Esthetic Dentistry Research Articles

An in-vivo Analysis of the Positional Relationship of Palatal Rugae with Maxillary Teeth in Different Arch Forms Among Young Dentulous Gujarati Individuals-A Pilot Study

Background- The palatal rugae are transverse folds of tissue located in the anterior portion of the hard palate. They are considered to be reliable landmarks with manifold uses in the field of orthodontics and forensics. The current study was carried out with the aim of determining if a positional relationship of palatal rugae exists with the maxillary teeth in individuals with different maxillary arch forms. Material and method- The study was carried out in 100 participitants (87 females and 13 males) . Irreversible hydrocolloid impressions were made and casts were poured in Type 3 dental stone. The casts were divided according to arch forms as taper, ovoid and square. Palatal rugae on the casts were assessed digitally and the position of the most posterior rugae evaluated in relation with the adjacent maxillary teeth. Results –It was observed that the palatal rugae had a higly significant positional relationship with the maxillary posterior teeth(p value <0.0001) . In the ovoid and square arches, majority of the individuals had the most posterior rugae lying at the level of distal margin of 2nd premolar while in cases of taper dental arches, maximum number of individuals had the distal margin of 1st premolar coincide with the most posteriorly located rugae. Conclusion- Hence, it can be concluded that the most posterior limit of the rugae may serve as a reliable guide for the arrangement of the maxillary teeth in different arch forms. Key Words- Palatal Rugae, maxillary anterior teeth , denture aesthetics

Presence of an included mesiodens. Report of a case

Introduction: Supernumerary teeth are additional teeth to the normal formula, in turn these can be retained; that is to say that they are prevented from erupting due to anomalies of position or situation. Objective: The objective of this work is to report the clinical case of an included mesiodens, its affectations in the oral cavity and the surgical treatment. Case report: A 20 year old male patient presented several dental malpositions; in addition to the radiographic examination (panoramic x-ray) the presence of a supernumerary tooth compatible with a mesiodens was observed, which due to its location was affecting the roots of the teeth and caused the partial extrusion of tooth 2.1 and the widening of its periodontal ligament. An occlusal radiograph was requested to establish the best approach. After the radiological diagnosis of the supernumerary tooth, surgical treatment was performed. Conlusion: In the present clinical case, the presence of impacted teeth is observed, indicating that some teeth have failed to fully emerge into the oral cavity. These impacted teeth may be causing dental misalignment, malposition and possible bite problems. Detailed radiographic evaluation and clinical analysis suggest the need to consider treatment options, such as extraction or surgical intervention, to allow proper eruption and restore optimal dental function and esthetics

Botox: Current and Emerging Trends for Dental Practitioners in Esthetic Dentistry.

There are numerous medical and dental disorders for which there are no effective traditional therapy options. For various medical and dental disorders, botulinum toxin (BT) can be employed as an alternate therapeutic option that uses the chemodenervation approach. The range of dentistry treatment choices is expanding quickly. Applications of non-traditional therapy alternatives, such as the use of BT, are becoming more and more common in this situation. Although BT has been shown to be effective in a number of circumstances, its application in esthetic operations, such as the treatment of facial wrinkles, has gained widespread acceptance. This research is especially interested in applications of BT related to dentistry in the craniofacial region. For many diseases that a dentist would be interested in treating, BT provides a temporary, reversible, and generally safe therapy option. Due to their extensive knowledge of the anatomy of the faciomaxillary region, dental surgeons are a potential pool of operators who, with a small amount of skill enhancement, can use BT in their toolkit. This broadens the scope of minimally invasive alternatives to invasive protocols or refractory conditions. An online search was conducted for the use of BT in dentistry; all studies and articles pertaining to the subject were chosen, and dental-related content was removed and summarized. The fundamentals of BT and some of its applications in dentistry are covered in this article. The comprehensive details of its application in dentistry will be covered in the upcoming sections.

