Soft Tissue Esthetics Research Articles

A New Era of Tooth Preparation and Gingitage Retraction Technique: A Case Report

The demand for procedures intended to improve dental aesthetics has increased recently. Preserving the teeth and surrounding soft structures to the greatest extent possible is preferred in this situation by both patients and dentists. When using fixed prostheses, maintaining the stability and health of soft tissues is a constant struggle. Bone tissue health and soft tissue health are directly correlated. The long-term efficacy of prosthetic therapy thus depends on preserving tissue health and being free of mucositis. This case report describes the successful application of the gingitage technique in a patient requiring aesthetic enhancement of the gingival margins surrounding dental restorations. The patient presented with uneven gingival contours and mild inflammation around subgingival margins of existing restorations, compromising both function and aesthetics. Results demonstrated significant improvements in gingival health, a more balanced gingival margin, and an enhanced aesthetic outcome. Follow-up assessments revealed stable gingival contours and an overall increase in patient satisfaction. This case report underscores the effectiveness of the gingitage technique as a minimally invasive solution for enhancing soft tissue aesthetics and supporting the longevity of dental restorations.

Exploratory study on a novel minimally invasive tunnel like flap approach for orthodontic movement of dental implants.

To propose a new flap design that utilize a minimally invasive approach to move implants. We also propose a 3D method to track changes in implant position without the need for CBCT. Implants were inserted in two mongrel dogs then a minimally invasive tunnel like flap was made. Bone cutting around implants was done using piezotome device and orthodontic force was applied on the implants. For tracking positional changes of implants, an impression was taken then scanned with an identical implant copy inside. The pre- and post-treatment 3D images were then superimposed over each other to detect changes in implant position. Healing of the flap was rapid with minimal swelling and edema. The position of the interdental papilla was preserved maintaining optimal esthetic outcome. Implant pocket depth was maintained. Our 3D imaging method was able to accurately detect the movement that occurred in the dental implants after their movement with significantly higher resolution than CBCT (6μm for this method versus 76-300μm for the CBCT). This flap can preserve the esthetic soft tissue contour of implants during orthodontic movement allowing rapid healing with minimum swelling and edema. Moreover, our proposed 3D method has many advantages over CBCT in tracking the movement of implants by being non harmful and cheap thus allowing several follow up points. Orthodontic movement of implants can be required in cases of improperly placed implants or to intentionally place the implant in a certain position then altering it to avoid the need for bone grafting.

Soft tissue aesthetics in implant-supported rehabilitation of lateral tooth

Soft tissue aesthetics in implant-supported rehabilitation of lateral tooth

A Comparative Evaluation of The Perception of the Layperson to the Variation in Soft Tissue Esthetics During Smile

A Comparative Evaluation of The Perception of the Layperson to the Variation in Soft Tissue Esthetics During Smile

Differences in linear and angular measurement of the lower facial third in lateral cephalometry and lateral photometry: A comparative study

BackgroundIn clinical orthodontic practice, to evaluate aesthetics in dentistry, lateral cephalometry and lateral photometry are used to measure and assess craniofacial morphology. In contrast to cephalometry, photometry has no radiation hazard and is less expensive. There has been a paradigm shift in contemporary orthodontics that now emphasizes soft tissue aesthetics, rather than depending entirely on hard tissue evaluation from lateral cephalometry. Therefore, the key question is whether lateral photometry can be a substitute for conventional cephalometry for diagnostics, prognostic analysis, and treatment planning. ObjectiveTo differentiate between lateral cephalometry and lateral photometry measurement in children with stage 2 and 3 vertebrae maturation in the Deutero Malay population. Materials and MethodsA standardized protocol was followed for all lateral cephalograms and photographs from 38 subjects who met the inclusion criteria. Three parameters focusing on the lower third craniofacial measurement were investigated: two linear parameters (mandibular ramus length and mandibular length) and one angular parameter (gonial angle). These parameters were measured using Webceph software. All parameters were digitized on both cephalograms and photographs and were compared using an independent sample t-test. ResultsWhen comparing the angular cephalometric and photometric variables, we found that the mandible length (Go-Me) and gonial angle (∠Go) in the cephalometry measurements had an insignificant difference compared to the photometric measurements, while the ramus length (Co-Go) in the cephalometry measurement had a significant difference compared to the photometric measurements. ConclusionAlthough we cannot rule out cephalometry as the primary record in orthodontics, lateral photometry assessment can be used as an alternative candidate for measuring mandibular body measurements and gonial angle in stage 2 and 3 cervical maturation in the Deutero Malay race.

