Aesthetic Index Research Articles

Prevalence of malocclusion and orthodontic treatment needs in children with special needs in district Mandi, Himachal Pradesh, India

Malocclusion plays an important role in overall oral health of every individual because it is associated with periodontal disease, temporomandibular disorder and may be complicated by an individual disability and special need.To determine the prevalence of malocclusion in children with special needs in District, Mandi, Himachal, Pradesh, India, using DAI and IOTN, and to assess whether the observed malocclusion is affected by sex. The study was consists of 200 children with mental retardation, physical disability, sensory impairment between 10-18 years of age from various special schools for people with special needs. A pre-structured proforma was used to record the findings and socio-demographic information. The special need children were examined in respective schools under natural light, using Dental aesthetic Index (DAI) and Index of orthodontic treatment need (IOTN).The prevalence of the malocclusion was found to be more in the subjects with the mental retardation and physical disability followed by hearing and visual impairment. There were no statistically significant differences in DAI and IOTN scores between gender.: The need for orthodontic treatment was found to be more in mentally retarded group than the other groups of special need children as per the IOTN and DAI scores in District, Mandi, Himachal, Pradesh.

AI assistance in aesthetic medicine-A consensus on objective medical standards.

Aesthetic medicine has traditionally relied on clinical scales for the objective assessment of baseline appearance and treatment outcomes. However, the scales focus on limited aesthetic areas mostly and subjective interpretation inherent in these scales can lead to variability, which undermines standardization efforts. The consensus meeting aimed to establish guidelines for AI application in aesthetic medicine. In February 2024, the AI Consensus Group, comprising international experts in various specialties, convened to deliberate on AI in aesthetic medicine. The methodology included a pre-consensus survey and an iterative consensus process during the meeting. AI's implementation in Aesthetic Medicine has achieved full consensus for enhancing patient assessment and consultation, ensuring standardized care. AI's role in preventing overcorrection is recognized, alongside the need for validated objective facial assessments. Emphasis is placed on comprehensive facial aesthetic evaluations using indices such as the Facial Aesthetic Index (FAI), Facial Youth Index (FYI), and Skin Quality Index (SQI). These evaluations are to be gender-specific and exclude makeup-covered skin at baseline. Age and gender, as well as patients' ancestral roots, are to be considered integral to the AI assessment process, underlining the move towards personalized, precise treatments. The consensus meeting established that AI will significantly improve aesthetic medicine by standardizing patient assessments and consultations, with a strong endorsement for preventing overcorrection and advocating for validated, objective facial assessments. Utilizing indices such as the FAI, FYI, and SQI allows for gender-specific, age adjusted evaluations and insists on a makeup-free baseline for accuracy.

Effect of facial and nasolabial asymmetry on perceived facial esthetics in children with non-syndromic cleft lip and palate

ObjectiveThe aim of the present study was to objectively assess the degree of residual facial asymmetry after primary treatment of non-syndromic unilateral cleft lip and palate (UCLP) in children and to correlate it with subjective ratings of facial appearance.Materials and methodsStereophotometry was used to record the faces of 89 children with UCLP for comparison of cleft and non-cleft sides up to 5 years after primary cleft closure. Root mean square values were calculated to measure the difference between the shape of cleft and non-cleft sides of the face and were compared to controls without a cleft lip. The Asher-McDade Aesthetic Index (AMAI) was used for subjective rating of the nasolabial area through 12 laypersons.ResultsChildren with a cleft lip (CL) showed no significant difference in RMS values compared to controls. Significant differences occurred when the evaluation was limited to the nasolabial area, however only in patients with cleft lip alveolus (CLA) and cleft lip palate (CLAP)(p < 0.001). In contrast, subjective ratings showed significantly higher values for all three cleft severity groups (CL, CLA, CLAP) compared to controls (p < 0.001). There was a non-linear correlation between the RMS (root mean square) values and the AMAI score.ConclusionsEven non-significant discrete objective deviations from facial symmetry in children after primary closure of UCLP are vigilantly registered in subjective ratings and implemented in the judgement of facial appearance.Clinical relevance3D stereophotometry is a usefull tool in monitoring asymmetry in patients with a cleft.

