Esthetic Profile Research Articles

DAS SUBJEKT DER LYRIK ODER: FÜR EINE PHILOLOGIE DER DUNKELHEIT – LYRIK ALS (EIN) PARADIGMA DER MODERNE

AbstractWhen Hölderlin argues in favour of modernity in the Querelle des Anciens et des Modernes, he rejects the claim that the highest form of art is tragedy and proclaims the primacy of poetry. However, Hölderlin frames a very different concept of poetry from Hegel, for instance, one of the most prominent representatives of the notion of subjectivity. For Hölderlin, poetry is not the medium of subjective self‐reassurance, but first and foremost the genre of memory, of patient endurance ‘when times are hard’ and of writing against ‘eccentric excitement’. It is through writing that he expects to achieve a revolution in future ‘modes of thought’. Hölderlin wants not only to define a poetics of genre for modernity but also to imbue it with an autonomous aesthetic profile, independent of the worn‐out language of tradition. This is why the language of modern poetry can only be one of obscuritas. This struggle for a genuinely modern mode of speaking leads to changes in the old modes, to alienation from them and, as a result, to the estrangement of recipients. Firstly, this article will reconstruct how the paradigmatic genre of modernity shifts from tragedy to poetry. Secondly, it will analyse Hölderlin's nexus between critiques of the subject and critiques of poetic language and then trace the paths that lead from it to Adorno.

Case Report: The TRTMI Procedure, a Novel Surgical Technique for Gynecomastia

Gynecomastia presents the most common breast issue in men. It is defined as benign proliferation and enlargement of male breast glandular tissue that distributes most prevalently among neonates, adolescents, and elderly men. With a prevalence of over 60% in the male population, various classifications and treatment options have emerged to address male gynecomastia. Surgical treatment presents challenges and is used when gynecomastia has been present for several years or if medical therapy has been unsuccessful. We attempt to address some of these surgical challenges as they relate to aesthetic goals by presenting our surgical technique. Our surgical technique, the Tissue Resection Through Minimal Incision method, is described with illustrations included. Surgical candidates are selected after a review of the patient’s history, a thorough physical evaluation, obtaining any necessary imaging, and a detailed discussion with the patient. A hybrid, minimally invasive, and direct excision technique is used, including both standard VASER liposuction and direct glandular tissue resection via only a single 3-mm, well-hidden incision using simple instruments readily available with reproducible outcomes. We stress the idea of tissue inversion being key to make this feasible. Several case examples are presented with before and after comparisons, demonstrating good aesthetic results and skin retraction. In the more than 80 cases performed, one patient presented with dusky nipple areolar complex in the recovery room, which resolved with topical nitroglycerin. No nipple areolar complex necrosis occurred, nor hospitalizations were required for the cases performed. A few cases of tissue edema and swelling occurred correlating with inadequate compression or strenuous activity. Incisions were well hidden and aesthetically pleasing to patients. We briefly review gynecomastia classification and treatment options focused on surgical approaches. Of the various surgical methods available to treat gynecomastia, limitations and challenges include unfavorable scar and risk profiles, as well as inadequacy of tissue resection with the minimally invasive techniques. To meet this unmet need, our patented Tissue Resection Through Minimal Incision technique offers a novel minimally invasive approach that includes adequate tissue excision while maximizing aesthetic results and with nominal scarring. There is great need in surgical treatment of gynecomastia to minimize incisions and improve outcomes. Glandular tissue excision is a challenge to the cosmetic profile because of incisions used. Our novel technique and benefits involved address those concerns. However, our procedure does not address gynecomastia cases with excessive skin redundancy that requires excision. Further studies are still needed to address such challenges regarding aesthetic profile goals.

Biomechanical considerations for total distalization of the mandibular dentition in the treatment of Class III malocclusion