Robotics in dental and facial esthetics

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

The influence of connective tissue grafting on the reconstruction of a missing facial bone wall using immediate implant placement and simultaneous bone reconstruction: a retrospective long-term cohort study

PurposeThis retrospective cohort study evaluates the influence of connective tissue grafts (CTG) on bone regeneration at implant sites with total loss of the buccal bone wall treated with flapless immediate implant placement (IIP) and reconstruction with autogenous bone chips (AB) within a follow-up of up to 13 years.MethodsSixty implants were inserted in 55 patients in sites with total loss of the buccal bone wall between 2008 and 2021. The implants were inserted and the buccal gaps were grafted by AB. A subgroup of 34 sites was grafted additionally with CTG using tunnel technique. Primary outcome was the vertical bone regeneration in height and thickness. Secondary outcome parameters were interproximal marginal bone level, recession, soft tissue esthetics (PES), width of keratinized mucosa (KMW) and probing depths (PPD).ResultsMean follow-up period was 60.8 months. In 55 sites a complete vertical bone regeneration was documented. The mean buccal bone level increased by 10.6 mm significantly. The thickness of the buccal bone wall ranged between 1.7 and 1.9 mm, and was significantly thicker in sites without CTG. Interproximal marginal bone level was at implant shoulder level. The mean recession improved significantly by 1.2 mm. In sites with CTG, recessions and PES improved significantly more.ConclusionsAdditional CTG in extraction sites with total buccal bone loss followed by IIP with simultaneous AB grafting led to improved PES and recession, but also to a thinner buccal bone wall compared to sites grafted just with AB.Graphical

РЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ КОЛЛАГЕНОВОГО МАТРИКСА ПРИ МЕНЕДЖМЕНТЕ МЯГКИХ ТКАНЕЙ В ОБЛАСТИ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ ВО ФРОНТАЛЬНОМ ОТДЕЛЕ ВЕРХНЕЙ ЧЕЛЮСТИ

The aim is to comparatively analyze the using of collagen matrix and free connective tissue graft in soft tissue thickness increase in the area of dental implants in the anterior region of the upper jaw.
 Materials and methods. 30 patients with partial absence of teeth and soft tissue thickness deficit in the anterior part of the upper jaw took part in the study. In the 1st group (n = 15) a free connective tissue graft (CTG) from the hard palate was transplanted, in the 2nd group (n = 15) a collagen matrix (CM) was used. The primary endpoint was the amount of soft tissue thickness gain 3 months after surgery. Secondary endpoints were: duration of surgery, severity of collateral edema and pain, amount of analgesic medication consumed, quality of life assessment, width of keratinized attached gingiva, and soft tissue aesthetics.
 Results. 3 months after augmentation the increase in soft tissue thickness from the vestibular surface was 0.86 ± 0.25 mm and 0.77 ± 0.26 mm (p = 0.34), from the occlusal surface - 0.46 ± 0.14 mm and 0.37 ± 0.18 mm (p = 0.137) in patients of the 1st and 2nd groups, respectively. The use of CM was characterized by less prolonged surgery (p = 0.002), less pronounced postoperative pain on the 1st and 3rd day (p = 0.007; p = 0.023), less consumption of analgesic drugs on the 1st, 3rd and 5th day (p = 0.014; p = 0.033; p = 0.002) and less reduction of patients' quality of life in the first 7 days after surgery (p = 0.023). When analyzing the "Pink Esthetics Scale" (PES) in patients, group 2 showed more pronounced inconsistencies in the assessment of the zenith level (p < 0.001), less natural soft tissue contour (p < 0.001) and more significant deficit of the alveolar ridge (p < 0.001).
 Conclusion. Collagen matrixes make it possible to obtain soft tissue augmentation comparable with the use of CTG, to reduce the time of surgical intervention and to provide a more comfortable postoperative period. The use of autogenous grafts provides better results in terms of soft tissue aesthetics.

