Analysis of shade-matching ability in dental students: a comparative study under clinical and correcting light conditions.

BACKGROUND: Selecting the ideal tooth shade is essential to the success of aesthetic dental restorations. Students' cognitive abilities are involved in the multifaceted and intricate process of shade matching. Hence, the present study aimed to assess and compare the shade-matching ability of undergraduate dental students in various years of dental education under clinical and correcting light. METHODS: This comparative cross-sectional study was instigated amongst male 4th, 5th, and 6th-year students of the dental complex of King Faisal University, Kingdom of Saudi Arabia. A total of 72 male dental students assessed the shade under clinical (fluorescent light) and correcting light (handheld Dental Base Light) by using VITA Classical shade guides. Statistical analysis was done using SPSS version 23 (Armonk, NY, USA). The Chi-square test was used to evaluate the association between correct and incorrect shade matching under correcting and clinical light. RESULTS: Out of 72 male students, 22(30.6%) were from the 4th year, 26(36.1%) were from the 5th year, and 24(33.3%) were from the 6th year, with a mean age of 22.92 ± 1.01 years. The majority of the 6th-year students selected shade of anterior tooth # 11 correctly under clinical and correcting light, and 3(12.5%) students selected incorrectly under clinical and correcting light, with a statistically significant association among them (p = 0.004). As far as the shade selection of the posterior tooth is concerned, a statistically significant difference was observed under clinical light among all clinical students (p = 0.008). CONCLUSION: The clinical performance of dental students in shade matching improved with advancing years of dental education. Additionally, the shade matching ability of all groups of dental students was superior under correcting light compared to conditions under clinical light.

Clinical application of lithium disilicate glass ceramic cantilever resin-bonded fixed partial denture in the restoration of single anterior tooth loss / 口腔疾病防治

Objective@#To investigate the clinical effect of lithium disilicate glass ceramic cantilever resin-bonded fixed partial dentures (CRBFPDs) on single anterior tooth loss to provide a reference for the selection of restoration methods for single anterior tooth loss.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Forty-two patients with less than two anterior teeth with monomaxillary loss were included in this study. After 6 months, 1 year, 2 years, and 3 years, the aesthetic and functional effects of the restorations and the periodontal health status were evaluated, and the visual analog scale (VAS) was used to assess patient satisfaction.@*Results@#During the observation period, the connector fractured in one case within 3 months. One case had debonded within 2 years. The aesthetic restoration effect of all lithium disilicate glass ceramic CRBFPDs was categorized as Class A. The periodontal health was good, there was no clinical absorption in the soft and hard tissues of the abutment or subbridge, periodontal status according to the evaluation indices was classified as class A, and the total satisfaction rate of the patient was 100%.@*Conclusion@#For single anterior tooth loss patients, lithium disilicate glass ceramic cantilever resin-bonded fixed partial denture can achieve the restoration effect of less invasion, better adhesion, aesthetics, comfort and good biocompatibility. With high patient satisfaction, it can be considered an ideal restoration method for replacing a single anterior tooth.

Digital Shade Matching in Dentistry: A Systematic Review.

The pursuit of aesthetic excellence in dentistry, shaped by societal trends and digital advancements, highlights the critical role of precise shade matching in restorative procedures. Although conventional methods are prevalent, challenges such as shade guide variability and subjective interpretation necessitate a re-evaluation in the face of emerging non-proximity digital instruments. This systematic review employs PRISMA protocols and keyword-based search strategies spanning the Scopus®, PubMed.gov, and Web of ScienceTM databases, with the last updated search carried out in October 2023. The study aimed to synthesise literature that identified digital non-proximity recording instruments and associated colour spaces in dentistry and compare the clinical outcomes of digital systems with spectrophotometers and conventional visual methods. Utilising predefined criteria and resolving disagreements between two reviewers through Cohen's kappa calculator, the review assessed 85 articles, with 33 included in a PICO model for clinical comparisons. The results reveal that 42% of studies employed the CIELAB colour space. Despite the challenges in study quality, non-proximity digital instruments demonstrated more consistent clinical outcomes than visual methods, akin to spectrophotometers, emphasising their efficacy in controlled conditions. The review underscores the evolving landscape of dental shade matching, recognising technological advancements and advocating for methodological rigor in dental research.

Ethical and Medico-Legal Considerations with Aesthetic Dentistry Involving the Aesthetic Zone.

The bedrock of delivering cosmetic dentistry remains good communication underpinned by a clear and transparent consent process. This article looks at this while exploring the ethical and risk management issues that have started to challenge the profession. While patients' demand for cosmetic dentistry has exploded, this article explores the ethical conundrums faced by these treatments against the backdrop of whether their happiness is affected by their image.

