Análise da performance de graduandos ingressantes e concluintes do curso de odontologia na identificação humana pela análise de fotografias do sorriso / Analysis of the performance of incoming and outgoing dental students in human identification through the analysis of smile photographs

Introdução: Os dentes são órgãos de valor inestimável para a identificação humana, uma vez que são as estruturas mais estáveis, duras e resistentes do corpo. Com a existência progressiva para o uso de câmeras digitais para captar fotografias sociais, como as "selfie", em que o foco principal está direcionado no rosto do indivíduo, estas fotografias são capazes de prover material com capacidade para resolver casos de identificação humana. Objetivo: Demonstrar a importância das fotografias do sorriso no processo de identificação humana e comparar e verificar o desempenho de graduandos em Odontologia (ingressantes e concluintes) na identificação humana por meio da análise do sorriso. Material e Métodos: Este estudo utilizou a metodologia e banco de imagens do trabalho de Silva et al. (2012), e o público alvo que avaliou as imagens, modificada. Cada aluno participante da pesquisa analisou um grupo de 4 imagens projetadas, sendo 2 de sorriso (A e B) e 2 intrabucais (C e D). Dentre as 10 fornecidas para cada grupo de imagem, somente uma é compatível com cada fotografia projetada. Resultado: Após análise dos dados, foi possível verificar que 84,6% dos alunos ingressantes (número de 26 alunos) acertaram os testes A e B, e 95,6% dos concluintes (número de 23) acertaram os testes A e B. No teste C podemos observar que 61,5% dos alunos ingressantes acertaram o teste, e 69,6% dos concluintes obtiveram acertos. E, por fim, o teste D mostrou que os ingressantes obtiveram um total de 80,8% de acertos, enquanto todos concluintes (100%) acertaram o teste D. Os parâmetros mais citados foram a coloração dos dentes, a inclinação dental, a morfologia das incisais e o alinhamento incisal. Conclusão: Nesta pesquisa, tanto os alunos ingressantes como os concluintes demostraram capacidade para analisar as fotografias do sorriso na identificação humana. Os alunos ingressantes obtiveram um número maior de erros pelo fato de ainda não terem conhecimento teórico e técnico mais aprofundado em anatomia, tornando isso uma diferença entre ingressantes e concluintes

Introduction: Teeth are invaluable organs for human identification, as they are the most stable, hard and resistant structures in the body. With the progressive use of digital cameras to capture social photographs, such as the "selfie", in which the main focus is on the individual's face, these photographs are able to provide material capable of solving human identification cases. Objective: To demonstrate the importance of smile photographs in the process of human identification and to compare and verify the performance of undergraduate dental students (beginners and graduates) in human identification using smile analysis. Material and Methods: This study used the methodology and image bank of the work by SILVA R.F. et al. (2012), and the target audience that evaluated the images, modified. Each student participating in the study analyzed a group of 4 projected images, 2 of which were smiles (A and B) and 2 intraoral (C and D). Of the 10 provided for each image group, only one was compatible with each projected photograph. Results: After analyzing the data, it was possible to see that 84.6% of the incoming students (26 students) got tests A and B right, and 95.6% of the outgoing students (23) got tests A and B right. In test C we can see that 61.5% of incoming students got the test right, and 69.6% of outgoing students got it right. And finally, test D showed that the entrants got a total of 80.8% right, while all the graduates (100%) got test D right. The most cited parameters were tooth color, tooth inclination, incisal morphology and incisal alignment. Conclusion: In this study, both new students and graduates demonstrated their ability to analyze smile photographs in human identification. The new students had a higher number of errors, due to the fact that they did not yet have in-depth theoretical and technical knowledge of anatomy, making this a difference between new students and graduates

Tratamento do sorriso gengival por meio da cirurgia periodontal: relato de caso / Treatment of gummy smile through periodontal surgery: case report

A busca por um sorriso considerado perfeito tem sido cada vez maior e isso tem se tornado um desafio para o Cirurgião-Dentista, visto que um sorriso harmônico não envolve somente dentes, mas também gengiva. A exposição excessiva da gengiva ao sorrir ou falar é considerada uma característica antiestética, pois gera uma desarmonia entre dentes, gengiva e lábios. Quando o paciente expõe 3 milímetros ou mais de gengiva ao sorrir, chamamos essa exposição de Sorriso Gengival. O presente trabalho tem como objetivo relatar o tratamento de um caso de sorriso gengival, onde foi realizada cirurgia periodontal ressectiva a fim de diminuir a exposição de tecido gengival ao sorrir. Descrição do caso: Paciente adulto 21 anos, sexo masculino, procurou atendimento no curso de graduação em Odontologia do Centro Universitário da Serra Gaúcha ­ FSG, com queixa de insatisfação estética devido ao tamanho de seus dentes e mostrar muito tecido Gengival ao sorrir. Após anamnese, exame clínico e radiográfico, o paciente foi diagnosticado com Sorriso gengival. O plano de tratamento proposto foi de cirurgia periodontal ressectiva. Conclusão: A partir do exposto, podemos concluir que o tratamento do sorriso gengival depende de sua etiologia. Um correto diagnóstico é de extrema importância, pois dependendo do fator etiológico do sorriso gengival, o plano de tratamento pode ser elaborado de acordo com a necessidade do paciente. No caso apresentado, o procedimento escolhido, cirurgia periodontal ressectiva, se mostrou efetivo no tratamento do sorriso gengival, devolvendo estética e satisfação ao paciente(AU)

