A clinical study assessing the short-term efficacy of combined in-office/at-home whitening treatment.

OBJECTIVE: The purpose of this randomized clinical trial was to assess the efficacy of color change in combined in-office/at-home whitening. MATERIALS AND METHODS: Thirty participants were randomly divided into two groups: 15 received combined treatment in-office whitening (6% hydrogen peroxide + 2 weeks at-home whitening with 16% carbamide peroxide [CP]); 15 were assigned to control group. Instrumental color measurements were obtained before whitening (t0 ), immediately after in-office whitening (tin-office ), after 1 week of active treatments (t1 ), and at the completion of the whitening treatment (t2 ). CIE L*a*b* values were recorded and CIE L*a*b* and CIEDE2000 color differences were calculated. RESULTS: The color change at tin-office was ΔEab = 4.7 and ΔE00 = 3.2 and overall color change of combined method at t2 was ΔEab = 8.2 and ΔE00 = 5.3 (P < 0.05). A statistically significant effect for the mean CIE L*a*b* and CIEDE2000 values was detected within time with the mean a*, b* and C' values decreasing and mean h' values increasing significantly (P < 0.05). CONCLUSIONS: Combined in-office/at-home whitening was effective. Whitening efficacy increased upon application of 16% CP in combined in-office/at-home treatment (P < 0.05). CLINICAL SIGNIFICANCE: The statistically significant increase in color change recommends clinical application of combined in-office/at-home whitening treatment.

Influence of Gender on the Patient's Assessment of Restorations on the Upper Anterior Teeth.

OBJECTIVE: The aim of this study was to assess the level of patients' satisfaction with appearance of maxillary anterior teeth restorations and to determine if there is a significant difference in patients' assessment of restoration appearance with regard to gender. MATERIALS AND METHODS: Two hundred subjects evaluated the colour, anatomical shape and surface texture of maxillary anterior teeth restorations (composite fillings, acrylic faceted metal crowns, porcelain-fused-to-metal crowns and all-ceramic crowns) in comparison with adjacent natural teeth. The data were expressed in patients' average assessment scores for colour, anatomical shape and surface texture as well as overall patients' average assessment scores for every type of restoration and overall patients' average assessment scores for colour, anatomical shape and surface texture of all the restorations in general. Patients also assessed the general impression of their maxillary anterior teeth restorations and rated it as satisfactory or unsatisfactory. RESULTS: There was a statistically significant gender difference in patient assessment of colour and surface texture for composite fillings and the overall patient average assessment score for colour of all assessments (p <0.05). Women were more dissatisfied with the general impression of their restorations on the upper teeth than men (p >0.05). Only overall patients' average assessment score for composite restorations almost reached the level of significance (p = 0.069) on patients' general impression. CONCLUSION: Colour of the restorations and the composite material are significant factors which affect dental appearance of maxillary anterior teeth in patients.

Influence of esthetic dental and facial measurements on the Caucasian patients' satisfaction.

PURPOSE: The purpose of the present study was to investigate how some esthetic dental and facial measurements may correlate the variability of patients' ratings of their satisfaction with the maxillary anterior teeth appearance in different gender groups. MATERIALS AND METHODS: The following measurements were made on 78 Caucasian subjects: width and length of each maxillary anterior tooth, their distal gingival zenith displacements, the upper lip height, intercommisural width, maximum maxillary central incisal, and gingival display at rest and smile. All the patients rated their satisfaction with the dental appearance on the visual-analogue scale (0 meaning absolute dissatisfaction, whereas 4 indicated complete satisfaction). All the parameters have been analyzed with respect to gender. RESULTS: The majority of the esthetic dental and facial measurements were larger in men (p<0.05). The great majority of the participants were completely satisfied with their dental appearance (75% of men and 89% of women; p>0.05). In the men, the two factors of maximal maxillary incisal display at rest and intercommisural width at smile paralleled the variability of the patients' satisfaction with dental appearance by 99% (p>0.05). In women, the combination of central incisor width/length ratio, intercommisural width at rest, central incisor gingival zenith displacement, intercommisural width at smile, upper lip height, and maximum maxillary incisal display at rest paralleled the variability of the patients' satisfaction with dental appearance by 99% (p>0.05). CONCLUSIONS: Within the population tested, the results suggest that the use of esthetic dental and facial measurements may serve as an esthetic guideline and should be considered in esthetic anterior oral rehabilitation. CLINICAL SIGNIFICANCE: The information presented in this article may be useful in helping to create dental restorations with an acceptable esthetic appearance to the patient. Prior to the treatment the dentist should consider not only the size of maxillary anterior teeth but also their gingival architecture and the soft tissue surrounding the teeth.

A quantitative evaluation of the distal displacement of the gingival zenith in the maxillary anterior teeth.

The aim of this study was to quantify the specific distal displacement of the gingival zenith in the maxillary anterior dentition. Bilateral measurements, taken with a digital caliper in maxillary stone casts were recorded in six maxillary anterior teeth to evaluate distal displacement of the gingival zenith in relation to the long axis of the crowns. The gingival zenith was distally displaced between 0.45 and 1.01 mm in 90%, 85% and 60% of the central incisors, lateral incisors and canines, respectively. Contralateral comparisons between the tooth groups revealed significantly larger distal displacement of the zenith in left canine (p < 0.05). Ipsilateral comparisons revealed that the lateral displacement of the zenith was significantly larger in central than in lateral incisors (p < 0.05). Similarly, the zenith of lateral incisors was displaced significantly more distal than that of canine teeth (p < 0.05). Comparisons of the frequency of coincidence of the position of the gingival zenith with the long axis of the tooth revealed that it was significantly greater in canines than in lateral and central incisors (p < 0.05). The frequency and magnitude of distal displacement is tooth-dependent and larger in central than in lateral incisors, which in turn, is larger than in canines. These data could be used as reference points during esthetic anterior oral rehabilitation, especially in case of porcelain laminate veneers.

Incidence of caries in children of rural and subrural areas in Croatia.

The aim of this paper was to determine certain regularities in caries incidence in children in primary and permanent dentition in respect of clinical and non-clinical variables that can be collected in everyday dental practice. This way it could be easier for the operator to adjust individual preventive therapy of patients. The study was conducted on 301 subjects, aged 3-6 (74 subjects) and 11-14 (227 subjects) inhabitants of Petrinja and Topusko, postwar rural and subrural areas in Central Croatia. Using an oral hygiene questionnaire, habits, diet and use of fluoride were assessed. The clinical finding comprised the dental status, amount of stimulated saliva, oral hygiene index and the presence of orthodontic anomaly. Children showed very high values of the dmf-t/DMF-T (decayed, missing, filled index) (7.7/6.7), dmf-s/DMF-S (16.5/11.8), and significant index of caries (SiC = 10.89). The study confirmed correlation between the OHI (oral hygiene index) and dmf-t/DMF-T and dmf-s/DMF-S index, and the influence of the regularity of dental check-ups and frequency of tooth brushing on OHI. Furthermore, the children that started practicing oral hygiene later, brush their teeth irregularly, and visit dentists only when having pain. It can be concluded that Croatia is still very far from achieving the goals set by WHO concerning oral health improvement.