Good Facial Esthetics Research Articles

Evaluation of open-face maxillary complete denture for patients with prominent premaxilla: a crossover study.

The establishment of good facial esthetics is one of the main objectives of complete denture construction. Unfortunately, it may be the caused issue for patients having a prominent premaxilla due to excessive lip support by the labial flange of the maxillary denture. Open-face dentures (OFD) may suggest suitable prosthetic management for these patients. However, clinical evidence regarding the efficiency of OFD is scarce. A total of 38 completely edentulous participants having prominent premaxilla and skeletal class I Angle's classification were enrolled in this study. Each participant received a mandibular complete denture and 2 opposing maxillary dentures; conventional (CD) and open-face (OFD). On the day of denture insertion, the participants were divided into 2 groups; CD-OFD and OFD-CD where CD-OFD group was instructed to use the mandibular denture and the maxillary CD for 3 months and then to use the maxillary OFD for another 3 months after a wash-out period of 2 weeks. While group OFD-CD was instructed to use the mandibular denture and the maxillary OFD for 3 months then to use the maxillary CD for another 3 months after a wash-out period of 2 weeks. The dislodging force of the maxillary dentures was evaluated using the universal testing machine and the patient perception of retention, esthetics, and comfort was evaluated using the Visual Analogue Scale (VAS). Evaluation was carried out 1 day, 1 month, and 3 months after denture insertion. The Student t-test was used to compare the 2 maxillary dentures and the intervals for each denture were compared by using the ANOVA test with repeated measures followed by a Post Hoc test (adjusted Bonferroni) for pairwise comparison. The significance of the obtained results was judged at the 5% level (P value). The dislodging force and patient perception of retention did not show significant differences between the 2 dentures, while the perception of esthetics showed significant differences throughout the follow-up period. Perception of comfort showed an insignificant difference only at the 3-month interval. Open-face maxillary dentures can be a suitable alternative for patients with prominent premaxilla to achieve satisfactory retention, aesthetics, and comfort.

Fotogrametrijski parametri lica kao pokazatelji lepote

Introduction: Beauty and attractiveness of a person's facial features are very subjective and also influenced by many factors, such as cultural, social, and personal. It is due to many complex neural mechanisms, that we are able to perceive everything, and also decide if something is attractive or not. The most common and the most significant factors associated with good facial aesthetics are symmetry and proportions of the face. It is important to note that they can be thoroughly analysed using photogrammetry, which represents a non-invasive technique that involves using photographs or 3D imaging methods to capture and analyze the craniofacial structures and features for diagnostic, treatment planning, monitoring and research purposes. When it comes to photogrammetry, angular parameters such as nasofrontal, nasolabial, mentolabial and facial profile angle and linear parameters such as facial width to height ratio, nasal width, interocular and interpupillary distance, philtrum length, chin and forehead height of the face are of great importance. Aim: In this literature survey authors wanted to highlight if these measurements and parameters were enough for determining the beauty and attractiveness of a face if used on their own. Conclusion: Facial photogrammetry has several applications in the field of medicine, particularly in areas such as dermatology, orthodontics, maxillofacial and plastic surgery, due to the usage of angular and linear parameters, as well as other purposes. With many advancements and adjustments, it has become accurate and accessible and has also significantly improved diagnostics, patient care, treatments and outcomes in various cases in medicine and dentistry.

A successful surgical management of pediatric ossifying fibroma in peripheral limited setting: a rare case report

Ossifying fibroma (OF) is a rare non-malignant fibro-osseous lesion of the craniofacial area with the characteristic of slow-growing and locally aggressive. The incidence rate in paediatric patients is still not clear. The management is varied from observation and serial radiologic imaging to radical resection of the tumour. To provide knowledge and information about diagnosing and managing a rare case of craniofacial ossifying fibroma. A-5-year-old boy diagnosed with orbito-inferonasal region ossifying fibroma underwent extirpation of the mass with the lateral rhinotomy- Webber Ferguson approach, anterior orbitotomy by the ophthalmologist, and obturator placement by the prosthodontist. OF remains a rare disease, particularly in paediatric patients, which is locally aggressive although it’s benign characteristic. Definitive excision is the treatment of choice for OF. Successful surgical outcome was due to a multidisciplinary team and surgical incision technique. We found that lateral rhinotomy Weber Ferguson incision showed excellent exposure. Vision and facial nerve function were preserved as well as good facial symmetry and aesthetics and recurrence prevention. Regular follow-up is necessary for young OF patients.

