Classified diagnosis and treatment scheme of oral cosmetic restoration based on aesthetic analysis (part â ¡): Chinese aesthetic connotation and analysis scheme.

At present, the commonly used clinical protocols of oral cosmetic restoration are mostly based on the oral aesthetic indexes proposed by Western developed countries (referred to as Western aesthetics), which are different from the oral aesthetic indexes unique to Chinese people (referred to as Chinese aesthetics). In the design of restoration schemes and the evaluation of restoration effects, these differences have a large or small effect on the doctor-patient-technology triad. Improper handling could directly weaken the cooperation efficiency of the three parties, reduce patient satisfaction, and even lead to medical disputes in serious cases. From doing a good job of oral cosmetic restoration in China, the connotative characteristics of Chinese oral aesthetics are introduced in this paper, and the value of oral aesthetic analysis in diagnosis and treatment is discussed. The process and method of aesthetic analysis and assessment through the modified Chinese psychosocial impact of dental aesthetics questionnaire and the evaluation ruler of the expected value of oral cosmetic restoration are further introduced in detail.

Adjacent Implant Influence on Tooth Restoration in a Gastro-Esophageal Reflux Disease (GERD) Patient Using Monoblock Post-Fused Crown: A Case Report.

This case report explores how the presence of an adjacent implant influenced the restoration of a tooth with pulpitis in a gastro-esophageal reflux disease (GERD) patient. A patient with GERD requires a tooth-colored crown not only for aesthetics but also to address potential galvanic concerns arising from an adjacent implant. GERD, a condition causing non-cavity erosion, weakens tooth structure over time, presenting significant challenges in treatment. It resulted in bite relapse and insufficient occlusal clarity over time. A comprehensive treatment approach was needed to restore both function and appearance. This involved managing galvanism using non-metallic materials to ensure optimal occlusal clarity, as well as meticulously reinforcing and restoring tooth structure. Monoblock post-fused crowns were chosen for their superior durability, stability, and comfort. The ceramic layering not only effectively prevented galvanic issues by insulating the tooth structure but also significantly improved the natural appearance of teeth, thereby promoting long-term oral health and successfully managing complex dental concerns. The dental team successfully restored the damaged tooth by considering specific factors that influenced the treatment plan, including achieving optimal aesthetic outcomes.

Development of a three-dimensional printed model from a digital impression of a real patient for aesthetic dentistry undergraduate teaching.

INTRODUCTION: The acquisition of skills and manual dexterity in aesthetic dentistry in undergraduate teaching requires preclinical practices with simulation that should approximate real clinical situations. OBJECTIVE: We will present a digital procedure for the creation of three-dimensional (3D) resin models adapted to the practices of the Aesthetic Dentistry course. MATERIAL AND METHOD: Stereolithography or Standard Tesellation Language (STL) files of a real patient were previously obtained with a 3-shape intraoral scanner. Using the Exocad computer programme for dental prosthesis design, various modifications were made, such as incisor rotation, surface alterations imitating dysplasias or erosions, the creation of diastemas, or even changes in tooth size. The virtual model was printed in resin for use by students. Once the practices were finished, the students and the teachers evaluated the use of the 3D printed models. RESULTS: The result is the typodont model, in which seven laboratory sessions took place: 1-Restoration of conoid tooth morphology, 2-Cervical abrasion/ erosion restoration, 3-Direct Composite Veneer, 4-Aesthetic correction in a tooth with rotation, 5-Diastem closure, 6-Occlusal abrasions/ erosion, and 7-Maryland bridge. 90.48% of the students evaluated the designed 3D model as the best method for laboratory practice compared to other methods, obtaining a general assessment of 8.3 out of 10. CONCLUSION: The method used has provided a reproducible standard analog model for direct aesthetic dental restoration practice, with a good assessment by students and teachers.

Evaluating the influence of dental aesthetics on psychosocial well-being and self-esteem among students of the University of Novi Sad, Serbia: a cross-sectional study.