Evaluating malocclusion patterns in children with autism spectrum disorder using the index of complexity, outcome and need: a cross-sectional study

BackgroundThe purpose of this study was to evaluate the complexity of malocclusion and existing patterns in children with autism spectrum disorders (ASD) using the index of complexity, outcome and need (ICON).MethodsThis cross-sectional study included children diagnosed with ASD, aged 9–15 years. A group of healthy children with the same demographic characteristics was randomly selected as the control group. Malocclusion was assessed according to ICON scoring protocol. The following parameters were recorded: dental aesthetics, upper arch crowding/spacing, presence of crossbite, anterior-vertical relationship (open and deep bite) and buccal segment anterior-posterior relationship. Finally, an overall ICON score was derived and reported for each patient. Descriptive analysis was performed for all investigated variables. Significance level was set at p < 0.05.ResultsA total of 324 children, divided into ASD (162) and control (162) groups, comprised the study population. Our results demonstrated that the average overall ICON score was significantly higher in the ASD group compared to the control group (38.77 vs. 27.43, p < 0.001). ASD children also obtained significantly higher scores regarding the dental aesthetics component (3.84 vs 2.78, p < 0.001). Study groups were significantly different in terms of the prevalence of incisor overbite and open bite (p = 0.002 and p < 0.001, respectively). Patients in the ASD group showed a higher prevalence of Class II and Class III malocclusions (p < 0.001).ConclusionASD children obtained significantly higher overall ICON scores, indicating more complex and severe malocclusions. These children also exhibited a greater tendency towards Class II and III malocclusions.

Reliability and self-perception of semi-automatically assessed orthodontic treatment need in elderly patients undergoing supportive periodontal therapy – a cross-sectional study

ABSTRACT Purpose Patients with periodontitis, who currently make up a large proportion of the adult population, show high interest in orthodontic therapy. It is therefore important to recognize and assess orthodontic treatment need in these patients. The index of orthodontic treatment (IOTN) is an established tool to determine malocclusions clinically and digitally. Materials and methods A semi-automatic IOTN-assessment using OnyxCeph3TM was performed on patients undergoing supportive periodontal therapy (SPT). Intra- and inter-rater reliability were investigated using intra-class-coefficient (ICC). Self-perceived aesthetic by patients and perception by the investigator according to the aesthetic component (AC) were compared to both each other and normative need, measured by the dental health component (DHC). Periodontitis stage and grade and the possibility of an orthodontic treatment were determined. Results The mean age of the 64 included patients in this study was 62.1 years (SD ± 8.6; min-max 45–81) at the time of the examination. Self-related AC was different to the investigator’s assessment (ICC: = 0.474; 95%-CI: [0.262, 0.643]). Normative treatment need compared to self-perceived treatment need resulted in poor reliability (ICC: = 0.098; 95%-CI: [−0.071, 0.298]). Comparison of IOTN between investigators showed moderate reliability for AC (ICC: = 0.618; 95%-CI: [0.331, 0.799]) and an excellent reliability for DHC (ICC: = 0.932; 95%-CI: [0.863, 0.967]). AC Intra-rater reliability was considered good (ICC: = 0.796; 95%-CI: [0.613, 0.898]). Orthodontic treatment was possible in 48 of the 64 patients. Conclusion Semi-automated IOTN-assessment showed satisfying inter- and intra-rater reliability, but patients’ self-perceived dental aesthetics differed from the dentist’s assessment as well as from the normative treatment need.

The Impact of Mouth Masks on Oral Hygiene Status, Seeking Dental Care, Esthetics, and Temporomandibular Joint Disturbances Among the Adult Population in Nellore District: A Cross-sectional Study

