Aesthetic Expectations Research Articles

Study on the applications of digital smile design planning technique in complete dentures

One of the most obvious trends in current prosthetic dentistry is the introduction of digital techniques. Of these, the techniques that offer the possibility of aesthetic prefiguration of the final prosthetic result are of particular interest to the dentist. The aim of this paper was to verify the applicability of the Digital Smile Design application, which is the most commonly, used aesthetic prefiguration application, an application designed for the dentate patient, to full edentulism. Two groups of full edentulous patients were formed: the first group, complete denture carriers, dissatisfied with the aesthetic aspects, that they wanted to improve in the new denture, and, the second group, newly bimaxillary full edentulous patients with high aesthetic expectations. Thus, on the first group, the tests were performed on the existing denture, and the second one with the maxillary occlusion template. However, the view of the final result offered the patients the chance to have a realistic picture of their desires regarding the shape, color, size of the teeth, which were inadequate in relation to age and facial typology. The use of this application also improves communication with the dental laboratory. In full edentulism, the current DSD technique can be used with some limitations and the use of it in this field needs more complex studies on larger groups of patients.

Effect of Nasal Skin Type on Skin Problems following Rhinoplasty.

Skin problems following rhinoplasty may cause dissatisfaction concerning the esthetic expectations of the patients. This study was conducted to determine whether nasal skin type has an effect on skin problems after rhinoplasty. Thirty-five patients undergoing rhinoplasty in our tertiary referral center between May 2018 and August 2019 were included in the study. The nasal skin sebum level was measured with Sebumeter preoperatively and patients were divided into two groups according to the median sebum level. Among the 35 patients, half of them with higher nasal skin sebum were categorized as oily skin group (n = 17; 14 males, 3 females; mean sebum level: 200.3 ± 26.9), and the other half were categorized as dry skin group (n = 18; 10 males, 8 females; mean sebum level: 101.9 ± 38). Periorbital edema and ecchymosis were assessed at postoperative days 1, 3, and 7. Acne and seborrhea severity determined with Global Acne Grading System and Seborrheic Dermatitis Area Severity Index the day before operation and postoperative days 7 and 14 and months 1, 3, and 10. Compared with dry skin group, upper eyelid ecchymosis score at postoperative day 7 was statistically higher in oily skin group (p = 0.044). There was no significant difference in upper eyelid edema scores between postoperative days 1 and 3 for oily skin group (p = 0.020). No statistically significant differences were found for acne and seborrhea severity. Nasal skin sebum levels may affect periorbital edema and ecchymosis after the procedure but no significant effect has been observed for acne and seborrhea. Predicting the effect of nasal skin types on these problems may help the surgeon to inform patients more correctly.

Aesthetic politics and community gardens in Singapore

ABSTRACT This paper explores the complexities of aesthetic politics in urban geographies using the case of community gardens in Singapore. Drawing from qualitative research, our findings suggest that community gardeners in Singapore attend to aesthetics – in particular the order and beauty of production spaces – in response to expectations and pressures anchored to the realities of a manicured “green” cityscape. These pressures are enforced not only by the juridical and executive powers of governmental and institutional authorities, but also through the diffused power of the “aesthetic gaze” – a set of aesthetic expectations that emanate from multiple actors across hierarchies to discipline community gardeners. However, rather than merely comply, community gardeners are aware of the impacts of aesthetic expectations on their everyday gardening and therefore are able to negotiate, and at times resist, these powers with varying degrees of agency and strategy.

Necrobiosis Lipoidica Affecting the Leg: What Is the Best Treatment in a Patient with Very High Aesthetic Demand?

