Dynamic UCLA for single tilted implant in an aesthetic region

The aim of this paper was to present a rehabilitation of a patient with a dynamic universal castable long abutment (UCLA) for a single tilted implant in the anterior maxillary area. A 57-year-old male patient attended the dentistry college clinic complaining of a vertical fracture of a residual root of the dental element 22. The tooth extraction was indicated for the implant installation. Due to the socket buccal wall thickness, the implant was installed with an inclination to the palate. It was done in a two-stage surgical protocol, and an external hexagon implant (3.75×11.5mm) was placed. After a six-month healing period to correct the implant position, a dynamic UCLA was set in place, rectifying the implant emergence profile at 20°. The ceramic structure fitting was performed and, after the patient's consent, the prosthesis was finalized and installed. After a follow-up period of twenty months, no complications were observed. The installation of tilted implants with a dynamic UCLA may be a viable option, faster and less invasive than bone grafts.

Esthetics in implant-supported prostheses: a literature review

Esthetics is important for success of implant-supported prostheses. This study aimed to review esthetics concepts for implant treatment. Research in the PubMed database included studies published from 1995 to 2010 with the keywords implant esthetics, implant-supported prostheses, and esthetics. Forty-five studies were evaluated regarding the presurgical planning, surgical phase, and temporary and final restoration phases. It was concluded that esthetics in implant-supported prostheses results from a multidisciplinary approach from planning until insertion of the final restoration.

Sexual haressement in dentistry: prevalence in dental school

OBJECTIVE: Sexual harassment is unlawful in all work and educational environments in most nations of the world. The goals of this study were to describe the sexual harassment prevalence and to evaluate the experiences and attitudes of undergraduate students in one dental school in Brazil. MATERIAL AND METHODS: An 18-item questionnaire was administered to 254 dental students with a completion rate of 82% (208). Students were requested to respond to questions about their background and academic level in dental school, their personal experiences with sexual harassment and their observation of someone else being sexually harassed. Bivariate statistical analyses were performed. RESULTS: Fifteen percent of the students reported being sexually harassed by a patient, by a relative of a patient or by a professor. Male students had 3 times higher probability of being sexually harassed than female student [OR=2.910 (1.113-7.611)]. Additionally, 25.4% of the students reported witnessing sexual harassment at the school environment. The majority of students did not feel professionally prepared to respond to unwanted sexual behaviors. CONCLUSION: These findings demonstrate that sexual harassment can occur in a dental school setting. There is a need for ongoing sexual harassment education programs for students and university staff. Increased knowledge of sexual harassment during graduation can better prepare dental professionals to respond to sexual harassment during their practice.

Brazilian dentistry profiles and workforce

The aim of this study was to assess the dentistry profile, based on social and demographic data, post-graduation formation, and to verify the insertion of dental graduates in the labour force. The participants were professionals graduated from a Brazilian Public Dental School, between 2000 and 2010. An instrument was sent by mail and/or e-mail to them. It was used Kruskal Wallis Test. Among 1047 questionnaires, 189 returned and 65.6% were answered by female. In relation to post-graduation course, 57.7% of professionals performed it, however 56.9% not attended only in their area; 66.6% of professionals are concentrated in cities larger than 100 thousand habitants. There was association between income and gender, and others. The predominant work modality was self-employed. Among the total, 36.5% want to work part-time in dentistry. The female gender was predominant and there was wage discrepancy between genders. The professionals have been concentrated in largest cities.

Qualitative methodogy: revealing a new path for research in dentistry

Currently, it is easy to find health professionals who not only attach importance to qualitative methods, but also recognize their help to better understand their patients' lives. However, its use in dentistry is still incipient, either due to ignorance or because of technical / operational difficulties in identifying possibilities for their use in research. Thus, the purpose of this study was to review the literature on the characteristics and peculiarities of the qualitative methodology, demonstrating their techniques of collecting, recording and analyzing data. For this, we performed a descriptive literature, from a survey in the "LILACS", "BBO" and "PUBMED" databases, by keywords related to the theme, selecting only the papers that mentioned the "importance" of qualitative research, the "characteristics and fundamentals," and the "techniques of collecting, recording and data analysis" involving this methodology. It was found that all studies have highlighted the importance of qualitative research to the construction of new knowledge that cannot be achieved by quantitative data. We found many different techniques to gather, record and analyze qualitative data applied to the dentistry field. It was concluded that qualitative research represents a new path to be followed by dentistry, so that we are able to plan actions in ethical and humane public health dentistry, bringing better results to the population, because of the depth of knowledge that your date can.