Class III malocclusions with mild to moderate skeletal discrepancies can be camouflaged by orthodontic tooth movement. Conventional methods using Class III elastics can correct Class III into Class I molar relationships. These mechanics show side-effects such as labioversion and intrusion of the maxillary incisors, extrusion of the maxillary molars, linguoversion and extrusion of the mandibular incisors, and intrusion of the mandibular molars along with flattening of the occlusal plane. Conventional mechanics can improve occlusal relationships and some profile esthetics but may produce detrimental smile esthetics by reducing the amount of maxillary incisor exposure. Recently, with the advent of temporary skeletal anchorage devices (TSADs), clinicians are able to achieve total distalization of the mandibular dentition and therefore improve the occlusal relationship without worsening smile esthetics. With the use of TSADs, the en masse movement of an entire dentition can be easily accomplished using a statically determinate force system, which makes treatment plans easier and treatment results more predictable. Finite element studies have identified the location of the center of resistance of the entire dentition and simulated displacement of the dentition depending on the force angulations (FAs) and have thus provided the theoretical basis for 3-dimensional tooth movement patterns. This article provides the biomechanical considerations and clinical applications of total distalization of the mandibular dentition depending on various FAs to the mandibular occlusal plane for camouflage treatment of various types of skeletal Class III malocclusions.

Evaluation of lower facial esthetics in females with different skeletal patterns

Objective: To evaluate lower facial profile in females in different skeletal patterns. Methods: Investigation pictures of three females with beautiful lower facial profiles from Department of Orthodontics, Henan Stomatological Hospital were collected. The skeletal patterns of these females were classified as average, low and high angle, respectively.Upper lip process point (UL) was moved backwards horizontally to reach towards the E line and go even further gradually in above pictures. The distance changed according to E line was defined as DE value. If UL was in front of E line,DE value was denoted as positive, or else negative. Collectively, we obtained 30 pictures (10 pictures in each skeletal facial type) with different DE values (-5, -4, -3, -2, -1, 0, 1, 2, 3, 4 mm), which were divided into average, low and high angle group according to the skeletal facial type. The pictures were evaluated by 144 randomly-selected adult orthodontic patients [66 males, 78 females, aged (29.4±7.7) years] who visited Department of Orthodontics, Henan Stomatological Hospital from June to September, 2019 and 138 orthodontists (including qualified orthodontists and postgraduate orthodontic students [60 males, 78 females, aged (32.2±7.1) years] who participated orthodontics conferences in Henan Stomatological Hospital in June, 2019. The acceptance rate was calculated and rate above 60% was deemed as acceptable DE range. Evaluators were also asked to choose the most esthetic profiles for the best DE value in each skeletal facial type.Data discrepancy was analyzed using Kruskal-Wallis analysis and chi-square test. Results: Most accepted DE was -2 mm among total investigators including orthodonticpatients and orthodontists. There was no difference in total acceptance rate between orthodontists and patients (P>0.05). There was statistic difference in total acceptance rate in different skeletal patterns between orthodontic patients and orthodontists (P<0.05). In total investigators, total acceptance rate was 62.1% (1 752/2 820) in average angle group, 55.4%(1 563/2 820) in high angle group and 33.5%(946/2 820) in low angle group, respectively. Acceptable DE range in three facial types was -4~2 mm (average angle), -2~2 mm (high angle) and -2~-1 mm (low angle), respectively. Conclusions: According to the evaluation of both orthodontic patients and orthodontists, the best DE was-2 mm.Total acceptance rate and acceptable DE range ranked first in average angle group, second in high angle group and third in low angle group.

Hard and Soft Tissue Changes in Patients with Borderline Class III Malocclusion after Maxillary Advancement or Mandibular Setback Surgery: A Cross-Sectional Study

Background: The primary aim of this study was to assess the esthetic profile and hard and soft tissue changes in patients with borderline class III malocclusion after maxillary advancement or mandibular setback surgery. The secondary aim was also to evaluate the patients’ face attractiveness after different surgical treatment. Materials and Methods: This observational cross-sectional study evaluated 50 patients with borderline class III malocclusion with a mean age of 29 ± 4 years treated from 2014 to 2019. They were divided into two groups based on the type of surgical treatment underwent: 13 patients were treated with mandibular setback (4 males, 9 females), and 37 patients with maxillary advancement (16 males, 21 females). Hard and soft tissue parameters were measured pre and postoperative evaluation. Frontal and profile photographs of these patients were judged by 15 orthodontists, 15 oral and maxillofacial surgeons, and 15 laypeople before and after surgery. The most and the least attractive profiles were scored 10 and 0, respectively. T-test was used to analyze normally distributed data while Mann-Whitney test for non-normally distributed data. The Kruskal-Wallis test was used to compare the esthetic judgement between the three groups of observers. Pairwise comparisons were carried out using the Mann-Whitney test. Results: Nasolabial angle, SNA, U1/NA (°), U1/NA (mm), L1/NB (°) and L1/NB (mm) were significantly different between the two groups p&lt;0.04, p&lt;0.001, p&lt;0.001, p&lt;0.005, p&lt;0.07, p&lt;0.08, p&lt;0.01 respectively Orthodontists, oral and maxillofacial surgeons, and laypeople all gave a lower score to mandibular setback and higher score to maxillary advancement in terms of facial profile esthetics (P&lt;0.001). Conclusion: Some cephalometric parameters were significantly different between the two groups. The maxillary advancement seemed to provide better results in facial profile esthetics than mandibular setback for patients with borderline class III malocclusion.