Summary:Necrobiosis Lipoidica (NL) is a rare necrotising disorder of the skin characterized by collagen degeneration, thickening of blood vessels, and granulomatous inflammatory process. Its main clinical features are brownish-red papules and yellowish plaques with atrophic central areas. NL affects 0.3% -1.2% of the diabetic population, mostly women (female/male ratio is 3:1). Management of NL is challenging, especially for large lesions refractory to medical therapy, thus requiring surgical excision as an alternative option. Due to the rare occurrence of this condition no treatment guidelines exist and individualized treatment mostly depends on the severity of the lesion, location and patient's expectations. A case of a 30-year-old diabetic woman with very high aesthetic expectations was succesfully treated with staged resections of a giant NL to the leg and reconstruction with dermal template and full thickness skin grafts. Grafts were taken from the groin region bilaterally and from the lower abdomen after a cosmetic mini-abdominoplasty procedure. This approach allowed for a stable and very satisfactory aesthetic result with no donor site exposed scars.

A Single-Stage Reconstruction of Maxillectomy Defects with Temporalis Muscle Flap—Revisiting the Past

Oncological resections involving the maxillofacial unit are aggressive and functionally mutilating. The inherently complex maxillary defects pose a reconstructive challenge. The reconstructive options described vary from regional soft tissue to free or combinations of soft tissue flaps and alloplastic implants. The temporalis myofascial flap is a versatile flap for reconstruction of maxillofacial defects. Due to its robust vascularity, adequate bulk, proximity to the defects, and minimal donor-site morbidity, it remains a popular choice of reconstruction for a contemporary surgeon. A retrospective analysis of nine patients undergoing a single-stage temporalis myofascial flap reconstruction following maxillectomy was performed to determine its utility, post-operative complications, and its impact on quality of life. The patients undergoing surgery had tumours involving maxillary alveolar–buccal complex (four), maxillary antrum (three), and hard palate (two). The histological types of the tumour were squamous cell carcinoma (six), adenocarcinoma (one), adenoid cystic carcinoma (one), and undifferentiated pleomorphic sarcoma (one). Post-surgical defects reconstructed with this flap included infrastructure maxillectomy (one), subtotal maxillectomy (one), total maxillectomy (five), and extended total maxillectomy (two). None of the flaps failed in any patient (flap survival rate of 100%); one patient had minimal dehiscence which was managed conservatively. No significant speech and swallowing-related issues were reported by any of the patients. Aesthetic expectations were met in most of the patients.

Perceptions of Dentists and Non-Professionals on Some Dental Factors Affecting Smile Aesthetics: A Study from Vietnam.

Aim: It is important to meet the aesthetic expectation regarding the smile concept of both dentists and non-professionals after treatment is complete. Therefore, the study aims to evaluate the effects of altered displays in incisors, gingival margin, and other smile-related-factors on dentists’ vs. non-professionals’ aesthetics perceptions. Materials and method: We altered the features of 42 digital smile photographs to generate the changed displays in incisors, gingival margin, and other smile-related-factors. Then, these altered photographs were presented to 51 dentists and 51 non-professionals, and each picture was rated by each participant with a visual analog scale ranging from 0 (very ugly) to 100 (very beautiful). Results: We found that the alterations in incisors, gingival margin, and other factors affected studied groups’ aesthetic perception of smile. The ugly smile threshold rated by both groups for crown length of maxillary central incisors was 2.0 mm. This threshold was 2.5 mm for dentists, with moving the gingival margin of maxillary lateral incisors to the incisal ridge. The ugly thresholds for other smile-related-factors were different between studied groups; for example, the ugly thresholds for gingival exposure levels were 3 and 4mm for dentists and non-professionals, respectively. Thus, our data indicate that altered displays in incisors, gingival margin, and other smile-related-factors affected perceptions of both studied groups on smile aesthetics, but dentists tended to feel more refined than non-professionals. Dentists and non-professionals had significantly different aesthetic perceptions of the alteration of the gingival exposure level. Conclusion: Both dentists and non-professionals’ perceptions should be fully considered during orthodontic and prosthodontic treatment to achieve optimum aesthetic results.