Effect of zirconia personalized gingival penetration on peri-implant soft and hard tissue of thin gingival biotypes in the anterior region: a retrospective study

Objective: To investigate the effect of zirconia personalized gingival structure on peri-implant soft and hard tissue stability after single-tooth implant restorations in patients with thin gingival biotypes in the anterior region, with a view to provide a clinical guideline. Methods: This retrospective study included 20 patients with thin gingival biotype and implant restorations in the anterior region. These patients included 9 males and 11 females, and the age was (35.2± 10.3) years. The patients were from the Department of Periodontal Implantology, Stomatology Hospital, Southern Medical University from January 2018 to December 2022. Computer-aided design/computer-aided manufacturing (CAD/CAM) techniques were used to fabricate a titanium base zirconia personalized gingival structure to maintain the soft-tissue perforated gingival contour of the anterior esthetic zone. This structure consists of two modalities: titanium base + zirconia outer crown or titanium base personalized zirconia abutment + zirconia outer crown. Clinical outcomes were recorded immediately and after delivery of the final restorations. Implant retention was recorded, esthetic scoring was performed using the pink esthetic index, the amount of bone resorption at the implant margins was measured based on digitized apical radiographs, and periodontal health was evaluated using the modified plaque index and the modified bleeding index. Results: The survival rate of the 20 implants was 100% after 3 years of wearing the final restorations, with a pink aesthetic score of 9.3±0.9. Bone resorption at the proximal and distal mesial margins of the implants was 0.09 (-0.21, 0.20) mm, 0.17 (-0.12, 0.27) mm after 3 years, respectively, and the difference was not statistically significant when compared to bone resorption immediately after placement of the final restoration [0(0, 0) mm] (Z=-1.03, P=0.394; Z=-2.05, P=0.065). Conclusions: Zirconia personalized gingival structure maintains the stability of peri-implant hard and soft tissues of thin gingival biotypes in the anterior region.

Single-piece zirconia versus single-piece titanium, narrow-diameter dental implants in the anterior maxilla: 5-year post-loading results of a randomized clinical trial.

The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single-piece zirconia versus titanium narrow-diameter implants. Additionally, clinical, radiological and patient-reported outcome measures (PROMs) were analyzed. Thirty implants (tissue level implant) were placed in 30 patients in the maxillary esthetic sector. Depending on randomization, a zirconia (test) or titanium implant (control) was placed. Esthetic, clinical, and radiological parameters, including the implant crown esthetic index (ICAI), pink esthetic score (PES), probing pocket depth, bleeding on probing, plaque index, and marginal bone levels, were evaluated at 12, 36 and 60 months after loading. Sixty months after crown placement, no significant differences were found between groups. The ICAI values were 5.25 ± 4.21 and 4.50 ± 2.98 for the test and control groups, respectively. The corresponding PES values were 7.44 ± 1.93 and 7.43 ± 1.74 for the test and control groups, respectively. There were no significant intergroup differences for the rest of the parameters evaluated. It can be suggested that monotype zirconia implants may serve as a potential alternative to titanium implants in selected clinical scenarios. While the results demonstrated comparable esthetic, clinical, and radiological aspects for zirconia implants as compared to titanium implants after a 5-year follow-up period, further research with larger sample sizes and longer-term follow-up is recommended.

Assessment of Nasal Aesthetic Parameters in Patients with Unilateral Cleft Lip and Palate – A Retrospective Study

Objectives To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to correlate the deviating cephalometric parameters with two aesthetic scoring systems. Design A retrospective study. Setting Dental college and hospital. Participants Pre-treatment lateral cephalograms and extra oral photographs of 20 adult patients with repaired UCLP presenting for orthodontic treatment. 20 patients with age and type of malocclusion matched control were selected. Main Outcome The nasal cephalometric parameters of patients with UCLP and a control group were compared. The nasolabial region of patients with cleft lip and palate (CLP) was scored using Asher McDade Aesthetic Index (AMAI) and Cleft Aesthetic Rating Scale (CARS). The scoring was done by six different groups assessors to study their perception of the nasolabial region. Correlation between cephalometric parameters and the aesthetic scores was done. Results The study found significant differences in nasal length ( P = .003) and depth ( P &lt; .001) between UCLP and the non-cleft control group. In the aesthetic assessment, orthodontist gave the least scores, while layman group scored the highest. The CARS nose aesthetic scores showed statistically significant high, negative correlation with the nasal length ( P = .01). Conclusion The cephalometric parameters and the aesthetic indices can be aid the orthodontists in the assessment of nasolabial aesthetics and additionally refer for further definitive rhinoplasty to improve the patient's overall facial aesthetics.

