Smile designing using recurring esthetic dental proportion and aesthetic pre-evaluative temporary technique with porcelain laminate veneers: a case report

Beautiful confident smile has a positive impact on the psychosocial well-being of patients. Spacing present in the anterior region makes a patient feel dissatisfied with their smile. Over the years, a number of innovative techniques have been described in the treatment of patient having spaces between teeth in the anterior region. However, a less invasive and short-time treatment procedure with satisfactory result is preferred by the patient. Laminates have a unique position in today’s dental practice. These conservative restorations are especially important for young permanent dentitions. Porcelain veneers can be considered to be very much in cosmetic dentistry because they deal innumerable advantages over any previous form of veneering systems. This case report described the technique of closure of spaces between teeth in the anterior region by applying recurring esthetic dental (RED) proportion and aesthetic pre-evaluative temporary (APT) technique for smile designing using laminates. The RED proportion has been stated to be an essential tool for achieving esthetics and harmony in smile. The APT technique facilitated diagnosis, communication, and preparation, providing predictability for the restorative treatment. Limiting the preparation depth to the enamel surface significantly increases the performance of porcelain laminate veneers.

Socioeconomic Determinants of Demand for Dental Cosmetic Treatments

Introduction: The demand for cosmetic dentistry is a growing trend globally. Increased media coverage, availability of free online information, and the improved economic status of the general population have led to an increase in the patient’s aesthetic expectations. Since no study has measured the relationship between the economic status of people and the choice of cosmetic dentistry in Iran and due to the growing demand for it, this study was designed. Method: In this descriptive epidemiological study, we visited three completely different areas in terms of Socioeconomic status (SES) in Tehran. A checklist was used to record the gender, job, age, education level, maternal status, and source of payment for cosmetic dentistry treatment. Result: The majority of the volunteers for dental cosmetic restoration were 23?26 years. Of 498 cosmetic restoration volunteers, 50 were men and 448 were women. As for the education level, most of the participants had a high school diploma. The cost of cosmetic restoration of 351 patients (70%) was paid by the parents or the spouse, and 147 patients paid the cost from their income. Our study showed that 7% of visits to dental clinics were only for cosmetic treatment demands in Tehran in 2021. Conclusion: Type of job, education level, and marital status had no significant relationship with the choice of cosmetic treatment while age had a significant relationship with the choice of cosmetic dental restoration treatment. In addition, the choice of cosmetic dental treatment was completely related to gender, and women were the main users of it.

Effectiveness and satisfaction of home-based external bleaching

Hydrogen peroxide is the main ingredient in bleaching products (BP), and based on the settings of the reaction, can produce (per-)hydroxyl anions, superoxide anions, and other radicals. The radical-related oxidative mechanism can trigger the breakage of molecular bonds in enameller and dentinal stains, while the exact process is not entirely grasped. Products as a consequence look less colorful. The amount of the active bleaching component, the likelihood of BP interaction with discolorations, and the contact duration all affect the effectiveness of the bleaching treatment. Effectiveness also depends on a number of variables, including the individual's age, the type of staining, and the number of bleaching treatments. A significant number of local adverse effects have been recorded with over-the-counter items due to poorly fitted tray, adjuvants such as binders, preservatives, and flavors as well as a low pH, coexisting gingivitis, abrasion, and erosion. In cases of the coupled utilization of tobacco and excessive alcohol intake because tobacco users demonstrate lower levels of hypersensitivity to the BP and may be heavily influenced by the positive cosmetic effects, they must particularly be counseled against getting bleaching done as the combination has been found to pose elevated oral carcinoma risk. Overall, current literature has found a positive relation between procedure efficacy and patient satisfaction.