BACKGROUND: A person's smile has been identified as one of the first observed facial characteristics. Even minor deviations from societal beauty standards, especially among younger individuals, can have a negative effect on their self-esteem. The aim of this research is to evaluate the self-perceived psychosocial impact of dental aesthetics and self-esteem among respondents and their association, as well as to determine the main factors contributing to dissatisfaction with dental appearance. METHODS: This research was conducted as a cross-sectional study that surveyed students of the University of Novi Sad. Other Universities and private faculties were excluded from participation. Data collection used standardized questionnaires measuring the Psychosocial Impact of Dental Aesthetics (PIDAQ) and the Rosenberg Self-Esteem Scale (RSES). Questionnaire (an online GoogleForms) was sent to the students via official Facebook groups of the faculties, student's e-mails and Instagram profiles. Data analysis included descriptive statistics, Students T-test, ANOVA, multiple linear regression analysis and Spearman coefficient. To test internal consistency, Cronbach's alpha(α) was calculated for the questionnaire as a whole (0,761) and each used questionnaire (PIDAQ - 0.766; RSES - 0.765). Cronbach's alpha(α) was also calculated for each domain from PIDAQ (DSC-0.946; SI-0.882; PI-0.953; AC-0.916). RESULTS: The study involved 410 participants, predominantly female (80%), aged between 21 and 23 (45.4%), primarily in ther first academic year (21.5%), and with a grade point average between 8.01 and 9.00 (42.4%). Data analysis has shown a statistically significant difference in the total PIDAQ score and SI subdomain in relation to the academic year (total PIDAQ p = 0.025; SI p = 0.000). In terms of self-esteem, results of multiple linear regression analysis showed that the academic year (95%CI: 0.410-1.837; p = 0.002) and the average point grade (95%CI: -0.025-1.600; p = 0.047) were significant predictors of greater self-esteem. The Spearman coefficient value (r=-0.316, p < 0.001) confirmed a statistically significant negative correlation between PIDAQ and self-esteem. Only 34% of respondents expressed satisfaction with their teeth. Dissatisfaction about the smile was primarily attributed to the arrangement and positioning of their teeth (32.2%). Financial constraints were identified as the main barrier for seeking interventions to improve smile satisfaction (39.5%). CONCLUSION: Students experiencing a greater psychosocial impact of dental aesthetics tended to exhibit lower self-esteem.

Prevalence and factors influencing bullying among Egyptian schoolchildren.

OBJECTIVE: To evaluate the prevalence of bullying among schoolchildren and to study the correlation between bullying and a specific type of malocclusion, self-esteem, oral health-related quality of life (OHRQoL), the need for orthodontic treatment and socioeconomic status. DESIGN: A cross-sectional study. SETTING: Low, middle and high socioeconomic-class schools in the same educational district in Cairo, Egypt. PARTICIPANTS: A total of 324 Egyptian schoolchildren aged 11-14 years. METHODS: Validated questionnaires were used to assess self-reported bullying frequency and intensity, self-esteem and OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to assess the orthodontic treatment need and the participants' occlusion was classified according to the British Standard Incisors (BSI) classification. RESULTS: Bullying was found to be prevalent in 61.7% of the sample. Regression analysis revealed that participants with a Class II division 1 incisor relationship had the highest odds ratio (OR) for predicting bullying (OR = 1.86, 95% confidence interval [CI] = 1.38-2.15). Being bullied was significantly associated with lower self-esteem (OR = 0.47, 95% CI = 0.13-0.78), worse OHRQoL (OR = 2.73, 95% CI = 1.95-3.15) and a high need for orthodontic treatment, as determined by the IOTN Dental Health Component score (OR = 1.33, 95% CI = 1.05-1.95) and IOTN Aesthetic Component score (OR = 1.52, 95% CI = 1.12-1.88). Moreover, participants in high and middle socioeconomic-class groups had a lower OR for predicting bullying than those in the low socioeconomic-class group (OR = 0.27, 95% CI = 0.13-0.54). CONCLUSION: The bullying prevalence among Egyptian schoolchildren aged 11-14 years was very high. The prevalence of bullying was higher in schoolchildren with higher orthodontic treatment need and Class II division 1 incisor relationship. Bullying was correlated to poor self-esteem as well as poor OHRQoL. In addition, low socioeconomic status was found to be a potential predictor for bullying.

Aesthetic oral rehabilitation of the upper-anterior sector with supra-nano filling resin in a patient with woolly hair syndrome: case report.