Comparison between two different techniques for peri-implant soft tissue augmentation: Porcine dermal matrix graft versus tenting screw.

The thickness of the soft tissues around dental implants is crucial for both the preservation of the marginal bone and esthetic profile. Many authors have showed the thickened soft tissues favor a better peri-implant bone stability; however, different thickening techniques can be used for this aim. Forty-seven patients were enrolled in this study, each one had one implant included in this analysis. According to the thickening procedure, patients were assigned into group A (porcine dermal matrix, n=24) or B (healing abutment used as tenting screw to sustain the soft tissues, n=23), soft tissue thickness was measured after flap elevation in a standardized way. Sixmonths after implant placement, implants were uncovered and soft tissue thickness measured again. At second stage, 6months after implant placement, the mean vertical thickness was 3.01 ± 0.58mm in group A and 2.25 ± 0.53mm in group B. The difference between the two groups at 6months was significant (P<0.001). The mean vertical gain in group A was 1.33 ± 0.71mm, whereas it was 0.43 ± 0.55mm in group B. This difference was also statistically significant (P<0.001). The use of a healing abutment for "tenting effect" has limited efficacy to obtain a significant increase in soft tissue thickness. The use of a porcine dermal matrix at time of implant placement is effective to thicken peri-implant tissues.

Sternoclavicular Joint Transfer in the Management of Temporomandibular Joint Ankylosis- A case report

Temporomandibular joint ankylosis is a clinical condition resulting in loss of jaw function and retardation of growth. The main objectives of the treatment for Temporomandibular joint ankylosis are to increase mouth opening, restore joint function, initiation of mandibular growth, improve the patient’s facial esthetic profile and prevent reankylosis. To release of ankylotic mass and gap is filled up with interpositional material. We reported a case of temporomandibular joint ankylosis in a 15 years old girl, whose treatment was done in the Department of Oral and Maxillofacial Surgery,Bangabondhu Sheikh Mujib Medical University, with sternoclavicular joint transfer which is very rare in our country and this was nearly fulfill treatment objective.&#x0D; Bangladesh J Otorhinolaryngol; April 2018; 24(1): 90-94

Procena estetike osmeha i različitih tipova profila lica

Background: Imperfect smile and face profile is one of the main reasons why patients turn to orthodontists. Aim was to investigate if there is a difference in perception of smile and profile esthetics between the examined groups. Subjects and method: In conducted research, smiles of 21 persons (8 male and 13 female), 18 to 30 years old were evaluated by 15 orthodontists, 15 students of dentistry and 15 laypeople. They were to rate esthetics of every smile from 1 to 9 and choose just one main reason that impairs aesthetics. Orthodontists and laypeople should also evaluate male and female normal, bimaxillary prognathic and bimaxillary retrognathic profiles from 1 to 3. The most beautiful profile should be marked with number 3. Results: Although there was no statistically significant difference in the evaluation of smile esthetics among groups, laypeople gave the lowest evaluation. Apart from irregular position of certain teeth, all investigated groups emphasized different factors that impair smile esthetics. Orthodontists and laypeople marked bimaxillary prognathic male and female profile as less beautiful than the others. Conclusion: Because of the differences in perception of the smile aesthetics between orthodontists and laypeople, it is necessary to create a new diagnostic plan of treatment protocols that includes studies investigating laypeople perception of smile and facial esthetics.

Esthetic perception of facial profile changes after extraction and nonextraction Class II treatment

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.