Emprego de ma teriais rest auradores adesivos direto no ângulo incisal de incisivos centrais fra turados

A case report of a patient who presents as chief complaint presence of stained restorations in the anterior teeth. After analysis and discussion of the clinical therapeutic approaches to be adopted, it was observed the presence of type class IV restorations on teeth 11 and 21, due to an oblique coronal fracture in the past. But the patient was not satisfied with the aesthetic result, then where was planned the realization of the removal of the restorations, for subsequently be used direct restorative materials for the correction of form, function and esthetics. The final result showed that the restorations were able to return the form, function and aesthetic dental, thereby evidencing the proven development of restorative dentistry in the solution of aesthetic problems.

Smile restoration through use of enamel microabrasion associated with tooth bleaching

Enamel microabrasion can eliminate enamel irregularities and discoloration defects, improving the appearance of teeth. This article presents the latest treatment protocol of enamel microabrasion to remove stains on the enamel surface. It has been verified that teeth submitted to microabrasion acquire a yellowish color because of the thinness of the remaining enamel, revealing the color of dentinal tissue to a greater degree. In these clinical conditions, correction of the color pattern of these teeth can be obtained with a considerable margin of clinical success using products containing carbamide peroxide in custom trays. Thus, patients can benefit from combined enamel microabrasion/tooth bleaching therapy, which yields attractive cosmetic results. Esthetics plays an important role in contemporary dentistry, especially because the media emphasizes beauty and health. Currently, in many countries, a smile is considered beautiful if it imitates a natural appearance, with clear, well-aligned teeth and defined anatomical shapes.1-3 Enamel microabrasion is one technique that can be used to correct discolored enamel. This technique has been elucidated and strongly advocated by Croll and Cavanaugh since 1986,4 and by other investigators1,2,5-13 who suggested mechanical removal of enamel stains using acidic substances in conjunction with abrasive agents. Enamel microabrasion is indicated to remove intrinsic stains of any color and of hard texture, and is contraindicated for extrinsic stains, dentinal stains, for patients with deficient labial seals, and in cases where there is no possibility to place a rubber dam adequately during the microabrasion procedure.1,2 It should be emphasized that enamel microabrasion causes a microreduction on the enamel surface,3,6,10 and, in some cases, teeth submitted to microabrasion may appear a darker or yellowish color because the thin remaining enamel surface can reveal some of the dentinal tissue color. In these situations, according to Haywood and Heymann in 1989,14 correction of the color pattern of teeth can be obtained through the use of whitening products containing carbamide peroxide in custom trays. A considerable margin of clinical success has been shown when diligence to at-home protocols is achieved by the patient and supervised by the professional.3 Considering these possibilities, this article presents the microabrasion technique for removal of stains on dental enamel, followed by tooth bleaching with carbamide peroxide and composite resin restoration, if required. - See more at: https://www.dentalaegis.com/cced/2011/04/smile-restoration-through-use-of-enamel-microbrasion-associated-with-tooth-bleaching#sthash.N6jz2Bwk.dpuf

Different esthetic techniques used in combination to improve the smile

This is a clinical case report of a patient who presented with dental stains in the buccal and proximal aspects of the anterior teeth. Buccal stains were removed using the enamel microabrasion technique, and vital tooth bleaching with carbamide peroxide was also performed. Restorative procedures employing composite resin were done for a better result in the proximal aspect of teeth. Clinical significance: The authors observed the combination of these esthetic techniques improved the patient's smile. Today, dental esthetics attempts to imitate natural teeth by making them white, well-shaped, and aligned with no spots. This has enabled the development of several esthetic techniques, such as microabrasion to remove dental enamel surface stains and surface irregularities,1-6 and vital tooth bleaching to treat yellowish teeth.7 The enamel microabrasion technique uses different abrasive agents associated with chemical solutions,1,2,4,6 allowing the removal of intrinsic, hard-texture stains, and different coloring spots on the enamel surface, as well as correction of irregularities on the dental buccal surface.1,8 The various microabrasive products include the Opalustre® (Ultradent Products, http://www.ultradent.com)or Prema® Compound (Premier Dental Products, http://www.premusa.com), a low-concentration hydrochloric acid product associated with silica microparticles that is certainly effective for microabrasion technique,4,6,9,10 providing a good safety profile for the patient and professional. The microabrasion technique also promotes micro-reduction on the adamantine surface.4,5,10 In some cases, after its completion, microabrasion may cause teeth to become darker or yellowish because of the thinner remaining enamel surface, leading to more evident observation of the dentinal tissue, which in general determines tooth color. In these clinical conditions, correction of the color pattern of dental elements can be obtained with carbamide peroxide products applied in custom trays, such as the bleaching products Whiteness Perfect at 10% or 16% (FGM Productos Odontologicos, http://www.fgm.ind.br) or Opalescence® at 10% or 15% (Ultradent Products), with a considerable margin of clinical success, provided it is well indicated, well performed, and supervised by the professional.4,6,9,10 Considering all the aforementioned aspects, the authors present a clinical case about a dental-enamel microabrasion technique used to remove buccal enamel surface stains associated with dental vital bleaching and restorative procedures in the proximal aspect of anterior teeth. - See more at: https://www.dentalaegis.com/cced/2010/08/different-esthetic-techniques-used-in-combination-to-recover-the-smile#sthash.McFoH7El.dpuf