Functional reconstruction of the masseter muscle by microvascular free gracilis muscle transfer: technique and outcome

Microvascular reconstruction of the cheek is most often performed using fasciocutaneous flaps and without functional reconstruction of the masseter muscle. This article reports a technique of masseter muscle resection, dissection of the masseteric nerve, and masseter muscle reconstruction with a functional gracilis muscle flap. The technique was applied in a 38-year-old man with recurrent intramuscular lipoma of the right masseter muscle. The flap was highly stable in form and showed good function. Bite force, electromyography results, and the radiological appearance of the gracilis muscle were similar to those of the contralateral masseter muscle at 12 months after surgery. In conclusion, full rehabilitation of masseter muscle function and good facial aesthetics were achieved by functional gracilis muscle reconstruction of the masseter muscle in a case of total resection.

Minimally traumatic implantation and bone regeneration: a systematic review

Introduction: Dental implant procedures have reached about one million dental implants per year worldwide. In this context, it is necessary to establish the state of the art of minimally traumatic procedures for dental implants, especially after bone grafting procedures and/or use of biomaterials for bone elevation. Objective: Conducted a systematic review of the main considerations for optimizing techniques for dental implants by proposing minimally invasive procedures, especially after bone recovery or elevation processes through the use of biomaterials such as FRP and Bio-Oss®. Methods: The survey was conducted from June 2021 to July 2021 and developed based on Scopus, PubMed, Science Direct, Scielo and Google Scholar, following the rules of Systematic Review-PRISMA. Study quality was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: Studies have shown that guided preoperative planning and dental implant-guided jaw reconstruction provide high success rates for implant and dental rehabilitation. Furthermore, the concept of using personalized implants with the help of 3D virtual treatment planning can greatly improve mandibular restoration and help to achieve good facial profile, esthetics and dental rehabilitation, avoiding complications with grafts in general.

Digital dentistry and guided treatments: a concise systematic review

Introduction: In the landscape of new digital technologies, many dental treatments have benefited from this digital advance. The development of computed tomography (CT) dental scanners has enabled powerful imaging capabilities and software applications. The prosthetic plane and implanted drill guides with the placement of trajectories based on a drill according to the position of the CT 3-D Space markers. Objective: To present, through a systematic review, the main considerations of guided surgery in implant dentistry and its respective advantages, disadvantages, and limitations. Methods: Clinical studies with qualitative and/or quantitative analysis were included, following the rules of the systematic review-PRISMA. Results: Out of a total of 102 articles found, 82 articles were evaluated and 57 were rejected for not meeting the GRADE classification, and only 25 articles were used in this study to compose the textual part. Advances in technology have contributed to the improvement of implant models. 3D reconstructions make it possible to determine the quantity and quality of available bone and also enable the simulation of implant installation in a virtual environment, reducing time and the possibility of errors, allowing for an overall reduction in the costs of oral rehabilitation. Conclusion: Guided preoperative planning or project-guided dental surgery provides high implant and dental rehabilitation success rates, also benefiting prosthetic restorations supported by fixed implants. Furthermore, the concept of using personalized implants with the help of 3D virtual treatment planning improves mandibular restoration with a good facial profile, esthetics, and dental rehabilitation.

Assessment of Nasal Tip Projection and Rotation in Different Types of Malocclusions in Maharashtrian Population: A Photographic Study

Introduction: Nose holds an anatomically strategic position on face which influences the facial aesthetics and soft tissue profile of an individual, making it indispensable to understand the variations in nasal features and influence of different factors on it. Present study aims at assessing nasal tip projection and nasal tip rotation among patients with different sagittal skeletal relations and vertical facial patterns in Maharashtrian population using photographic analysis. Materials and Methods: Records of 410 patients with age ranging from 17 to 25 yrs were selected from the institutional archives; to assess the nasal projection and rotation. Data obtained was divided into groups depending on the type of sagittal skeletal relation and vertical facial pattern and subjected to the statistical analyses. Results: Nasal tip projection was greater among patients with skeletal Class III malocclusion (mean 0.39) as compared to other malocclusion types, but did not differ significantly (P-value>0.05). Nasal tip rotation was clockwise among patients with skeletal Class III malocclusion and anticlockwise in Class I and Class II malocclusion patients, which was statistically significant (P-value<0.05). Amongst the patients with different vertical facial pattern, no statistically significant result could be obtained for nasal tip projection and rotation. Conclusion: The result of the present study gives an insight about the nasal features prevalent among different types of malocclusion, thus assisting the clinician in treatment planning and achieving good facial aesthetics with pleasing soft tissue profile.

