Interdisciplinary esthetic approach in clinical dental rehabilitation.

During the esthetic evaluation of smile, the presence of diastemas, tooth color, size and shape, and the amount of gingival exposure are important factors to be considered. A 23-year-old female patient was referred to us with a dissatisfaction with her smile. After clinical examination revealed esthetic alterations as generalized tooth yellowish discoloration, a slight diastema in the upper anterior region, and a shortened appearance of maxillary dental crowns, providing a gingival smile. The proposed treatment consisted of an esthetic rehabilitation for resolution of gummy smile and closure of diastema in anterior teeth by the use of digital planning as a guide for the accomplishment of integrated procedures. The result obtained by the multidisciplinary treatment associating periodontal surgical procedure for esthetic crown lengthening with in-office bleaching and direct restorations with composite resin, by digital planning, provided evident harmonization between tooth color and shape and gingival contour, enabling more harmonious smile esthetics.

Factors influencing dental appearance satisfaction in adolescents: a cross-sectional study conducted in Southern Brazil

The perception of dental aesthetic appearance may affect social interaction and psychologicalstatus, influencing dental needs and the search for treatments. Aim: To investigate the satisfactionwith dental appearance and influencing factors among adolescents. Methods: The study was carriedout among adolescents aged 14 to 19 years attending a private high school in Brazil. Data ondemographic information, the perception of dental appearance, previous aesthetic treatments andwish to perform dental treatments were collected in the school. Data were analyzed using Pearson’schi-square test or Linear Trend. Multivariate analysis was performed using the Poisson regression.Results: A total of 531 adolescents (Response rate = 98.3%) answered the questionnaire. Theprevalence of dissatisfaction with dental appearance was 17.4%. Almost 65% had history of previousorthodontic treatment and 16% performed dental bleaching. Approximately 45% of children wishedto undergo orthodontics and 54.8% to bleach their teeth. Dissatisfaction with dental appearancewas associated with individuals unsatisfied with dental color (95% IC[1.73;4.32]), those perceivingpoor dental alignment (PR3.16 95% IC[2.11;4.72]) and those wishing orthodontic treatment (PR2.9;95% IC[1.79; 4.70]). Conclusions: The prevalence of dissatisfaction was considerable and wasassociated with aesthetic concerns such as tooth color, dental alignment and with the wish fororthodontics. In this young population, a large part of adolescents had already performed orthodonticand bleaching treatments and wished to perform those treatments again. Satisfaction with dentalappearance could affect the adolescents’ behavior regarding search for dental treatment, thuscausing possible overtreatment.

Validation of the digital photographic assessment to diagnose traumatic dental injuries.

INTRODUCTION: Alternatives for monitoring dental trauma in epidemiological surveys may be useful, as data collection of epidemiological investigation can be jeopardized due to several conditions. AIM: To investigate the validity of standard digital photographs to determine the occurrence of anterior dental trauma compared to the clinical examination in an epidemiological survey. METHODS: Participants were children aged 8-12 years old attending both private and public schools; children were clinically evaluated for the assessment of dental trauma, and standard photographs were taken from maxillary and mandibular permanent incisors of each child. Validity was determined by calculating the percentages and respective 95% confidence interval of sensitivity, specificity, positive predictive value, and negative predictive value. Cohen's kappa statistic was also used. RESULTS: A total of 412 children were included, totaling 3296 teeth assessed for dental trauma presence. The prevalence of dental trauma was 11.2% (95% CI 8.29-14.61) and 10.2% (95% CI 7.45-13.53), respectively, for the clinical examination and the photographic method. Agreement between the gold standard and the photographic diagnosis was good: 0.64 for the prevalence of dental trauma and 0.66 for diagnosis of dental trauma on a tooth basis. The diagnosis through the photographic method had higher specificity (96.7%) than sensitivity (65.2%). High positive likelihood ratio and low negative likelihood ratio were also observed. CONCLUSION: The photographic assessment method of dental trauma was valid and reliable as compared to the oral clinical examination.