Smile restoration through use of enamel mricroabrasion associated with tooth bleaching

Enamel microabrasion can eliminate enamel irregularities and discoloration defects, improving the appearance of teeth. This article presents the latest treatment protocol of enamel microabrasion to remove stains on the enamel surface. It has been verified that teeth submitted to microabrasion acquire a yellowish color because of the thinness of the remaining enamel, revealing the color of dentinal tissue to a greater degree. In these clinical conditions, correction of the color pattern of these teeth can be obtained with a considerable margin of clinical success using products containing carbamide peroxide in custom trays. Thus, patients can benefit from combined enamel microabrasion/tooth bleaching therapy, which yields attractive cosmetic results. Esthetics plays an important role in contemporary dentistry, especially because the media emphasizes beauty and health. Currently, in many countries, a smile is considered beautiful if it imitates a natural appearance, with clear, well-aligned teeth and defined anatomical shapes.1-3 Enamel microabrasion is one technique that can be used to correct discolored enamel. This technique has been elucidated and strongly advocated by Croll and Cavanaugh since 1986,4 and by other investigators1,2,5-13 who suggested mechanical removal of enamel stains using acidic substances in conjunction with abrasive agents. Enamel microabrasion is indicated to remove intrinsic stains of any color and of hard texture, and is contraindicated for extrinsic stains, dentinal stains, for patients with deficient labial seals, and in cases where there is no possibility to place a rubber dam adequately during the microabrasion procedure.1,2 It should be emphasized that enamel microabrasion causes a microreduction on the enamel surface,3,6,10 and, in some cases, teeth submitted to microabrasion may appear a darker or yellowish color because the thin remaining enamel surface can reveal some of the dentinal tissue color. In these situations, according to Haywood and Heymann in 1989,14 correction of the color pattern of teeth can be obtained through the use of whitening products containing carbamide peroxide in custom trays. A considerable margin of clinical success has been shown when diligence to at-home protocols is achieved by the patient and supervised by the professional.3 Considering these possibilities, this article presents the microabrasion technique for removal of stains on dental enamel, followed by tooth bleaching with carbamide peroxide and composite resin restoration, if required.

Implant-Supported Prosthesis Misalignment Related to the Dental Arch: A 14-Year Clinical Follow-up

The purpose of this study was to warn the dental community about a possible problem in function with partial implant-supported prostheses used for long periods. The misalignment between natural teeth and the implant-supported prosthesis on teeth 11 and 12, observed in a 14-year clinical follow-up, illustrates the fact. The metal-ceramic crowns were placed in 1995 after a rigorous occlusal adjustment. Evaluations were made at 4, 6, 9, and 14 years, when it was noticed that the restorations were positioned palatally and extruded in comparison with the natural teeth. After 9 years, a greater discrepancy was noticed, with anterior occlusion and esthetic changes. The possible causes have been discussed: occlusal problems, parafunctional habits, and natural movement. The first 2 options were discarded after clinical analysis and diagnosis. Therefore, the natural movement probably deriving from an interaction of mechanical and genetic factors might have been the cause. The implants do not have periodontal ligaments but rather ankylosis, so they do not suffer those movements. This case emphasizes the need to inform patients that implants can last more than 10 years in function, but this is not the case with restorations, which lose function and esthetics and must be replaced.

