Aesthetic Problems Research Articles

Maryland Bridges: A Conservative Approach to Aesthetic Tooth Replacement – A Case Report

Restoring missing central incisors in the mandibular jaw is a challenging esthetic challenge in dentistry, especially for younger patients. Maryland bridges are a highly effective treatment option, restoring oral function and aesthetics, and resulting in high patient satisfaction. These bridges have advantages over conventional fixed dental prosthesis, such as minimal removal of the tooth structure, minimal pulpal trauma risk, and reduced time and cost. Provisional restorations are usually not required. Maryland bridges are cemented to the abutment tooth using electrolytic etching to retain the metal framework. The bond is strengthened after etching, and the development of resin cements has enhanced bridge retention. A missing anterior tooth poses an esthetic, functional, and rehabilitative problem, especially for younger patients. Resin bonded bridges are minimally invasive, offering advantages such as minimal removal of the tooth structure, minimal pulpal trauma risk, and reduced time and cost. This case report describes the fabrication technique for a single missing lower anterior tooth, focusing on conservative, economical, and esthetic treatment outcomes.

Most common congenital syndromes with facial asymmetry: A narrative review.

Symmetry is present in various aspects of everyday life. A symmetrical face is considered attractive, whereas a lack of facial symmetry is regarded as a source of functional and aesthetic problems. Most of the people exhibit slight asymmetries, but some of them reveal severe asymmetries. Among patients presenting with severe facial asymmetries, there may be those with congenital defects. Congenital defects may manifest at the time of birth or be a result of birth trauma.One of the most prevalent asymmetrical birth defects is cleft lip and/or cleft palate. Other congenital defects include craniofacial syndromes, such as Treacher Collins syndrome (TCS) and Goldenhar syndrome. Among the rare syndromes with facial asymmetries, Klippel-Feil syndrome (KFS), PHACE (posterior fossa brain malformation, hemangiomas, arterial anomalies, cardiac anomalies, and eye abnormalities) syndrome, plagiocephaly, and Parry-Romberg syndrome are worth noticing. The majority of craniofacial asymmetries require surgery to improve the patient's facial appearance. The treatment is multidisciplinary and long, and the most common procedures involve reparative and regenerative surgeries. The aim of this review was to present the most common congenital defects with facial asymmetry.

Aesthetic rehabilitation of a complex crown-root fracture by fragment reattachment with a fiber-reinforced post: A case report

Complex crown-root fractures are characterized by the involvement of both crown and root with pulp exposure. They pose aesthetic, functional, and psychological problems for the patient. Furthermore, they can pose technical difficulties for the practitioner. The purpose of this case report is to describe the management of a complex crown-root fracture of the right upper central incisor with subgingival limit by reattaching the tooth fragment with fiber-reinforced post. We considered a coronal elongation (gingivectomy and osteoplasty) to recreate the biological space and to expose the limit of the fracture line to guarantee the quality of the bond.

INTERCORRÊNCIAS NO USO ESTÉTICO DA TOXINA BOTULÍNICA FACIAL

Botulinum toxin, the causal agent of botulism, is the fermentation product of the bacteria Clostridium Botulinum. Toxins exist in 8 types, although in Brazil, only type A has ANVISA approval for cosmetic and therapeutic purposes. Due to its versatility and specific mechanism of action, it has become a great option for both therapeutic and cosmetic use worldwide, given the great potential in relation to its minimally invasive technique. Botulinum toxin injections treat aesthetic problems induced or aggravated by muscle contraction, controlling local neurotransmission. However, there are some risks and possible complications arising from its use. The present study, carried out in the form of a narrative review, aimed to describe the possible complications arising from the therapeutic and cosmetic use of the toxin for facial rejuvenation. To this end, studies published in the last 10 years were selected, retrieved from the Google Scholar and CAPES databases that addressed the topic. In addition to complications at the injection site, such as erythema, edema, pain, ptosis of the eyelid or eyebrow and ecchymosis, there is a group of aesthetic and functional adverse effects associated with different muscular responses to botulinum toxin or its migration. These complications occur less frequently than injection-associated reactions, but their risks and consequences are potentially greater. There are no reports of serious or fatal complications resulting from the cosmetic use of botulinum toxin. Complications depend on the technique used, so it is important to have adequate knowledge and training on the application technique.