Treating facial overfilled syndrome with impaired facial expression-Presenting clinical experience with ultrasound imaging.

Facial overfilled syndrome is an adverse event following minimally invasive soft tissue filler injections. It presents in most cases as excess midfacial volume and/or as unnatural smile which is difficult to detect due to the absence of standardized evaluation methods. To showcase how to identify, evaluate, and treat facial overfilled syndrome by utilizing facial ultrasound and simultaneous hyaluronidase injections. Twenty-eight consecutive patients (26 females, 2 males) were enrolled in this study in which facial ultrasound was performed to evaluate the location previously implanted filler material. The position of the oral commissure was objectively measured in relation to bony landmarks, and the severity of lateral canthal lines was assessed by independent and blinded raters. The material was identified in 35.7% inside the subdermal fatty layer, in 28.6% inside the deep supra-periosteal fatty layer, in 10.7% inside the fibrous layer deep to the subdermal fatty layer, whereas in 25.0%, the product was not possible to locate clearly inside one specific layer. On average, 81.6 I.U. [range: 75-150] of hyaluronidase were injected. Lateral canthal line severity was before the treatment 2.28 (1.4) and was after the hyaluronidase treatment 2.02 (1.3) with p = 0.578. The position of the oral commissure increased by 0.60 cm in vertical and by 0.30 cm in horizontal directions (both p < 0.001). Facial overfilled syndrome following aesthetic soft tissue filler injections can present as excess midfacial volume but also as unnatural smile. Targeted hyaluronidase injections into the culprit pockets inside the midfacial soft tissues have shown to re-establish a natural smile, to reduce excess midfacial volume, and to decrease lateral canthal line severity.

Is constant needle motion during soft tissue filler injections a safer procedure? A theoretical mathematical model for evaluating patient safety.

The safety rationale behind the constant needle motion injection technique is based on the assumption that due to the constant needle motion and simultaneous soft tissue filler material administration a smaller amount of product per area may be injected into an artery if an artery within the range of the moving needle is inadvertently entered. To perform mathematical calculations for determining the probability for causing intra-arterial product administration when constantly moving the needle during facial aesthetic soft tissue filler injections. This study was designed as a theoretical investigation into the probabilities for causing adverse events due to intravascular injection of soft tissue filler material when constantly moving a 27-G needle during facial soft tissue filler administration. It was revealed that with a higher number of conducted injection passes a greater soft tissue area can be covered by the needle. The odds of encountering an artery within the covered soft tissue volume and the odds of injecting any volume greater than zero into the arterial blood stream increases with the number of performed injection passes. This increase is greatest between 1 and 10 performed injection passes. This model demonstrates that the constant needle motion technique increases the probability of encountering an artery within the treatment area and thus increases the odds for intra-arterial product administration. The constant needle motion technique does not increase safety but rather may increase the odds of causing intra-arterial product administration with the respective adverse consequences for the patient.

A Non-Surgical Approach to enhance Soft Tissue Esthetics in Anterior Fixed Restorations: A Case Report

The sound health of the supporting tissues is critical to the long-term success of Fixed Prosthodontic treatment, especially when it involves the Maxillary Anterior region. This will contribute immensely to a lasting esthetic outcome. The final prosthetic value may be may be compromised by factors such as extend of gingival display, gingival architecture, coronal dimensions clinically, and tooth position. Surgical correction for optimization of soft tissue contour possesses certain drawbacks as it is an invasive procedure which could involve a longer and unpredictable healing period as well as the possible risk of an infection. This article describes a non-surgical approach for the re-contouring of the soft tissue through the sustained application of pressure using a provisional fixed prosthesis, which could avoid potential complications that a surgical approach may invite and provide a reliable option to enhance anterior aesthetic value in the final fixed prosthesis. Keywords: Anterior aesthetics, Non-surgical, Soft tissue re-contouring, Provisional prosthesis, Zirconia

Evaluation of the relationship between incisor torque and profile aesthetics in patients having orthodontic extractions compared to non-extractions