The search for a smile that is considered perfect has been increasing and this has become a challenge for the Dental Surgeon, since a harmonious smile does not only involve teeth, but also gums. Excessive exposure of the gums when smiling or talking is considered an unsightly feature, as it creates disharmony between teeth, gums and lips. When the patient exposes 3 millimeters or more of gum when smiling, we call this exposure Gummy Smile. The present work aims to report the treatment of a case of gummy smile, where resective periodontal surgery was performed in order to reduce the exposure of gingival tissue when smiling. Case description: A 21-year-old adult patient, male, sought care at the undergraduate course in dentistry at the Centro Universitário da Serra Gaúcha ­ FSG, complaining of aesthetic dissatisfaction due to the size of his teeth and showing a lot of gingival tissue when smiling. After anamnesis, clinical and radiographic examination, the patient was diagnosed with gummy smile. The proposed treatment plan was resective periodontal surgery. Conclusion: From the above, we can conclude that the treatment of gummy smile depends on its etiology. A correct diagnosis is extremely important, because depending on the etiological factor of the gummy smile, the treatment plan can be elaborated according to the patient's needs. In the case presented, the chosen procedure, resective periodontal surgery, proved to be effective in the treatment of gummy smile, restoring aesthetics and patient satisfaction(AU)

Aumento de coroa clínica: reparação do desequilíbrio dentogengival com finalidade estética / Clinical crow augmentum: repair of the dentogengival imbalance with aesthetic purpose

O anseio por um sorriso harmônico tem se tornado cada vez maior, uma vez que muitos pacientes relatam desconforto ao sorrir, pois correlacionam a estética do sorriso a problemas de baixa autoestima e em alguns casos suscetibilidade a alterações psicossociais decorrente aos padrões estéticos impostos pela sociedade. O sorriso gengival é uma das grandes queixas relatadas por pacientes. A exposição excessiva de gengiva maxilar pode ser decorrente a fatores gengivais, ósseos, dentários e musculares. Dentre os tratamentos disponíveis para diminuir essa exposição, contamos com cirurgias periodontais, aplicação de toxina botulínica, tratamentos ortodônticos, cirurgia ortognática e reposicionamento labial. O tratamento adequado será definido de acordo com o fator etiológico de cada caso. Diante disso o objetivo do trabalho é realizar um relato de caso sobre aumento de coroa clínica estética. A paciente estava descontente com a exibição de uma grande quantidade gengival ao sorrir. Após estudos clínicos e de imagem o diagnóstico foi de erupção passiva alterada, tipo IB. O tratamento de escolha foi a gengivoplastia associada a remodelação óssea osteotomia e osteoplastia. O tratamento estético vai além de uma boa aparência, através deste trabalho, foi possível evidenciar impactos benéficos que o sorriso harmônico pode acarretar na vida do indivíduo, atendendo suas expectativas e a do cirurgião-dentista(AU)

The desire for a harmonic smile has become increasing, since many patients report discomfort when smiling, as they correlate smile aesthetics to problems of low self-esteem and in some cases susceptibility to psychosocial changes due to aesthetic standards imposed by society. Gummy smile is one of the major complaints reported by patients. Excessive exposure of the maxillary gingiva may be due to gingival, bone, dental and muscular factors. Among the treatments available to reduce this exposure, we have periodontal surgeries, botulinum toxin application, orthodontic treatments, orthognathic surgery and lip repositioning. The appropriate treatment will be defined according to the etiological factor of each case. Therefore, the objective of this work is to carry out a case report on aesthetic clinical crown augmentation. Patient discount with the display of a large amount of gingival when smiling. After clinical and imaging studies, the diagnosis was an altered passive eruption, type IB. The treatment of choice was gingivoplasty associated with bone remodeling, osteotomy and osteoplasty. Final comments and conclusions: The aesthetic treatment goes beyond a good appearance, through this work, it was possible to evidence beneficial impacts that the harmonic smile can have on the individual's life, meeting their expectations and that of the dentist(AU)

Reanatomização estética dos dentes anteriores com resina composta: relato de caso / Reanatomización estética de dientes anteriores com resina compuesta: reporte de caso / Aesthetic reanatomization of front teeths with composite resin: case report

Introdução: A alta busca por tratamentos estéticos levou a indústria odontológica a aprimorar suas técnicas e desenvolver materiais com novas características que possibilitam a mimetização da estrutura dental, associando alta qualidade estética à saúde. Para isso, é necessário uma anamnese detalhada e exame físico intra e extrabucal, análise morfológica dos dentes e da face, para que a reabilitação proposta seja adequada. Objetivo: O objetivo deste estudo é descrever um caso clínico de reanatomização dos elementos dentais anteriores superiores, por meio de restaurações diretas em resina composta, restabelecendo a estética e função da paciente. Relato de caso: Paciente do sexo feminino, 19 anos, procurou a Clínica Escola da Faculdade de Odontologia do Recife -FOR relatando insatisfação com seu sorriso e declarou não estar disposta a se submeter a um tratamento ortodôntico. Ao realizar o exame clínico, observou-se que havia desalinhamento dos elementos dentários ântero-superiores. Após a realização do enceramento diagnóstico e validação da mesma através do mockupcom resina bisacrílica, optou-se por realizar a reanatomização estética com resina composta nanohíbrida, de forma conservadora, ou seja, sem desgastar os dentes em questão. Conclusão: As etapas do planejamento foram fundamentais para maior previsibilidade e obtenção do excelente resultado. Os materiais e técnicas selecionados para realização dos procedimentos aliaram características de resistência e estética, visando maior longevidade (AU).

