Effect of personality traits on the association between clinically assessed malocclusion and the psychosocial impact of dental aesthetics.

OBJECTIVE: We aimed to assess whether personality traits affect the relationship between malocclusion and the psychosocial impact of dental aesthetics and whether they act as its mediators or moderators. SETTINGS AND SAMPLE POPULATION: The cross-sectional study included 252 participants with permanent dentition (62% female) aged 12-39 years. MATERIALS AND METHODS: The Big Five Inventory, the Psychosocial Impact of Dental Aesthetics Questionnaire and the Index of Complexity, Outcome and Need were used. Moderation and mediation were tested by hierarchical stepwise multiple linear regression. RESULTS: Malocclusion was the most significant predictor of dental self-confidence (DSC), aesthetic concern (AC), social impact (SI) and psychological impact (PI), accounting for 12%-28% of respective variability (P < .05). Adult age, male sex and higher neuroticism and agreeableness were additional predictors of higher DSC (P < .05). Adolescent age was a predictor of higher AC, SI and PI, and female sex of higher AC and PI (P < .05). Mediation by personality traits was not proven, however, openness, agreeableness and neuroticism were moderators. A tendency of decrease in AC was associated with an increase in malocclusion complexity in adolescents lower in openness and decrease in SI in adolescents with lower agreeableness. There was also a tendency of higher increase of AC associated with an increase of malocclusion degree in adults higher in neuroticism. CONCLUSION: In adolescents, openness and agreeableness moderate the relationship between malocclusion and AC and SI, respectively. Neuroticism is a moderator of the association between malocclusion and AC in adults.

The effect of nickel ions on the susceptibility of bacteria to ciprofloxacin and ampicillin.

To explore the interaction effects of ciprofloxacin and ampicillin with nickel on the growth of bacteria, Staphylococcus aureus strain ATCC 29213, Enterococcus faecalis ATCC 29212 and Escherichia coli ATCC 25922 were used. Minimum inhibitory concentrations (MICs) were determined for nickel, ciprofloxacin and ampicillin, and the checkerboard method was used to assess their cumulative effects on bacterial growth. The interactions between the metal and antibiotics were assessed by the fractional inhibitory concentration (FIC). The MICs for ciprofloxacin and ampicillin were 0.31 and 1 mg/L for E. faecalis, 0.62 and 1 mg/L for S. aureus and 0.005 and 2.5 for E. coli, respectively. The MIC for nickel was 1000 mg/L for all bacteria. The FIC results for ciprofloxacin and nickel demonstrated an antagonistic effect of the two agents on the growth of E. coli and E. faecalis and an additive effect on S. aureus. The FICs for ampicillin and nickel demonstrated a synergistic effect on the growth of E. faecalis and E. coli. Different interactions of metals and antibiotics were observed depending on the bacteria and the type of antibiotic.

Facial aesthetic concern is a powerful predictor of patients' decision to accept orthognathic surgery.

OBJECTIVE: To investigate differences in quality of life in subjects with and without skeletal malocclusions and factors influencing patients' decision to accept orthognathic surgery. MATERIALS AND METHODS: DESIGN: Cross-sectional with stratified sampling. SETTINGS AND SAMPLE POPULATION: 190 Caucasian subjects (65% females), aged 17-46 years. 95 subjects were consecutive patients referred to University Dental Clinic for skeletal malocclusion treatment of which 58 subjects accepted suggested surgery, 37 refused. The other 95 were age-and sex-matched controls, without malocclusions, recruited from the pool of students and employees of local high schools and university. MAIN OUTCOME MEASURES: Psychosocial and functional issues were evaluated by Orthognathic Quality of Life Questionnaire. Complexity of malocclusion and treatment need was assessed by the Index of Orthognathic Functional Treatment Need. RESULTS: Discriminant analysis demonstrated that in quality of life, three groups differed mostly in facial aesthetic concern, followed by altered oral function, then by social interactions which were the highest in the group that accepted surgery. When controlling for age, sex, oral function impairment, awareness of facial deformity and inhibitions in social contacts in a multiple logistic regression analysis, only IOFTN and facial aesthetic concern were significant predictors of orthognathic surgery acceptance, increasing the odds for acceptance by 2.9x and 4.7x, respectively (P ≤ .045). CONCLUSION: Facial aesthetic concern is very important factor in patients' decision-making process for accepting orthognathic treatment for skeletal malocclusions, with greater importance than high normative need for functional orthognathic treatment.