BACKGROUND: Woolly Hair Syndrome (WHS) is a rare birth condition that affects the structure of hair in non-black people. The pathogenesis is not yet defined. It is postulated that the hair follicle's desmosomes (specifically desmoplaquine, placoglobin and placofilin-1, which are cell structural proteins that keep the adhesion among close cells) would be altered in this pathology, leading to fragility in the cellular union. It is subdivided into two large groups: the localized or circumscribed variant and the generalized variant. From birth or first months of life, patients with WHS are clinically characterized by the presence of a portion or entire scalp area of very short frizzy hair, usually of a smaller diameter, brittle and lighter color. The most frequent skin manifestations are pilar keratosis and palmo-plantar keratodermia. The diagnosis is based on the clinical findings, and it is facilitated by trichotoscopic examination. However, a definitive diagnosis of WHS requires genetic testing. Oral agenesis, enamel defects (such as hypomineralization), atypical caries, dental inclusion, and malformed pin-shaped teeth may occur. OBJECTIVE: To describe an aesthetic alternative of oral rehabilitation using the mock-up technique in a patient with WHS. CLINICAL CASE: A 5-year-old female patient diagnosed with WHS from the National Institute of Child Health NIHCH: Breña, Lima, who was referred from the Genetic service to the Pediatric Dentistry service in order to screen outbreaks of infection associated with odontogenic origin and dental anomalies. At the ectoscopy, a patient with short capillary length, brittle and curly hair, dry skin, and nail dystrophy was observed. At the intraoral clinical examination, anterior pieces of 52, 51, 61, 62, and enamel hypomineralization were observed in all teeth. The radiographic examination showed agenesis of parts 41, 34, and 45. Integral dental treatment was performed in the operating room under general anesthesia due to the complexity of the case. Pulpectomy in pieces 52, 51, 61, 62, post of composite resin, and rehabilitation with supra-nanow filling resin using the mock-up technique were proposed as alternative treatments. CONCLUSION: The making of supra-nano filling resin-based crowns using the mock-up technique is an alternative treatment for aesthetic oral rehabilitation in deciduous dentition of patients with WHS. The aesthetic treatment was achieved using supra nano-filling resins. After 12 months of dental treatment, a favorable response was observed, improving the chewing, phonation and aesthetics of the patient.

Impact of COVID-19 on the self-esteem, psychological and dental esthetics of dental students.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has badly affected the mental health, quality of life, and self-esteem of students worldwide. OBJECTIVE: The current study aimed to evaluate the psychological impact and self-esteem of dental students using Rosenberg self-esteem scale and PIDAQ during the COVID-19 pandemic. METHOD: This cross-sectional research was conducted amongst the dental students studying at various dental colleges in Karachi, Pakistan from January to May 2022. Evaluation of psychological aspect and self-esteem of students was carried out using "Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ)", and "Rosenberg self-esteem scale" as perceived by students during the pandemic. For data analysis SPSS v24 was used. Data analysis comprised of descriptive analysis, Spearman correlation, One-way Anova and Linear regression. The level of significance of p value was less than 0.05. RESULTS: Overall 332 students participated, among which there were 181 females (54.5%), 151 males (45.5%). Dental self-confidence showed a negative relationship with social influence, psychological effect, and aesthetic concern, while it was positively linked with self-esteem during the pandemic. Social impact demonstrated association with psychological impact, aesthetic concern, and self-esteem, while it was negatively correlated with dental confidence. Rosenberg score showed positive correlation with all the variables. Statistically significant association was identified for variables when compared with gender. Regression analysis indicated association of age with dental confidence and RSS, while gender with social influence. CONCLUSION: The pandemic, aside from affecting the health of individuals worldwide, also badly affected the well-being, mental health, and self-esteem of the dental students. Dental aesthetics plays a crucial role in the mental wellbeing and self-esteem of the students.

Soft-Tissue Augmentation in Periodontally Compromised Patients during Immediate Placement and Immediate Loading Dental Implant Surgery - A Retrospective Study.

Introduction: The purpose of this article is to describe a soft-tissue augmentation procedure for multiple tooth extraction sites during immediate placement and immediate loading (IPIL) dental implant surgery in periodontally compromised patients and to present follow-up results of its effectiveness. Methods: A retrospective study was conducted on data from patients who underwent IPIL dental implant surgery between 2018 and 2021 at an oral implant centre in Bulgaria. Based on inclusion and exclusion criteria, 103 patients were included, 53 of whom had pre-operative indications for connective tissue grafts (CTGs) and 50 of whom did not. The post-operative incidence of gum recession was evaluated in the two patient groups. Results: The majority of the 53 patients (56.60%) had six, seven or eight tooth sites grafted. A significant proportion (87%) needed CTGs at the canine teeth (13 and 23), P < 0.001. The post-operative data showed a low incidence of gum recessions in both the patient groups, with a lower rate in the CTG group at tooth no: 13 (2.20% vs. 18%, P = 0.016) and in the total sum of 10 tooth sites with CTGs (P = 0.001). A reduction in gum problems and increased satisfaction with gum health and aesthetics were reported by 100% of the CTG patients. Discussion: Soft-tissue augmentation at multiple tooth extraction sites during IPIL dental implant treatment may benefit periodontally compromised patients through an improved prosthesis-tissue interface in the aesthetic area and a reduction in gum infections, swelling, bleeding and pain.

Impact of Orthodontic Appliances on Hiring Prospects in Saudi Arabia: A Cross-Sectional Study.