Introduction: The high demand for aesthetic treatments has led the dental industry to improve its techniques and develop materials with new characteristics that allow mimicking the tooth structure, associating high aesthetic quality with health. This requires a detailed anamnesis,intra-and extraoral physical examination, and morphological analysis of the teeth and faceto allow an adequate proposed rehabilitation. Objective:The objective of this study is to describe a clinical case of reshaping of upper anterior teeth, by direct composite resin restorations, reestablishing the patient's aesthetics and function. Case report:Female patient, 19 years old, sought the Clínica Escola da Faculdade de Odontologia do Recife -FOR, reporting dissatisfaction with her smile and declared that she was unwilling to undergo orthodontic treatment. Clinical examinationrevealed misalignment of the upper anteriorteeth. After diagnostic waxing and validation by mockup with bis-acryl resin, it was decided to perform the aesthetic reshaping with nanohybrid composite resin in a conservative manner, i.e., without tooth wearing . Conclusion:The planning stages were fundamental for greater predictability and obtaining excellent results. The materials and techniques selected for the procedurescombined resistance and aesthetic characteristics, aiming at greater longevity (AU).

Introducción:La gran demanda para tratamientos estéticos ha llevado a la industria dental a mejorarsus técnicas y desarrollar materiales con nuevas características que permitan mimetizar la estructura dental, combinando una alta calidad estética con la salud. Para que esto ocurra, es necesario realizer una anamnesis detallada y un examen físicointra y extraoral, así como un análisis morfológico de los dientes y de la cara, para que la rehabilitación propuesta sea da adecuada. Objetivo:El objetivo de este studio es describir un caso clínico de reanatomización de los elementos dentales de resinacompuesta, restabeleciendo la estética y función de la paciente. Informe de caso:Paciente del sexo feminine, 19 años de edad, que acudió a la Clínica Escuela de La Facultad de Odontología de Recife ­FOR menifestando insatisfaccíon con su sonrisa y declarando no estar dispuesta a someterse a tratamiento de ortodoncia. En el examen clínico se observódesalineación de los elementos dentarios anterosuperiores. Tras realizar un encerado diagnóstico y validarlo con un mock-up de resina bisacrílica, se optó porrealizer una reanatomización estética con resina compuesta nanohíbrida de forma conservadora, es decir, sin desgastarlos dientes implicados. Conclusión:Las etapas de planificacíon han sido fundamentales para una mayor previsibilidad y la obtención de excelentes resultados. Los materiales y técnicas seleccionados para la realización de los procedimentos combinaron características de resistencia y estética, buscando una mayor longevidad (AU).

Esthetic crown lengthening in the treatment of gummy smile associated with altered passive eruption: A case report

Introduction: Excessive gummy smile affects the aesthetics of the patient and can be the result of several factors, including altered passive eruption, which can be surgically corrected by aesthetic crown lengthening. Case report: 22-year-old female patient, who was treated by aesthetic crown lengthening for the correction of type 1B altered passive eruption. Discussion: Considering the patient's age and periodontal phenotype, surgical correction of the gummy smile by aesthetic crown lengthening shows stable long-term results. Conclusion: Surgically correcting excessive gingival exposure through esthetic crown lengthening can help patients improve the appearance of their smile and regain their self-confidence.

The visual and instrumental analyses of different single-shade resin composites / Análisis visual e instrumental de diferentes resinas compuestas omnicromáticas

Abstract The purpose of this study was to evaluate the color adaptation of single-shade resin composites applied to different tooth shades. A total of 108 class III preparations (n=6) were performed on the acrylic denture maxillary incisors (2mm depth and 2mm height). 5 single-shade resin composites (Vittra APS Unique, Omnichroma, ZenChroma, Clearfil Majesty ES-2 Universal, Charisma Topaz One) and 1 multishade resin composite (Estelite Asteria) were placed in the cavities and polished. I performed visual and instrumental color analyses. The CIEDE2000 formula was used to assess the shade differences (ΔE) between teeth and restorations. The obtained ΔE values were recorded and statistically analyzed. For the instrumental analysis, ZenChroma in A1 shade groups showed statistically significant higher differences (p<0.05). Among all tested materials, A3 shade groups showed lower ΔE values (p<0.05). For the visual analysis, there were no significant differences between materials and scores in A1 and A3 shade groups (p>0.05). There were statistically significant differences between the materials and the scores in A2 shade groups (p<0.05). As a result of this study, it was concluded that, making esthetic restorations with single-shade resin composites promises proper color adaptation, but their properties still need improvement. Single-shade resin composites can reduce chair-time and technical sensitivity with good color matching.

Resumen El objetivo de este estudio fue evaluar la adaptación del color de resinas compuestas omnicromáticas. Se realizaron un total de 108 preparaciones de clase III (n=6) en los incisivos superiores de prótesis acrílicas (2mm de profundidad y 2mm de altura). Se colocaron cinco resinas compuestas omnicromáticas (Vittra APS Unique, Omnichroma, ZenChroma, Clearfil Majesty ES-2 Universal, Charisma Topaz One), además de una resina multitono (Estelite Asteria) en las cavidades y se pulieron. Se realizó el análisis de color visual e instrumental. Se utilizó la fórmula CIEDE2000 para evaluar las diferencias de tono (ΔE) entre dientes y restauraciones. Los valores de ΔE obtenidos se registraron y analizaron estadísticamente. Para el análisis instrumental, ZenChroma en los grupos de color A1 mostró diferencias mayores estadísticamente significativas (p<0,05). Entre todos los materiales probados, los grupos de tonos A3 mostraron valores de ΔE más bajos (p<0.05). Para el análisis visual, no hubo diferencias significativas entre materiales y puntuaciones en los grupos de color A1 y A3 (p>0,05). Hubo diferencias estadísticamente significativas entre los materiales y las puntuaciones en los grupos de color A2 (p<0,05). Como resultado de este estudio, se concluyó que la realización de restauraciones estéticas con resinas compuestas omnicromáticas promueve una adecuada adaptación del color, pero aún necesitan mejorar sus propiedades. Las resinas compuetas omnicromáticas pueden reducir el tiempo de atención clínica y la sensibilidad técnica con una adecuada combinación de colores.