ARNETT YUMUŞAK DOKU SEFALOMETRİK ANALİZİNİN ORTODONTİK VE CERRAHİ UYGULAMALARI-

Orthodontic treatment and orthognathic surgery are widely used nowadays in terms of life expections, socioeconomic level, aesthetic expectations. The key to achieving an aesthetic, functional and ideal result is the correct diagnosis of the patient and the correct treatment plan. Although orthodontic and orthognathic treatments cause changes on hard tissues, the effects of treatments on soft tissues are also very important when aesthetic expectations are considered. Arnett & MSınıfaughlin Soft Tissue Cephalometric Analysis is one of the most recent methods to measure the effects of orthodontic treatment on soft tissues. The analysis makes it possible to evaluate the soft tissue and skeletal structures in detail and objectively, regardless of the relationship with cranial base. During Sınıfinical and cephalometric examinations, the patient should be in the natural head position, jaws in the centric relationship and the lips in the relaxed position. After Sınıfinical examination is obtained, the patient’s face is analyzed in three dimensions of the space and a cephalometric radiograph is taken by placing metallic marks on certain soft tissue points of the face. First, a Sınıfinical examination is performed, the face of the patient is analyzed in three dimension and essential measurements are made and a cephalometric X-ray is made by placing metallic marks on certain soft tissue points of the face. After determination of the true vertical line on the cephalometric film, the measurements on the soft and hard tissues were determined and facial analysis are completed. Arnett Soft Tissue Cephalometric Analysis allows detailed and objective evaluation of soft tissue and skeletal structures irrespective of their relation to cranial base.

The Modified Rectangle Flap Epicanthoplasty: A Novel and Individualized Design.

The epicanthal fold is ordinary in the eyelids of Asians, and the aesthetic appearance of eyelid surgery could be reduced and undermined; thus, medial epicanthoplasty is commonly performed to eliminate the effect of the epicanthal fold with less scarring. At present, there are a lot of techniques that have been described for the treatment of epicanthal fold. The potential problems, however, such as visible scar or under correction in the medial canthus area are challenges to surgeons. The purpose of our study was to explore a novel and individualized design using a modified rectangle flap with acceptable functional and aesthetic outcomes. From January 2017 to January 2018, epicanthoplasty was performed for 40 patients by using a modified rectangle flap. All patients underwent double-eyelid surgery at the same time when they needed it. The evaluation criteria included the intercanthal distance (ICD), interpupillary distance (IPD), the ratio of ICD to IPD (ICD ratio), scar visibility, and cosmetic results. From January 2017 to January 2018, the modified rectangle flap method was carried out on 40 patients, who were evaluated at follow-up from 7 to 15months. The average intercanthal length was 36.9 ± 2.2mm preoperatively and decreased significantly to 31.5 ± 1.8mm postoperatively, 7months after the surgery (P < 0.01). The excellent cosmetic results, in terms of an open medial canthus, were observed during follow-up periods, with no definite recurrence, hypertrophic scar, or injury of the lacrimal apparatus. The inner canthus and lacrimal caruncle are fully exposed with an invisible scar. Both the patients and the surgeon judged that the aesthetic outcomes were excellent or good. This modified rectangular flap is an effective and personalized method of correcting the medial folds that leave no additional scar in the medial canthal area, and the procedure meets the patient's aesthetic expectations. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Analysis of facial asymmetry in patients with crooked noses

Surgical management of crooked nose is challenging even for experienced rhino surgeons, although numerous techniques for correction have been described. Not infrequently, there is a facial asymmetry in addition to the crooked nose influencing the aesthetic results of the operation. Therefore, the purpose of this study was to determine how often there is an asymmetry of the face in addition to a crooked nose. Retrospectively the data of 607 patients with a crooked nose (304 women, 303 men, mean age 30 years) were evaluated. The preoperative photos of the face were anthrometrically assessed based on angle measurements. 382 of the 607 patients had a c-shaped (63 %) and 225 an i-shaped (37 %) crooked nose. More than three-quarters of the patients had facial asymmetry in respect to the connecting line of the pupils and nasal base line. 49 % of patients reported a history of nasal trauma, but this had no relevant influence on the frequency of facial asymmetry. Pre-existing facial asymmetry is very common in patients with crooked nose and can significantly affect the aesthetic outcome of nasal surgery. This should be addressed as part of the informed consent. In particular, it should be mentioned that the surgical outcome can remain below the patient's aesthetic expectations. Not rarely, a revision surgery may be necessary.