This study provides valuable insights into the cosmetic impact of orthodontic appliances on job-hiring prospects in Saudi Arabia. Both ceramic braces and clear aligners are considered cosmetic corrective devices compared to traditional metallic braces. This survey-based, cross-sectional study used two models, one male, and one female. Four standardized smiling frontal photographs were taken for each model: one without any appliance and three with different orthodontic appliances (i.e., metal braces, ceramic braces, and clear aligners). The photographs of each model were shown to potential employers, followed by three questions for each photo to assess the employers' views on the applicants' professionalism, communication skills, and the likelihood of being hired. The survey was distributed via an electronic questionnaire to employers in Saudi Arabia, collecting feedback from 189 participants. The sample was collected from October 2022 to February 2023. The models' scores while wearing metal and ceramic bracket appliances were significantly lower than when the models were wearing clear aligners or were not wearing any appliance in each domain. In conclusion, orthodontic appliances have cosmetic implications that affect job-hiring prospects, with a higher chance of being hired if the candidate does not have an orthodontic appliance.

Conocimiento sobre carillas dentales en estudiantes universitarios peruanos

Introducción: las carillas dentales son una opción de tratamiento estético solicitado mayormente para mejorar la apariencia. En Perú, son escasas las investigaciones que miden el conocimiento acerca de este tratamiento. Por ello, el objetivo de este estudio fue determinar el conocimiento sobre carillas dentales en estudiantes de una universidad peruana. Métodos: estudio descriptivo, prospectivo y de corte transversal; conformado por una población de 1417 estudiantes matriculados durante el año 2022 en las Escuelas de Medicina Humana, Psicología y Enfermería de la Universidad Católica Santo Toribio de Mogrovejo, de donde se obtuvo, un tamaño muestral de 160 participantes; sin embargo, fueron 187 quienes respondieron el cuestionario. El instrumento fue previamente validado a través de juicio de expertos y, mediante la prueba Kuder Richardson se obtuvo una confiabilidad alta correspondiente a 0.7. El análisis de datos fue realizado utilizando estadística descriptiva y prueba Chi Cuadrado de Pearson. Resultados: los participantes fueron 55 varones y 132 mujeres. Se reportó un nivel de conocimiento medio sobre el tratamiento con carillas dentales en 75.9% de los estudiantes, y nivel bajo en 5,9% de ellos, la población, en su mayoría obtuvo información de más de una fuente, seguido de redes sociales, amigos y/o familiares, programas de televisión y, finalmente por parte del odontólogo. Conclusión: el conocimiento sobre carillas dentales en estudiantes de una universidad peruana fue de nivel medio, estos resultados fueron similares al ser comparados entre edad, sexo, escuela profesional y fuente de información.

Introduction: dental veneers are an aesthetic treatment option requested mostly to improve appearance. In Peru, there are few investigations that measure knowledge about this treatment. Therefore, the objective of this study was to determine the knowledge about dental veneers in students at a Peruvian university. Methods: descriptive, prospective, and cross-sectional study; made up of a population of 1417 students enrolled during the year 2022 in the Schools of Human Medicine, Psychology and Nursing of the Santo Toribio de Mogrovejo Catholic University, from which a sample size of 160 participants was obtained; however, there were 187 who answered the questionnaire. The instrument was previously validated through expert judgment and, through the Kuder Richardson test, a high reliability corresponding to 0,7 was obtained. Data analysis was performed using descriptive statistics and Pearson's Chi-square test. Results: the participants were 55 men and 132 women. A medium level of knowledge about the treatment with dental veneers was reported in 75,9% of the students, and a low level in 5,9% of them. The population mostly obtained information from more than one source, followed by social networks, friends and / or relatives, television programs and, finally, by the dentist. Conclusion: knowledge about dental veneers in students from a Peruvian university was medium level, these results were similar when evaluated between sex, age, professional school, and source of information.

Faceta Direta de Resina Composta utilizando Pigmentos Opacificadores para Reabilitação Estética Anterior de Dente Escurecido: Relato de Caso / Direct Composite Resin Veneer using Opacifying Pigments for Anterior Aesthetic Rehabilitation of Discolored Teeth: Case Report

O tratamento estético de dentes com alteração de cor é um grande desafio na Odontologia Restauradora. Nesse sentido, a utilização de técnicas de estratificação com resina composta associada ao uso de pigmentos opacificadores permite que seja possível restaurar por meio de uma técnica direta, que resulta em um menor desgaste da estrutura dental durante o preparo. Dessa forma, o presente trabalho apresenta um caso clínico de faceta direta de resina composta utilizando associação de três pigmentos opacificadores. Paciente do sexo masculino, 54 anos, procurou atendimento apresentando alteração de cor severa do dente 21, relato de trauma dental, tratamento endodôntico e contraindicação de novo protocolo de clareamento interno, sendo sugerido, como plano de tratamento, a restauração direta com resina composta. Para a confecção da faceta direta de resina, foi utilizada uma mistura de três opacificadores na consistência fluida. Para verificar o valor da camada aplicada da mistura, foram feitas fotografias em preto e branco. A estratificação prosseguiu com camadas de resina translúcida para a base palatina, resina opaca de dentina e resina acromática translúcida para o esmalte. Como resultado, constatou-se a função e eficácia do uso da associação de pigmentos opacificadores na resolução do caso, em seguida, foi realizada uma reavaliação após 30 dias e 7 meses do procedimento restaurador, quando verificou-se a estabilidade de cor da restauração. Concluiu-se, portanto, que a utilização da técnica de estratificação de resinas compostas associada a utilização de pigmentos opacificadores traz resultados estéticos satisfatórios e favoráveis por meio de uma técnica direta, realizada em sessão clínica única e com alta previsibilidade.