ObjectiveThe aim of the present study was to evaluate the relationship between soft tissues aesthetics and incisor torque, as well as the effect of crowding, anchorage, and extraction pattern, in adult patients treated without extraction or with two or four extractions.Materials and methodsSeventy-seven subjects with permanent dentition were selected retrospectively. Among these, 24 patients were treated with four extractions, 24 with two extractions and 29 without extractions. Lateral cephalograms and photographies taken before (T0) and after (T1) treatment were retrieved. The amount of crowding and the type of anchorage were recorded, and a cephalometric analysis was performed. A one-way ANOVA was used to compare the variables within and between groups. Linear regressions were performed to evaluate the effect of different predictors on soft tissues variables at T1.ResultsThe statistical analysis showed no differences within and between groups for soft tissue aesthetics. A significant reduction of the angle obtained from the intersection of Frankfurt plane and mandibular plane was observed in the four-extractions group, and a significant proclination of the lower incisors was observed in the two-extraction group. Linear regressions revealed that the change in soft tissue profile aesthetics was affected by the type of anchorage and the two-extractions pattern.ConclusionsSimilar soft tissue aesthetics were observed after treatment in the three groups, despite the presence of some skeletal and dental differences.Clinical relevanceA well-controlled incisor torque helps to preserve soft tissues aesthetics. The type of anchorage could influence soft tissues.

Evaluation of Human Gingival Fibroblasts (HGFs) Behavior on Innovative Laser Colored Titanium Surfaces.

The use of ytterbium laser to obtain colored titanium surfaces is a suitable strategy to improve the aesthetic soft tissue results and reduce implant failures in oral rehabilitation. To investigate the relationship between novel laser-colored surfaces and peri-implant soft tissues, Human Gingival Fibroblasts (HGFs) were cultured onto 12 colored titanium grade 1 light fuchsia, dark fuchsia, light gold, and dark gold disks and their viability (MTT Assay), cytotoxicity (lactate dehydrogenase release), and collagen I secretion were compared to the machined surface used as control. Optical and electronic microscopies showed a HGF growth directly correlated to the roughness and wettability of the colored surfaces. A higher viability percentage on dark fuchsia (125%) light gold (122%), and dark gold (119%) samples with respect to the machined surface (100%) was recorded. All specimens showed a statistically significant reduction of LDH release compared to the machined surface. Additionally, a higher collagen type I secretion, responsible for an improved adhesion process, in light fuchsia (3.95 μg/mL) and dark gold (3.61 μg/mL) compared to the machined surface (3.59 μg) was recorded. The in vitro results confirmed the innovative physical titanium improvements due to laser treatment and represent interesting perspectives of innovation in order to ameliorate aesthetic dental implant performance and to obtain more predictable osteo and perio-osteointegration long term implant prognosis.

LIP ABSCESS FORMATION SECONDARY TO HYALURONIC ACID SOFT TISSUE FILLERS

The number of esthetic soft tissue filler treatments has rapidly increased, along with an increase in complications associated with such treatments. This study presents a case of a 62-year-old woman who received an injection of hyaluronic acid to the nasolabial fold and lips, and developed a painful lesion in the lip a year after injection. Extraoral examination presented a pustule in the inferior lip. The surrounding area was also hot, erythematous, and soft to the touch. Based on the patient´s history, the diagnosis was an abscess secondary to the filler. The area was decontaminated, and the abscess was drained. To prevent a recurrence, cephalexin 2g daily for seven days was prescribed. There was no recurrence at 17 months. Abscesses following soft tissue filler treatment usually occur two weeks after treatment, but less commonly, they can occur months or years after injection procedure. The number of esthetic soft tissue filler treatments has rapidly increased, along with an increase in complications associated with such treatments. This study presents a case of a 62-year-old woman who received an injection of hyaluronic acid to the nasolabial fold and lips, and developed a painful lesion in the lip a year after injection. Extraoral examination presented a pustule in the inferior lip. The surrounding area was also hot, erythematous, and soft to the touch. Based on the patient´s history, the diagnosis was an abscess secondary to the filler. The area was decontaminated, and the abscess was drained. To prevent a recurrence, cephalexin 2g daily for seven days was prescribed. There was no recurrence at 17 months. Abscesses following soft tissue filler treatment usually occur two weeks after treatment, but less commonly, they can occur months or years after injection procedure.