Effect of small incision lenticule extraction on the treatment of myopia patients and the impact on corneal biomechanics / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of small incision lenticule extraction(SMILE)on the treatment of myopia patients, and the impact on corneal biomechanics.METHODS:Retrospective study. A total of 120 myopic patients(240 eyes)who were scheduled to undergo corneal refractive surgery in Anyang Eye Hospital from January 2020 to December 2021 were selected. The patients were divided into SMILE group(64 patients, 128 eyes)and transepithelial photorefractive keratectomy(TransPRK)group(56 patients, 112 eyes)according to the surgical treatment method. The two groups were compared in terms of uncorrected visual acuity, corneal biomechanics, corneal endothelial cell count, posterior corneal surface height and corneal surface regularity index at 1, 7 d, 1, 3, 6 mo and 1 a after surgery, and surgical complications.RESULTS:The uncorrected visual acuity of the SMILE group at 1, 7 d and 1 mo after surgery was better than that of the TransPRK group(all P&#x003C;0.001), but there was no statistically significant difference between the groups at 3, 6 mo and 1 a after surgery(all P&#x003E;0.05). Compared with preoperative values, corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, corneal resistance factor, and corneal hysteresis in both groups showed a first decreasing and then increasing trend after surgery. The corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, corneal resistance factor, and corneal hysteresis in the SMILE group at 1, 7 d and 1 mo after surgery were higher than those in the TransPRK group(all P&#x003C;0.05), but there was no statistically significant difference between the groups at 3, 6 mo and 1 a after surgery(all P&#x003E;0.05). There were no significant changes of corneal endothelial cell count and corneal posterior surface height in the two groups after surgery(all P&#x003E;0.05). Furthermore, corneal surface regularity index of the two groups showed a first increasing and then decreasing trend after surgery, with no statistically significant difference between the groups(P&#x003E;0.05), and there was no statistically significant difference in the incidence of postoperative complications between the groups(P&#x003E;0.05).CONCLUSION:Compared with TransPRK, SMILE has less influence on corneal biomechanics, and better visual recovery in the early stage. There is no difference in long-term visual acuity between the two surgeries, and both have good safety and effectiveness.

Clinical effect of cross positioning method for correcting low and moderate astigmatism during small incision lenticule extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the clinical outcomes of using the cross-positioning method for correcting low and moderate astigmatism during small incision lenticule extraction(SMILE)surgery with Alpins vector analysis.METHODS: A total of 50 patients(81 eyes)with low and moderate astigmatism with the rule ≤1.50 D who underwent SMILE surgery at the laser myopia treatment center of Xi'an No.1 Hospital from May 2022 to November 2022 were included in the prospective randomized controlled study, and they were divided into two groups according to the random table, with 25 case(41 eyes)in cross-positioning group and 25 cases(40 eyes)in control group. In the cross-positioning group, the patients' head position was adjusted based on the cross intersection lines before the standard SMILE procedure, aligning the lateral canthi with the horizontal line and the midpoint of the eyebrows and the nose bridge with the vertical line. Postoperative visual acuity and refractive results at 3 mo were observed in both groups, and astigmatic changes were analyzed and evaluated using the Alpins vector analysis method.RESULTS: During the follow-up period, 6 cases(11 eyes)in the cross-positioning group were lost to follow-up, while in the control group, 8 cases(14 eyes)were lost to follow-up, with 19 cases(30 eyes)and 17 cases(26 eyes)finally included in the cross-positioning group and the control group, respectively. At 3 mo postoperatively, the uncorrected visual acuity(UCVA)of both groups' operated eyes was ≥1.0, and no serious complications occurred, with no significant differences in UCVA, best corrected visual acuity(BCVA), spherical power, and spherical equivalent between the cross-positioning group and the control group(all P&#x0026;#x003E;0.05). The cylindrical power in the cross-positioning group was 0.00(0.00, 0.00)D, which was lower than -0.13(-0.50, 0.00)D in the control group(P=0.01). The vector analysis results showed that the difference vector(DV)in the cross-positioning group was lower than that in the control group [0.00(0.00, 0.00)vs 0.13(0.00, 0.50), P=0.01], and the index of success(IOS)was better than that of the control group [0.00(0.00, 0.00)vs 0.18(0.00, 0.77), P&#x0026;#x003C;0.01]. At 3 mo postoperatively, 26(87%)and 15(58%)eyes in the cross-positioning group and control groups achieved an angle of error(AE)within ±5°, respectively.CONCLUSION: The cross positioning method was used to calibrate the patients' head position during SMILE surgery, which reduced the axial position error and improved the accuracy of SMILE in correcting low and moderate astigmatism.

Correção de sorriso gengival em paciente com displasia cemento óssea florida / Correction of gingival smile in patient with cemento bone dysplasia florida

Com os avanços tecnológicos na odontologia o planejamento digital se tornou algo mais presente na prática clinica. O objetivo desse trabalho é relatar uma experiência vivida em clínica sobre harmonização do sorriso através de uma gengivoplastia e remodelação óssea em paciente com displasia cemento óssea florida. Paciente 42 anos, autodeclarada do sexo feminino, não relatou nenhuma alteração sistêmica, uso de medicamento ou tabagismo, entretanto relatou ter displasia cemento óssea florida com diagnóstico de periodonto saudável. Compareceu a clínica escola de uma instituição de Ensino Superior para realização de tratamento odontológico queixando-se da aparência de seus dentes. Neste caso, foi utilizado escaneamento digital, tomografia computadorizada para tecidos moles, Digital Smile Design (DSD) e Perioguide (guia cirúrgico) para a realização do procedimento de harmonização do sorriso através da cirurgia periodontal. Em suma, apesar da displasia óssea ser um fator limitante ao sucesso ideal do procedimento, o resultado final alcançado foi satisfatório sob ótica do paciente e profissional não havendo recidiva(AU)