IMMEDIATE RESTORATION CUSTOM-MADE BY ADDITIVE MANUFACTURING ABOUT DENTAL IMPLANTS: PREDICTABLE RESULTS FOR PINK AND WHITE ESTHETICS

The definition of dental implant failure has evolved from focusing solely on lack of osseointegration to encompass broader concerns such as aesthetics. However, the criteria for aesthetic failure in implant dentistry are not well defined. Although several aesthetic indices have been validated to objectively evaluate clinical outcomes, including failure of an implant-supported crown. In this sense, aesthetic flaws in implant dentistry can be categorized into pink and white tissue flaws. This study aims to describe an extensive rehabilitation protocol where implants were placed using printed surgical guides and adaptations for bone and tissue grafts, facilitating restoration in the aesthetic zone. Key clinical stages and aspects are illustrated through the case of a fractured upper left central incisor, where an implant system was used for immediate patient rehabilitation. By highlighting these crucial steps and considerations, this study underscores the effectiveness of immediate implantation and restoration techniques in achieving optimal aesthetic and functional outcomes in dental rehabilitation

A Longitudinal Investigation of Nasolabial Changes With and Without Revision Surgery in Patients with Non-Syndromic Unilateral Cleft Lip and Palate.

To determine a baseline of anticipated change in nasolabial appearance following primary repair of unilateral cleft lip/palate and evaluate the degree to which revision surgery improves nasolabial appearance. Retrospective chart review. Patients treated at the Lancaster Cleft Palate Clinic interdisciplinary clinic. Twenty-three patients with complete unilateral cleft lip and palate who underwent primary surgical repair and 19 additional patients who underwent subsequent revision surgery were included. Patients in the non-revision group underwent a Tennison-Randall triangular flap lip repair at 3mo. Patients in the revision group underwent a modification of the Nakajima straight-line repair after primary Tennison-Randall triangular flap lip repair at an average age of 141mo. A modification of the Asher-McDade Aesthetic Index was utilized to evaluate Nasolabial Frontal (NLF), Nasolabial Profile (NLP), Vermillion Border (VB), and total change in appearance. Scores for patients in the revision group were evaluated before and after revision while appearance for patients without revision was evaluated at 3 distinct ages. Scores were averaged across time-points and inter-rater reliability was assessed. Nasolabial appearance in the non-revision sample did not change significantly over time, except for nasal profile. Scores improved after revision surgery - NLP: 3.48 to 2.97, (p = 0.001); NLF: 3.50 to 2.95 (p = 0.001); and Total Nasolabial Score: 3.29 to 3.01 (p = 0.004), with no significant change in VB. Decisions regarding need for nasolabial revision surgery may be made as early as 5yo with successful outcomes following secondary surgery improving appearance except for vermillion border appearance.

An Assessment of the Subjective Psychological and Social Effects of Malocclusion-Related Dental Aesthetics and Its Influence on Body Self-Image and Oral Health-Related Quality of Life in Young Adults.

Malocclusionhas a psychological impactrelated to the patient's age. It also influences the quality of life.This research aims to test the null hypothesis that there is no association between the self-perceived psychosocial impacts of dental aesthetics with the severity of malocclusion, oral health-related quality of life (OHRQoL), and self-image of the body in young adults seeking orthodontic treatment. A convenience sample of young adults between 19 and 30 years old was selected for the study.The severity of malocclusion and orthodontic treatment needs were evaluated using the Dental Aesthetic Index (DAI). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile-14 (OHIP-14), and Body Satisfaction Scale (BSS) were used to evaluate the self-perceived effects of malocclusion. The Kruskal-Wallis test is used to analyze the distribution of components with different grades of DAI.Spearman's correlation test evaluated the correlation between independent variables and their domains. The study utilized stepwise multiple linear regression analysis to assess the predictive value of independent factors on the PIDAQ and its domains. A total of 181 subjects with a mean age of24.4 ± 1.5 years, 42% males and 58% females, participated inthis study. There was a significant correlation (p < 0.05) between all variables (OHIP-14, DAI, and BSS) and PIDAQ. There were significant correlations between the independent variables and the total score of PIDAQ (R2 = 0.16), psychological impact (R2 = 0.09), and social impact (R2 = 0.18), as well as dental self-confidence (R2 = 0.21) and aesthetic concern (R2 = 0.16). In young adults, the self-perceived impact of dental aesthetics is moderated by the severity of malocclusion, oral health-related quality of life, and body satisfaction. The null hypothesis is rejected.