The esthetic treatment of teeth with discoloration is a major challenge in restorative dentistry. In this sense, the use of composite resin veneering techniques associated with the use of opacifying stains allows restorations to be made using a direct technique, which results in less wear to the tooth structure during preparation. Thus, the present study presents a clinical case of a direct composite resin veneer using an association of three opacifying pigments. A 54-year-old male patient presented with severe color change on the central upper left incisor, a report of dental trauma, endodontic treatment, and contraindication for a new internal bleaching protocol. In order to make the direct resin veneer, a mixture of three opacifiers in a fluid consistency was used. To check the value of the applied layer of the mixture, black and white photographs were taken. Layering proceeded with translucent resin layers for the palatal base, opaque dentin resin and translucent achromatic resin for the enamel. As a result, the function and efficacy of the use of the association of opacifying pigments was verified in the resolution of the case. A reevaluation was performed 30 days and 7 months after the restorative procedure, when the color stability of the restoration was verified. This case allows to conclude that using composite resin layering technique associated with the use of opacifying pigments brings satisfactory and favorable aesthetic results through a direct technique, performed in a single clinical session and with high predictability.

Dental aesthetic related popularity and peer pressure, a survey of adolescents in Pakistan.

OBJECTIVES: Most research has focused on determining how popularity and peer pressure impact behaviours, rather than identifying a key feature such as dental aesthetics and studying its impacts in relation to popularity and peer pressure. METHODS: A cross sectional study was conducted on a sample of 527 children from four schools located in Lahore, Pakistan. A 14-point questionnaire was developed, using existing measures of peer pressure, and popularity. The selected questions were modified to investigate the issues of dental aesthetics and integrated into the WHO oral health questionnaire for children. RESULTS: More than 50 % of the participants indicated popularity issues regarding dental aesthetics. 63.5 % of the responses indicated an influence of relatives and friends, whereas 38 % responses reported of harassment and bullying at schools. Regression analysis shows that the females were 1.99 times more likely to get comments from relative or friends about their teeth and 2.17 times more likely to be bullied or harassed at school due to their teeth when compared to the males. Fathers with a higher education brought about higher popularity and peer pressure issues. Mothers with a higher education were less likely to cause popularity and peer pressure issues than mothers with a lower education. Popularity and peer pressure were both significantly related to higher dental visitation. CONCLUSIONS: Popularity and peer pressure have a direct link to dental aesthetics in an individual and are impacted by gender, family relatives and parental influences. The area of popularity and peer pressure related to dental aesthetics can be targeted in health education programs to empower children to adopt better oral health behaviours.

What impact do personality traits have on self-perception of dental aesthetics?

BACKGROUND: Malocclusion has significant social, psychological and physical impacts on the quality of life. This study aimed to study psychosocial impact of dental aesthetics among students, and how it was modified by personality traits. METHODS: Chinese version of Eysenck Personality Questionnaire Short Scale of (EPQ-RSC) and Chinese version of Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) were used to investigate 555 undergraduate students, aged 18 to 24 years. The participants and investigators self-rated their own dental aesthetics using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). The malocclusion was assessed by two independent investigators using the Dental Health Component (DHC) of IOTN. RESULTS: No statistically significant difference was found for gender (p = 0.829) nor for majors (p = 0.598) in the psychosocial impact of dental aesthetics. Total and subscale PIDAQ scores differed significantly among the 3 IOTN grades. PIDAQ scores strongly correlated with Eysenck personality. The dimensions of extraversion and neuroticism, and dental health component grades had significant impact on participants' psychosocial well-being of dental aesthetics. CONCLUSIONS: Neurotic people with high self-concerns perceived greater psychosocial impact. Outgoing people appear to be less affected psychosocially by dental aesthetics.

Relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion.