Abstract Background: Despite preventing infection transmission, because of its prolonged use, the impact of masks on social life, behavior, and oral hygiene status and habits of everyday people are still unknown. The knowledge of the changes in patients’ esthetic complaints, perceptions, and habits with the use of masks is essential for clinicians. Aim and Objectives: The aim of the study was to evaluate the impact of the continuous use of face masks on oral hygiene habits; dental, smile and oral conditions, and self-perception; current reasons to seek dental care; and the importance attributed to teeth and smile esthetics among the adult population (students/employees) who wear masks 6 h per day for 6 months from August 30, 2021 to February 28, 2022. Materials and Methods: An electronic survey (Google Forms) was used to generate a web-based platform for the responses in the form of a questionnaire. A link to the structured questionnaire was posted on Facebook, Instagram, Twitter, and WhatsApp. The study considered all the individuals willing to participate, and the subjects were informed about the survey’s objectives. Data Analysis Method: The recorded data were analyzed using the SPSS software. Proportions were compared using the Chi-square test. P &lt; 0.05 was selected to denote statistical significance with the confidence level, and the significance level was set at 95% and 5%, respectively. Conclusion: The study gave the current status of participants and their motivational levels toward seeking dental treatment, suggesting further studies in planning preventive strategies for the participants.

The link between oral health status and psychological well-being among young adults

ABSTRACT Background: To live a healthy, happy, and fulfilling life, oral health is vital. The one who has a healthy oral cavity can engage with people, eat, and interact without feeling uncomfortable or ashamed. Oral illness has a subtle but significant effect on people’s daily lives, affecting social and professional duties. Aim: The purpose of the study is to investigate how young individuals’ psychological well-being is impacted by their oral health. Materials and Methods: Psychological Well-being Questionnaire by Goldberg (1972), Oral Hygiene-Simplified Index (OHI-S) by John C. Greene and Jack R. Vermillion (1964), Psychosocial Impact of Dental Aesthetics Questionnaire by Klages et al., (2005), and Decay, Missing, and Filled Teeth (DMFT) Index by the World Health Organization (1987) were the instruments utilized for this study. Eighty-four working young adults in and around Chennai made up the study’s entire sample, and a purposive sampling technique was used; oral health-care therapies were provided, increasing the degree of oral hygiene status, decreasing the amount of decay, and replacing missing teeth with filled teeth. After that, secondary data gathering was completed. The Pearson correlation, independent sample t-test, and paired t-test were used as the statistical analysis methods for this investigation to confirm the hypotheses. Results and Conclusion: According to the study’s findings, maintaining good oral health helps working young adults feel psychologically well and can change their lifestyles to improve workplace well-being.

PERIOESTHETICS: PERIODONTAL APPROACH TO ESTHETIC DENTISTRY A CASE SERIES

Esthetic dentistry is evolving and so is its importance in periodontal treatment with increasing awareness. The harmony between lips, gums and teeth is the key to maintain facial esthetics. Multidisciplinary approach is important for acquiring an esthetic smile with periodontal treatment playing a vital role. Attention should be paid on maintaining an ideal and harmonious relationship between teeth and its supporting hard and soft tissue structures. This article presents a series of cases wherein periodontal treatment has played a vital role in improvising smile. This article aims to emphasize the role played by periodontal treatment in rehabilitating an esthetic smile.

Exploring patient perspectives: orthognathic surgery outcomes and experiences assessed by patient-reported outcome measures and patient-reported experience measures

Evaluating the effectiveness of orthognathic treatment can be difficult. To address this issue, patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) have been proposed as valuable instruments for understanding the quality of healthcare from the patients’ standpoint. Therefore, the aim of this project was to employ PROMs and PREMs questionnaires to capture the patients’ perspectives regarding their experience during the orthognathic treatment process, as well as their perception of their postoperative state. Preoperative and postoperative questionnaires were offered to patients at consenting appointment and at various timepoints after the surgery. The assessment of statistical relationships was carried out by means of Fisher’s exact test. A total of 64 preoperative and 126 postoperative responses were received. The primary motivators for pursuing the surgery were the improvement of facial and dental aesthetics, as well as increased satisfaction with photographic and video appearances. These three factors were also cited as the most important postoperative benefits. Of the respondents, 58% reported experiencing altered sensation to the lower lip at the 24-month follow up (p = 0.02); however, the affected patients reported that this did not have an impact on their daily activities. The use of PROMs and PREMs to appraise the quality of life constitutes a valuable method for surgeons to gauge their treatment efficacy. Above all, such tools are particularly useful for evaluating patient satisfaction, which is the ultimate objective of any treatment.