With technological advances in dentistry, digital planning has become something more present in clinical practice. The objective of this work is to report a clinical experience on smile harmonization through gingivoplasty and bone remodeling in a patient with florid cemento-osseous dysplasia. Patient 42 years old, self-reported female, did not report any systemic changes, use of medication or smoking, however she reported having florid cemento-osseous dysplasia with a diagnosis of healthy periodontium. He attended the school clinic of a Higher Education institution for dental treatment, complaining about the appearance of his teeth. In this case, digital scanning, soft tissue computed tomography, Digital Smile Design (DSD) and Perioguide (surgical guide) were used to perform the smile harmonization procedure through periodontal surgery. In short, despite bone dysplasia being a limiting factor for the ideal success of the procedure, the final result achieved was satisfactory from the perspective of the patient and professional, with no recurrence(AU)

Reposicionamiento Labial. Caso Clínico

El reposicionamiento labial es un procedimiento quirúrgico mínimamente invasivo que se utiliza para tratar una sonrisa gingival, la cual, es una afección en la que una cantidad significativa de la encía queda expuesta cuando una persona sonríe y puede deberse a una variedad de factores, como un exceso de tejido gingival, un labio superior corto o músculos hiperactivos del labio superior, entre otros. El alargamiento clínico de la corona, por otro lado, consiste en eliminar el exceso de tejido gingival y, si es necesario, el tejido óseo para exponer una mayor parte de la corona natural del diente. Se reporta un caso clínico de paciente femenino de 31 años que presentó una sonrisa gingival provocada por hipermovilidad de labio superior y un exceso de tejido gingival localizado. El plan de tratamiento involucró una combinación de reposicionamiento labial y alargamiento de corona. Los resultados estéticos fueron significativos, con la sonrisa del paciente más equilibrada y proporcionada. Se redujo la cantidad de tejido gingival expuesto cuando la paciente sonreía y la longitud de los dientes fue más visible, lo que dio como resultado una sonrisa de aspecto más natural, además de aumentar su aceptación al sonreír.

SUMMARY: Lip repositioning is a minimally invasive surgical procedure used to treat a gummy smile, which is a condition in which a significant amount of the gum is exposed when a person smiles and may be due to a variety of factors, such as excess gum tissue, a short upper lip or overactive muscles of the upper lip, among others. Clinical crown lengthening, on the other hand, involves removing excess gingival tissue and, if necessary, bone tissue to expose more of the natural crown of the tooth. Clinical case: A clinical case of a 31-year-old female patient who presented a gummy smile caused by hypermobility of the upper lip and an excess of localized gingival tissue is reported. The treatment plan involved a combination of lip repositioning and crown lengthening. The aesthetic results were significant, with the patient's smile more balanced and displayed. The amount of the patient's exposed gum tissue when smiled was reduced and the length of the teeth was more visible, resulting in a more natural-looking smile, as well as increasing their acceptance of smiling.

Vantagens e limitações do uso da fotografia de sorriso para a identificação humana - relato de caso / Advantages and limitations of smile photographs in human identification ­ case report

Dentre as diversas técnicas de identificação humana na Odontologia Forense, a análise pericial do sorriso vem destacando-se recentemente, pelo fato dos dentes apresentarem características individualizadoras e com relevante potencial identificador. Dentre as várias técnicas de análise pericial do sorriso, três se destacam: comparação direta, sobreposição computadorizada e delineamento incisal, sendo que cada uma possui vantagens e limitações. O objetivo deste trabalho é demonstrar, por meio de um relato de caso pericial as vantagens e limitações do uso da fotografia de sorriso para a identificação humana. Conclui-se que as fotografias de sorriso, como qualquer outro material utilizado para identificação humana, podem ser utilizadas isoladamente ou em conjunto com outros métodos de identificação, sendo que a comparação direta foi o método mais efetivo para o caso analisado

Among several human identification techniques used in Forensic Dentistry, the smile analysis has recently been increased its used due the teeth uniqueness and their identification potential in several cases. Three smile exam techniques are more frequently used: direct comparation, computerized overlap and incisal outline. This paper aims to show a case report of a human identification using smile photograph, as well presents its advantages and limitations. It was concluded that smile photographs, as any other identification method, can be used alone and in addition with other methods. The direct comparation was the most effective to the analyzed case

Reabilitação estética anterior em abordagem multidisciplinar: relato de caso / Aesthetic rehabilitation in a multidisciplinary approach: case report

A estética tem um papel importante na aceitação e autoestima das pessoas e, em virtude disso, os pacientes buscam cada dia mais ter um sorriso harmonioso. As reabilitações estéticas devem envolver um planejamento completo, atrelando função e estética, avaliando tamanho dos dentes, perfil e alturas gengivais, altura do sorriso e corredor bucal. Por conta disso, a odontologia nos permite uma série de abordagens terapêuticas diferentes que chegam a resultados satisfatórios para o paciente. Sendo assim, o presente trabalho tem como objetivo descrever um relato de caso de uma paciente com queixa estética do seu sorriso devido à diferentes tonalidades, formas e tamanhos dos dentes. Após anamnese, exame clínico e radiográfico, o plano de tratamento proposto foi de harmonizações periodontal com aumento de coroa e enxerto gengival, além de coroas em cerâmicas de dissilicato de lítio. Dentro desse contexto, mostra-se que uma abordagem multidisciplinar para reabilitação estética e funcional do sorriso é fundamental, a qual nos proporciona equilíbrio e naturalidade entre estética branca e vermelha no resultado do tratamento reabilitador(AU)