Crown Lengthening Procedures for Functional and Esthetic Purposes

The crown lengthening (CL) procedure is one of the most common procedures in daily dental practice. The purpose of this review is to examine the newer techniques along with parameters that need to be considered in the decision-making process for optimal functional and esthetic results. The parameters that need to be considered during the decision-making process for CL include the patient’s restorative needs and esthetic expectations, supracrestal attachment, level of bone, and gingival phenotype. While gingivectomy with or without osseous resection is the traditional approach, more recently less invasive procedures have been used including dental lasers, orthodontic extrusion, and lip repositioning. Correct evaluation of the patient’s anatomical factors, restorative and esthetic needs should lead to the utilization of the most appropriate procedure. Adequate time for healing should be allowed prior to the final restoration for the most stable and predictable long-term result.

Time and Again: Feminism, Form, and the Failures of the Legend of Good Women

Abstract At the heart of many readers' frustration with the Legend of Good Women is its repetitive narrative structure. This article considers how we can adapt feminist and queer theories of time to set aside gendered aesthetic expectations and reevaluate that form. Setting the Prologue in dream time raises the possibility of awakening and acting differently in the future. The God of Love and Alceste sketch out different plans to effect that change through penance, offering narrative structures aligned with the key metaphors of the calendar and the daisy. The poem allows these multiple possibilities to coexist, and the recursive nature of the legends as a collection invites readers to synchronize as a community and engage in the process of change alongside the dreamer.

Contemporary management of minimal invasive aesthetic treatment of dentition affected by erosion: case report

BackgroundThe paradigm shift obtained with new dental materials permits minimally invasive dentistry, by following a biomimetic approach. Erosion increasingly affects the adult population through dental substance loss by acid attack. Oral rehabilitation is often extensive and requires careful mouth examination and treatments codified in the literature.Case presentationThis clinical report proposes a reasoned approach to erosion treatment for a 39-year-old male patient presenting several old fixed prostheses. These old restorations are all of correct quality and are retained. The temporomandibular joint was free from disorder. Only defective reconstructions are remade together with eroded teeth, according to a three-step technical protocol. In the first step, mock-up manufacturing is performed which occlusal vertical dimension increased to 1 mm provoking passive dental overeruption to the second and third molars. In all, one ceramic crown was remade, and two ceramic onlays and a resin composite were integrated on the posterior teeth. The last step consisted of palatal veneers on the maxillary incisor and canine, and an aesthetic resin composite on the incisor edge. After these treatments, regular assessments were carried out at 4 months then at 6 months with visual, photographic and radiographic examinations.ConclusionThe present dental care philosophy is to preserve dental tissue as much as possible, even in large erosion cases, and to respond to the aesthetic and functional expectations of the patient. This methodology requires a thorough evaluation phase, compliance with the protocol and regular patient follow-up.

Trashed Beauty: Abjection and Burned Females in Mariana Enríquez’s The Things We Lost in the Fire

Abstract The Things We Lost in the Fire presents a wave of femicides in Argentina, committed by men burning and deforming women, leaving them to die or to become disabled. As a protest to these femicides, a group of women devises a vendetta by resignifying a past ritual: they start burning themselves at the stake. With their disabled bodies, these women disrupt the patriarchal expectations about beauty and femininity. Using Kristeva’s abjection theory alongside disability study theories, I will demonstrate how “trashed” beauty and disability can represent a liberation from heteronormative aesthetic expectations, as well as how these bodies reimagine female identity.

Psychological Desire of Facial Esthetics in Males.

