ABSTRACT
National studies indicate that an increasing proportion of children are receiving needed oral health care. However, this increase is not uniform throughout all populations of youngsters. Overall national study findings regarding the use of dental services mask the fact that, a significant subset of low-income, minority, medically and developmentally compromised and socially vulnerable children continue to lack access to care and suffer significant and consequential dental and oral disease. In addition, these same children will face continued difficulties in securing needed care as they reach their early adult years.
Subject(s)
Dental Care for Children/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Adolescent , Black or African American/statistics & numerical data , Asian/statistics & numerical data , Child , Child, Preschool , Dental Care for Chronically Ill/statistics & numerical data , Dental Care for Disabled/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Humans , Insurance, Health/statistics & numerical data , Medically Uninsured/statistics & numerical data , Minority Groups/statistics & numerical data , Poverty/statistics & numerical data , Transition to Adult Care , United States , Vulnerable Populations/statistics & numerical data , White People/statistics & numerical dataABSTRACT
A fundamental goal of orthodontics is to improve the smile, but no objective criteria exist to assess the lip-teeth relationship, establish objectives of treatment or measure treatment outcome. Here we propose a method to digitally measure the smile characteristics of orthodontic patients. Specifically, the 'posed smile' is measured. By definition the posed smile is voluntary and not elicited by an emotion. It can be a learned greeting or a signal of appeasement and can be sustained. The posed smile is reliably repeatable. The multimedia computer program for smile measurement we developed was based on studies of the utility of the smile photograph and the assessment of the lip-teeth characteristics of the posed smile in treated and untreated patients. On the computer screen a grid, or smile mesh, employs horizontal and vertical lines to measure eleven attributes of a smile. Not all orthodontically 'well-treated' patients with exemplary plaster casts exhibit desirable anterior tooth display while smiling. We suggest that the photographic analysis of an unstrained posed smile might be a standard orthodontic record.
Subject(s)
Face/anatomy & histology , Facial Expression , Malocclusion/therapy , Smiling , Child , Dental Records/standards , Evaluation Studies as Topic , Female , Humans , Image Processing, Computer-Assisted , Male , Outcome Assessment, Health Care/methods , Patient Care Planning , Photography/methods , Reproducibility of ResultsABSTRACT
The full coverage restoration (FCR) and its effect on the periodontium have been the subject of much controversy over the last half century. The conflict relates to whether the margin of the FCR should be placed at or above the gingival crest, or into the gingival crevice. Clinicians and researchers alike have focused their attention primarily on the mechanistic aspects of fixed prosthetic design (i.e., marginal configuration and fit). Although marginal quality and form are factors in the fabrication of the FCR, they alone will not determine periodontal health and restorative success. What determines the success of the FCR is its ability to restore form and function to the masticatory system without adversely affecting its biology. Each technical phase of treatment (i.e., tooth preparation, impression-taking, the provisional restoration, and the final restoration) must be performed within the limits of biologic adaptation. This literature review discusses the scientific evidence regarding FCR margin placement and periodontal health.