One Piece CAD/CAM Abutment for Screw-Retained Single-Tooth Restorations: A 5-Year Prospective Cohort Study.

The use of ceramic-coated patient-specific CAD/CAM titanium abutments represents a therapeutic option for the rehabilitation of single tooth. The utilization of highly customized abutments enables the accurate three-dimensional positioning of the prosthetic emergence. This study evaluates the clinical performance of implant-prosthetic rehabilitations carried out using ceramic-coated CAD/CAM titanium abutments. Thirty implants were placed in thirty patients and rehabilitated with thirty single crowns attached to CAD/CAM titanium abutments. A conventional procedure was applied, with implant placement after post-extraction socket healing and prosthetic restoration after implant healing. Implants of lengths ranging from 6-15 mm and widths of 3.6, 4.2, and 4.8 mm were used in this study. At the time of prosthesis delivery (T0), after two years (T1), and after five years (T2), plaque (PI) and bleeding (BoP) indices, probing depths (PPD), marginal bone levels (MBL), and PES/WES were evaluated for each implant. No patient dropped out of the study during the follow-up period. All thirty implants were clinically successful at five years post-prosthesis delivery (survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of patients; and 75% in 3% of patients). The mean PPD was 2.05±0.56 mm at T0, 1.992±0.6 mm at T1, and 1.867±0.439 mm at T2. The mean MBL at T0 was 0.413±0.440 mm, at T1 was 0.306±0.388 mm, and at T2 was 0.263±0.368 mm. The mean PES, WES, and PES/WES indices, 7.43±1.04, 7.57±0.82, and 15.00±1.17, respectively, indicate good integration of soft tissues, satisfactory aesthetics, and an overall positive outcome. The success rates, maintenance of marginal bone levels, and periodontal and aesthetic indices suggest the validity of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns.

Are changes in malocclusion associated with adulthood psychosocial well-being?

The purpose of this study was to investigate the longitudinal psychosocial effects of changes in malocclusion from adolescence to adulthood on oral health-related quality of life (OHRQOL), self-rated dental appearance, and overall life satisfaction. The Dunedin Multidisciplinary Health and Development Study is a longitudinal birth cohort study of 1037 children born at Queen Mary Hospital, Dunedin, New Zealand, between April 1, 1972 and March 31, 1973. Data on their health and development, including dental examinations, has since been collected periodically. Malocclusion severity was measured using the Dental Aesthetic Index in participants aged 15 and 45 years (data collected at age 18 years was supplemented for data missing at age 15 years). Other data collected included clinically assessed oral health (dental caries and periodontal disease experience) and self-rated dental appearance, OHRQOL, life satisfaction, and personality traits. Malocclusion data were available for 868 participants in adolescence and 834 aged 45 years. For those with a severe handicapping malocclusion at 15 years old, 46.6% who received orthodontic treatment transitioned to a resolved (ie, mild-moderate) malocclusion when aged 45 years, whereas only 16.2% of those who did not receive orthodontic treatment made that transition. A transition to a worse malocclusion was associated with impacts on OHRQOL when aged 45 years in the subdomains of functional limitation, psychological discomfort, and physical disability as well as worse self-ratings of dental appearance, and these findings were held after adjusting for potential confounders. Malocclusion was not associated with overall life satisfaction. Maintenance of acceptable occlusion after orthodontic treatment requires a strong emphasis on achieving and maintaining excellent dental health and avoiding chronic oral conditions such as dental caries and tooth loss. The long-term benefits of orthodontic treatment may diminish by midlife unless good dental health is maintained. Orthodontists have the responsibility to raise awareness among their patients on how to maintain good oral health after orthodontic treatment.