OBJECTIVE: This study aimed to evaluate the relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion. METHODS: A cross-sectional study developed with 543 adolescents from 11 to 13 years of age and severe malocclusion was selected. Dental aesthetic index (DAI) diagnosed the malocclusion and selected the groups with greater severity (DAI 3 and 4). Aesthetic concern was assessed using the oral aesthetic subjective impact scale (OASIS) and considered an outcome variable. The global negative self-evaluation (GSE) evaluated self-esteem. The variables were analysed using Poisson multiple regression and the model adjustment determined by the Akaike information criterion (AICC). The effect of each variable on OASIS was expressed as a prevalence ratio (PR) with 95% confidence intervals. The analyses were performed using the R program with a significance level of 5%. RESULTS: A significant association was observed between aesthetic concern scores and self-esteem (p<.05). Individuals with low self-esteem had OASIS scores 14% higher (PR: 1.14; 95% CI: 1.08-1.21). There was no significant association between OASIS and gender and age (p>.05). CONCLUSIONS: Self-esteem modulates how the individual perceives malocclusion. Adolescents with severe and very malocclusion and low self-esteem have greater aesthetic concerns.

The Prevalence of Body Dysmorphic Disorder and Its Associated Risk Factors Among Dental Patients: Why Are My Patients Not Satisfied?

BACKGROUND: Body dysmorphic disorder (BDD) is a common disorder that consists of a distressing or impairing preoccupation with imagined or slight defects in appearance. In dentistry, those patients will have unrealistic expectations and usually will be unsatisfied with the outcomes of dental treatment. This study investigated the prevalence of BDD and its associated factors among dental patients. MATERIAL AND METHODS: In this cross-sectional survey-based study, a purposive sample was used to recruit adult patients seeking dental treatment in private and public facilities. Data was collected using the validated Arabic version of the Cosmetic Procedure Screening Questionnaire (COPS) for Body Dysmorphic Disorder, a validated nine-item self-administrated instrument that is scored from zero (least impaired) to five (most impaired). Chi-Square, Mann-Whitney U, and Fisher's Exact tests were used to compare the associations between the study variables and BDD. RESULTS: A total of 507 patients responded to the questionnaire. The prevalence of BDD was 34.1%. The average age of the participants was 35.2 years; the majority were males 290 (57%) and Saudis 436 (86%) with a college education 304 (60%). None of the demographics was associated with BDD but the type of treatment was significantly associated with BDD with teeth crowning and restorations. CONCLUSION: This study provides insights into the prevalence of BDD and its associated factors among dental patients in Eastern Saudi Arabia. The findings highlight the need for further research to better understand the factors contributing to the development of BDD and to guide prevention and intervention strategies in dental settings.

Correção de desvio de linha média dentária com o auxílio de ancoragem esquelética e extrações unilaterais ­ relato de caso / Correction of dental midline deviation with the aid of skeletal anchorage and unilateral extraction ­ case report

Resumo Atualmente temos pacientes mais preocupados com a estética facial, e essa tem sido o principal motivo para a procura do tratamento ortodôntico, sendo a linha média facial um fator importante na análise morfológica do sorriso do ponto de vista estético. O desvio da linha média dentária atinge o complexo dentoalveolar, e ocorre quando existe um desequilíbrio entre os dentes e a base apical, do hemiarco direito e esquerdo ou entre os dentes superiores e os inferiores. A utilização de microparafusos como unidades de ancoragem, além de anular os efeitos colaterais indesejáveis, simplifica a mecânica ortodôntica, fornece uma maior previsibilidade ao resultado do tratamento, proporciona maior conforto e estética ao paciente, reduz o tempo de tratamento e possibilita a correção de casos com perdas dentárias, já que fornece uma ancoragem direta. O objetivo principal deste trabalho foi demonstrar através de um relato de caso clínico a correção da assimetria de desvio da linha média e uma melhor harmonia facial com a utilização de exodontias assimétricas de pré-molares e o uso de microparafusos ortodônticos de titânio como ancoragem (AU)

Abstract Currently, patients are more concerned with facial aesthetics, and this has been the main reason for seeking orthodontic treatment, with the facial midline being an important factor in the morphological analysis of the smile from an aesthetic point of view. Deviation from the dental midline affects the dentoalveolar complex, and occurs when there is an imbalance between the teeth and the apical base, of the right and left hemiarch or between the upper and lower teeth. The use of microscrews as anchorage units, in addition to canceling undesirable side effects, simplifies orthodontic mechanics, provides greater predictability of treatment results, provides greater comfort and aesthetics to the patient, reduces treatment time and allows for correction of cases with tooth loss, as it provides direct anchorage. The main objective of this work was to demonstrate, through a clinical case report, the correction of midline deviation asymmetry and better facial harmony with the use of asymmetric extraction of premolars and the use of titanium orthodontic microscrews as anchorage(AU)

Comportamento dos tecidos peri-implantares pós- reabilitação unitária em região estética comparando pilares protéticos pré-fabricados versus personalizados / Behavior of peri-implant tissues after unitary rehabilitation in the aesthetic region comparing prefabricated versus customized prosthetic abutments