Background:Males have specific facial esthetic priorities for a variety of reasons. There exists a common perception that expectations from male facial cosmetic surgery are similar globally. The possibility of different esthetic requests of males at a single Indian center is not widely reported. This investigation aimed to identify the facial esthetic expectations and requests among males.Materials and Methods:The study was based on in-house, qualitative survey regarding facial esthetics conducted during the clinical interview among males seeking facial esthetics in a single Indian center. Preferences regarding the hairline, forehead periorbital region, nose, lip, and jaw features, were surveyed.Results:Facial esthetic preferences among males were identified. Despite the geographical and anthropological variation, the demand was largely correction of the lower eyelid, entire midfacial region – alteration of zygomatic prominence, nose, and premaxillary unit. There is a high demand for a sharp, long, straight nose as well as prominent jawline and gonial angle. The expectations of the patients appear to be influenced by the biopsychosocial constructs including race, age, and personality traits.Conclusion:The results demonstrate that there is a wide variation in facial esthetic expectation, especially one that has typical “metrosexual male” ideations. This possibly stems from their deep-seated psychological desire for a facial and personality trait. Only an in-depth clinical interview and detailed discussion would help the surgeon to understand the patient's concepts of beauty, their expectations, and surgical outcome reality.

THE ROLE OF DIGITAL TREATMENT PLANNING IN MAXILLOFACIAL PROSTHETICS

Advances in treatment planning have changed patients’ expectations of the functional and aesthetic outcomes of maxillofacial prosthetic treatments. This case report describes and discusses the role of digital technology in the treatment planning of a facial prosthesis for a patient with complex maxillofacial prosthetic needs. A 75-year-old man was diagnosed with squamous cell carcinoma of the left maxillary sinus. The tumor was surgically resected and resulted in extensive tissue loss. The four key elements of visualization, design, manufacture, and evaluation were considered in digital treatment planning of the facial prosthesis; the first two are discussed in this report. The defect areas were three-dimensionally digitized using computed tomography and stereophotogrammetry. The scanned data were saved as a standard tessellation language file. From these data, virtual three-dimensional models were created for treatment planning options. With the aid of computer-aided design software, two types of facial prostheses were designed: an open-eyeprosthesis and a closed-eye prosthesis. These designs were discussed with the patient to determine the one most suitable to meet his aesthetic expectations. Patients’ expectations of treatment options can be improved through the virtual visualization and design offered by digital treatment planning. This case report confirms the applicability of digital treatment planning in managing patients with complex maxillofacial prosthetic needs.

A comparison of water quality and greenhouse gas emissions in constructed wetlands and conventional retention basins with and without submerged macrophyte management for storm water regulation

The city of Winnipeg (Manitoba, Canada) has numerous conventional stormwater retention basins to attenuate stormwater runoff. Significant operational resources are applied to control the proliferation of aquatic macrophytes and filamentous algal mats in these conventional stormwater retention basins to meet the aesthetic expectations of surrounding residents. Recent urban developments in the city of Winnipeg have used constructed wetlands to handle stormwater as opposed to conventional basins. We examined the differences in water quality, greenhouse gas emissions and cumulative greenhouse gas fluxes between conventional stormwater retention basins and urban constructed wetlands. Additionally, we examined how water quality and greenhouse gas emissions were impacted by the removal of submersed aquatic vegetation in conventional stormwater retention basins. Our results indicate large phytoplankton blooms were consistently reduced both pre and post treatment in the urban constructed wetlands (chlorophyll-a = 13 µg l−1 and 33 µg l−1) relative to the untreated conventional stormwater retention basins (chlorophyll-a = 56 µg l−1 and 128 µg l−1) and treated conventional stormwater retention basins (chlorophyll-a = 58 µg l−1 and 405 µg l−1). Mean daily greenhouse gas fluxes were lower pre and post treatment in the urban constructed wetlands (CO2eq = 26.5 kg ha−1 d−1 and 53.1 kg ha−1 d−1) relative to the untreated (CO2eq = 85.5 kg ha−1 d−1 and 89.0 kg ha−1 d−1) and treated conventional stormwater retention basins (CO2eq = 98.5 kg ha−1 d−1 and 129.8 kg ha−1 d−1). Over the 22 week period, mean total basin cumulative CO2eq flux was lowest in the urban constructed wetlands (6,447 g ha−1 d−1) compared to the untreated (12,631 g ha−1 d−1) and treated (17,633 g ha−1 d−1) conventional stormwater retention basins. The combined treatments (herbicides and harvesting) applied to the conventional stormwater retention basins to remove aquatic vegetation result in poorer water quality and appear to stimulate methane emissions resulting in noticeably higher cumulative fluxes of greenhouse gases from these basins. The use of urban constructed wetlands in new residential areas should result in enhanced water quality and reduced cumulative greenhouse gas fluxes, while avoiding the cost associated with macrophyte removal.