Determination, implication, and satisfaction of shade selection in aesthetic dentistry

Delivering an aesthetic solution that proportionally complements the patient's neighboring teeth is crucial. In the discipline of cosmetic dentistry, qualities like surface form, translucency, and color are the most important factors for creating esthetic prostheses. The final color of translucent ceramic restorations is determined by many factors such as the thickness of the porcelain veneer, the thickness and color of the luting agents and the color of the underlying tooth structure. In order to the results to be accurate, homogenous, and predictable—all of which are crucial for cosmetic dentistry—color matching must be carried out in a methodical manner. Lighting control at the site, the surrounding environment, state of the teeth, patient positioning, time, and clinician proximity to the tooth, squint test, visual color guidelines, Vita Classical shade guide, Vita Toothguide 3D-Master, Chromascop, customized shade guides, and dentinal and extended shade guides are all considered when mapping shade and translucency. A sensor, a signals conditioner, and technology that allows the conversion of the signals into data usable in the dental laboratory or operatory make up the three components of every color-measuring instrument. Colorimetry, spectrophotometry, digital photography, hybrid equipment, and spectroradiometry comprise a few types of color measurement technology. Both print and electronic shade systems need to be used when choosing the right shade in order to create acceptable aesthetics. The practitioner and patient are both satisfied when the appropriate shade is matched, and the patient also has a more appealing appearance.

Full digital workflow in fixed adhesive dental prosthesis: Description of a clinical technique / Fluxo de trabalho digital completo em prótese fixa adesiva: descrição de uma técnica clínica

Digital dentistry has gained space in several dental specialties. It is possible to achieve excellent results with the digital workflow, which combines the efficiency of the restorative material with a greater marginal adaptation. This study aimed to report a clinical case through the digital workflow, with a faster and clinically acceptable prosthetic resolution. In this clinical case report, digital workflow allowed a faster and clinically acceptable prosthetic resolution. A 45-year-old female patient reported cementation failure of the prosthetic crown on tooth 14. As it was a vital tooth, the tooth received a total crown preparation. In the same clinical session, the patient's mouth was scanned then a capture software obtained a virtual model. After, the design software planned a digital "diagnostic wax-up", so a leucitic ceramic was chosen for the rehabilitation. The ceramic block was milled and receive stain and glaze, dispensing the prosthesis laboratory. Then, the adhesive cementation was performed with a dual-polymerized resin cement. The final crown had ideal adaptation, with no need for interproximal and occlusal adjustments, with an excellent marginal fit. Within the limitations of this study, this case report showed that the digital workflow allowed a favorable result in a shorter working time, which brought back function and aesthetics, without the need for interproximal and occlusal adjustments. (AU)

A odontologia digital vem ganhando espaço em diversas especialidades odontológicas. Com o fluxo de trabalho digital, é possível alcançar excelentes resultados na reabilitação protética, combinando a eficiência do material restaurador com a adaptação marginal proporcionada pela odontologia digital. O objetivo desse estudo foi relatar um caso clínico através do fluxo de trabalho digital, com uma resolução protética mais rápida e clinicamente aceitável. Paciente do sexo feminino, 45 anos, relatou falha de cimentação da coroa protética do dente 26. Por ser um dente vital, o dente recebeu um preparo de coroa total e os dentes foram escaneados e um software de captura obteve um modelo virtual. Posteriormente, o software de projeto planejou um "enceramento diagnóstico" digital, sendo escolhida uma cerâmica leucítica para a reabilitação. O bloco cerâmico foi fresado e recebeu acabamento, maquiagem e glaze pelo próprio dentista, dispensando um técnico laboratorial de prótese dentária. Em seguida, foi realizada cimentação adesiva definitiva. Este relato de caso mostra que, dentro das limitações desse estudo, o fluxo digital permite um resultado favorável em um menor tempo de trabalho, devolvendo a função e estética, sem necessidade de ajustes interproximais e oclusais (AU)

Conceitos atuais sobre a performance clínica e principais falhas do tratamento restaurador com laminados cerâmicos: uma revisão da literatura / Current status on clinical performance and main failures of laminate veneers: a review of the literature