Aesthetics plays an important role in people's acceptance and self-esteem and, as a result, patients increasingly seek to have a harmonious smile. Aesthetic rehabilitations must involve a complete planning, linking function and aesthetics, evaluating tooth size, gingival profile and heights, smile height and buccal corridor. Because of this, dentistry allows us a series of different therapeutic approaches that reach satisfactory results for the patient. Therefore, the present work aims to describe a case report of a patient with an aesthetic complaint of her smile due to different shades, shapes and sizes of teeth. After anamnesis, clinical and radiographic examination, the proposed treatment plan was periodontal harmonization with crown augmentation and gingival graft, in addition to lithium disilicate ceramic crowns. Within this context, it is shown that a multidisciplinary approach to the aesthetic and functional rehabilitation of the smile is fundamental, which provides us with balance and naturalness between white and red aesthetics in the result of the rehabilitation treatment(AU)

Comparative study of small incision refractive lenticule extraction with 5 mm versus 6.5 mm optic zone for myopia

Purpose: To compare residual stromal thickness (RST) in eyes undergoing small incision refractive lenticule extraction (SMILE) using a lenticular diameter of 6.5 mm versus those with a diameter of 5 mm. Methods: In this retrospective comparative case series, consecutive patients who underwent SMILE between 2016 and 2021 with at least 6 months of follow?up were included. Preoperative best?corrected distance visual acuity (BCDVA), refractive error, contrast sensitivity, central corneal thickness, keratometry, higher order aberrations, and scotopic pupil size were recorded using a Placido disk topography with Sheimpflug tomography?based system. Patients underwent SMILE with a lenticular diameter of 6.5 mm until 2018 (n = 372 eyes). Thereafter, the lenticular diameter was reduced to 5 mm (n = 318). The RST, postoperative refraction, aberrations, subjective glare, and halos were compared across groups at 1 and 6 months. Results: The mean age of participants was 26.8 ± 5.8 years with a mean preoperative spherical equivalent of ?4.48 D ± 2.16 D (range: ?0.75 to ?12.25 D) and mean scotopic pupil of 3.7 ± 0.75 mm. Eyes in the 5 mm group had 30.6 m (95% confidence interval [CI] = 28 to 33 m, P < 0.001) greater RST compared to the 6.5 mm group after adjusting for spherical equivalent and preoperative pachymetry. There were no differences in vision, contrast sensitivity, aberrations (wavefront error of 0.19 ± 0.2 vs. 0.25 ± 0.2, P = 0.19) or glare between the two groups. Conclusion: SMILE performed with a lenticular diameter of 5 mm leads to greater RST across the myopic range, but without inducing significant higher?order aberrations.

Percepciones estéticas del canteamiento del plano incisal, de la desviación y de la angulación de la línea media dentaria maxilar evaluadas en una universidad peruana / Aesthetic perceptions of incisal plane edging, deviation and angulation of the maxillary dental midline evaluated at a Peruvian university / Percepções estéticas da borda do plano incisal, desvio e angulação da linha média dentária maxilar avaliadas em uma universidade peruana

RESUMEN Objetivo : Determinar las diferencias en la percepción estética del canteamiento del plano incisal (CPI), de la desviación de la línea media (DLM) y de la angulación de la línea media (ALM) dentaria maxilar entre personas naturales, estudiantes de pregrado y de posgrado de una universidad peruana. Material y métodos : Se empleó la fotografía de un sujeto, la cual fue digitalmente manipulada para crear un modelo facial simétrico (MFS). A partir de este modelo se hicieron modificaciones a nivel del plano incisal y de la línea media dentaria, realizando desviaciones y angulaciones con diferentes valores. Se recolectó la información mediante una encuesta virtual a 60 personas naturales, 30 estudiantes de pregrado y 30 de posgrado, sobre su preferencia estética. Resultados : Se encontró que las imágenes calificadas por la mayoría de cada uno de los tres grupos como «muy poco estético¼ fueron la DLM de 3mm, el CPI de 3°, la ALM de 7°, y la imagen con dos variables combinadas de DLM 3mm y ALM 7°. Conclusión : El aumento de CPI, DLM y ALM disminuye el atractivo de la sonrisa.

ABSTRACT Objective : The aim of this study is to identify differences in aesthetic perception regarding incisal plane edging (IPC), midline deviation (MLD), and maxillary dental midline angulation (MLA) among natural individuals, undergraduate students, and graduate students at a Peruvian university. Material and methods : A photograph of a subject was digitally manipulated to generate a symmetrical facial model (SFM). Subsequently, alterations were introduced to the incisal plane and dental midline, incorporating variations in deviations and angulations with distinct values. A virtual survey was administered to 60 natural individuals, 30 undergraduate students, and 30 graduate students, gathering information regarding their aesthetic preferences. Results : The analysis revealed that images which were consistently rated by the majority within each group as "very unaesthetic" included the following: dental midline deviation (DLM) of 3 mm, midline deviation (MLD) of 3°, and maxillary dental midline angulation (ALM) of 7°. Similarly, the combined image involving a DLM of 3 mm and an ALM of 7° was also perceived as very unaesthetic. Conclusion : The study demonstrates that an increase in CPI, DLM, and ALM leads to a reduction in the perceived attractiveness of a smile.

RESUMO Objetivo : Determinar as diferenças na percepção estética da borda do plano incisal (CPI), do desvio da linha média (DLM) e da angulação da linha média dentária maxilar (ALM) entre pessoas com dentição natural, estudantes de graduação e pós-graduação em uma universidade peruana. Material e métodos : Foi utilizada uma fotografia de um indivíduo, que foi digitalmente manipulada para criar um modelo facial simétrico (MFS). Com base nesse modelo, foram realizadas modificações nos níveis do plano incisal e na linha média dentária, introduzindo desvios e angulações com diferentes valores. Os dados foram coletados por meio de um questionário virtual respondido por 60 pessoas com dentição natural, 30 estudantes de graduação e 30 estudantes de pós-graduação, sobre suas preferências estéticas. Resultados : Foi constatado que as imagens classificadas pela maioria dos três grupos como "muito inestéticas" foram aquelas com um DLM de 3 mm, um CPI de 3°, uma ALM de 7° e a imagem contendo duas variáveis combinadas, ou seja, um DLM de 3 mm e uma ALM de 7°. Conclusão : O aumento do CPI, DLM e ALM diminui a atratividade do sorriso, conforme percebido pelos participantes do estudo, que incluíram pessoas com dentição natural, estudantes de graduação e pós-graduação.