Women’s facial attractiveness nowadays – results from analysis of public figures

Aim. To identify the main facial features associated to facial attractiveness in women nowadays. Method. A descriptive study was conducted on a sample of 20 female public figures, very famous and successful women, most frequently actresses, singers or models, considered very beautiful nowadays. Their selection followed the analysis of several recent tops that aimed identifying most beautiful women, in which raters were lay persons. Data was collected by analyzing photos from frontal and lateral view, during rest position and smiling. Results. The persons analyzed registered diverse facial traits. Most obvious trends, encountered in more than 75% of them, included: Caucasian race; straight and long hair; average nasal tip protrusion; maxillary dental midline concordant to facial midline; a thicker lower lip compared to the upper lip; exposure of only maxillary incisors during smile; decreased or absent buccal corridor; maxillary central incisors of oval/rectangular shape; absence of maxillary teeth crowding. Other frequently encountered features were: American nationality; brown hair; eyes with medium size, almond shape, wide set, of green color; nose with an average width; face with a decreased lower third and a slightly convex profile; a thick lower lip and an average upper lip; exposure during smiling till the first molar, with a normal smile line. Conclusions. The public beautiful women nowadays register features that are generally associated to an increased facial attractiveness. Knowledge of trends in facial beauty is useful in dental practice, in order to understand better patient’s need in terms of esthetic expectations.

Contemporary Dental Ceramic Materials, A Review: Chemical Composition, Physical and Mechanical Properties, Indications for Use.

BACKGROUND:The high esthetic expectations from the prosthodontic restorations have directed the qualitative development of the materials towards the all-ceramic materials that are capable of replacing porcelain-fused-to-metal systems.AIM:This article reviews the literature covering the contemporary all-ceramic materials and systems with a focus on the chemical composition and materials’ properties; also it provides clinical recommendations for their use.RESULTS:The glass-matrix ceramics and polycrystalline ceramics are presented, as well as recently introduced machinable materials, all-zirconia and resin-matrix ceramics. The specific properties of zirconia, such as transformation toughening, stabilisation of the crystallographic structure, low-temperature degradation and factors affecting the zirconia’s ageing, are emphasised.CONCLUSION:The favourable properties of the resin-matrix ceramics, such as modulus of elasticity similar to dentin, shock-absorbing characteristics and high resilience and fracture resistance, are also covered in this article.

Enigma of Fixed Retainers

Fixed retainers are a reliable form of retention for avoiding relapse and maintaining dental arch shape. They function regardless of patient cooperation, and they fulfill high esthetic expectations. Teeth have tendency to return to their former position, as time required for retaining the treatment result. The most appropriate mode of retention for the post-treatment situation should be used, based on a careful evaluation of the patient’s pretreatment diagnostic records, habits, cooperation, growth pattern, and age. Retention after orthodontic intervention is as important part of the therapy as the active treatment. Age and maturity of the patients, result of the orthodontic intervention, origin and character of the anomaly, type of the retainer, compliance of the patients; all can influence the chance of relapse. The retention period should be twice longer than the active orthodontic treatment. This article covers various aspect of fixed retention in detail

An evidence-based evaluation of contemporary dental ceramics

Abstract: Based on data from three recently published laboratory surveys with large numbers of different types of contemporary ceramic restorations, specific indications and contra-indications are given. The indications are based on longevity data, aesthetic expectations, tooth position, level of parafunctional activity, tooth reduction requirements, and potential wear of the opposing dentition. CPD/Clinical Relevance: This article provides an evidence-based guide for clinicians to use when placing contemporary ceramic restorations. The article details which specific ceramic restorations are indicated in specific clinical situations, based on data from laboratory surveys and clinical parameters.