O objetivo do presente estudo foi revisar a literatura dos últimos cinco anos e identificar os índices de sobrevivência, principais causas de falha relatadas e verificar a confiabilidade dos laminados cerâmicos como tratamento estético e funcional em longo prazo. Métodos: foi realizada uma busca ativa na Biblioteca Nacional de Medicina dos Estados Unidos (pubmed.ncbi.nlm.nih.gov), através da base de dados Medline, dos últimos cinco anos (2015-2020) na língua inglesa, utilizando os descritores: Laminate Veneers, Porcelain Laminate Veneers e Ceramic Laminate Veneers, que resultou em 35 artigos. Após a leitura dos resumos, foram excluídos 9 estudos que utilizaram laminados cerâmicos não produzidos em cerâmicas feldspáticas, ou vidro ceramizados reforçados por cristais de leucita, ou dissilicato de lítio. Foram selecionados 26 artigos categorizados como: relatos de caso, estudos clínicos, estudos in vitro e revisões de literatura. Resultados: os estudos apontaram índices de sobrevivência de 100%, após 2 anos de cimentação, até valores superiores a 80%, após 14 anos. As três principais causas de falhas apontadas foram: desadaptação de marginal (37%), pigmentação das margens (30%) e fratura ou lascamento das restaurações (3%). Considerações finais: dentro das limitações do estudo, foi possível concluir que as principais causas de falha estão associadas às margens da restauração, no entanto, os laminados cerâmicos podem atingir índices elevados de sobrevivência mesmo 14 anos após a cimentação, mostrando um alto nível de confiabilidade. (AU)

The objective of the present study was to identify the survival rate and cause of failure of ceramic laminate veneers. Methods: An active search of the last five years (2015 ­ 2020) was carried out in the United States National Library of Medicine (pubmed.ncbi.nih.gov) the MEDLINE database, in English, using the descriptors: Laminate Veneers, Porcelain Laminate Veneers and Ceramic Laminate Veneers, which resulted in 35 papers. After reading the abstracts, 9 studies that evaluated ceramic laminates that were not produced using felspathic porcelain, leucite-reinforced glass-ceramicc, or lithium disilicate glass-ceramic were excluded. Twenty-six scientific papers were selected, categorized as: Case reports, clinical studies, in vitro studies and literature reviews. Result: The studies showed survival rates between 100% after two years of cementation up to values above 80% after 14 years. The three causes of failure identified were: marginal misfit (37%), pigmentation of the margins (30%), and fracture or chipping of the restorations (3%). Final Considerations: Within the limitations of this study, it was possible to conclude that the leading causes of failure are associated with the restoration's margins. However, ceramic laminates can achieve high survival rates even 14 years after cementation, showing a high-reliability level.(AU)

Application of minimally invasive cosmetic dentistry in the clinics of pediatric dentistry / 华西口腔医学杂志

With the minimally invasive treatment attracting considerable attention in the field of dentistry, a series of oral minimally invasive treatment technologies, including minimally invasive cosmetic dentistry (MICD) technology, is emerging. Children, as a special group of patients, are in the critical stage of the initial formation of psychological structure. Therefore, children's dental treatment should not be limited to restoring function and relieving pain. The development, aesthetics, and physical and mental health should also be given attention. Therefore, in recent years, MICD technology has been widely used in diagnosis and treatment of pediatric dentistry. This review provides a detailed introduction regarding a series of techniques in pediatric dentistry.

Minimally invasive approach in esthetic dentistry: composite resin versus ceramics veneers / Abordagem minimamente invasiva em odontologia estética: resina composta versus facetas cerâmicas

Unsatisfactory anatomical shape of anterior tooth promotes disharmony in the smile esthetics. The conservative dental esthetic reestablishment treatments has been improved and evaluated with the development of adhesive materials. The adhesive dentistry allowed minimally invasive preparation through direct treatments with composite resin and indirect ceramic laminates veneers. These two treatments methods present advantages and disadvantages. The aim of this manuscript is to describe two clinical reports and compare alternatives to rehabilitate the smile esthetic appearance by direct and indirect minimally invasive treatments. In the first case, a 24-years-old patient, female, complained of unsatisfactory anterior maxillary size and incisal wear. After the functional and esthetic planning, nanoparticle composite resin by free hand technique was indicated to rehabilitation. In the second case, a 24-years-old patient, male, reported dissatisfied with his anterior central incisive shape. On clinical examination, maxillary anterior conoid teeth were verified. Based on this evaluation, a conservative treatment using minimally invasive ceramic veneers in maxillary central and lateral incisor and ceramic fragments on canine was planed to the smile rehabilitation. It can be concluded that conservative treatment using direct composite resin restorations and minimum thickness ceramic veneers laminate, even with their specific limitations and advantages, provide satisfactory esthetic and functional treatment results, preserving the dental structure.