A Conservative Approach for Restoring Anterior Guidance: A Case Report

One of the most common dental problems in today's clinics is tooth wear, specifically when related to bruxism. In such cases, the esthetics of anterior teeth may be compromised when excessive wear to the incisal surfaces occurs. Anterior tooth wear resulting from parafunctional bruxism can be conservatively treated with the use of direct resin composite restorations. This restorative approach has the advantages of presenting good predictability, load resistance, acceptable longevity, preservation of healthy dental tissues, and lower cost when compared with indirect restorations. The use of resin composites to solve esthetic problems, however, requires skill and practice. Thus, the present article demonstrates a conservative approach for restoring the esthetics and function of worn anterior teeth with the aid of direct resin composite restorations and selective occlusal adjustment. CLINICAL SIGNIFICANCE A conservative approach to restore anterior teeth with excessive wear is possible with direct resin composites. (J Esthet Restor Dent 24:171-184, 2011)

Perception of the esthetic impact of mandibular incisor extraction treatment on laypersons, dental professionals, and dental students

Objective: To evaluate the degree of perception of laypersons, dental professionals, and dental students regarding dental esthetics in cases with mandibular central incisor extraction. Materials and Methods: Using a smile photograph of a person with normal occlusion and all teeth, modifications were made to reflect the extraction of a mandibular incisor of various compositions and sizes. For this purpose a program specifically for image manipulation (Adobe Photoshop CS3, Adobe Systems Inc) was used. After manipulation the images were printed on photographic paper, attached to a questionnaire and distributed to laypersons, dental professionals, and dental students (n = 90) to evaluate the degree of perception and esthetic using a scale of attractiveness, where 0 = hardly attractive, 5 = attractive, and 10 = very attractive. The differences between examiners were checked by the Mann-Whitney test. All the statistics were performed with a confidence level of 95%. Results: The results demonstrated the skill of the dental professionals and dental students in perceiving the difference between cases of normal occlusion and cases where an incisor was lacking (P < .05). The photograph in which the lateral incisors were shown to be larger than the central incisor was the one that obtained the highest value among the cases of extraction in all groups of evaluators. Conclusions: It can be concluded that dental professionals and dental students are more skillful at identifying deviation from normality. In addition, central incisor extraction should always be discarded when there are other treatment options available. (Angle Orthod. 2012;82:732-738.)

Clinical strategies for esthetic excellence in anterior tooth restorations: understanding color and composite resin selection

Direct composite resin restorations have become a viable alternative for patients that require anterior restorative procedures to be integrated to the other teeth that compose the smile, especially for presenting satisfactory esthetic results and minimum wear of the dental structure. Technological evolution along with a better understanding of the behavior of dental tissues to light incidence has allowed the development of new composite resins with better mechanical and optical properties, making possible a more artistic approach for anterior restorations. The combination of the increasing demand of patients for esthetics and the capacity to preserve the dental structure resulted in the development of different incremental techniques for restoring fractured anterior teeth in a natural way. In order to achieve esthetic excellence, dentists should understand and apply artistic and scientific principles when choosing color of restorative materials, as well as during the insertion of the composite resin. The discussion of these strategies will be divided into two papers. In this paper, the criteria for color and material selection to obtain a natural reproduction of the lost dental structures and an imperceptible restoration will be addressed.

Evaluation of facial esthetics in rehabilitated adults with complete unilateral cleft lip and palate

Objectives. The aim of this study was to evaluate the facial esthetics of White-Brazilian adults with complete unilateral cleft lip and palate (UCLP) rehabilitated at a single center. Design. 30 patients (13 females; 17 males; mean age of 24.0 years), rehabilitated at a single center, were photographed and evaluated by 25 examiners, 5 orthodontists, and 5 plastic surgeons dealing with oral clefts, 5 orthodontists and 5 plastic surgeons with no experience in the cleft treatment, and 5 laymen. Their facial profiles were classified into esthetically unpleasant, esthetically acceptable, and esthetically pleasant. Results. Orthodontists dealing with oral clefts classified the majority of the sample as esthetically pleasant. Plastic surgeons dealing with oral cleft, orthodontists, and plastic surgeons without experience with oral clefts classified most of the sample as esthetically acceptable. Laymen evaluation also considered the majority of the sample as esthetically acceptable. Conclusions. The facial profiles of rehabilitated adults with UCLP were classified mostly as esthetically acceptable, with variations among the categories of examiners. The examiners dealing with oral clefts gave higher scores to the facial esthetics when compared to professionals without experience in oral clefts and laypersons, probably due to their knowledge of the limitations involved in the rehabilitation process