Soft Tissue Retraction Maneuver in Cone Beam Computed Tomography Prior to Crown-Lengthening Procedure-A Technical Note.

Background: An accurate determination of the biological width and the relationship of the cemento-enamel junction with the border of the alveolar bone is crucial during a clinical crown-lengthening (CCL) procedure. The aim of this study was to present a technical note about the retraction techniques in cone beam computed tomography (CBCT) prior to CCL, highlighting the significant enhancement in procedural accuracy and predictability that these techniques offer. Methods: Clinical and radiological examinations should be performed before a CCL procedure. It is necessary to determine the length of the tooth crowns, the periodontal pockets' depth, and the phenotype of the gingiva. The ideal CBCT examination should be performed with soft tissue retraction. This can be achieved using retractors or cotton rolls. Results: Retraction of the lips, cheeks, and tongue allows one to assess the marginal gingiva, the cemento-enamel junction, and the alveolar bone. A detailed plan of the CCL procedure, which involves retraction, ensures both the aesthetic appeal and the achievement of a newly defined gingival zenith, enhancing the overall visual harmony. Conclusions: Compared with conventional radiographic imaging, the soft tissue retraction maneuver in CBCT prior to CCL surgery offers an effective approach to the evaluation and diagnosis of soft and hard tissue. This is because of the detailed planning of the aesthetic CCL procedure. Such an approach leads to superior aesthetic outcomes in dentistry, contributing to the advancement of aesthetic dentistry through a harmonious blend of art and science.

Dental Aesthetic Perception of Dentistry Students: A Literature Review

The appearance of a smile has increasingly become a factor that significantly impacts an individual's self-esteem and social context. Consequently, there is a growing desire for changes in the oral region to achieve what is considered an ideal smile, particularly in light of new beauty standards, where white and aligned teeth are deemed highly relevant. However, the concept of beauty is highly subjective, and sometimes dental standards do not align with patients' aesthetic desires. This study aims to evaluate the dental aesthetic perception of dentistry students through an integrative review. For the reference framework, we searched articles from the PubMed and Lilacs databases from the past five years, using the keywords "Dental esthetic," "dental student," and "Smiling," with the Boolean operator "and." After a thorough reading of all the articles, nine studies were selected. This review showed that the level of education and gender presented differences in the perception of dental aesthetics. However, students generally agree that aesthetics must be associated with the health and naturalness of the smile, following dental anatomy, dental alignment, buccal corridor, level of gingival exposure, and color.

The Recent Use, Patient Satisfaction, and Advancement in Digital Smile Designing: A Systematic Review.

Digital smile designing (DSD) is a concept of dentistry which combines the old and the new and becomes a different world in the world of smile aesthetics and functionality. Dental aesthetics is not just a cosmetic issue but a multidimensional part of oral health that has a great impact on psychological well-being, social life, functional capabilities, and, hence, the quality of life. To put it simply, the recognition of its significance stresses the necessity of complete dental care which is the one that combines beauty and function as well as health. This systematic review aims to analyze the recent use and patient satisfaction of DSD and to show the recent advances in DSD. A thorough literature search was conducted across the online databases for articles about the implementation of digital smile analysis in dentistry. The articles that were published between 2013 and 2023 on DSD were selected which included randomized and non-randomized trials and observational studies covering the effectiveness, advantages, and patients' opinions about the treatment. The National Institutes of Health tool was applied for bias assessment. Ten studies were selected to address the use of DSD in dentistry based on the inclusion criteria. The findings from these studies suggest that DSD is useful in improving communication, reducing working time, minimizing errors, enhancing patient satisfaction, and providing clinical adequacy for final prosthetic pieces, indicating the usefulness of this approach in dental procedures.Smile designing using digital technologies has the potential to improve dental aesthetics and treatment procedures while showcasing their reliability and clinical effectiveness.