Comparison of the Factors Affecting Smile Esthetics with the Patient and Physician Perceptions Using the Smile Esthetic Index

Objective: This study aimed to evaluate the smile esthetics of individuals and the factors affecting it using the smile esthetic index (SEI) and compare them with the patient’s perception of smile. Methods: Seventy-six patients consisting of 44 females and 32 males who presented to for routine periodontal treatments were included in study. The smile esthetics were evaluated by three researchers on the photographs taken from the patients. The visual analog scala was used for the subjective evaluation of smile esthetics. Results: According to the results obtained from the study, the average of the SEI total scores was 6.38; the mean subjective evaluation of smile aesthetics was 6.33. There was no statistically significant difference depending on gender and age in the subjective and objective evaluations of the patients’ smile aesthetics. A statistically significant correlation was found between the physician’s scoring for objective smile aesthetics and the age of the patients. Conclusion: The SEI is an index that can be applied in the clinic and is used to evaluate the smile esthetics revealing objective values. Different esthetical outcomes may occur with objective and subjective evaluation.The use of these indices for diagnosis and treatment planning will allow for developing appropriate treatments.

A comparative study of the use of digital technology in the anterior smile experience

Objectivesthis study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations.MethodsSixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index.ResultsBased on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction.ConclusionDigitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

Contextual and individual factors associated with traumatic dental injuries in deprived 12-year-old schoolchildren: A cohort study.

Traumatic dental injuries (TDIs) among children and adolescents have been acknowledged as of public health concern worldwide. The aim of the study was to assess the relationship between contextual and individual characteristics and TDIs in 12-year-old schoolchildren. A cohort study was conducted with 355 schoolchildren living in deprived communities in the city of Manaus, Brazil. Contextual factors (place of residence and socio-economic indicators) and individual characteristics, including sex, family income, parents/guardians years of schooling, overjet and open bite (Dental Aesthetic Index), self-esteem (Rosenberg Self-Esteem Scale), sense of coherence (Sense of Coherence Scale), oral health beliefs, social support (Social Support Appraisals) were assessed at baseline. TDIs were measured at baseline and at 2-year follow-up using the O'Brien Index. Data were analysed through confirmatory factor analysis and structural equation modeling. The baseline prevalence of TDIs was 17.6% and the incidence of TDIs at 2-year follow-up was 26.8%. Better psychosocial status had a direct protective effect on the incidence of TDIs (β = -.184). Better contextual characteristics (β = -.135) and greater overjet (β = -.203) were directly associated with poor psychosocial status. Higher schooling of parents/guardians directly predicted better psychosocial status (β = .154). Psychosocial status mediated the relationship of greater overjet (β = .036), contextual factors (β = .024) and parental/guardian schooling (β = -.027) with TDIs. Contextual factors and individual characteristics predicted TDIs. Psychosocial status was a relevant individual attribute in the causal network of TDIs, due to the direct effect on the incidence of TDIs as well as a mediator on the influence of contextual factors, overjet and parents/guardians schooling on the incidence of TDIs.

Classified diagnosis and treatment scheme of oral cosmetic restoration based on aesthetic analysis (part Ⅱ): Chinese aesthetic connotation and analysis scheme.

At present, the commonly used clinical protocols of oral cosmetic restoration are mostly based on the oral aesthetic indexes proposed by Western developed countries (referred to as Western aesthetics), which are different from the oral aesthetic indexes unique to Chinese people (referred to as Chinese aesthetics). In the design of restoration schemes and the evaluation of restoration effects, these differences have a large or small effect on the doctor-patient-technology triad. Improper handling could directly weaken the cooperation efficiency of the three parties, reduce patient satisfaction, and even lead to medical disputes in serious cases. From doing a good job of oral cosmetic restoration in China, the connotative characteristics of Chinese oral aesthetics are introduced in this paper, and the value of oral aesthetic analysis in diagnosis and treatment is discussed. The process and method of aesthetic analysis and assessment through the modified Chinese psychosocial impact of dental aesthetics questionnaire and the evaluation ruler of the expected value of oral cosmetic restoration are further introduced in detail.