Dentes com formato anatômico insatisfatório podem causar desarmonia na estética do sorriso. Os tratamentos para restabelecer a estética do sorriso vêm evoluindo concomitantemente com o desenvolvimento dos materiais dentários. A odontologia estética permite um preparo minimamente invasivo através de resinas compostas e laminados cerâmicos. Estes dois métodos de tratamento apresentam algumas vantagens e desvantagens. O objetivo deste artigo é descrever dois relatos de casos clínicos e comparar alternativas para a reabilitação da estética do sorriso pelos tratamentos minimamente invasivos diretos e indiretos. No primeiro caso, paciente de 24 anos do gênero feminino, estava descontente com o tamanho e com o desgaste incisal dos dentes maxilares anteriores. Após o planejamento funcional e estético foi indicado restauração direta com uma resina nanopartículada pela técnica da mão livre. No segundo caso, paciente de 24 anos do gênero masculino relatou insatisfação com a forma dos incisivos centrais superiores. No exame clínico foi observado incisivos conoídes. Baseado no exame clínico foi planejado um tratamento conservador com laminados cerâmicos nos incisivos centrais e laterais, e fragmentos cerâmicos nos caninos. Pode-se concluir que os tratamentos conservadores utilizando resina composta e laminados cerâmicos, mesmo com suas limitações, promove uma estética satisfatória e resultados funcionais preservando a estrutura dental.

Reabilitação estética do sorriso por meio de procedimento restaurador direto com resina composta nanoparticulada: relato de caso / Esthetic smile rehabilitation throught direct restorative procedure with nanoparticulate composite resin: a case report

Pacientes acometidos por traumas em dentes anteriores são comumente encontrados na prática clínica. Estes traumas ocasionam diversas complicações, que podem prejudicar a função como fonética, estética e em casos mais graves, até resultar em perda do elemento dentário. Na ocorrência de fraturas dentárias, uma das alternativas de reabilitação é o procedimento restaurador por meio de técnica direta, com utilização de resina composta. Tais materiais possuem facilidade na execução da técnica, apresentam baixo custo, quando comparado às restaurações indiretas e ainda possuem propriedades físicas e mecânicas que são semelhantes à estrutura dentinária, funcionando de forma a biomimetizar a estrutura perdida do elemento dentário. O presente caso clínico relata reabilitação funcional e estética do sorriso de um paciente jovem, por meio de procedimento restaurador direto, o qual foi possível devolver aspecto de naturalidade aos dentes e harmonia do sorriso.

Patients affected by injuries in anterior teeth are commonly encountered in clinical practice. These cause a variety of complications, which may impair the function as phonetics, esthetics and in more severe cases, even result in dental element loss. On dental fractures occurrence, one of the rehabilitation alternatives is the restorative procedure through direct technique, using composite resin. Such materials have ease in execution of the technique, feature low cost, when compared to the indirect restorations and still possess physical and mechanical properties, which are similar to dentin structure, working in order to resemble the lost dental element structure. The present clinical case reports functional and esthetic smile rehabilitation of a young patient, through direct restorative procedure, which was possible return aspect of naturalness to the teeth and the smile harmony.

Algunos factores relacionados con la estética dental: una nueva aproximación / Some factors associated to cosmetic dentistry: a new approach

Introducción: el propósito de este estudio fue determinar el comportamiento de algunos factores que influyen en la estética dental en estudiantes de la Facultad de Odontología de la Universidad de Antioquia (F. de O. de la U. de A.), entre 18 y 30 años de edad, de ambos géneros. Métodos: estudio descriptivo-transversal en 203 estudiantes de la F. de O. de la U. de A. Se registraron medidas directas en los seis dientes anteriores maxilares, con un "Pie de rey" digital (Digimatic)® y se tomaron fotografías del tercio inferior de cara. Para el análisis estadístico, se utilizó SPSS 17. Se obtuvieron las medidas descriptivas y, luego de realizar las pruebas de distribución normal, se realizó una prueba t de student para establecer diferencia de medias entre las proporciones ideales de los incisivos laterales. Resultados y conclusiones: en los hombres, la Línea Media Facial (LMF) coincidió con la Línea Dentaria Superior en el 61,4% de los casos, y las dentarias entre sí en el 38,6%. En las mujeres, la LMF coincidió con la Línea Dentaria Superior en el 62,25% y las dentarias, entre sí, en el 31,1%. Ningún individuo presentó las proporciones doradas entre el incisivo central y lateral superior. El rango más prevalente de la Proporción Dentaria Individual (PDI) fue el superior al 80%. La longitud promedio del labio superior para mujeres fue de 21,41 mm y del inferior 47,18 mm; para los hombres, el labio superior fue 22,78 mm y el inferior 52,45 mm. La posición del margen gingival del incisivo lateral superior más frecuente fue la incisal, en ambos sexos.