Effect of occlusal contact on TMJ loading during occlusion: An in silico study

Alterations in occlusal features may have significant consequences, ranging from dental aesthetics to health issues. Temporomandibular joint disorders (TMDs) are often associated with joint overload, and the correlation between occlusal features and TMDs has been thoroughly discussed. In current work, we introduced a novel stomatognathic model that aligns well with in vivo experimental measurements, specifically designed to decouple the impact of occlusal contact and periodontal ligament (PDL) negative feedback on temporomandibular joint (TMJ) loading. Utilizing an in-silico approach, the simulation analysis included six symmetric occlusal contact scenarios. Furthermore, a biomechanical lever model was employed to clarify the mechanical mechanism and investigate the multi-factorial effects of TMJ overload. These findings indicate that anterior shifts in the occlusal centre lead to increased TMJ loading, particularly in occlusal contact cases with anteroposterior changes. Considering the symmetrical distribution of occlusal contact, mediolateral alterations had a more modest effect on TMJ loading. Additionally, potential negative feedback activated by principal strain of periodontal could not only alleviate joint load but also diminish occlusal force. These investigations enhance our understanding of the intricate interactions between masticatory muscles, occlusal forces, and joint contact forces, thereby providing motivation for future comprehensive studies on TMJ biomechanical overload.

Rehabilitation of Anterior Esthetics Using CAD-CAM Fabricated Zirconia Maryland Bridge: A Case Report.

Introduction: Missing anterior teeth have a great impact on the psychological status of an individual due to the unesthetic appearance. These can be restored using removable prostheses, conventional bridges, resin-bonded prostheses, or implants. A resin-bonded fixed prosthesis is a minimally invasive treatment option in such cases to restore function and esthetics. Case Presentation: This case report describes the CAD-CAM zirconia Maryland bridge as a treatment modality for effective restoration of the missing maxillary central incisor in a 32-year-old female patient who reported the chief complaint of unesthetic appearance. The patient had a history of extraction due to trauma 6 months ago with normal overjet and overbite. Discussion: One of the types of resin-bonded prosthesis is a Maryland bridge which involves minimal tooth preparation with supragingival margins, thus maintaining periodontal health. Maryland bridges enhance dental esthetics with minimal loss of tooth structure. Conclusion: CAD-CAM fabricated all-ceramic resin-bonded prosthesis is an efficacious way of replacing missing anterior teeth, restoring function, providing excellent esthetics, and thus boosting patient’s confidence. Keywords: CAD-CAM zirconia, Maryland bridge, missing anterior tooth, resin-bonded fixed prosthesis, resin-bonded restoration.

Robotics in dental and facial esthetics

Dental and facial esthetics is an essential part of modern stomatology. With the development of science and technology and the advancement of interdisciplinary studies, the research of robot technology in the field of dental and facial esthetics is becoming more extensive, and its clinical applications are gradually increasing. This article provides insights into the research and application of robot technology in dental hard tissue esthetics, periodontal soft tissue esthetics, dentition space esthetics, and maxillofacial esthetics. It also highlights the current limitations and development trends and provides references for future research and application of robots in oral esthetics.

The Effect of Soft Tissue Structure on the Psychosocial Impact of Dental Aesthetics in Women and Men

Purpose: This study aimed to determine the impact of soft tissue structure on the psychosocial effects of malocclusions in women and men. Material and Methods: The severity of malocclusion was determined in 84 individuals with a Class I skeletal pattern. The Psychosocial Impact of Dental Aesthetics Questionnaire was administered to determine the malocclusion perceptions of the patients. Arnett’s soft tissue analysis was performed to determine the soft tissue structure. The difference between the sociodemographic factors and severity of malocclusion averages of men and women was statistically examined. Subsequently, the impact of Arnett’s soft tissue analysis parameters on the Psychosocial Impact of Dental Aesthetics Questionnaire scores of each gender was evaluated. Results: No statistically significant association was observed between women and men related to the sociodemographic factors and the severity of malocclusions. The number of Arnett’s soft tissue analysis parameters affecting the Psychosocial Impact of Dental Aesthetics Questionnaire scores was higher in men than women. Women were more psychologically affected by malocclusions, while men were affected by soft tissue structure changes, and women were affected by dental factors. Conclusion: Although the soft tissue structure did not affect the perception of malocclusions in women, women experienced a more severe psychological effect of malocclusion.