Immunohistochemical and Histopathological Features of Persistent Gingival Enlargement in Relation to Metal Allergic Sensitisation during Orthodontic Treatment.

This study aimed to analyse the immunohistochemical profile of inflammatory infiltrates in the gingival tissue of patients undergoing orthodontic treatment in relation to patients' titanium and/or nickel allergy status. Patients with gingival enlargement received initial periodontal therapy, followed by external gingivectomy in the case of persistent gingival enlargement. The sample included 44 patients (22 had metal allergic sensitisation). Histopathological changes were assessed, and an immunohistochemical analysis was performed on formalin-fixed and paraffin-embedded gingival samples using antibodies against CD1a, CD3, CD4, CD8, CD20, CD68, and CD138. Computer-assisted image analysis was performed to evaluate the positive cell count in the gingival tissue. The gingiva of the sensitised patients was characterised by the absence of multifocal inflammatory infiltrates (p < 0.05), while pronounced exocytosis and band-like inflammatory infiltrates were more frequently observed in sensitised patients. In addition, there was an increase in Langerhans cells and T-helper lymphocytes and a decrease in naïve T-lymphocytes, cytotoxic T-lymphocytes, macrophages, and plasma cells in the sensitised subjects compared to non-sensitised. However, the differences were only statistically significant for macrophages, with a moderate effect size (82.8 vs. 133.9; p = 0.041; r = 0.308). The absence of multifocal inflammation appears to be the most characteristic histopathological feature of the gingiva of sensitised patients. Although their gingiva presented certain characteristics of late hypersensitivity immune reactions the observed changes imply dominant irritative effect e.

Presence and Maturation Dynamics of Mandibular Third Molars and Their Influence on Late Mandibular Incisor Crowding: A Longitudinal Study.

The objective of this study was to investigate the relationship between the absence, presence and dynamics of mandibular third molar development and the occurrence and amount of late mandibular incisor crowding. Dental plaster casts and panoramic radiographs of 72 orthodontically untreated subjects from the Nittedal growth study, Norway were analyzed. The subjects were recalled for a checkup at 12, 15, 18 and 21 years of age. Mandibular incisor crowding was assessed using Little's irregularity index and dental maturation of the third molars by the Cameriere's index. The majority of the subjects (64%) had ≥1 mm increase in irregularity; 22% experienced an increase of 0.1-0.9 mm and 14% had unchanged or decreased irregularity. Incisor irregularity increased with age, regardless of absence or presence of third molars. The amount of change in incisor irregularity from 12 to 21 years did not differ significantly between subjects with hypodontia of third molars, extraction and those with third molars present. No differences were observed between erupted, unerupted or impacted third molars. No correlation was found between the amount of change in irregularity and maturation of the third molars. In conclusion, occurrence and amount of mandibular late incisor crowding is not significantly influenced by the presence of mandibular third molars or their development dynamics.

Bacterial Exposure to Nickel: Influence on Adhesion and Biofilm Formation on Orthodontic Archwires and Sensitivity to Antimicrobial Agents.