Introduction: the purpose of this study was to determine the behavior of some factors influencing dental esthetics in male and female students of Universidad de Antioquia School of Dentistry (FOUA for its Spanish initials), aged 18 to 30 years. Methods: this was a descriptivetransversal study on 203 FOUA students. Direct measurements of the six maxillary anterior teeth were recorded with a digital Vernier caliper (Digimatic)® and the lower third of the face was photographed. The statistical analysis was conducted with SPSS 17. Descriptive measurements were obtained and a Student's t test was performed after testing normal distribution, in order to establish mean differences between the ideal proportions of lateral incisors. Results and conclusions: in males, the Facial Midline (FML) coincided with the Upper Teeth Line in 61.4% of the cases and both teeth lines coincided with each other in 38.6%. In females, the FML coincided with the Upper Teeth Line in 62.25% and both teeth lines coincided with each other in 31.1%. None of the subjects had the Golden Proportion between central and lateral upper incisors. The most prevalent Individual Tooth Ratio (ITR) range was the one over 80%. The average length of females' upper lip was 21.41 mm and the bottom lip 47.18 mm; in males, the upper lip measured 22.78 mm in average and the bottom lip 52.45 mm. In both sexes, the most frequent position of the upper lateral incisors' gingival margin was the incisal one.

Necesidad de tratamiento ortodóncico según el índice de estética dental en adolescentes de 12 años, Chile / Orthodontic treatment needs according to the Dental Aesthetic Index in 12-year-old adolescents, Chile

Introducción: el objetivo de esta investigación fue evaluar la necesidad de tratamiento ortodóncico en adolescentes de 12 años, de las localidades de Ayacara, Cabrero, Coronel y Niebla, Chile, según el Índice de Estética Dental (IED). Métodos: estudio descriptivo, observacional, transversal, y no probabilístico. Se aplicó el IED en 129 estudiantes de 12 años pertenecientes a las localidades rurales de Ayacara, Cabrero, Coronel y Niebla, en Chile. La muestra se obtuvo por disponibilidad. La información se obtuvo a través de un examen clínico estandarizado, hecho por investigadores previamente calibrados, respetando las recomendaciones descritas por la OMS para este tipo de estudios. Los criterios del IED se analizaron de manera descriptiva y se analizó la significancia estadística entre hombres y mujeres. Resultados: de los 129 pacientes, 65 (50,4%) eran hombres y 64 (49,6%) mujeres. El 35,7% de los niños examinados obtuvo puntajes del IED ≤ 25, indicativo de oclusión normal o maloclusión mínima, y que determina que el tratamiento sea innecesario o poco necesario, el 27,1% obtuvo puntuación entre 26 y 30, indicativo de maloclusión manifiesta y necesidad de tratamiento optativa, el 20,9% obtuvo puntuación ≥ 36, indicativo de maloclusión muy severa o discapacitante con necesidad de tratamiento obligatoria. Solo en el componente que mide los dientes anteriores perdidos se observa diferencia significativa entre hombres y mujeres (P < 0,05). Conclusiones: existe una alta necesidad de tratamiento ortodóncico en la población adolescente de 12 años, lo que se tradujo en que el 64,3% de la muestra estudiada presentaba una maloclusión definida.