Linguistic Validity and Reliability of Urdu Version of Psychosocial Impact of Dental Aesthetic Questionnaire PIDA For Orthodontic Patients in Lahore, Pakistan

Linguistic Validity and Reliability of Urdu Version of Psychosocial Impact of Dental Aesthetic Questionnaire PIDA For Orthodontic Patients in Lahore, Pakistan

The Midline Supernumerary Tooth – Mesiodens: A Case Series

Supernumerary teeth have been proposed to be one of the most significant dental defects affecting the primary and early mixed dentition. These teeth can cause poor facial and dental aesthetics, as well as many pathological problems for the development of permanent dentition. Mesiodens are the extra teeth that have erupted or not yet erupted in the maxilla between the central incisors. Early identification and treatment are necessary to mitigate the negative effects of the mesiodens dentoalveolar structures. This case series discusses three different cases for the presence of supernumerary teeth leading to discomfort and aesthetic concerns. Extraction of the supernumerary teeth was performed to reduce future complications and was further suggested for orthodontic correction. Key Words: Children, Mesiodens, Supernumerary tooth

Evaluation of the colour stability of different ceramic materials with two thicknesses

Society places a great emphasis on aesthetics, &amp; there is a constant rise in the demands placed on dental restorations' aesthetics. The aim of this in-vitro research was to study the impact of the finishing protocol on the color stability parameter of different glass-ceramic materials with two different thicknesses, before &amp; after thermocyling. One hundred twelve specimens had been prepared with standard dimensions of one mm &amp; two mm thickness &amp; ten mm diameter for the four different glass-ceramic materials. The ceramic specimens had been separated into 4groups according to ceramic material (n=28): IPS e.max Press, CeraMotion, Rosetta SP &amp; CeltraPress, each group had been subdivided into two sub-groups according to the specimen thickness (n=14): 1 mm and 2 mm. Each sub-group was further split into 2 divisions according to the finishing protocol (n=7): glazed only &amp; polished then glazed. The results of our study all samples have shown color change within visually perceptible but clinically acceptable level (more than 1 and less than 3.7), emax glazed samples (1mm&amp;2mm) together with emax glazed and polished samples (1mm) have shown significantly higher ΔE beyond the clinically acceptable level. Increasing ceramic thickness from 1 mm to 2 mm has shown better color stability in Emax group. Polishing before glazing increased color stability in Emax while decreased it in Celtra.

A comparative assessment of dento-facial aesthetics among dental, medical, nursing and physiotherapy students in a college of health sciences

There is increased awareness and concerns about dentofacial aesthetics in most population. We sought to determine the self-assessment of dental aesthetics and perceived treatment need among a group of health professions trainees and compare the same with the researcher’s report using the Aesthetic component (AC) of Index of Orthodontic Treatment Need (IOTN). This was a cross-sectional study of undergraduates in our College of Health Sciences. The researcher was calibrated. Subjects supplied their socio-demographic details, responses on perception of their teeth, and smile on a self-administered questionnaire. Additionally, respondents selected and documented a picture that best matches theirs from the AC of the IOTN chart, while the researcher did the same and compared the scores. Data were analyzed using the SPSS version 16.0.: 121 students were studied. 59% were previous dental clinic attendees. The majority (80.2%) usually females rated their smile pleasant. 69.4% expressed satisfaction with the appearance of their teeth. Male and female subjects differed significantly in the ratings of their smile and teeth; with significantly more females rating themselves better than average. Subjects’ scores differ significantly from the researcher’s; most subjects rated their occlusion better especially females (p&amp;#60;0.001), physiotherapy students(p=0.0016), and previous clinic attendees(p=0.02). The odds of correct self-assessment increased by 1.6 with respondents' gender and department.: While dental students are well suited for dento-facial aesthetic assessment, there is a need to introduce aspects of dental aesthetics and orthodontic treatment need appraisal among other oral health subjects to curricula in college of health science.