The importance of nutrition and overweight as a risk factor in family medicine

Improper nutrition leads to changes in the body that are not only an aesthetic problem, but also lead to chronic diseases. The goals of the research are to analyze knowledge, habits and attitudes about nutrition and knowledge about obesity, to determine the body mass index (BMI) of all respondents, to analyze the connection between nutrition, excess body weight and the frequency of chronic non-communicable diseases. The study was cross-sectional epidemiological, descriptive-analytical, was conducted on a sample of 200 respondents of patients Family medicine, Public Health Center of the Sarajevo Canton. The survey was conducted by interviewing respondents using a modified questionnaire, made up of 27 questions. Analyzing the results, it was determined that the respondents' knowledge of nutrition is satisfactory, but that the majority of respondents (121) have a BMI over 25. For men in the age group of 46-55 years, the average BMI is 29.3, and for women in the same age group, it is 27. 5, which shows that they do not apply their own knowledge about nutrition. The majority of respondents (32%) whose BMI is over 25 have one or more chronic non-communicable diseases. Most respondents stated that they get information about proper nutrition through the media, although many of them suffer from some chronic diseases, they do not get information at the health center. In the family doctor's clinic, it is very important to recognize excess body weight, bad eating habits of patients in time, plan a prevention strategy, and prevent the further development of chronic diseases with professional counseling.

Mulberry lesion: Fibro-epithelial hyperplasia with an unusual clinical presentation

Fibro-epithelial hyperplasia comes under the category of reactive lesions which are basically progressive fibrous overgrowths which arise from the gingival connective tissue and periodontal ligament fibres and are presented in the oral cavity due to long standing local irritation which are not neoplastic and/or may cause esthetic and functional problems. Following case is presented describing an unusual type of clinical presentation of a long standing fibro-epithelial hyperplasia in a 55 year old female with a history of 3 years which was excised using a scalpel and was sent for a histopathogical analysis.

Multidisciplinary Treatment of A Class III Patient With Giant Open Bite Secondary to Macroglossia

Skeletal Class III malocclusion deformity is one of the most common maxillofacial malocclusions in East Asia and is either due to maxillary retrusion, mandibular protrusion, or both. It could cause functional and aesthetic problems. This deformity could be attributed to either hereditary or environmental factors or both. Tongue lymphangioma-induced skeletal class III deformity with open bite is a relatively rare condition. Therefore, its management poses a significant challenge to surgeons and requires a multidisciplinary approach. In this case report, such deformity was successfully managed through a multidisciplinary approach.

Multidisciplinary Consideration for Managing Gingival Black Triangles in Aesthetic Dentistry: A Review

The importance of aesthetics in modern dentistry is paramount. Aesthetics has its different values and perceptions, which may be different from the eyes of the patient and those of the clinician [1]. It is dependent on the socio-economic status and the upbringing and mentality of each individual person. Open gingival embrasures or black triangle cause complex functional and aesthetic problems. Management of such problems requires careful evaluation of the underlying causes. In today’s aesthetic environment where both the dentist and the patient are aware of aesthetic value, the real challenge was to reconstruct this lost papilla and moreover to obtain stable and sustainable results. asure area, root angulations, interproximal contact position, triangular-shaped crowns and aging. Treatment of black triangles often requires an interdisciplinary approach, involving of periodontal; orthodontic and restorative treatment. In this review, the authors highlighted the important etiological factors that predispose to the occurrence of the black triangles. In addition to the common biological factors, dimensional changes of papilla during orthodontic alignment, the relevant consequences of periodontal disease treatment and iatrogenic treatment mishaps such as poor veneers and crowns are factors have also been discussed as factors that may lead to black triangles.

Impact of pectus excavatum deformity on the cardiopulmonary function: a literature review

BACKGROUND: Pectus excavatum deformity is the most common chest wall malformation. Currently, surgeons and researchers of this problem have no consensus on whether pectus excavatum is a purely aesthetic problem or whether pectus excavatum disturbs the function of the cardiopulmonary system. AIM: To analyze publications on the effect of pectus excavatum on the cardiorespiratory system and the functional features of the heart and lung after thoracoplasty in patients with pectus excavatum. MATERIALS AND METHODS: Data were searched in the scientific databases PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary without language limitation. In this article, the method of analysis and synthesis of information was used. Most of the studies included in the analysis were published in the last 20 years. RESULTS: In patients with pectus excavatum, severity of cardiorespiratory dysfunction depends on the degree of chest deformity. According to obtained data, the pulmonary function test in patients with pectus excavatum in the majority of cases revealed restrictive pattern (formed vital capacity 80% of the norm, with normal ratio of forced expiratory volume in 1 minute to forced lung capacity). In most cases, echocardiography showed compression of the right heart chambers. Comparative analysis of the pre- and postoperative study of cardiorespiratory system in most cases indicated improvement and adaptation of the cardiopulmonary system to stress after surgical intervention. CONCLUSIONS: Funnel chest is an aesthetic problem wherein a severe degree of deformity leads to impaired respiratory mechanics and dysfunction of the cardiovascular system. Surgical restoration of the volume of the retrosternal space allows improvement of the functional capabilities of the heart and lungs.

