Influence of maxillary incisor edge asymmetries on the perception of smile esthetics among orthodontists and laypersons

Introduction: Our objective was to determine the perception of smile esthetics among orthodontists and laypeople with respect to asymmetries on the maxillary incisor edges in a frontal smile analysis. Methods: Two frontal close-up smile photos of 2 women, 1 white and 1 Afro-Brazilian, were selected for this study. Both smiles displayed healthy maxillary anterior dentitions. The images were digitally altered to create tooth wear on the maxillary left central and lateral incisors in 0.5-mm increments. The final images were randomly assembled into a photo album that was given to 120 judges, 60 orthodontists and 60 laypersons. Each rater was asked to evaluate the attractiveness of the images with visual analog scales. The data collected were statistically analyzed with 1-way analysis of variance with the Tukey post-hoc test and the unpaired Student t test. Results: The most attractive smiles in both types of smiles were those without asymmetries and the 0.5-mm wear in the lateral incisor. In general, tooth wear was considered unattractive by both groups of raters following a pattern: the more tooth wear, the more unattractive the smile; tooth wear in the central incisor was considered more unattractive than in the lateral incisor. For both group of raters, 0.5 mm of wear in the central incisor was considered unattractive, whereas the thresholds for lateral incisor discrepancies were 0.5 mm for orthodontists and 1.0 mm for laypersons. Conclusions: The result of this study corroborates the clinical assumption that symmetry between the maxillary central incisors is a paramount goal for esthetic treatments. Copyright © 2013 by the American Association of Orthodontists.

Influence of the Vertical Position of Maxillary Central Incisors on the Perception of Smile Esthetics Among Orthodontists and Laypersons

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influence of spacing in the upper lateral incisor area on the perception of smile esthetics among orthodontists and laypersons

Background: The aim of this study was to determine the perception of smile esthetics among orthodontists and laypeople with respect to the presence of diastemas in the upper lateral incisor in the mesial, distal, and both surfaces using an oblique smile analysis. Methods: Two standardized oblique photos of pleasant smiles from two white women were selected. Images were digitally altered to create diastemas in the lateral incisor, in 0.5-mm increments, in the mesial, distal, or both surfaces. Final images were randomly assembled in a photo album, which was given to 120 judgesd60 orthodontists and 60 laypersons. Each rater was asked to evaluate the attractiveness of the images on a visual analog scale. The data collected were submitted to statistical analysis by the means of one-way ANOVA with the Tukey post hoc test and the unpaired Student’s t test. Results: The most attractive smile was the one without spacing, and the presence of diastemas was considered unattractive by both groups of raters, following a pattern: the greater and the more mesially located, the more unattractive was the smile. Conclusions: The results of this study suggest that diastemas in the upper lateral incisor area were considered unattractive, following a pattern: the greater and the more mesially located, the more unattractive was the smile.

Assessment of changes in smile after rapid maxillary expansion

INTRODUCTION: This study evaluated changes in the smile characteristics of patients with maxillary constriction submitted to rapid maxillary expansion (RME). METHODS: The sample consisted of 81 extraoral photographs of maximum smile of 27 patients with mean age of 10 years, before expansion and 3 and 6 months after fixation of the expanding screw. The photographs were analyzed on the software Cef X 2001, with achievement of the following measurements: Transverse smile area, buccal corridors, exposure of maxillary incisors, gingival exposure of maxillary incisors, smile height, upper and lower lip thickness, smile symmetry and smile arch. Statistical analysis was performed by analysis of variance (ANOVA), at a significance level of 5%. RESULTS: RME promoted statistically significant increase in the transverse smile dimension and exposure of maxillary central and lateral incisors; maintenance of right and left side smile symmetry and of the lack of parallelism between the curvature of the maxillary incisal edges and lower lip border. CONCLUSIONS: RME was beneficial for the smile esthetics with the increase of the transverse smile dimension and exposure of maxillary central and lateral incisors.

