorations were manufactured and bonded to teeth. After the adhesive program was completed, the satisfaction of the patients in the shape of restorations, the degree of coordination with the adjacent teeth, color, pronunciation, smile effect and doctor-patient communication effect were evaluated by the questionnaires. The patients were required to regularly return after one month, three months, six months and twelve months, and observe the clinical effects of restoration was observed referring to the modified American Public Health Service (USPHS) standard. Results: The patients' satisfaction rates of each evaluation content were all over 90%. Among them, the satisfaction rates of the smile effect and the doctor patient communication were as high as 100%. The clinical performances of the rehabilitations in each period were as follows: One month after treatment, there were four teeth occurred mild gingivitis and three teeth appeared the postoperative sensitivity symptoms; three months after treatment, there were one tooth showed a minor fracture in the restoration without affecting the appearance and function and three teeth had mildly congestive gums reaction, at the same time one tooth showed slight discoloration of the restoration; six months after treatment, one tooth showed ceramics fracture of restoration and four teeth developed mild gingivitis; twelve months after treatment, two teeth showed ceramics fracture, the edge of three restorations had slightly crack and one tooth appeared gingivitis. The periodontal conditions of the patients with gingival inflammation after treatment were improved significantly after receiving the correct oral hygiene guidance. The above defects didn't affect the aesthetics effect and the functions of restorations, and the restorations could be used normally after intraoral adjustments. Both the doctors and the patients were satisfied with the repair effects of the restorations. Conclusion: The combination of DSD and porcelain veneer in repairing anterior aesthetic teeth is good treatment plan that can achieve high patient satisfaction and ideal clinical effect.
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Objective: The present study aimed to explore the existence of golden proportion (GP) between the widths of maxillary anterior teeth and golden standard (GS) for width to height ratio of maxillary central incisor in individuals with attractive and non-attractive smiles. Material and Methods: A total 82 females were recruited and divided into 2 groups: attractive smile (n=41) and non-attractive smile (n=41). Frontal photographs were taken, scanned, and saved in a personal computer. The apparent mesiodistal width of each anterior tooth was measured. The data were analyzed using the appropriate statistical tests at a P-value of 0.05). Conclusion: Frequency of the golden proportion was very low among the study population. Smile attractiveness was not greatly related to the proportions between the teeth. (AU)
Objetivo: O presente estudo teve como objetivo explorar a existência de proporção áurea (GP) entre as larguras dos dentes anteriores superiores e padrão-ouro (GS) para a relação largura-altura do incisivo central superior em indivíduos com sorrisos atraentes e não atraentes. Material e Métodos: Foram recrutadas 82 mulheres, divididas em 2 grupos: sorriso atraente (n = 41) e sorriso não atraente (n = 41). Fotografias frontais foram tiradas, digitalizadas e salvas em um computador pessoal. A largura aparente mesiodistal de cada dente anterior foi medida. Os dados foram analisados por meio dos testes estatísticos apropriados, com valor de p 0,05). Conclusão: A frequência da proporção áurea foi muito baixa na população estudada. Atratividade de sorriso não foi fortemente relacionada com as proporções entre os dentes. (AU)
Subject(s)
Humans , Female , Smiling , Tooth , Esthetics, DentalABSTRACT
@#The normal torque angle of the maxillary anterior teeth is an important factor in the aesthetics and function of the anterior teeth, and torque control of the front teeth is an extremely important aspect of the correction process. At present, the normal torque angle of the front teeth is among the phase Ⅲ clinical test items recognized by the American orthodontic professional committee; consequently, good control of front teeth torque is of great significance to the aesthetics of the upper anterior teeth. In this paper, the influence of a lip appliance on the bad torque of upper anterior teeth and the associated methods of control are reviewed in detail. The advantages and disadvantages of various control methods for the anterior teeth and the significance of correct anterior teeth torque angle are summarized. The existing research results indicate that the torsion of a straight arch wire applied directly to individual teeth is too great, making it difficult to enter the groove. Although the bending of the arch wire overcomes these shortcomings, the procedure is cumbersome; it stimulates the soft tissue of the vestibular groove and increases the patient’s discomfort. The bending mechanism of the rocking chair is more complicated; it is greatly affected by the friction between the arch wire and the bracket and is not conducive to closing the tooth extraction gap using the sliding method. The portal auxiliary arch and the single bending torque are suitable for correcting the torque angle of a single tooth. Auxiliary arch torque can be used to correct the upright upper anterior teeth during the process of closing the extraction space and after adduction; therefore, this procedure is worth popularizing. However, the accuracy of orthodontic control of anterior teeth torque requires further study.