Surgical Treatment and Implant Restoration of Bilateral Incomplete Cleft Lip and Palate Patient with Constricted Maxilla and Congenital Missing of Upper Anterior Teeth: Case Report

Purpose: We report a case of a skeletal Class III patient with bilateral incomplete cleft lip and palate who successfully underwent orthodontic treatment with orthognathic surgery and dental implant restoration. Case Report: An 11-year-old girl with cleft lip and palate showed narrow maxilla and congenital missing of upper anterior teeth. To solve transverse deficiency of premaxilla and provide sufficient space for implant restoration, maxillary segmental osteotomy and transverse distraction osteogenensis with fan-type expander was operated. After growth, the patient took orthodontic treatment for orthognathic surgery. For implant restoration on the cleft site, tertiary alveolar bone graft with autogenous & alloplastic bone was performed. After revision surgery and filler injection on retruded upper lip, patient’s lateral facial profile was improved with balanced upper and lower lip profile. Conclusions: For successful implant restoration on alveolar cleft site, sufficient space needs to be regained and tertiary bone graft should be considered. Normal function and esthetic profile can be achieved by multidisciplinary treatment approach for the patient with cleft lip and palate.

Assessment of buccal bone thickness of aesthetic maxillary region in Nepalese adults: A Cone Beam Computed Tomography (CBCT) Study

Introduction: The dental implant has now become a routine treatment for oral rehabilitation. The treatment planning and positioning of implants is greatly dependent upon the clinicians’ understanding of the alveolar architecture of the maxilla and mandible. In the esthetic zone, the implants therapy can be successful only if it is in harmony with the surrounding tissues.&#x0D; Objectives: To study the labial osseous wall thickness of the anterior maxillary bone at various sites apical to the cemento-enamel junction using the cone beam computed tomography (CBCT).&#x0D; Materials and Methods: Cone beam tomographic scans of 150 Nepalese adults (70 females and 80 males) were obtained from the Oral Radiology Unit, Kantipur Dental College Teaching Hospital &amp; Research Center. CBCT scans were carried out by trained technicians using CS 9300 (Carestream Dental, Atlanta, GA, USA). In the CBCT images, distances between the CEJ and alveolar crest (AC) as well as the labial bone thickness at different levels (at the crest, 1mm, 3mm and 5 mm) were measured for central incisor (CI), lateral incisor (LI), and canine (C).&#x0D; Results: It showed that the average distance between CEJ and crest of CI, LI, and C were 1.98±0.84 mm, 2.09±0.83 mm, and 2.12±1.20 mm, respectively. Only 3.3% of the CI, 10.7% of the LI, and 13.3% of the C showed a thick labial bone (1–2 mm) at the crestal level. At the 1 mm level, 75.3% of the CI, 64.5% of LI, and 70% C showed a very thin bony wall. Similarly, none showed very thick bony wall (&gt;2mm). The thickness level was significant at the crest and at 5 mm level. The highest bone thickness of LI was found at the 1 mm level. In addition, there was also significant difference in different levels of LIs. The mean distance between the CEJ and the AC for the CI and the C was significantly higher in males than females.&#x0D; Conclusion: The labial bone in the anterior maxilla is inherently thin, with more than 80% of the sites showing less than 1 mm. The results of this study may be useful for the implant planning in the esthetic zone and it is recommended tissue augmentation (soft and hard) to achieve esthetic emergence profile.

Level and modalities of origin of the small saphenous vein: toward codification of the proximal approach level.

The proximal approach to the small saphenous vein (SSV) must be performed according to precise anatomical landmarks to respect the esthetic profile of venous insufficiency surgery. In this work, we propose the tip of the lateral malleolus and the lateral edge of the calcaneal tendon as palpable landmarks from which to easily identify the situation of this vein. This was a cadaveric dissection study involving 62 members of fresh and embalmed anatomical subjects. We used a horizontal line passing through the tip of the lateral malleolus and the lateral edge of the calcaneal tendon as reference marks. Once the origin of the SSV as dissected, the distances between the saphenous vein and the landmarks were measured. We found that the small saphenous vein was often unique. The origin of this small saphenous vein projected, on average, to 4.40cm from the horizontal passing through the tip of the lateral malleolus and 1.2cm from the lateral edge of the calcaneal tendon. These two measurements constitute the orthogonal coordinates for the situation of the small saphenous vein origin.