Low-level laser therapy for skin rejuvenation: A safe and effective solution baked by data and visual evidence.

Skin aging and photoaging is a process that may appear at a relatively early age, causing an aesthetic problem. Common signs of skin aging include wrinkles, dyspigmentation, and decreased elasticity. Aim of this article is to study the effectiveness and safety of low-level laser therapy (LLLT) for skin rejuvenation. Thirty Syrian female patients aged 25-50 participated in this study and were diagnosed with moderate to severe melasma and wrinkles. The patients were divided into two groups and received LLLT with a wavelength of 660 nm emitting a continuous wave. The power density and dose used were 15.6 mW/cm2, and 3 J/cm2 respectively, and the laser effective area was 32 cm2. The evaluation was done before, during, and after 12 treatment sessions, based on photographs, in addition to the modified Melasma Area Severity Index (MASI), Pinch test, and Fitzpatrick's classification of facial wrinkling at baseline. Comparing before, and after treatment, and between the two groups, revealed a significant improvement in skin rejuvenation, with a statistical significance (p < 0.05). Additional outcome measures included assessments of patient satisfaction scores, and no adverse effects or re-pigmentation were reported. Our results suggest that LLLT may be a useful and safe therapeutic option in treating melasma, skin elasticity, and wrinkle improvement, which we advised to be integrated into treatment, and follow-up programs in cosmetics and dermatology.

Masticatory function and three-dimensional facial morphology of soft tissues: One year after orthognathic surgery

ObjectiveDentofacial deformities (DFD) require orthodontic treatment, orthognathic surgery, and speech therapy for aesthetic and functional problems. This longitudinal study analyzed changes in masticatory function and three-dimensional (3D) facial soft tissue in patients with Class II and Class III DFD after orthognathic surgery. In addition, the study investigated the relationship between facial measurements, maximum bite force (MBF), and orofacial myofunctional status (OMS). DesignThe sample consisted of 46 participants, including 10 patients with Class II DFD, and 11 patients with Class III DFD. These groups were assessed before (T0) and 6 months (T1) after surgery. Twelve patients who completed the treatment protocol were evaluated 12 months post-surgery (T2). The patient groups were compared with each other and with a control group (CG) of 25 healthy subjects. The participants underwent MBF and clinical evaluation of OMS, including masticatory behavior, using a validated protocol. The 3D facial soft tissue was assessed using laser scanning. ResultsCompared to the CG, DFD patients showed reduced MBF, masticatory behavior, and OMS scores at T0. At T2, there was an improvement in MBF, masticatory, and OMS scores, but differences were observed compared to the CG. Changes in facial soft tissue followed the underlying hard tissue movement resulting from surgery, and reduction of vertical measurements contributed to improvements in masticatory function. ConclusionThese findings indicated that combined surgery, orthodontic treatment, and speech therapy can lead to a significant improvement in masticatory function and facial soft tissue in DFD patients, although not completely 12 months post-surgery.

Mandibular asymmetry. Hemimandibular hyperplasia vs. hemimandiubular elongation

Introduction. Hemimandibular hyperplasia and elongation create a developmental asymmetry characterized by volumetric changes of the hemimandible. Both entities cause progressive aesthetic and functional problems causing depression with poor quality of life. The treatment of these anomalies is combined, orthodontic and surgical Material and methods. The study was based on the analysis of bibliographic sources as well as the rehabilitation of two patients diagnosed with hemimandibular hyperplasia and hemimandibular elongation. Results. The specialized literature proposes a variety of surgical techniques for osteotomy of the mandible to correct mandibular asymmetries. The surgical planning of the interventions was carried out using the digital protocol, with the manufacture of intermediate and final splints. Conclusions. Contemporary digital medical imaging in combination with virtual surgical planning allows a patient specific treatment protocol, a fact that significantly contributes to optimizing not only the treatment plan but also the surgery itself.