Incidence of Peri-Implantitis, Technical and Biological Complications of Single Implants Placed with Flap or Flapless Surgery-A 10-12-Year Case-Series.

Long-term follow-up of single implants and crowns is scarce, especially when inserted using flapless surgery. Evaluate survival, peri-implantitis incidence, and technical/biologic complications of solitary implants/crowns after 10-12 years of function. 49 patients with 53 single implants, initially operated with a one-stage flap (F) or flapless (FL) surgery and delayed loading, were recalled. Implant survival, radiographic bone-level changes compared to baseline, peri-implant health, and soft tissue aesthetics were registered. Differences in implant level between and within groups were statistically tested using the Mann-Whitney U-Test and Wilcoxon Signed Ranks Test, respectively. 36 patients with 40 implants were reassessed, yielding 100% implant and 97.5% crown survival. The bone loss in F (n = 19) was 0.56 mm (SD 0.89; range -0.9-2.02) and -0.85 mm (SD 0.98; range -2.84-0.53) in FL (n = 21), indicative of bone gain in FL (p = 0.003), the latter due to a difference at baseline but bone-level was comparable (p = 0.126). Groups were comparable for probing pocket depth (PPD); (3.32 vs. 3.19 mm), Bleeding Index (BI); (0.15 vs. 0.22), and gingival recession; (0.38 vs. 0.17 mm). According to international criteria, the peri-implantitis incidence was 0%, but 32.5% of the implants/crowns experienced biological or technical complications irrespective of surgical technique. Solitary implants and crowns show good long-term clinical outcomes and peri-implant health. Flapless surgery is a good alternative to conventional in straightforward cases with sufficient bone volume and proper treatment planning.

Factors Associated with Esthetic Outcomes of Flapless Immediate Placed and Loaded Implants in the Maxillary Incisor Region—Three-Year Results of a Prospective Case Series

Flapless immediate implant placement and provisionalization (FIIPP) is often associated with an increased risk of buccal soft-tissue recession. This study aims to assess the 3-year esthetic outcome. In 100 consecutive patients, one maxillary incisor, with or without a pre-extraction buccal bone defect (≤5 mm), was replaced by an implant installed in a maximal palatal position (buccal gap ≥2 mm). The created gaps were filled with bovine bone substitute. Patient satisfaction (PS), pink esthetic scores (PES/modPES), and white esthetic score (WES) were calculated at different time points. A multilevel regression analysis (MRA) was performed to analyze which factors may be associated with the esthetics. After three years, PS scored 8.9 ± 0.84 on a scale of 10 (n = 83), and the soft-tissue esthetics were high (PES = 12.2; modPES = 8.5), as was the WES (8.2), showing no decrease from one year. Buccal bone defect size and smoking could not be associated with the soft-tissue outcome; however, implant location, gap size, and emergence profiles could. Performing FIIPP, the final crown (WES) scored highest when it was cemented, the soft tissue (PES/modPES) in central-incisor positions, and all (WES/PES/modPES) with concave emergence profiles.

Hard and soft tissue regeneration of severe peri-implantitis defects with the laser-assisted peri-implant defect regeneration technique: 3-year results

PurposeThis retrospective cohort study evaluates the regeneration of severe peri-implantitis deficiencies treated with the laser-assisted peri-implant defect regeneration (LAPIDER) approach within a 3-year follow-up.MethodsTwenty-four implants with severe peri-implantitis in 18 patients were treated according to the LAPIDER technique. In contrast to classic techniques for reconstructive peri-implantitis surgery with a marginal incision, a buccal split-flap preparation avoiding papillae separation was used. After a coronal flap elevation and a laser-assisted peri-implant defect cleaning, connective tissue and autogenous bone grafting was performed. Primary outcomes were the changes of the marginal bone levels (MBL) and the buccal bone thickness. Secondary outcomes included implant survival, peri-implant probing depths (PPD), bleeding on probing (BOP), recession, width of keratinized mucosa (KMW), thickness of keratinized mucosa (KMT), soft tissue esthetics (PES), and implant success.ResultsMBL improved interproximal by 3.10 ± 2.02 mm (p < 0.001), buccal by 3.49 ± 2.89 mm (p < 0.001), and lingual by 1.46 ± 1.98 mm (p = 0.003); buccal bone thickness by 0.55 ± 0.60 mm (p = 0.005), and 1.01 ± 1.25 mm (p = 0.001) at 1 and 3 mm below reference level. Two implants were removed; 22 implants were still in function at a mean follow-up of 36 months. PPD changed from 5.05 ± 1.39 to 3.08 ± 0.71 mm (p < 0.001); recession was reduced from 2.07 ± 1.70 to 0.91 ± 1.13 mm (p = 0.001); KMW increased from 2.91 ± 1.81 to 4.18 ± 1.67 mm (p = 0.006); KMT improved from 1.73 ± 0.50 to 2.44 ± 0.43 mm (p < 0.001); PES changed from 7.7 ± 2.8 to 10.7 ± 1.9 (p < 0.001). 45.8% to 54.2% of the implants met the criteria of implant success.ConclusionsThe favorable results document the proof of principle for the regeneration of severe peri-implant hard and soft tissue deficiencies by the LAPIDER treatment approach.