The preliminary study for three-dimensional alveolar bone morphologic characteristics for alveolar bone restoration

BackgroundThe concept of the ideal morphology for the alveolar bone form is an important element to reconstruct or restore the in maximizing esthetic profile and functional alveolar bone restoration. The purpose of this preliminary study is to evaluate the normal alveolar bone structure to provide the standard reference and guide template for use in diagnosing for implant placement, determining the correct amount of bone augmentation in actual clinical practice and producing prostheses based on three-dimensional imaging assessment of alveolar bone.MethodsThis study was included 11 men and 11 women (average age, 22.6 and 24.5 years, respectively) selected from among 127 patients. The horizontal widths of alveolar bone of maxilla and mandible were measured at the crestal, mid-root, and root apex level on MDCT (multi-detector computed tomography) images reconstructed by medical imaging software. In addition, tooth dimensions of the central incisors, canines, second premolars, and first molars of maxilla and mandible, including the horizontal width of the interdental alveolar bone crest, were also measured and statistically analyzed.ResultsThe horizontal alveolar bone width of the palatal side of maxilla showed a distinct increment from the alveolar bone crest to the apical region in both anterior and posterior areas. The average widths of the maxillary alveolar ridge were as follows: central incisor, 7.43 mm; canine, 8.91 mm; second premolar, 9.57 mm; and first molar, 12.38 mm. The average widths of the mandibular alveolar ridge were as follows: central incisor, 6.21 mm; canine, 8.55 mm; second premolar, 8.45 mm; and first molar, 10.02 mm. In the buccal side, the alveolar bone width was not increased from the crest to the apical region. The horizontal alveolar bone width of an apical and mandibular border region was thinner than at the mid-root level.ConclusionsThe results of the preliminary study are useful as a clinical guideline when determining dental implant diameter and position. And also, these measurements can also be useful during the production of prefabricated membranes and customized alveolar bone scaffolds.

Polysomnography to Determine the End Point of Neonatal/Pediatric Mandibular Distraction

Untreated or inadequately treated obstructive sleep apnea (OSA) has significant comorbidities in the neonatal and pediatric population, increasing the need for tracheostomy and gastrostomy1. Infants with diagnosed moderate or severe OSA resulting from mandibular retrognathia need early recognition and effective treatment such as mandibular distraction (MD)1. Currently, there is no objective measure of the amount of mandibular advancement. In most studies, the endpoint of distraction is variable because it is based on subjective measures including aesthetic profile (prognathia), improvement in symptoms of airway obstruction, and vitals signs2,3. The purpose of this study was to evaluate if traditional methods of determining the end point of MD correlated with treating the OSA and to evaluate the use of polysomnography (PSG) to determine the end point.

A novel approach of torque control for maxillary displaced incisors

Effective torque control is crucial for the successful treatment of impacted incisors; however, torque control is often a challenge with the use of conventional bracket systems, especially when the adjacent teeth require opposite torque managements. A novel approach of torque control for adjacent anterior teeth is introduced in this case report. A 12-year-old boy had an impacted maxillary right central incisor with the adjacent teeth severely displaced. The treatment plan was to regain space and pull the impacted incisor into the dentition. An upper removable appliance was first used to regain space for the impacted central incisor, followed by a spontaneous eruption of the impacted incisor. Subsequently, fixed appliances were bonded to level and align the dentition. However, the crown of the maxillary right central incisor was found to be tipped lingually, while the maxillary right lateral incisor was tipped labially. Traditional torque control, including torque bend and the use of a Warren spring, were first used for the correction, but they were ineffective due to the overlap of the root apex of the maxillary central incisor and lateral incisor. After the roots were separated with a V-shaped curve, auxiliary brackets were bonded on the gingival one-third areas of the maxillary incisors and canine with nickel-titanium wires used for the torque control. This approach of using the auxiliary brackets and wires was demonstrated to be efficient and effective in the torque control of adjacent anterior teeth with opposite torque control requirements. The final result and the 2-year follow-up records demonstrated the proper torque of anterior teeth and good and stable dental and profile esthetics.

Factors associated with the beauty of soft-tissue profile.