Patients perception of orthodontic treatment - A questionnaire based study

The patient perception of malocclusion is important in determining orthodontic treatment. The purpose of this study was to determine participant’s perception, attitude, dental awareness, motivation, factors influencing the necessity of treatment and considerations before opting for orthodontic treatment. A questionnaire-based survey including 14 questions, was conducted for 160 participants who came to OPD of Department of Orthodontics, BBDCODS or at private clinics for any dental problem or those who had queries for orthodontic treatment.A google form with multiple choice questions was created to assess the patient’s perception of Orthodontic treatment to investigate aesthetic concern, functional problems, psychological concern, Orthodontic awareness, and other reasons for seeking orthodontic treatment. The data of responses of participants was analysed on google form application itself with the help of spread sheet, pie charts and graphs. The study revealed that aesthetics was the main concern for getting treatment whereas functional concern was less frequently reported. Patient believed that the treatment could make them more beautiful. This survey-based questionnaire helped in assessing the patient perception and attitude towards Orthodontic treatment. Aesthetic was the major issue for seeking orthodontic treatment, and also motivating factor for the start of treatment. Cost and duration of the treatment were major barrier for the start of the orthodontic treatment.

Modified Mandibular Lingual Arch for Orthodontic Traction of Impacted Mandibular Canine and Premolar: Case Reports

Impaction of the tooth can cause functional and esthetic problems, so early intervention is critical. This report describes two cases of orthodontic traction of impacted mandibular canine and mandibular premolar teeth using a modified mandibular lingual arch soldered with traction hooks rather than a conventional orthodontic appliance. By planning the position and shape of the traction hooks with consideration for the three-dimensional position and angulation of the impacted teeth, clinicians can apply the intended direction and magnitude of traction force. Furthermore, this appliance can be used for multiple impacted teeth in various locations within the mandibular arch by modifying the position and shape of the traction hooks.

농촌공간 재생을 위한 통합적 농촌공간 정비계획 - 거창군 동산마을을 중심으로

The purpose of this planning study is to present a case of integrated rural space planning by solving the aesthetic and environmental problems caused by abandoned livestock farms in Dongsan Village, Geochang-eup, Geochang-gun, Gyeongsangnam-do, and establishing a spatial plan to restore the area. Dongsan Village, formed by the settlement of Hansen's disease survivors, has relied on livestock farming as a means of livelihood, but due to the designation of a water supply protection area and a livestock breeding restriction zone, it has been unable to continue livestock farming, and abandoned livestock farms have been left unattended, adversely affecting the landscape and environment. This study identified the potential and problems of the space through a current status analysis, presented basic directions and goals based on this, set the planning area through spatial configuration, and proposed a sustainable rural space plan for Dongsan Village by establishing land use plans and detailed space maintenance plans.

Assessment and Management of Maxillary Labial Frenum-A Scoping Review.

The maxillary labial frenum (MLF) is a soft tissue fold connecting the upper lip to the alveolar process. Abnormal attachment can cause periodontal, functional, and esthetic problems. Differential diagnosis is important and can prevent unnecessary interventions. This study aims to summarize the current evidence on the assessment and management of abnormal MLF. A thorough review of the literature was conducted. Five online databases were searched for relevant peer-reviewed human studies. Article screening and data extraction were performed independently by two reviewers using predefined inclusion/exclusion criteria. Information about article type, study design, participants' characteristics, interventions, and outcomes was extracted and synthesized. 52 articles met the review criteria. MLF is a dynamic structure characterized by a wide normal morphological variation. MLF assessment in infants has not been standardized. Studies in pre-adolescents reported a change in the thickness and position of the MLF observed over time, resulting in a lower prevalence of abnormal MLF morphology. Studies in adolescents and adults reported variable differential diagnosis criteria. Lasers appear as the most advantageous frenectomy modality. There is a need for more objective MLF diagnostic protocols and treatment guidelines, which could prevent unnecessary surgical interventions.

Dental bleaching: patient perception and satisfaction.

Teeth bleaching is a common practice performed by dental hygienists and dentists to correct aesthetic problems due to dental discoloration. Patients' opinions on this procedure may be different according to their personal experiences, expectations and individual sensitivities. The aim of this study is to assess the degree of satisfaction and related sensitivity of patients to professional and home bleaching treatment. A questionnaire consisting of 12 multiple-choice questions was submitted to 625 subjects among general population. These were related to: 1) patient's age and whether the patient is a smoker; 2) personal satisfaction; and 3) post-treatment tooth sensitivity. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out by Chi-square test and Fisher's Exact test. Of the people surveyed, 66% performed home bleaching, while the remaining performed the treatment in a dental office. Thirty-three percent of patients had previously undergone teeth bleaching and the 95.7% stated that they were satisfied with the treatment. Of these, only 36.4% reported experiencing postoperative hypersensitivity. Most patients (91.3%) received professional scaling before undergoing bleaching treatment. Patient satisfaction with tooth whitening treatment can vary from patient to patient and represents a strong indicator of treatment efficacy and suitability. A proper communication, careful management and individualized patient assessment are key to maximizing satisfaction and ensuring a positive and fulfilling patient experience.