Comparative analysis of visual outcomes following small-incision lenticule extraction with or without cyclotorsion compensation in eyes with high astigmatism: Contralateral eye study

Purpose: To compare the visual outcomes in patients undergoing small?incision lenticule extraction (SMILE) for correction of myopic astigmatism (??1.50 D) with or without manual cyclotorsion compensation. Methods: A prospective, double?blinded, randomized, contralateral study was conducted in the refractive services of a tertiary eye care center. Eligible patients with bilateral high myopic astigmatism (?1.5 D) and intraoperative cyclotorsion (?5°) undergoing SMILE between June 2018 and May 2019 were included. Cyclotorsion compensation was performed using triple centration method before femtosecond laser delivery. Uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) measurement, manifest refraction, slit?lamp biomicroscopy, and corneal tomography were performed preoperatively and at 1 and 3 months’ postoperative visit. Astigmatic outcomes were analyzed using Alpins criteria. Results: A total of 30 patients (60 eyes) were included in this study. The patients underwent bilateral SMILE surgery, with manual cyclotorsion compensation in one eye (CC group, n = 30 eyes) and no cyclotorsion compensation in the other eye (NCC group, n = 30 eyes). Preoperative astigmatism and intraoperative cyclotorsion were ?2.0 D and 7.03° ± 1.06° (CC) and ?1.75 D and 7.24° ± 0.98° (NCC) (P = 0.472 and 0.240, respectively). No significant differences were noted in mean refractive spherical equivalent (MRSE), UDVA, CDVA, and refractive error between the two groups at 3 months’ postoperative visit. Astigmatic outcomes measured using Alpins criteria demonstrated no significant difference between the two cohorts. Conclusion: The cyclotorsion compensation technique provided no additional advantage in terms of astigmatic outcomes or postoperative visual quality, in eyes with high preoperative astigmatism and intraoperative cyclotorsion.

Higher-order aberrations and visual quality after incision lenticule extraction surgery with intraoperative angle kappa adjustments between small and large kappa patients: A 2-year follow-up

Purpose: To evaluate the postoperative visual outcomes, that is, corneal higher?order aberrations (HOAs) and visual quality, of patients with an angle kappa greater than 0.30 mm who underwent angle kappa adjustment during small?incision lenticule extraction (SMILE) 2 years after surgery compared to eyes with an angle kappa less than 0.30 mm. Methods: This was a retrospective study and included 12 patients from October 2019 to December 2019 who underwent the SMILE procedure for correction of myopia and myopic astigmatism and had one eye with a large kappa angle and another eye with a small kappa angle. Twenty?four months after surgery, an optical quality analysis system (OQAS II; Visiometrics, Terrassa, Spain) was used to measure the modulation transfer function cutoff frequency (MTFcutoff), Strehl2D ratio, and objective scatter index (OSI). HOAs were measured with a Tracey iTrace Visual Function Analyzer (Tracey version 6.1.0; Tracey Technologies, Houston, TX, USA). Assessment of subjective visual quality was achieved using the quality of vision (QOV) questionnaire. Results: At 24 months postoperatively, the mean spherical equivalent (SE) refraction was ? 0.32 ± 0.40 and ? 0.31 ± 0.35 in the S?kappa group (kappa <0.3 mm) and the L?kappa group (kappa ?0.3 mm), respectively (P > 0.05). The mean OSI was 0.73 ± 0.32 and 0.81 ± 0.47, respectively (P > 0.05). There was no significant difference in MTFcutoff and Strehl2D ratio between the two groups (P > 0.05). Total HOA, coma, spherical, trefoil, and secondary astigmatism were not significantly different (P > 0.05) between the two groups. Conclusion: Adjustment of angle kappa during SMILE helps reduce the decentration, results in less HOAs, and promotes visual quality. It provides a reliable method to optimize the treatment concentration in SMILE.

Safety and efficacy of low-energy small incision lenticule extraction for the correction of myopia and myopic astigmatism: A retrospective analysis

Purpose: To determine the safety and efficacy of low?energy settings in small incision lenticule extraction (SMILE) for correcting myopia and myopic astigmatism. Methods: We included patients aged ?18 years with the myopia of ?0.5 to ?10 D and myopic astigmatism of ?0.5 to ?5 Dcyl in this retrospective case series performed at a private eye hospital in South India. All patients had preoperative best?corrected visual acuity of LogMar 0.0 ± 0, with stable refraction for 1 year and normal corneal topography. Ocular surface disease and other pathology cases were excluded. The repetition rate of the laser was 500 kHz, and the pulse energy was 110 nJ. The lenticule diameter was set at 6.5 mm, cap diameter was 7.20 mm, and intended cap thickness was 110–130 ?. The spot distance was 4.5 ?m. All patients were evaluated immediately postoperation and on postoperative days 1, 8, and 30. Results: Overall, 541 eyes were included. The mean patient age was 25.03 ± 4.1 years. The mean spherical error was ?3.76 ± 1.84 Ds. The mean cylinder was ?1.24 ± 0.91. The mean spherical equivalent of refraction was ?4.22 ±1.94 D. The logMAR on postoperative day 1 was 0.0 ± 0. The mean spherical equivalent at 1 month was 0.28 ± 1.06 D. There was no loss of Snellen’s lines after the procedure. The mean spherical equivalent of refraction to the target was 95% within ± 0.50 D. The postoperative astigmatism was within 0.5 Dycl. No intraoperative complications of SMILE including retained lenticule fragments, tears of incision, or improper dissection occurred. Conclusion: Low?energy settings in SMILE are safe and effective in correcting myopia and myopic astigmatism including high cylinders (>3 Dcyl).