Factors affecting the attractiveness of soft-tissue profile have been assessed in only a few studies, with limited methodologies (such as few variables, small sample sizes) and bivariable analyses. Therefore, this study was conducted to elucidate esthetic factors of profile silhouettes among a long list of cephalometric variables with the use of multivariable analyses for the first time. Profile silhouettes of 70 Iranians (35 men and 35 women) with Class I/good occlusions and balanced faces were rated twice by 10 Iranian laypersons, and were given overall profile beauty scores (from 10 to 50). After careful landmark identification by 3 orthodontists, unrepeated cephalometric measurements (from Holdaway, Ricketts, Z-Merrifield, Epker, and Legan-Burstone analyses) were traced twice on all cephalographs. The effects of these variables (plus sex and age) on profile beauty scores were assessed with the use of Pearson coefficient and multiple linear regression. Cephalometric characteristics of Persian attractive profiles (scores from 40 to 50) were compared with Caucasian orthodontic norms (α=0.05). The following variables were significant in the best models: soft-tissue facial angle (β=-0.348, P=0.016), nose prominence (β=-0.245; P=0.044), skeletal profile convexity (β=0.255; P=0.052), upper lip curvature (β=0.405; P=0.042), nasolabial angle (β=0.546; P=0.000), nasofacial angle (β=0.259; P=0.028), Z-angle (β=0.557; P=0.015), H-angle (β=-0.360; P=0.013), upper lip to E-plane (β=0.691; P=0.001), lower lip to E-plane (β=-0.674; P=0.002), Sn-lower lip (β=0.338; P=0.055), lower lip-menton (β=-0.299; P=0.025), Sn FH-perp to upper lip (β=-0.425; P=0.001), Sn-Stms:Stms-Me' (β=-0.372; P=0.016), facial convexity angle (β=0.710; P=0.000), lower lip protrusion (β=-0.342; P=0.005), and interlabial gap (β=-0.179; P=0.050). Sex and age were not associated with profile attractiveness (P>0.75). More convex skeletal and soft-tissue profiles, less prominent noses with higher tips, subnasales anterior to the upper lip, more protruded upper lips, less prominent lower lips, smaller interlabial gaps, and more protruding chins might improve profile esthetics.

Le Fort I Distraction Osteogenesis of Edentulous Maxillae Combined with Simultaneous Sinus Floor Grafting to Obtain Orthoalveolar Form for Emergence Profile Dental Implant Restorations: Report of Three Patient Treatments Followed for 12Years.

Three edentulous maxillary patients were treated with 9- to 15-mm advances of the maxilla by Le Fort I distraction osteogenesis combined with simultaneous sinus floor autograft placement. The patients were subsequently treated with 8 implants placed in the molar, bicuspid, and canine regions for complete arch ceramo-metal fixed restorations. Anterior emergence profile esthetics was obtained in 2 patients who had high smile lines. Following final restoration, no maxillary relapse was evident, and no implants were lost. Implant bone levels were stable, although 2 implants had 3mm of bone loss over the 12-year follow-up period.

Relationship between the Position of the Incisors and the Thickness of the Soft Tissues in the Upper Jaw: Cephalometric Evaluation.

ABSTRACTAimThe aim of this study is to verify if the thickness of soft tissues and inclination of the incisors have some relation with profile, to analyze its relevance considering these two parameters separately and to screen how the combination of different inclinations and different thickness can generate different facial patterns.Materials and methodsThe study was performed on 47 Caucasian patients aged between 6 years and 16 years of divided into 24 males and 23 females. None of the patients presented craniofacial changes of syndromic nature. All patients presented a value of SNA in between 80° and 84°. The inclination of the upper incisor related to the bispinal plane was between 104° and 116°. Each radiograph has been digitized or analyzed directly in digital format. To analyze the relationships between soft tissues and position of the incisors using various cephalometric measures and statistical methodology were used.ResultsAnalysing the general correlation between all the cephalometric parameters considered, the results found show that the thickness of the tissues had an effect in modifying the aesthetic profile with respect to the position of the incisors. The cephalometric parameters related to the esthetic profile of the maxilla are all linked by strong correlations, especially correlation between SU, ULA and LS were very high. The differences between the means were statistically significant for different groups. Using the values of Mx1 and thickness of the lip as independent variables, while the LS, SU, ULA and NLA values as dependent variables all results are significant with respect to the prediction p < 0.05.ConclusionThickness of the soft tissues showed a significant influence on the profile with respect to the position of the incisors.Clinical significanceData obtained highlighted that thickness of the soft tissues must be taken into account before starting an orthodontic treatment in order to obtain best aesthetic results.How to cite this articleMaddalone M, Losi F, Rota E, et al. Relationship between the Position of the Incisors and the Thickness of the Soft Tissues in the Upper Jaw: Cephalometric Evaluation. Int J Clin Pediatr Dent 2019;12(5):391–397.