Assessment of knowledge, attitude, and practice of solid waste management system among households of Darge sub-city, east Wollega Zone, Oromia, Western Ethiopia

Background: Inappropriate solid waste management produced in the course of human activities has serious problems for the environment that adversely affect the health of the human population. Thus, towns and cities in developing countries like Ethiopia face environmental health and aesthetic problems resulting from improper management of solid waste disposal. Uncontrolled waste management may also contribute to the transmission of communicable diseases from different systems as well as encourage fly breading, which has nuisance effects in addition to disease transmission. Objective: To assess knowledge, attitude, and practice of solid waste management systems in households in Darge sub-city, East Wollega Zone, Oromia, Ethiopia. Methods: A community-based cross-sectional study was conducted using systematic random sampling techniques from February 1st to February 15th, 2022. Data was collected from 278 households using a structured interviewer-administered questionnaire. After data collection, data analysis was performed using SPSS computer software version 22.0. Results: The study showed that 67.3% had good knowledge, 65.86% had a positive attitude, and 63.3% had good practice in solid waste management (SWM). Among the households, 12.6% and 42.1% dispose of solid waste in open fields and open disposal pits, respectively. The perceived reason for improper solid waste disposal was a lack of awareness (55.4%) and a shortage of a place for solid waste disposal (30.6%). Conclusion: The knowledge, attitude, and practice of households in the study area need improvement according to standards for towns and sub-cities. Increasing knowledge, changing attitudes, and improving practice in SWM using the existing structure are recommended.

Thermoablation Using Radiofrequency and Microwaves of Autonomous Thyroid Nodules: Our Experience

Significant results have been achieved using ultrasound-guided and ultrasound-assisted ablative techniques, such as Laser Thermal Ablation (LTA), Radiofrequency Ablation (RFA), High-Intensity Focused Ultrasound (HIFU), and Microwave Ablation (MWA). These techniques are ideally suited for the treatment of normally functioning benign thyroid nodes with local compressive symptoms or aesthetic problems. These treatments have been applied to hyperfunctioning “hot” nodes. LTA and RFA are the most commonly used. From January 2021 to July 2023 at our Center, a total of 160 patients with benign thyroid nodules were treated, of which 35 had autonomous nodules [1-4]. Our analysis focused on evaluating the locoregional treatment of the latter. Based on the volume and ultrasound-vascular characteristics, patients were selected for thermoablative treatment with either RFA or MWA (Amica Gen HS - Hospital Service) starting in July 2022. No complications were documented. However, one patient was referred for surgery and 1 patient was re-treated with MWA. In the light of personal experience ultrasound-guided thermal ablation treatment with RFA in patients with a single pretoxic or toxic thyroid nodule with or without associated compressive or aesthetic symptoms has proven to be very effective and satisfactory. The treatment must be preceded by adequate information regarding the advantages and disadvantages of the various procedures and the methods of the treatment session. MWA proved to be more effective than RFA with no functional recovery of the treated nodules even if they were relatively larger in size. We obtained the suspension of thyrostatic therapy with normalization of the TSH level in the third month after treatment.

Lactate promotes bone healing by regulating the osteogenesis of bone marrow mesenchymal stem cells through activating Olfr1440

Bone malunion or nonunion leads to functional and esthetic problems and is a major healthcare burden. Activation of bone marrow mesenchymal stem cells (BMSCs) and subsequent induction of osteogenic differentiation by local metabolites are crucial steps for bone healing, which has not yet been completely investigated. Here, we found that lactate levels are rapidly increased at the local injury site during the early phase of bone defect healing, which facilitates the healing process by enhancing BMSCs regenerative capacity. Mechanistically, lactate serves as a ligand for the Olfr1440 olfactory receptor, to trigger an intracellular calcium influx that in turn activates osteogenic phenotype transition of BMSCs. Conversely, ablation of Olfr1440 delays skeletal repair and remodelling, as evidenced by thinner cortical bone and less woven bone formation in vivo. Administration of lactate in the defect area enhanced bone regeneration. These findings thus revealed the key roles of lactate in the osteogenic differentiation of BMSCs, which deepened our understanding of the bone healing process, as well as provided cues for a potential therapeutic option that might greatly improve bone defect treatment.