Introduction: the objective of this study was to evaluate the needs for orthodontic treatment in 12-year-old adolescents from the towns of Ayacara, Cabrero, Coronel, and Niebla, Chile, according to the Dental Aesthetic Index (DAI). Methods: this was a descriptive, observational, cross-sectional, and non-probabilistic study. The DAI was applied on 129 12-year-old students from the rural towns of Ayacara, Cabrero, Coronel and Niebla in Chile. The sample was obtained by availability. Information was gathered through standardized clinical examinations carried out by previously calibrated researchers, following the WHO recommendations for this type of studies. The DAI criteria were descriptively analyzed, and statistical significance between males and females was considered. Results: out of the 129 patients, 65 (50.4%) were males and 64 (49.6%) females. 35.7% of the examined kids obtained DAI scores ≤ 25, which indicates normal occlusion to minimum malocclusion and means that treatment is unnecessary or slightly needed, 27.1% obtained scores between 26 and 30, which indicates evident malocclusion and optional treatment, 20.9% obtained a score ≥ 36, indicating very severe or handicapping malocclusion and mandatory treatment. Significant differences between males and females (P < 0,05) were observed in terms of missing anterior teeth only. Conclusions: there is a high need for orthodontic treatment in the adolescent population aged 12 years, as 64.3% of the sample presented definite malocclusion.

Proporciones divinas en la sonrisa en un grupo de estudiantes de la facultad de odontología de la Universidad de Carabobo, Venezuela. Año 2013 / Divine proportions in smiling in a group of students of the facultad de odontología de la Universidad de Carabobo, Venezuela Year 2013

La estética dental es considerara como la búsqueda de la perfección en el ámbito bucal. El objetivo del estudio fue analizar la prevalencia por sexo de las proporciones divinas, en la sonrisa de los estudiantes de quinto año de la Facultad de Odontología de la Universidad de Carabobo. Se realizó para ello, un estudio descriptivo, con diseño no experimental y transversal. La muestra fue no probabilística e intencional, quedando conformada por 34 estudiantes de quinto año. Se aplicó la observación directa y un compás dental para recoger los datos y se recopilaron en una hoja de registro. Los valores promedio del ancho mesiodistal de las unidades del cuadrante superior izquierdo fueron ligeramente superiores a los del superior derecho. El cuadrante superior derecho mostró un mayor porcentaje de proporciones divinas a razón que el izquierdo, correspondiendo el mayor valor el par 11 y 12 (58,8%). El 76,5% de los estudiantes presentaron proporción divina en al menos un par de unidades, resaltando que el 20,6% la presentó en los 4 pares valorados. En conclusión, se reportó un bajo porcentaje de proporciones divinas en la muestra analizada, siendo los incisivos central y superior, los que mostraron la mayor proporción...

Dental aesthetics is considered as the pursuit of perfection in the mouth area. The aim of the study was to analyze the prevalence by gender of divine proportions, smiling fifth year students of the Faculty of Dentistry at the University of Carabobo. A descriptive study was made for it, with no experimental and cross-sectional design. The sample was not random and intentional, being made up of 34 fifth graders. Direct observation and dental compass was used to collect data 2013, were collected on a record sheet. The average values of the mesiodistal width of the left upper quadrant units were slightly higher than in the top right. The upper right quadrant showed a higher percentage of divine proportions right than the left , with the highest value pair 11 and 12 ( 58.8 %). 76.5% of students had divine proportion in at least a couple of units , noting that 20.6% introduced in the 4 rated peers. In conclusion, we reported a low percentage of divine proportions in the sample, with the central and upper incisors, which showed the highest proportion...

Aplicación clínica de los parámetros estéticos en odontología restauradora

El mantenimiento y el restablecimiento de la salud, función y estética son los objetivos principales de la odontología general. En los últimos años el aumento del interés por la estética en la sociedad se ha transformado en el principal motivo en la búsqueda de atención odontológica para una mejora de la apariencia dental y facial que permita alcanzar al paciente confianza, autoestima y respeto. Esto exige por parte del profesional conocimiento y experiencia en la aplicación de principios y referencias estéticas como guías para resolver los diferentes problemas que se presentan en la odontología restauradora actual. Este trabajo analiza los parámetros estéticos aplicados en odontología restauradora.

The maintenance and the reestablishment of the health, aesthetic and function are the primary targets of the general odontology. In the last years the increase of the interest by the aesthetic in the society has been transformed into the main reason in the search of attention for an improvement of the dental and face appearance that allows reaching to the patient confidence, self-esteem and respect. It demands on the part of the professional knowledge and experience in the application of references and aesthetic principles as it guides to solve the different problems that appear in restorative dentistry. This work analyzes the aesthetic references used in restorative dentistry.