The esthetic profile preferences of Class II malocclusion patients treated with extraction or non-extraction

Abstract The treatment of Class II can have a positive or a negative impact on the facial profile aesthetic. The present study aims to evaluate the impact of two methods of orthodontic treatment of Class II malocclusion on the facial profile aesthetics. The facial profiles of 46 patients with Class II malocclusion were outlined by radiography before and after treatment; 23 of the patients were treated by the extraction of two maxillary first premolars (EXT group), and the other 23, with the Thurow Appliance (TA group), followed by braces. The profile silhouettes were filled in using the Corel Draw program. An album containing the patient’s silhouettes of both groups was created randomly, with two profiles of a patient per page. The preferences of 30 orthodontists, 30 dentists, and 30 laypersons in relation to the profile were recorded along with their perceived differences between the pre-treatment and post-treatment profiles, according to the visual analog scale. All groups of evaluators preferred the post-treatment profile more frequently. There were statistically significant differences in the evaluators’ preferences only between the orthodontists’ and the laypersons’ groups. None of the evaluators’ groups indicated substantial differences between the pre-treatment and post-treatment profiles. It may be concluded that both Class II treatment protocols, i.e., the double-extraction of the first premolars and the use of TA, improved the patients’ facial profile aesthetics.Keywords: Face. Malocclusion, Angle Class II. Tooth Extraction.Resumo As modalidades de tratamentos da Classe II tem um impacto sobre a estética da face que pode ser positivo ou negativo. O objetivo deste estudo foi avaliar o impacto da estética do perfil facial decorrente de dois tipos de tratamento para a Classe II. Foram traçados os perfis faciais das telerradiografias pré e pós-tratamento de 46 pacientes Classe II, sendo 23 de um grupo tratado com extração de dois primeiros pré-molares superiores e 23 de um grupo tratado com AEB Conjugado seguido de aparelho fixo, e estes traçados foram preenchidos com o programa Corel Draw. Foi montado um álbum com as silhuetas dos pacientes (AEB e EXO) de forma aleatória, sendo dois perfis em cada folha do mesmo paciente. Foi pedido para 30 ortodontistas, 30 cirurgiões-dentistas e 30 leigos para verificarem a sua preferência em relação ao perfil e a quantidade de diferença entre os perfis pré e pós-tratamento, de acordo com a escala analógica visual. Os 3 grupos de avaliadores preferiram o perfil pós-tratamento com maior frequência. Houve diferenças estatisticamente significantes somente entre os grupos de avaliadores ortodontistas e leigos; os 3 grupos de avaliadores indicaram que os perfis pré e pós-tratamento, não diferiram substancialmente. Pode-se concluir que o tratamento da Classe II, com extração de dois primeiros pré-molares, e com o uso do aparelho AEB Conjugado produziu um impacto positivo na estética do perfil.Palavras-chave: Face. Má Oclusão de Angle Classe II. Extração Dentária.

Effectiveness and effect of non-vital bleaching on the quality of life of patients up to 6 months post-treatment: a randomized clinical trial.

The aim of this study was to evaluate the esthetic perception of patients at 6months after bleaching of non-vital teeth with 35% of hydrogen peroxide and 37% of carbamide peroxide using a walking bleach technique. We also assessed psychosocial impacts as well as the clinical effectiveness and stability of the color change. The teeth bleaching treatment was randomly assigned to two groups according to the bleaching agent used: G1 HP = 35% of hydrogen peroxide (n = 25) and G2 CP = 37% of carbamide peroxide (n = 25). The non-vital bleaching was performed in four sessions using the walking bleach technique. The color was objectively (ΔE) and subjectively (ΔSGU) evaluated. The esthetic perception and psychosocial factors were evaluated before treatment as well as one and 6months post-treatment using Oral Health Impact Profile (OHIP) esthetics and Psychosocial Impact of Dental Esthetics Questionnaire (PIDAQ). The color change (ΔE) at 6months (G1 = 14.53 ± 5.07 and G2 = 14.09 ± 6.61) for both color groups remained stable until the 6-month post-treatment (p > 0.05). There was a decrease in the values of OHIP esthetics and PIDAQ after treatment compared to the baseline (p < 0.05), and this effect was maintained 6months post-treatment. Both agents were highly effective and maintained the color stability at 6months; this positively affected the esthetic perception and psychosocial impact of patients who also remained stable over time. Non-vital bleaching produces a positive and stable impact on the esthetic perception and psychosocial factors at medium-term follow-ups.