Facial microcystic adnexal carcinoma — treatment with a “jigsaw puzzle” advancement flap and immediate esthetic reconstruction: A case report

BACKGROUNDMicrocystic adnexal carcinoma (MAC) is a rare malignant tumor of the skin that is commonly found on the face. It grows slowly and has a low mortality rate. However, for various reasons, including strong histological invasiveness, clinical inexperience and inadequate procedure design, immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARYThis article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip. She declined the recommended treatment plan, which included two-stage reconstruction, skin grafting, or surgery that could have resulted in obvious facial dysfunction or esthetic deformity. We accurately designed a personalized procedure involving a “jigsaw puzzle advancement flap” for the patient based on the lesion location and the estimated area of skin loss. The procedure was successful; both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSIONThis study suggests that when treating facial MAC or other skin malignancies, a surgical team should have sufficient plastic surgery-related knowledge and skills. An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.

Desired Smile and Effect of Facial Esthetics on the Confidence Level of Saudi Public: A Survey-based Study

Aim: To assess the perception of the general public towards an ideal smile, to determine an association of good facial esthetics with the high confidence level, to compare the findings based on age, gender, and socioeconomic status. Materials and methods: This study was targeted towards the Saudi general public in Riyadh city; therefore, all males and females more than 18 years of age were recruited to fill up the questionnaire. A total of 10000 Saudi general public were targeted in this study. The survey was sent using online links via social media and other sources. Results: A total of 8437 Saudis male and females filled up the online survey, which comprised of 39% (n=3307) males and 61% (n=5130) females. The participants were grouped based on their education level, which demonstrated that 3% (n=230) are primary level, 34% (n=2861) are high school level, 63%(n=5320) are university graduates. The participants were also grouped based on their socio-economic status, which demonstrated that 5% (n=428) are low status, 89% (n=7539) are moderate status and 6%(n=460) are high status. The participants were also grouped based on their dental visits, which demonstrated that 68% (n=5671) visit 0-2 times, 22% (n=1823) visit 3-5 times and10%(n=911) visit 6 times or more. Conclusion: Females were found to be more concerned about their smile, Educational levels did not affect the decision making, Higher socioeconomic status groups had more concern about their aesthetic smile, Patients with an increased number of dental visits had greater concern about their smile.

Interdisciplinary management of congenitally missing maxillary lateral incisors

ObjectiveMissing maxillary lateral incisors is a common developmental anomaly and often creates a major esthetic problem due to their position in the dental arch. Treatment in such cases depends on either creation of space followed by prosthetic replacement or closing the space and replacing the missing lateral incisors by canines. In this report we highlight some of the key factors which should be considered for replacement of missing lateral incisors using single tooth implant. MethodsThis clinical report describes the treatment of a patient with bilateral missing maxillary lateral incisors. An interdisciplinary approach involving Orthodontist, implant surgeon and prosthodontist was used in the treatment. ResultsAt the end treatment, the patient presented with class I molar and canine, normal overbite and overjet, and good facial esthetics with canine protected occlusion. ConclusionWhen indicated, space opening and replacement of missing lateral incisors with implant supported tooth substitution may provide excellent esthetics and functional results.

Minimally invasive ortho-surgical management of an adult patient with hemifacial microsomia - a case report

The purpose of this article is to report the treatment of an adult patient with hemifacial microsomia (HFM) by a minimally invasive method of aesthetic surgery and orthodontics. The patient was treated by orthodontic fixed appliance using the extraction protocol and the facial asymmetry due to hemifacial microsomia was camouflaged with lateral sliding and advancement genioplasty. Good dental aesthetics and occlusion was achieved by orthodontic treatment. Adult patients presenting with mild dentofacial deformities, who do not agree for the routine treatment protocols, can be successfully camouflaged using minimally invasive and cost effective ortho-surgical treatment protocol to achieve good facial aesthetics.