The presence of nickel could modify bacterial behavior and susceptibility to antimicrobial agents. Adhesion and biofilm formation on orthodontic archwires can be a source of bacterial colonization and possible health hazards. Staphylococcus aureus was subjected to exposure and adaptation to various sub-inhibitory concentrations of nickel. Five strains of bacteria adapted to nickel in concentrations of 62.5-1000 µg/mL were tested for adhesion and biofilm formation on nickel-titanium archwires. Archwires were previously incubated in artificial saliva. Bacteria were incubated with orthodontic wire with stirring for 4 h (adhesion) and 24 h (biofilm formation). The number of adherent bacteria was determined after sonication and cultivation on the Muller-Hinton agar. Disk diffusion method was performed on all bacteria to assess the differences in antimicrobial susceptibility. Bacteria adapted to lower concentrations of nickel adhered better to nickel-titanium than strains adapted to higher concentrations of nickel (p < 0.05). Biofilm formation was highest in strains adapted to 250 and 500 µg/mL of nickel (p < 0.05). The highest biofilm biomass was measured for strains adapted to 250 µg/mL, followed by those adapted to 1000 µg/mL. Bacteria adapted to lower concentrations of nickel demonstrated lower inhibition zone diameters in the disk diffusion method (p < 0.05), indicating increased antimicrobial resistance. In conclusion, bacteria adapted to 250 µg/mL of nickel ions adhered better, demonstrated higher biofilm formation and often had higher antimicrobial resistance than other adapted and non-adapted strains.

Craniofacial Growth in Adolescence and its Influence on the Mandibular Incisor Crowding.

BACKGROUND: To analyze craniofacial growth during adolescence from the ages of 12 to 21 years and its relation to late mandibular incisor crowding. MATERIAL AND METHODS: The study included 61 orthodontically untreated subjects (49% males). Lateral cephalograms were used to assess the jaw growth and inclination of the incisors. Little's Irregularity Index and the anterior mandibular dental arch depth of mandibular dentition were measured. RESULTS: A reduction of the skeletal class angle (ANB) was observed in both genders, although it was significant only in males (η2=0.188; p=0.015). The growth of the mandible was more prominent compared to that of the maxilla, and it was more prominent in males than in females. The skeletal vertical dimension, however, demonstrated a significant reduction in both genders (η2=0.527-0.593, p<0.001). The mandibular incisors tended to retrocline in both genders, while the maxillary ones tended to procline in males, and slightly retrocline in females. A decrease in the mandibular dental arch depth occurred in both genders (η2=0.259; p<0.05). An increase in the irregularity of incisors for 1.8±1.7 mm on average (95% CI 1.3-2.2; η2=0.520; p<0.001) was observed in both genders. A logistic regression revealed that less sagittal growth of maxilla (increase of SNA angle ≤2°) and reduction of convexity in skeletal sagittal interjaw relationship (reduction of ANB ≥1°) were significant predictors of the occurrence of crowding (Δ Little Irregularity Index ≥1mm) yielding odds ratios of 4.9 and 4.8. CONCLUSIONS: The differential growth of the maxilla and mandible is related to the occurrence of late crowding, mostly in smaller amounts in maxillary sagittal growth compared to the mandible.

Perfectionism, self-esteem and body image related to self-perception of orofacial appearance - development and validation of psychometric instrument.

PURPOSE: To develop an instrument for the assessment of perception of orofacial appearance and psychologic issues that can affect peoples' judgments. MATERIALS AND METHODS: A panel composed of five members (one psychologist, two prosthodontists, one orthodontist, and one final-year dental student) generated 31 items that could draw specific hypothetical dimensions. The questionnaire was self-administered by individuals attending local high schools and university (N = 261; 26.4% men) in the 14- to 28-year age range. Internal consistency, construct validity, responsiveness, and temporal stability were assessed. RESULTS: Factorial analysis and Cronbach's alpha identified four dimensions (self-esteem, perfectionism, body image, and smile appearance concern) that could be best fitted by 17 items. Internal consistency was good (α in the 0.70 to 0.80 range). The dimensions were correlated with existing instruments that measure similar constructs. In responsiveness testing, tooth whitening did not induce changes in perfectionism or body image; however, it did increase self-esteem and decreased esthetic concern (P < .05). CONCLUSION: The newly created questionnaire is a consistent and reliable short instrument that measures psychologic issues related to the perception of orofacial appearance.

Effects of Visual Stimuli from Media on the Perception of Dentofacial Esthetics.