Development of an Instrument for the Online Evaluation of Orthodontic-Treated Cases: A Pilot Study

Background: It is necessary to create a sound method for the optimal evaluation of treated cases of orthodontic board exam candidates. This cross-sectional study aimed to design and validate a new method for the national orthodontic board exam using a web-based program. Methods: Complete documents of 10 patients randomly selected from a pool of the previously presented cases at the national board examination were entered into a web-based program called "the Orthoboard". The documents were arranged according to the European Board of Orthodontist Standards, and 15 related questions were asked based on the index of complexity, outcome, and need index and the American Board of Orthodontics evaluation standards. A customized grading system was used for the finalized questionnaire. They were asked to be evaluated by 10 orthodontists (5 with less and 5 with more than 10 years of experience). The content validity of the questionnaire was analyzed by the content validity index and content validity ratio. The reliability of this questionnaire was measured using the Kappa statistical test. Results: Most evaluators do not consider it necessary to ask questions about the diagnostic resume, problem list, treatment plan, and treatment resume. Crowding after treatment and cross-biting before and after treatment had the best interexaminer reliability. The least agreement among examiners was between the pre-treatment aesthetic index and the pre-treatment buccal segment relationship. Conclusion: Inter-examiner reliability was lower than expected, indicating that the orthodontic board test scoring is too subjective. The addition of a 3-dimensional cast is recommended for better objective evaluation.

Immediate implant placement with immediate or delayed provisionalization in the maxillary aesthetic zone: A 10-year randomized trial.

To compare the marginal bone level of immediately placed implants, with either immediate or delayed provisionalization (IP or DP), in the maxillary aesthetic zone after 10 years of function. Participants with a failing tooth in the maxillary aesthetic zone were randomly assigned to immediate implant placement with either IP (n = 20) or DP (n = 20) after primary wound closure with a free gingival graft. The final restoration was placed 3 months after provisionalization. The primary outcome was change in marginal bone level. In addition, implant survival, restoration survival and success, peri-implant tissue health, mucosa levels, aesthetic indices, buccal bone thickness and patient satisfaction were evaluated. After 10 years, the mean mesial and distal changes in marginal bone level were -0.47 ± 0.45 mm and -0.49 ± 0.52 mm in the IP group and -0.58 ± 0.76 mm and -0.41 ± 0.72 mm in the DP group (p = .61; p = .71). The survival rate was 100% for the implants; for the restorations, it was 88.9% in the IP group and 87.5% in the DP group. Restoration success, according to modified USPHS criteria, was 77.8% in the IP group and 75.0% in the DP group. The prevalence of peri-implant mucositis was 38.9% and 35.7% and of peri-implantitis 0.0% and 6.3%, respectively, in the IP group and DP group (p = 1.0; p = .40). The Pink Esthetic Score and White Esthetic Score was 15.28 ± 2.32 in the IP group and 14.64 ± 2.74 in the DP group, both clinically acceptable (p = .48). The buccal bone thickness was lower in the DP group. Patient satisfaction was similar in both groups (p = .75). The mean marginal bone level changes after immediate implant placement with IP were similar to those after immediate placement with DP. Registered in the National Trial Register (NL9340).

Dental health in the adult population of Arkhangelsk: а study protocol

BACKGROUND: The Arkhangelsk region is characterized by a high prevalence and intensity of dental diseases among adults, but most of the studies were either hospital-based or used small samples with questionable representativeness.&#x0D; AIM: This article is a protocol of an original study, the purpose of which is to assess the dental status and its association with somatic health in a representative sample of the adult population of Arkhangelsk.&#x0D; MATERIAL AND METHODS: In 2022, a cross-sectional study “Prevalence of dental pathology among the population of the Arctic zone of the Russian Federation (using the example of Arkhangelsk) and associated characteristics of the microbiome of the intestine and the respiratory tract” (hereinafter referred to as the dental study) was conducted in Arkhangelsk. The dental study was a part of the study “Molecular and genetic markers of the response to coronavirus infection and changes in the human microbiota and metabolome during the COVID-19 pandemic” (hereinafter referred to as the study on the effects of COVID-19). Data collection for the study was carried out from October 3 to November 10, 2022 at the Northern State Medical University. The study involved 463 adults aged 42–76 years living in the city of Arkhangelsk, representing a random sample of the adult population who had previously taken part in the “Know Your Heart” project in 2015–2017. All participants were asked to undergo an additional dental examination. The response rate was 91.6%. The dental examination included a questionnaire, assessment of dental status as recommended by the World Health Organization (2013), assessment of oral hygiene and gum inflammation, dental aesthetic index (DAI), collection of gingival fluid, autofluorescence stomatoscopy (AFS), examination by an orthodontist with periotestometry, performing a photo protocol, conducting biometrics of plaster models. When indicated, participants were asked to undergo an in-depth diagnostic to identify orthodontic pathology, namely, teleradiography and a cone-beam computed tomography.&#x0D; EXPECTED RESULTS: The proposed study using validated instruments and a representative sample has a major strength in providing unbiased assessment of the prevalence of oral health conditions in Arkhangelsk in the studied age group. Moreover, the material collected in this study has a potential to provide a unique opportunity to assess the associations between dental health and somatic health, lifestyle, microbiota, and metabolome since the data on the abovementioned characteristics were collected during the other projects and stored in a biobank.