HYPODONTIA WITH CLASS I MALLOCLUSION AND MAXILLARY DIASTEMA

Background: Dental agenesis is a term that refers to the absence of one or more teeth, and hypodontia refers to a severe type of tooth agenesis involving less than six or more than one congenitally missing teeth, excluding the third molars. Purpose: This aimed to report the correction of overbite by using intrusion archwires. Case: A 20-year-old female patient had class I malocclusion and deep overbite, incisor retroclination, mild mandibular crowding and agenesis of 12, 13, 14, 15, and 24. Case management: The case was treated with non-extraction using 0.022 pre-adjusted technique to level and unravel using intrusion archwires to correct the deep overbite. Conclusion: The 17-month treatment resulted in a corrected overbite, good occlusion, and good facial aesthetics.

Two-phase orthodontic treatment in a unilateral cleft lip and palate patient with 1-year follow-up results

Treatment of a patient with cleft lip and palate can be challenging. A 10-year and 10-month-old girl presented with uneven and crowded teeth. She had unilateral cleft lip and palate on left side for which she had undergone primary lip repair and palatoplasty when she was younger. On examination, she had concave facial appearance, crossbite of upper arch with reverse overjet of 2 mm, wits appraisal of 6 mm and impacted 23. She was treated with two-phase orthodontic treatment; growth modification appliances followed by fixed mechanotherapy. Total treatment time was 5 years. 1-year follow-up shows that results have been stable with good facial aesthetics and functional occlusion.

Pre-arthroplastic and simultaneous mandibular distraction for correction of facial deformity in temporomandibular joint ankylosis

IntroductionIn cases of temporomandibular joint (TMJ) ankylosis, interposition arthroplasty allows return of functional jaw movements. In order to improve the facial appearance, distraction osteogenesis is the treatment of choice, and may be timed either as a pre-arthroplastic, simultaneous or post-arthroplastic procedure. This study was planned to compare the treatment outcomes of pre-arthroplastic distraction (PAD) and simultaneous arthroplastic distraction (SAD) to establish the better treatment modality in terms of improvement in function and aesthetics. Materials and methodsThis prospective randomized experimental study included 20 children and adolescents suffering from facial deformity due to long standing unilateral TMJ ankylosis. They were randomly allocated to the two surgical groups with ten in each group. ResultBoth groups resulted in good facial symmetry and aesthetics. Initially, during the distraction period, mouth opening of SAD group scored less than that of PAD group but became comparable in 30 days. More pain at the distraction site and over the normal TMJ was observed in PAD group. The excursive movements were almost comparable in both the groups. ConclusionWe conclude that both procedures are effective in correcting the post-ankylotic deformity and improving function. Although PAD has better control over movement of the distracting segment, the contralateral TMJ may experience pain. SAD requires a shorter management period but is associated with a temporary decrease in function. Also, control of distraction may be difficult and chances of reankylosis are always there.

Lower incisor extraction: Can it be justified? A report of two cases

Extraction versus nonextraction debate is still continuing since 1900s. Some cases demand extraction of premolars, but the decision making is difficult in the border line cases with good facial esthetics. Lower incisor extraction becomes a therapeutic alternative to premolar extractions in lower anterior crowding cases with good facial esthetics and well occluded posterior teeth. Diagnostic setup reveals the posttreatment occlusal possibilities and hence the most important step in the diagnosis and treatment planning of these cases. Lower incisor extraction decision would be a better option in cases with anterior Bolton's discrepancy. Two cases treated with single lower incisor extraction, indications, contraindications and measures to attain posttreatment stability are discussed in this presentation.

A dilemma in orthodontics: Extractions in borderline cases

Patient with good facial esthetics require extractions to reach a stable and functional occlusion can be categorized as a borderline case. It may also be defi ned as the case caught in between the confl ict of extraction and nonextraction. Empirical evidence of uncertainty exists with these patients. Borderline cases may also have an absence of dental or craniofacial anomalies, permanent dentition, healthy periodontium and normal anteroposteriorly relationship between maxilla and mandible. Therefore, the aim of this paper is to describe criteria, which should be kept in mind before deciding to go for extraction or nonextraction treatment in borderline cases.