OBJECTIVES: The study explored whether television commercials change the perception of one's own dentofacial attractiveness and to identify if it is influenced by personality traits. MATERIALS AND METHODS: The sample included 83 participants, aged 19-27 years. The experimental group (N=42) watched commercials portraying famous young individuals with high smile esthetics, bright teeth and no visible malocclusions, while the control group (N=41) watched neutral commercials (without people or visible teeth). The perception of subjects` own orofacial esthetics and its psychosocial effects were assessed a month before the exposure and immediately after it. The subjects` malocclusion severity and personality characteristics (extraversion, conscientiousness, agreeableness, neuroticism, intellect, self-esteem and perfectionism) were assessed. RESULTS: In their second report, respondents were inclined to report less psychosocial impacts with small differences (ranging from 0-3 scalar points on average) and less significant in the active group compared to neutral group (2 out of 7 vs. 5 out of 7 aspects). Types of visual stimuli were a significant predictor only of changes pertaining to psychological impact of dental esthetics (p=0.045; r=0.221). The intellect moderated perception of smile esthetics, after having been exposed to commercials, accentuated beautiful smiles as a suppressor (ΔR2=0.076; p=0.005; total model R2=0.347; p=0.033). In subjects with higher cognitive abilities, an increase in the self-perceived malocclusion level induced a smaller decrease in psychological impact of dental esthetics as compared to those with lower intellect. CONCLUSION: Psychosocial influences of malocclusion are not stable and tend to decrease during time. However, the exposure to a high smile esthetic of other individuals can inhibit that process in persons with more severe malocclusion and higher cognitive abilities.

Parental influence is the most important predictor of child's orthodontic treatment demand in a preadolescent age.

The aim was to explore the predictive value of objective treatment need, impaired quality of life, and parental influence on orthodontic treatment demand in preadolescents and adolescents. A secondary goal was to validate 16-item Child Perceptions Questionnaire for the 11-14 year age group (CPQ11-14): item-impact and stepwise-regression short-forms. A convenience sample of 287 participants (55% female) was used for validation. Internal consistency, test-retest reliability, and convergent validity were evaluated. Predictors of treatment demand were explored in 197 orthodontic patients: 93 preadolescents (51% females), 104 adolescents (55% females). Hierarchical linear regression and multilevel logistic regression models were used to explore the predictive power of age, gender, objective treatment need, impaired quality of life and parental influence on treatment demand. CPQ11-14 regression short-form had acceptable psychometric properties. Significant linear predictors of treatment demand were impaired emotional well-being (EW) (ß = 0.335, p = 0.002), parental influence (ß = 0.221, p = 0.002), and malocclusion severity (ß = 0.152, p = 0.025). In logistic regression, parental influence was revealed as the most important predictor of treatment demand in preadolescents, OR = 7.7 (95% confidence interval CI 2.4-25.1; p = 0.001); objective treatment need in adolescents, OR = 4.5 (95% CI 1.5-12.9; p = 0.006). The increase of impairment in EW by one scalar point increased treatment demand by 1.4 (95% CI 1.1-1.9; p = 0.017) in preadolescents; 1.3 (95% CI 1.0-1.7; p = 0.021) in adolescents. Greater parental agreement and motivation for treatment could result in higher preadolescents' cooperation. Orthodontic treatment in adolescents might be more effective with the patient-oriented approach.

Changes in quality of life induced by tooth whitening are not influenced by global self-esteem: a randomized double-blind placebo-controlled trial.