Soft tissue esthetics around immediately provisionalized delayed implants with and without connective tissue graft: A randomized clinical trial pilot study

Evaluate the peri-implant soft tissue esthetics following a single, immediately provisionalized, delayed implant with/-out subepithelial connective tissue graft (SCTG). The eligible patients were randomized into two groups. Immediate provisionalization was performed with (test group: SCTGG) or without SCTG (control group: NGG). The soft tissue esthetics was assessed by Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI), at 6 and 12 months, following final implant restoration. The SCTGG, compared to NGG, yielded a 0.2 increased PES at 12 months (95% confidence interval (CI): -1, 1.4) and a 0.2 decreased MSI score (95% CI -0.9, 0.5) with no statistically significant differences in PES and MSI between both groups (p > 0.05). Soft tissue grafting around immediately provisionalized delayed implants could exhibit comparable results to immediate provisionalization alone in terms of peri-implant soft tissue esthetics using PES and MSI (ClinicalTrials.gov Identifier: NCT03770975).

Partial Extraction Therapy with Early Implant Placement in the Esthetic Zone: A Clinical Case Report

Immediate replacement of teeth designated for extraction is an appealing treatment rationale for both the patient and the operator. However, it has been associated with a greater risk of facial recession and compromised soft-tissue esthetics. Partial extraction therapy (PET) or synonymously socket shield technique (SST) or root membrane technique (RMT) has been proposed to conserve the facial alveolar contour and soft-tissue esthetics. In this article, a special case is described where a root membrane was used to prevent the modeling of the facial aspect of the extraction socket. Partial extraction was performed allowing the socket with the facial root membrane in situ to partially heal for 8 weeks before implant placement. Successful integration and restoration were achieved with very minimal hard- and soft-tissue changes, accentuating satisfactory esthetic results as dictated by objective esthetic assessment. PET with early implant placement may be considered a viable treatment option for selected cases.

Advancement of Marginal Bone and Soft Tissue Aesthetics for Slope-Configured Implants

The aim of the study was to examine changes within the marginal bone and soft tissue aesthetics following placement of implants with a sloped shoulder configuration. Thirty patients with a single missing tooth who showed a palatal/lingual–buccal bone height discrepancy of 2.0–3.0 mm on CBCT were enrolled in the study. The thickness of buccal and palatal/lingual bone plates 1 and 3 mm apically from the platform; Pink Aesthetic Score and Papilla Index were evaluated. After the implant insertion the mean thickness of the buccal bone plate when measured 1 mm and 3 mm from the shoulder was 1.85 ± 0.68 mm and 1.99 ± 1.05 mm. Six months after the definitive crown delivery, the value of this parameter decreased by 0.32 ± 0.53 mm and 0.15 ± 1.05 mm, respectively. After the temporary crown delivery, the median Pink Aesthetic Score was 5, and it increased to 7.75 six months after the definitive crown delivery. Likewise, the Papilla Index median improved from 1 to 2. After the use of implants with a sloped shoulder configuration, a slight decrease in buccal bone plate thickness can be expected. However, the reduction in the thickness of this bone plate does not have a negative impact on soft tissues, as evidenced by the improvement in indices assessing aesthetics.