Influence of malocclusion on sleep bruxism and orofacial pain: data from a study in school children.

This cross-sectional school-based study explored the influence of malocclusion on temporomandibular disorders (TMD) pain complaints, and whether this association would be mediated by sleep bruxism in a representative sample of 7- to 8-year-old children. Path analysis estimated direct, indirect, and total effects of occlusal features on sleep bruxism and TMD pain in 7- to 8-year-old children. Occlusal features were assessed with Dental Aesthetic Index (DAI), orofacial pain complaints using the TMD pain screener, possible sleep bruxism based on self-reports, and probable sleep bruxism based on self-reports combined with clinical findings. Structural equation modeling analyzed data with confounding factors. From 580 participants, possible sleep bruxism was observed in 136 children (31.5%), probable sleep bruxism in 30 children (6.7%), and TMD pain complaints in 78 children (13.8%). Malocclusion had no direct effect on either possible sleep bruxism [standardized coefficient (SC) 0.000; p = 0.992], or TMD pain complaints (SC - 0.01; p = 0.740). When probable sleep bruxism was set as the mediator of interest, malocclusion did not directly affect probable sleep bruxism (SC 0.01; p = 0.766), nor TMD pain complaints (SC - 0.02; p = 0.515). A direct effect of probable sleep bruxism on TMD pain complaints was observed with an SC of 0.60 (p < 0.001). However, in neither case, malocclusion indirectly affected TMD pain complaints via bruxism. Malocclusion in 7- to 8-year-old children did not directly influence possible or probable sleep bruxism or TMD pain complaints. Instead, probable sleep bruxism was strongly associated with TMD pain complaints. The impact of occlusal features on TMD pain complaints and bruxism has been a long-standing controversy in dentistry. However, the scientific literature linking this association may be inconsistent, mainly due to biased sample selection methods with inadequate consideration of confounders. Further research should try to identify additional risk factors for TMD pain in addition to probable sleep bruxism in children.

Preliminary study on reliability and validity of the Chinese version of the Asher-McDade aesthetic index.

This study aims to test the reliability and validity of the Chinese version of the Asher-McDade aesthetic index and clarify its feasibility for the postoperative outcome evaluation of cleft lip in China. The Chinese version of the Asher-McDade aesthetic index was established through translation, back translation, debugging, and pre-survey. Eighty postoperative photographs of patients with cleft lip admitted to the West China Hospital of Stomatology, Sichuan University were included. Ten healthcare professionals, including surgeons, nurses, and students, in the department of cleft lip and palate surgery finished the index to test its reliability and validity. The Cronbach's alpha coefficient and retest reliability of this index are 0.804 and 0.895, respectively. The item-level content validity index (I-CVI) and scale-level content validity index ave-rage (S-CVI/ave) of the index are 1.000 and 0.95, respectively. For this index, the Kaiser-Meyer-Olkin (KMO) test score is 0.706, the χ2 value of Bartlett's test for the consistency of the index is 962.260 (P<0.01), and the cumulative variance contribution rate is 63.095%. The Chinese version of the Asher-McDade aesthe-tic index has good reliability and validity and is applicable to the professional evaluation of the effect of postoperative photographs in Chinese patients with cleft lip.