The purpose of this paper is to investigate which elements of tooth colour are most influenced by whitening and to identify the short-term changes in satisfaction with smile aesthetics and quality of life induced by tooth whitening and the role of global self-esteem. Sixty participants were randomly assigned to a treated or a placebo group (each group N = 30). Their anterior teeth were bleached with a photo-activated whitening gel, or subjected to a placebo. Lightness, chroma and the translucency of teeth were assessed before and 1 week after the procedure using a spectrophotometer. The Self-Esteem Scale, Psychosocial Impact of Dental Aesthetics Questionnaire, the Orofacial Aesthetic Scale and the Oral Health Impact Profile were administered to subjects. Changes in colour and chroma were greater in the treated than the placebo group (3.8 ± 1.5 vs. 1.7 ± 1.5 and - 3.2 ± 1.5 vs. 0.0 ± 1.1; p < 0.001). The treated group reported increased satisfaction with appearance and a decrease in psychological and social impacts (p < 0.05). In the placebo group there was no objective change in colour but the subjects reported an increase in satisfaction and dental self-confidence, as well as a decrease in psychological impact (p < 0.05). Self-esteem did not have a moderation nor a mediation effect. In conclusion, patients are not able to accurately detect the colour change induced by tooth whitening after 1 week, but they are also largely suggestible when evaluating the changes in quality of life. Changes in quality of life induced by tooth whitening are not influenced by global self-esteem.ClinicalTrials.gov Identifier NCT03380702.

Do Chlorhexidine and Probiotics Solutions Provoke Corrosion of Orthodontic Mini-implants? An In Vitro Study.

PURPOSE: The aim of this study was to explore the surface roughness and hardness of the implant head of orthodontic mini-implants made from different alloys before and after their in vitro exposure to agents for prevention of gingivitis, mucositis, and peri-implantitis: chlorhexidine and probiotics. MATERIALS AND METHODS: Three types of commercially available mini-implants were tested: 316 stainless steel, titanium Grade 5, and titanium Grade 23 (both Ti-6Al-4V alloys with the same atomic weight percentage of Ti, Al, and V, with the difference being in maximal reduction of O2 in Grade 23 to 0.13% of atomic weight). They were immersed in three experimental solutions: artificial saliva, saliva with probiotic bacteria Lactobacillus reuteri, and saliva with oral antiseptic chlorhexidine (CHX). Samples were immersed for 28 days, thermocycled, then stored in an incubator at 37°C. Surface roughness and microhardness on five samples of each of the three implant types were measured by atomic force microscopy and the Vickers method, respectively. RESULTS: Exposure of titanium implant Grade 5 to probiotics significantly increased roughness compared with other media (P < .005). Exposure to CHX significantly increased the roughness of steel implants (P < .05). Neither saliva, probiotic, nor CHX altered microhardness of titanium implants significantly. In steel implants, the exposure to CHX and probiotics decreased microhardness compared with unexposed implants (P < .031), but not in comparison to saliva. CONCLUSION: Probiotics seem to increase roughness of titanium mini-implants, while CHX seems to increase roughness of steel mini-implants. Only stainless steel implants had an altered, decreased hardness after exposure to CHX, although the same was found after their exposure to saliva. For patients undergoing orthodontic treatment with temporary anchorage units, CHX could be recommended for titanium, and probiotics for stainless steel mini-implants in oral-hygiene maintenance.

Changes of mandibular dental arch shape during adolescence and its influence on late mandibular incisor crowding.

The aim was to analyze the changes in mandibular dental arch shape during adolescence and assess its relation to late mandibular incisor crowding. Longitudinal study included 68 orthodontically untreated subjects (49% female) and analyzed their data for the ages of 12, 15, 18 and 21 years. Measurements included anterior arch depth, intercanine, interpremolar/anterior and intermolar/posterior width, Little's Irregularity and Bolton's index and the ratio between anterior arch depth and width. Males had significantly greater posterior widths than females at any age (p < 0.05). The anterior arch depth continuously decreased (p < 0.05), while width increased after the age of 18 years. Mandibular incisor crowding increased during all investigated periods (p < 0.05). The increase of intercanine width at 12-21 years of age reduced the risk for mandibular incisor crowding in the same period by 74% (OR: 0.265: 95% CI 0.076-0.931; p = 0.045). The shape of mandibular dental arch continues to change during adolescence becoming more squared while mandibular incisor crowding increases. The increase in mandibular intercanine width reduces the risk of crowding.

Tooth Color as a Predictor of Oral Health-Related Quality of Life in Young Adults.