Perceptions of laypersons and orthodontists regarding the buccal corridor in long- and short-face individuals

Objective: To determine the perception of orthodontists and laypersons regarding the size of the dark spaces in the buccal corridors and how that affects smile esthetics in individuals with long and short faces.Materials and Methods: Images of eight smiling individuals were modified to create five sizes of dark spaces in the buccal corridors (2%, 10%, 15%, 22%, and 28%) and were submitted to a group of laypersons and a group of orthodontists.Results: Laypersons were more critical in their evaluation than orthodontists. Laypersons could not distinguish the gradation of dark spaces in the buccal corridor unless it was very plain. Orthodontists perceived this gradation beginning at 15%. Female evaluators were more critical than male evaluators in both groups.Conclusions: The presence or absence of dark spaces in the buccal corridors has little influence over smile esthetics. While this aspect must be considered in the orthodontic diagnosis, there is no justification for expanding the buccal corridor to eliminate dark spaces unless they are very evident. (Angle Orthod. 2011;81:86-90.)

Percepção estética de parâmetros ortodônticos por diferentes grupos de indivíduos

Pós-graduação em Ciências Odontológicas - FOAR

Avaliação da influência do espaço negativo na estética, durante o sorriso

Pós-graduação em Odontologia - FOAR

Analysis of the smile photograph.

Optimal facial esthetics is one of the objectives in orthodontic treatment and an important issue in modern society. In this context, orthodontic treatment permits individuals with dental malpositions to achieve improved dentofacial esthetics. To reach this result, the orthodontist needs to recognize the characteristics considered normal and pleasant in dental arches and smiles. The objective of this article is to review and discuss criterion adopted by dental literature to technically analyze the smile, such as dental midline, smile line, dental exposure, negative space, dental proportion, and symmetry. This article proposes a way to visualize an ideal smile for each patient.

Conservative reconstruction of the smile by orthodontic, bleaching, and restorative procedures

The following is a clinical case report of a patient whose chief complaint was the presence of generalized spacing in the maxillary anterior segment following orthodontic treatment. After meticulous clinical analyses and discussions of the clinical procedures to be adopted, dental bleaching was performed in both arches with 10% hydrogen peroxide (Opalescence Trèswhite Supreme 10% Hydrogen Peroxide - Ultradent Products, Inc., South Jordan, USA) after the conclusion and stabilization of orthodontic treatment. Then, the orthodontic appliance was removed and the diastemas in the maxillary anterior teeth were closed with Amelogen Plus (Ultradent Products, Inc., South Jordan, USA) resin composite. It was observed that the association of orthodontic, bleaching, and restorative procedures was capable of restoring dental shape, function, and esthetics, allowing the patient to smile without hesitation.

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.

Diastemas: reestablishment of an attractive smile

A healthy and attractive smile is very valued in today s society. Yet this requires better aesthetic and cosmetic solutions from dental surgeons.The present paper presents a case report of diastema closure using an association of tooth movement induced by orthodontic elastics,dental cosmetics and resin-bonded prosthesis. The female patient L.B.A.J., aged 19 years, visited the Integrated Clinic of Araçatuba DentalSchool UNESP mainly complaining of missing teeth and poor esthetics. After anamnesis, clinical and radiographic examination revealedhypodontia of the maxillary right and left first premolars, abnormal maxillary right lateral incisor shape and diastema between the maxillaryright lateral incisor and canine and between the maxillary left lateral incisor and canine. Planning was done which included indication ofdiastema closure with composite resin restoration and metal-free resin-bonded prosthesis, with a structure made of Vectris (Ivoclar VivadentInc., Amherst, NT, USA). The option for dental cosmetics associated with resin-bonded prosthesis after movement with orthodontic elasticsresulted in an excellent aesthetic outcome of low cost and short treatment duration.Indexing terms: composite resins; diastema; fixed resin bonded partial denture.