A estética e estabilidade dos tecidos moles e ósseo ao redor do implante é um componente crítico para o sucesso do implante em longo prazo e pode ser influenciado por fatores como os tipos de conexões protéticas. OBJETIVO: Comparar o comportamento do tecido peri-implantar em reabilitação com coroas implantossuportadas cimentadas na região estética usando um pilar protético pré-fabricado em titânio (GT) e um pilar protético personalizado em zircônia (GZ). METODOLOGIA: Neste estudo longitudinal do tipo ensaio clínico controlado, cego e não randomizado, 30 coroas cimentadas sobre implantes dentários unitários em região estética anterior foram alocados sequencialmente: 15 reabilitados sobre um sistema de implante com pilar protético pré-fabricado em titânio (GT) e 15 sobre um sistema de implantes com pilar protético personalizado em zircônia (GZ). O comportamento do tecido peri-implantar foi avaliado em T0 (início do condicionamento tecidual), T1 (fim do condicionamento tecidual), T2 (7 dias após cimentação final), T3 (6 meses após cimentação final). Índice de Placa Visível (IPV), Índice de Sangramento Gengival (ISG), Sangramento a sondagem (SS), Profundidade de Sondagem (PS), Relação Altura/Largura da papila interdental (AP/LP), Faixa de Mucosa Ceratinizada (MC), Espessura gengival (EG), Fenótipo periodontal (FP), Recessão Gengival (RG), distância radiográfica da crista óssea para o ponto de contato e Pink Esthetic Score (PES) foram avaliados. A análise dos dados foi realizada utilizando os seguintes testes estatísticos: Friedman, Mann-Whitney e Qui- quadrado/Exato de Fisher, com nível de significância de 5%. RESULTADOS: Não houve diferenças estatísticas significativas entre os grupos para nenhum dos parâmetros clínicos periodontais nos tempos avaliados (p>0,05). Entretanto, a análise intragrupo mostrou uma redução estatística no IPV e ISG entre T1 e T2 apenas para o GZ (p<0,05). Houve diminuição significativa entre os tempos T0 e T3 para o parâmetro de EG (1,67 mm - 1,47 mm no GT; 1,70 mm -1,47mm no GZ) e aumento da razão AP/LP (0,56 ­ 0,80 no GT; 0,70-0,83 no GZ) em ambos os grupos (p<;0.001). O PES também aumentou significativamente para ambos os grupos (9 ­ 12 no GT; 7 ­ 12 no GZ) de T0 para T1, mantendo-se elevado nos demais tempos analisados. CONLUSÃO: Os resultados mostraram que os pilares protéticos utilizados não impactaram em diferenças nas variáveis clínicas e estética relacionadas ao comportamento dos tecidos periimplantares ao longo do tempo. Sendo assim, a decisão pela seleção dos componentes para a reabilitação em região estética poderia se basear em aspectos como o custo, fluxo e tempo de trabalho (AU).

The esthetics and stability of the soft tissue and bone around the implant is a critical component to the long-term success of the implant and can be influenced by factors such as the type of prosthetic connections. OBJECTIVE: To compare the behavior of the periimplant tissue of single implant-supported crowns in the anterior aesthetic area using prefabricated titanium prosthetic abutments (GT) and customized zirconia prosthetic abutments (GZ). METHODOLOGY: In this controlled, blinded, non- randomized clinical trial, 30 single cemented crown over anterior implants were sequentially allocated: 15 implants rehabilitated on implant system with a prefabricated titanium prosthetic abutment (GT) and 15 on implant system with customized zirconia prosthetic abutment (GZ). The behavior of the peri- implant tissue was evaluated at T0 (beginning of tissue conditioning), T1 (end of tissue conditioning), T2 (7 days after final cementation), T3 (6 months after final cementation). Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Bleeding on Probing (BoP), Probing Depth (PD), Interdental Papilla Height/Width Ratio (PH/PW), Keratinized Mucosa Width (KM), Gingival Thickness (PT), Periodontal Phenotype (PF), Gingival Recession (GR), radiographic distance from the bone crest to the contact point and Pink Esthetic Score (PES) were registered. The results were analyzed with the following statistical tests: Friedman, Mann-Whitney and Chi- square/Fisher; Exact test with a significance level of 5%. RESULTS: No statistically significant differences were observed between groups for any of the clinical parameters in any, (p>0.05). However, intragroup analysis showed a statistical reduction in VPI between T1 and T2 only for GZ (p< 0.05). There was a significant decrease between T0 and T3 for GT (1.67 mm - 1.47 mm in GT, and 1.70 mm -1.47 mm in GZ) and increase in the ratio PH/PW (0.56 - 0.80 in GT and 0.70- 0.83 in GZ) in both groups (p<0.0001). PES also increased significantly for both groups (9 ­ 12 in GT and 7 ­ 12 in GZ) from T0 to T1 and remained high in the other periods. CONCLUSION: The results showed that the prosthetic abutments used did not impact differences in clinical and aesthetic variables related to the behavior of peri-implant tissues during the study. Therefore, the decision to select components an aesthetic area should be based on aspects such as cost, workflow and timing (AU).