PURPOSE: Smiling plays an important role in social interaction. The purpose of this research was to explore the extent to which objective parameters of color of one's own teeth affected the social and emotional dimensions of young adults' lives. MATERIALS AND METHODS: The sample included 134 subjects-students of the University of Rijeka, Croatia (65% female) aged 19 to 28 years (median 21). All subjects had six intact maxillary anterior teeth without restorations or severe malocclusions and healthy gingiva with no signs of inflammation. Tooth color was assessed intraorally using a spectrophotometer. Lightness, chroma, and translucency of the right maxillary central incisors (the reference teeth) were calculated and used for analysis. Subjects reported dimensions of their oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP), Orofacial Esthetic Scale (OES), and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Linear relationships between elements of tooth color and OHRQoL were explored using Pearson correlations. Multiple linear regression, while controlling for the influence of age and gender, was also calculated. ANOVA with a Tukey post hoc test was employed to test whether nonlinear relationships existed between OHRQoL and categories of color elements. RESULTS: Dental self-confidence, esthetic concerns, orofacial appearance, social impact and psychological impact were not related to lightness, chroma, or translucency of the subjects' teeth. Neither linear nor nonlinear relationships were detected between those aspects. Satisfaction with smile esthetics was only related to translucency where subjects with moderate translucency were least likely to be satisfied (p = 0.033). Women tended to report greater psychosocial impacts than men (p < 0.05), regardless of their tooth color. CONCLUSION: According to the results of this study objective, measurable, quantitative parameters of tooth color did not accurately predict psychosocial dimensions of OHRQoL in dentate young adults.

Oral antiseptics and nickel-titanium alloys: mechanical and chemical effects of interaction.

The effect of oral antiseptics on the corrosion of nickel-titanium (NiTi) alloys with various coating was investigated. Uncoated, titanium nitride-coated and rhodium-coated NiTi archwires (0.020 × 0.020″) were tested in interaction with artificial saliva pH 4.8 and oral antiseptics based on hyaluronic acid (Gengigel), chlorhexidine (Curasept) and essential oils in alcohol base (Listerine). The dynamics of nickel and titanium ions release were recorded during 28 days. Springback ratio and modulus of resilience were assessed by three-point bending test. The results showed that corrosion of NiTi is related to type of antiseptic mouth rinse and coating formulations. Exposure to an artificial saliva and antiseptics tend to reduce flexibility and resilience of NiTi archwires. The influence of the media is more significant than the influence of the type of the alloys coating. The largest release of nickel ions is in the first 3 days. Antiseptics do not cause further deterioration of the elastic properties in uncoated NiTi compared to saliva. As a result of exposure of nitrified NiTi wires in Listerine, there is bigger release of nickel ions, decrease in elastic properties and lower force delivery in unload. Listerine tends to reduce elastic properties of rhodium-coated wires also. In conclusion, except for Listerine, changes of mechanical characteristics induced by antiseptics are small and would not have a clinically important impact. Generally, Curasept would be the most suitable option.

Changes in Quality of Life Induced by Tooth Whitening are Moderated by Perfectionism: A Randomized, Double-Blind, Placebo-Controlled Trial.

PURPOSE: To explore the influence of perfectionism on the short-term changes in satisfaction with smile esthetics and quality of life (QoL) induced by tooth whitening. MATERIALS AND METHODS: A total of 60 subjects were analyzed: 30 in the active group, in which the subject's anterior teeth were whitened with a photoactivated gel, and 30 in the placebo group. The Smile Esthetics-Related Quality of Life and Multidimensional Perfectionism Scale questionnaires were administered to all participants. RESULTS: The active group demonstrated an increase in dental self-confidence and a decrease in dissatisfaction with color (P < .05). The amount of color change did not correlate linearly with change in dissatisfaction or with QoL. In subjects with higher perfectionism, increasing the color change led to more decrease in dental self-consciousness. CONCLUSION: Perfectionism moderates perception of smile esthetics.

Smile Aesthetics Satisfaction Scale: development and validation of a new brief five-item measure of satisfaction with smile aesthetics in adults and the elderly.