Changes in retinal peripheral refractive status and aberrations before and after femtosecond laser-assisted laser in situ keratomileusis and small incision lenticule extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe and compare the changes in retinal peripheral refraction and aberrations after femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)versus small incision lenticule extraction(SMILE)for myopia correction.METHODS: A total of 71 patients(71 eyes)with myopia who underwent FS-LASIK from October 2022 to April 2023 in our hospital were selected as the FS-LASIK group, and 80 patients(80 eyes)with myopia who underwent SMILE were selected as the SMILE group. All patients underwent corneal wavefront aberration measurement and multispectral refractive topography preoperatively and 3mo postoperatively, as well as refraction difference value(RDV)in the range of 0°～10°, 10°～20°, 20°～30°, 30°～40°, and 40°～53° in the annulus of the retina, which were recorded as RDV-(0°～10°), RDV-(10°～20°), RDV-(20°～30°), RDV-(30°～40°), and RDV-(40°～53°). The results of two groups of patients were compared.RESULTS: No significant differences were observed in RDV-(0°～10°), RDV-(10°～20°), RDV-(20°～30°), RDV-(30°～40°), RDV-(40°～53°)between the two groups at 3mo post-operation(all P&#x003E;0.05). Furthermore, the RDV-(20°～30°), RDV-(30°～40°)and RDV-(40°～53°)of the two groups at 3mo postoperatively were all significantly lower than those preoperatively(all P&#x003C;0.05). The changes in coma(horizontal)and spherical aberration(SA)at 3mo postoperatively were smaller in the SMILE group [0.106(0.056, 0.171)and 0.115(0.081, 0.182)μm] than in the FS-LASIK group [0.206(0.104, 0.355)and 0.197(0.128, 0.254)μm](Z=-4.170, -5.016, all P&#x003C;0.05). A negative correlation was found between postoperative SA and postoperative RDV-(10°～53°)(rs=-0.205, -0.181, -0.226, -0.244, all P&#x003C;0.05).CONCLUSION: Both FS-LASIK and SMILE reduced retinal hyperopic defocus in the peripapillary macular range of 20°～53° eccentricity, and the postoperative changes in coma(horizontal)and SA were smaller with SMILE than with FS-LASIK. There was a certain correlation between postoperative SA and postoperative retinal peripheral defocus.

Research progress of opaque bubble layer created in corneal stroma during femtosecond laser surgery / 国际眼科杂志(Guoji Yanke Zazhi)

Femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)and small incision lenticule extraction(SMILE)are the mainstream corneal refractive surgeries at present. Despite efficacy, safety and predictability they have showed in refractive error correction, there are still complications relating to femtosecond laser, such as suction loss and opaque bubble layer(OBL), due to that the production of corneal flap or lenticule is dependent on the femtosecond laser. OBL is a complication that is unique to femtosecond laser surgery and the bubbles are generated from photo-disruptive effect towards corneal tissues which consisted of water vapor and carbon dioxide, and OBL gradually formed when the bubbles are trapped in the stroma. The bubbles can influence the intraoperative manipulation and postoperative visual quality. This review discusses the mechanism, grading, classification, and influencing factors of OBL and its effects on intraoperative manipulations and postoperative recovery, in the hope of providing reference and basis for further clinical studies.

Changes in corneal biomechanics after small incision lenticule extraction and femtosecond laser-assisted laser in situ keratomileusis evaluated by corneal visualization Scheimpflug technology / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the changes in corneal biomechanics of patients with moderate refractive error after receiving small-incision lenticule extraction(SMILE)and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)using the corneal visualization Scheimpflug technology(Corvis ST).METHODS:Prospective cohort study. A total of 65 moderate myopia patients(65 eyes)who were scheduled to undergo refractive surgery at the Ophthalmic Refractive Surgery Center of the Ningxia Eye Hospital from November 2020 to November 2021 were included in the study, and there were 30 eyes in the SMILE group and 35 eyes in the FS-LASIK group. The changes in corneal biomechanical parameters, including integrated radius(IR), inverse concave radius(ICR), deformation amplitude ratio 2mm(DAR2), stiffness parameter at first applanation(SP-A1), ambrosio relational thickness(ARTh)and the central curvature radius at highest concavity(HC-Radius)were observed by Corvis ST between both groups preoperatively and 1 and 3mo postoperatively.RESULTS: There were no statistical significance in biomechanical parameters between two groups of patients 1 and 3mo postoperatively(P&#x0026;#x003E;0.05). IR, ICR and DAR2 of each groups of patients 1 and 3mo postoperatively were significantly increased than those preoperatively, and SP-A1, ARTh and HC-Radius were significantly decreased than those preoperatively(all P&#x0026;#x003C;0.05). The biomechanical parameters at 1mo and 3mo postoperatively showed no statistical significance(P&#x0026;#x003E;0.05). In addition, a positive correlation was found between central corneal thickness(CCT)and ARTh and SP-A1 of the two groups of patients at 3mo postoperatively(FS-LASIK group: r=0.727, 0.819, SMLIE group: r=0.683, 0.434, all P&#x0026;#x003C;0.05), while a negative correlation was found between CCT and IR and ICR at 3mo postoperatively.(FS-LASIK group: r=-0.697, -0.622, SMLIE group: r=-0.447, -0.491, all P&#x0026;#x003C;0.05).CONCLUSION:For patients with moderate myopia, both SMILE and FS-LASIK can reduce corneal biomechanical stability. Both surgeries showed no significant differences in the effect on biomechanical, and the biomechanical has been stabilized at 1mo postoperatively. A correlation was found between postoperative CCT and ARTh, SP-A1, IR and ICR.