Prosthetically Guided Orthodontics (PGO): A Personalized Clinical Approach for Aesthetic Solutions Using Digital Technology.

Conformative rehabilitation generally involves the treatment of partial dentate or the application of veneers. In this regard, conformative rehabilitation aims to generate an aesthetic prosthetic solution minimizing the amount of tissue removal without generating occlusal input interfering with the equilibrium of neuro-muscular function. In fact, pre-prosthetic orthodontics aims to re-establishing the correct position/inclination of the neighboring or antagonist teeth, providing appropriate space for the prosthetic crown. Clear aligners therapy (CAT) represents a valuable tool in the management of prosthetic cases with a conformative approach, as it allows clinicians to plan orthodontic movements that are guided by the prosthetic outcomes. In the present manuscript, we argue the concept of prosthetic guided orthodontics (PGO) by presenting and discussing three cases treated with the Invisalign GO system, which has been developed for the clinical management of multidisciplinary orthodontic-prosthetic cases with a conformative approach. In this regard, the rationale of this paper is to address the effectiveness and predictability of the digital set-up and CAT for aesthetic conformative rehabilitations.

Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents.

BACKGROUND: The psychological impact of malocclusion, social acceptance, self-esteem, and the development of personality traits are considerations that can affect the demand for orthodontic treatment. The aim of this study was to assess the effect of malocclusion severity and self-perceived smile and dental aesthetics on self-esteem among adolescents in Lagos, Nigeria. METHODS: This analytical cross-sectional study was performed among 393 adolescents (210 females and 183 males) at a university teaching hospital in Nigeria. The need for orthodontic treatment was assessed using the Dental Aesthetic Index, whereas self-esteem was measured using the Rosenberg Self-Esteem Scale. Smile analysis was performed on photographs of posed smiles, whereas photographs of posed smiles and intraoral frontal view with teeth in centric occlusion were rated with the Visual Analog Scale for self-perception of smile and dental aesthetics. A comparison of variables among self-esteem groups was made using the ANOVA and Tukey post hoc tests, whereas an association among all variables was examined using the correlation coefficient. Stepwise regression analysis examined the effects of independent variables on self-esteem. RESULTS: A significant correlation was found between self-esteem and self-perceived smile (r = 0.294; P < 0.001) and dental aesthetics (r = 0.212; P < 0.001). Adolescents with high self-perceived smile (mean ± standard deviation, 7.66 ± 2.20) and dental aesthetics (6.68 ± 2.58) had higher self-esteem than participants with low self-perceived smile (4.75 ± 2.73) and dental aesthetics (4.36 ± 2.29). Self-perceived smile aesthetics had the most predictive impact on self-esteem. CONCLUSIONS: The results showed that self-perception of smile and dental aesthetics is a significant factor that influences self-esteem among adolescents.

Aesthetic perception of smile in long face pattern patients who underwent maxillary impaction with miniplates or orthognathic surgery.

INTRODUCTION: The gummy smile is perceived in 10% of the population aged 20 to 30 years old, and it causes an aesthetic imbalance in the smile. This study investigated the existence of differences in the aesthetic perception of the smile after correcting the gummy smile using two different techniques: orthognathic surgery for maxillary impaction and miniplate-aided orthodontic impaction. METHODS: Photographs of 16 Long Face Pattern female patients were evaluated by 56 oral and maxillofacial surgeons, 56 orthodontists, and 56 laypeople before and after the treatment with one of the two techniques. These photographs were standardized using the Photoshop program, randomly organized, and then presented to the evaluators via the Google Meeting® application in the PowerPoint® program. To evaluate the attractiveness of the smile, the Visual Analogue Scale (VAS) was used. To analyze the intra and inter-examiner concordances, Spearman's correlation and Kendall's concordance tests were used, respectively. For intergroup comparison, the Friedman test was used, with a 5% significance level. RESULTS: For all three groups of evaluators, the post-treatment evaluation results were superior to the results before the treatment: surgeons and orthodontists assigned higher scores for surgical cases and laypeople for orthodontic cases. CONCLUSION: From a clinical point of view, there was no difference between the results of both techniques with regard to the aesthetic perception of smiles. A gingival exposure ranging from zero to two millimeters was considered the most aesthetic for all evaluators.