OBJECTIVE: To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry. MATERIALS AND METHODS: A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86 years of age, were included in the investigation. The internal consistency, validity and stability of the questionnaire, along with the responsiveness induced by the tooth-whitening procedure, were evaluated. The relationship between self-perceived satisfaction with the smile aesthetics and the clinical status of the dentition was assessed. RESULTS: The questionnaire had one dimension accounting for 64.3% of variance and showed a high level of reliability (Cronbach α = 0.859). It measured a construct similar to concern with tooth appearance and the desire to improve this appearance (r = -0.403 and r = -0.353, respectively; P < 0.001). High test-retest reliability was demonstrated (intraclass correlation coefficient = 0.985). The questionnaire was able to detect an increase in satisfaction with smile aesthetics as a result of the tooth-whitening procedure (P = 0.016). Clinical predictors of greater satisfaction with smile aesthetics were greater tooth display when smiling, decreased chroma and the absence of gingivitis, as well as absence of crowded, fractured and restored teeth in the anterior segment. CONCLUSIONS: A new questionnaire, titled the Smile Aesthetics Satisfaction Scale (SASS), showed good psychometric properties and its use can be recommended.

Development and validation of a new condition-specific instrument for evaluation of smile esthetics-related quality of life.

OBJECTIVE: Orofacial esthetics raises psychosocial issues. The purpose was to create and validate new short instrument for psychosocial impacts of altered smile esthetics. MATERIALS AND METHODS: A team of an orthodontist, two prosthodontists, psychologist, and a dental student generated items that could draw up specific hypothetical psychosocial dimensions (69 items initially, 39 in final analysis). The sample consisted of 261 Caucasian subjects attending local high schools and university (26% male) aged 14 to 28 years that have self-administrated the designed questionnaire. Factorial analysis, Cronbach's alpha, Pearson correlation, paired samples t-test and analysis of variance were used for analyses of internal consistency, construct validity, responsiveness, and test-retest. RESULTS: Three dimensions of psychosocial impacts of altered smile esthetics were identified: dental self-consciousness, dental self-confidence and social contacts that can be best fitted by 12 items, 4 items in each dimension. Internal consistency was good (α in range 0.85-0.89). Good stability in test-retest was confirmed. In responsiveness testing, tooth whitening induced increase in dental self-confidence (P = 0.002), but no significant changes in other dimensions. CONCLUSION: The new instrument, Smile Esthetics-Related Quality of Life (SERQoL), is short and has proven to be a good indicator of psychosocial dimensions related to perception of smile esthetics. CLINICAL SIGNIFICANCE: Smile Esthetics-Related Quality of Life questionnaire might have practical validity when applied in esthetic dental clinical procedures.

Neoclassical canons of facial beauty: Do we see the deviations?

AIM: To explore the presence of neoclassical canons of facial beauty among young people in Croatia and to question possible psychosocial repercussions occurring in those who demonstrate deviations in relation to canons. SUBJECTS AND METHODS: The study was cross-sectional and the sample included 249 subjects (60% female) aged 12-39 (median 20). Their en face and profile photographs were taken in Natural Head Position. Photogrammetry included analysis of nine neoclassical canons of facial beauty originating from the Renaissance. Psychosocial issues were assessed using the Self-Esteem Scale, Big Five Inventory and three domains of Orthognathic Quality of Life Questionnaire. RESULTS: Significant deviations from neoclassical facial beauty canons were observed in 55-65% of adolescents and young adults. Gender and age showed no relation to deviations. The deviations from canons that influenced the quality of life were mainly those related to vertical facial proportions and demonstrated increased facial aesthetics concern and social impact, and higher self-reported treatment need (p < 0.05). Deviations from canons were not related to self-esteem but a decrease in openness, agreeableness and neuroticism was observed. CONCLUSION: Neoclassical canons were not valid for the majority of adolescents and young adults in Croatia. Only deviations from some canons appear to provoke mild psychosocial repercussions.

Comparison of Activator-Headgear and Twin Block Treatment Approaches in Class II Division 1 Malocclusion.

The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8-13 years with class II division 1 malocclusion treated with either AH (n = 25) or TB (n = 25) appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p < 0.001). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p < 0.05). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.