An orthodontic analysis of the smile dynamics with videography.

BACKGROUND AND OBJECTIVES: Smile is one of the most effective means by which people convey their emotions. The objective of this study was to capture, analyse and measure the parameters through videos clips for studying the dynamics of posed and unposed smile and to measure the parameters through video clips for studying the dynamics of speech. METHODOLOGY: A total of 100 subjects seeking orthodontic treatment with Angle's Class I malocclusion were included in the study. The principal investigator selected the frames for speech and a panel of five members selected the appropriate frames for posed smile and unposed smiles. Frames after videography were used for measurements. Parameters like Maximum incisor exposure, Lower lip to upper incisor, Gingival exposure, Inter-labial gap etc were measured in "mm" for posed and unposed smile frames. Categorical data was compared using McNemar's test. p â€‹< â€‹0.05 was considered significant. RESULTS: The median of maximum upper incisal exposure (p â€‹= â€‹2.2e-16), lower lip to upper incisor (p â€‹= â€‹2.422e-13A), inter-labial gap (p â€‹= â€‹2.2e-16 A), smile width (p â€‹= â€‹5.212e-16 A) and smile index were significant (p â€‹= â€‹0.0001 A). There was a significant change from not exposed to exposed gingival exposure over posed smile to unposed smile (p â€‹= â€‹0.0008). The most posterior maxillary tooth visible in the posed and unposed groups were the second premolars in 57% and 74% patients, respectively. In both the smile groups, 55% of subjects exhibited a consonant smile. CONCLUSION: It can be concluded that the information obtained from the current video graphic study can be used as a guideline for the diagnosis and as a part of comprehensive treatment planning.

Abfraction: Etiopathogenesis, clinical aspect, and diagnostic-treatment modalities: A review.

BACKGROUND: Abfraction is a loss of tooth structure along the gingival margin and manifests with different clinical appearances. It has multifactorial etiology and may occur due to normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The theory behind the abfraction is that the tooth flexure in the cervical area is caused due to occlusal compressive forces and tensile stresses. This results in the fractures in the hydroxyapatite (HA) crystals. It is also caused by the low packing density of the Hunter-Schreger band (HSB) at the cervical area. Unfortunately, there is a lack of evidence regarding the outcome of abfraction with or without intervention. The aim of this review is to collect clinical information from the literature and discuss the etiology, pathogenesis, clinical representation, and management. Also, search databases for clinical studies that describe the role of sclerotic dentine in non-carious cervical lesions (NCCLs) are becoming a clinical challenge. METHODS: The literature was searched that described the etiology, pathogenesis, clinical representation, and management of the abfraction lesions. Also, a specific question regarding the formation of sclerotic dentin in the NCCL lesion was described and searched for evidence that challenges etching, bonding, and successfully restoring NCCLs. The databases PUBMED, SCOPUS, MEDLINE, WEB of SCIENCE, and EMBASE were searched using the key terms. The inclusion criteria were the randomized controlled clinical trial, cohort studies, and cross-sectional studies that aimed at determining the role of sclerotic dentine in NCCLs and its effect on etching, bonding. RESULTS: One clinical study was retrieved according to the PRISMA flowchart and PICO format. The longer etching time, total-etch adhesive system, and EDTA pre-treatment of the sclerotic dentin of cervical wedge-shaped defects could improve the bonding strength in lesions like NCCL's. CONCLUSION: In conclusion, clinical challenges that occur due to NCCLs are better managed by a proper understanding of factors like etiopathogenesis, ultra-structure of enamel, and dentine and their effect on the bonding of restorations of the tooth.

Is there evidence for Novamin application in remineralization?: A Systematic review.

BACKGROUND: Calcium sodium phosphor-silicate material, a type of bio-glass was originally developed as an implant material to regenerate bone and recently adapted for use in oral care products (NovaMin Technology Inc.). Novamin is used for many dental problems like hypersensitivity, gingivitis, bleeding, non-carious lesions, carious lesions, whitening and is currently emerging as one of the treatment modality for the remineralization of the tooth. Since the prescription of these novel materials to the patients are based on cost effectiveness, efficacy and effectiveness, a clinician should make decision based on best available evidence. Hence, the objective of this review is to find out the current evidence available on the use of Novamin as an agent for remineralization. MATERIALS AND METHODS: Relevant articles were searched and screened from several databases including PubMed, Cochrane review, Science Direct and trip which were published till 1988 to July 2017; The articles relevant to the objective of this review were included (RCT's) and articles out of interest of this review were excluded. The primary outcome for the chosen studies is the remineralization capacity of Novamin. Data extraction is done independently and jointly by 3 authors using data collection forms. Studies obtained were evaluated using the Cochrane Collaboration tools for accessing risk bias. The assessment of the quality of the evidence and the bias risk was obtained using the Grading of Recommendations Assessment Development and evaluation System. RESULTS: The articles from the database obtained for further review was N = 1. According to the study reviewed, the baseline comparisons using decalcification index obtained between Novamin study group (ReNew) and the control group (Crest) yield a P-value of 0.97 whereas after a 3 months interval follow up the value is 0.0403 suggesting there was a trend towards improvement in white spot lesions in the control group and at 6 months' time point the p-value is 0.81 concluding that there are no significant difference of remineralization process obtained by using traditional toothpaste and Novamin. CONCLUSION: Review shows that Novamin has significantly less clinical evidence to prove its effectiveness as a remineralization agent in treating both carious and non-carious lesion. Hence, better designed clinical trials should be carried out in the future before definitive recommendations can be made.