Two-phase treatment in a patient with a skeletal Class III malocclusion: Early orthopedic treatment and subsequent camouflage treatment with temporary anchorage devices

In this case report, we describe the outcome of a two-phase orthodontic approach used to treat a 4-year and 8-month-old girl who exhibited excessive negative overjet and skeletal Class III jaw relationship. In Phase I treatment, growth modification using a protraction headgear appliance was used to normalize maxillomandibular growth. A forward growth of the maxilla and a normal overjet were achieved. During pubertal growth period, a skeletal Class III jaw relationship persisted due to differential jaw growth. A Phase II camouflage treatment with the help of temporary anchorage devices (TADs) was used to distalize the mandibular dentition. Good occlusion and facial esthetics were achieved, and the outcome has been maintained for 2 years after completion of the active treatment.

Correction of Class II Division 2 Deepbite Malocclusion with Non-extraction Therapy

The article presents a case report of a teen age girl with Class II Division 2 malocclusion with deep over bite. The case was treated on non-extraction basis using 0.018 pre-adjusted edgewise appliance with anterior bite plate (monobloc) to correct deep bite and forward placement of the mandible. Use of Class II elastics helped to achieve Class I canine and molar retention. Treatment was completed in 22 months with good occlusion and facial esthetics. DOI: http://dx.doi.org/10.3126/ojn.v3i1.9287 Orthodontic Journal of Nepal, Vol.3, No.1, 2013: 73-75

Re: response to: Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion. The Angle Orthodontist 2013(2) 334-340

Because a major reason for orthodontic treatment is to overcome psychosocial difficulties related to facial and dental appearance and enhance social well-being, the evaluation of dental and facial esthetics has become an important part of the clinical examination. Whether a face is considered beautiful is affected substantially by cultural and ethnic factors, but whatever the culture, a severely disproportionate face becomes a psychosocial problem. Differences in facial types and body types obviously must be taken into account when facial proportions are assessed, and variations from the average ratios can be compatible with good facial esthetics. An important point, however, is to avoid treatment outcomes that would change the ratios in the wrong direction, as for example, treatment with interarch elastics that could rotate the mandible downward in a patient whose face already is too long for its width. As for the long-term vertical skeletal effects produced by functional appliances, our study found that treatment did not induce any significant increase in vertical skeletal relationships, as assessed either by the inclination of the palatal plane to Frankfort horizontal or with the inclination of the mandibular plane to the Frankfort horizontal and to the palatal plane. In the Discussion we reported that ‘‘A significant increase in lower anterior facial height in the treated group was associated with a significant increase in the height of the mandibular ramus in the long term. Adequate control of vertical skeletal relationships in the long term was achieved through a good balance between posterior and anterior facial height increases.’’ The case cited by Dr. Mew and published on the Journal of Clinical Orthodontics was included in an unpublished study in which the aesthetics of both the teeth and face were rated by lay and orthodontic judges. We do not know if the evaluation was performed on the comparisons of the photos taken before and after treatment. The main esthetic issue of the face of the specific clinical case can be related to the large nasolabial angle rather than to the increase in the lower anterior facial height that is compatible with the normal vertical growth of the face. However, we certainly look forward to seeing the published data of the study quoted by Dr. Mew.

Disyunción y extracción de primeros premolares maxilares en maloclusión clase II división 1- paciente mesofacial

The patient was a healthy 9 year old boy with malposition of the teeth in mixed dentition, in the facial profile analysis, an apparent increase in the lower third of the face is noticed, jaw is slightly retrognatic. .Class II Div 1 malocclusion, Incomplete eruption of dental piece 11, piece 12 has not erupted. (Tooth Identification , FDI system), showing slight giroversion of lower central incisors, overjet increased 5.5 mm, crossbite of upper right supporting area (primary pieces: canine, first and second molar). Upper midline was coincident with facial midline, teeth midline maxillary and mandibular aren’t coincident in centric occlusion or centric relation. , their mandibular dental midline is shifted 1½ mm to the right of the patient in centric occlusion and centric relation. He was treated with orthotics (maxillary disjunction) and orthodontics through the extraction of maxillary first premolars, upper incisor retrusion, leveling and alignment of the upper and lower dental arches. The total time of active treatment in the different phases was 5 years 10 months. Pre and Post treatment records are shown. Overjet, overbite and Spee curve are evident in the standard, and excellent alignment and symmetry in the dental arches. At the end of the case Class II molar and Class I canine relationship Is noticed. We obtained a very good facial aesthetics, no clinical discrepancy between OC and RC. The TMJ was free of symptoms.