[Pain syndrome correction after teeth whitening]. / Korrektsiya bolevogo sindroma pri otbelivanii zubov.

THE AIM OF THE STUDY: Was to develop an algorithm for the correction of pain syndrome using the drug Ketorol Express depending on the level of situational and personal anxiety of patients during office teeth whitening. MATERIALS AND METHODS: The study involved 60 people (mean age 25±0.85 years), who were divided into three groups depending on the level of personal and situational anxiety according to the Spielberger scale modified by Yu. L. Khanin. In the first group of patients with a high level of anxiety Ketorol Express was prescribed as a preventive analgesia before the whitening procedure, then the drug was used in case of pain. In the second group, patients with an average level of anxiety the drug was prescribed immediately after the whitening procedure, and then used in the event of a pain syndrome. The third group of patients with a low level of anxiety took the drug only in case of pain. To assess the severity of pain, the general well-being by the patient and the general well-being by the doctor, visual analogue scales were used. RESULTS: The study showed that the occurrence and correction of pain syndrome during teeth whitening depends on the patient's psycho-emotional state (both personal and situational anxiety). CONCLUSION: The developed regimen for prescribing Ketorol Express can significantly reduce pain in patients with different levels of anxiety.

Effect of Thickness and Translucency on Color Change and Masking Ability of Ceramic Materials used for Laminate Veneers.

This study evaluated the effect of the thickness and translucency of lithium disilicatebased glass ceramics on resin composite substrates on color change and masking effect. Laminate veneers were fabricated using IPS e.max CAD (A1) blocks with two different light transmittance values (High translucent [HT], Low translucent [LT]). Slices of two different thicknesses (0.3 mm, 0.5 mm) were obtained (n=10) and laminate veneers were cemented on the resin composite substrates of two different shades (A2, A3.5). The color change (ΔE values) was evaluated with the CIELab color system using a spectrophotometer, while the masking effect was calculated. The data were analyzed using independent-samples t-test and two-way analysis of variance. The ceramic thickness and translucency had a significant effect on final color and masking. When HT was used, and the laminate veneer thickness decreased (0.3 mm), the masking effect in ΔE values were lower (p⟨0.05). The ΔE values (⟩3.7) were clinically unacceptable. With the increase in thickness, translucency of porcelain laminate veneers decreases showing better color masking ability. Veneer thickness seems to be more effective on the restoration's masking ability than the shade of the substrate and translucency. Cinically, in case a 0.5-mm or thinner laminate veneer is planned, tooth color, resin cement and ceramic type should be considered.

The Influence of a Novel, Crenelated Design of CAD-CAM Ceramic Veneers on the Debonding Strength.

(1) Background: Aesthetic dentistry has become one of the most dynamic fields in modern dental medicine. Ceramic veneers represent the most appropriate prosthetic restorations for smile enhancement, due to their minimal invasiveness and highly natural appearance. For long-term clinical success, accurate design of both tooth preparation and ceramic veneers is of paramount importance. The aims of this in vitro study were to assess the stress in anterior teeth restored with Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) ceramic veneers and compare the resistance to detachment and the fracture of ceramic veneers prepared using two different designs. (2) Methods: Sixteen lithium disilicate ceramic veneers were designed and milled using the CAD-CAM technology and divided into two groups according to the preparations (n = 8): Group 1, conventional (CO), with linear marginal contour and Group 2, crenelated (CR), the latter with our novel (patented) sinusoidal marginal design. All samples were bonded to anterior natural teeth. The mechanical resistance to detachment and fracture was investigated by applying bending forces on the incisal margin of the veneers in order to determine which type of preparation leads to better adhesion. An analytic method was employed, as well, and the results of the two approaches were compared. (3) Results: The mean values of the maximum force recorded at the veneer detachment were 78.82 ± 16.55 N for the CO group and 90.20 ± 29.81 N for the CR group. The relative increase, equal to 14.43%, demonstrated that the novel CR tooth preparation provided higher adhesive joints. In order to determine the stress distribution within the adhesive layer, a finite element analysis (FEA) was performed. The statistical t-test showed that the mean value of the maximum normal stresses is higher for the CR-type preparations. (4) Conclusions: The patented CR veneers represent a practical solution to augment the adhesion and mechanical properties of ceramic veneers. The obtained results demonstrated that CR adhesive joints triggered higher mechanical and adhesive forces, which subsequently led to a higher resistance to detachment and fracture.

Finishing Analysis of Dental Outcome (FADO) as a New Guide in Orthodontic Treatment.

OBJECTIVES: Orthodontic treatment has both functional and esthetic goals. The finishing phase is one of the most important and seeks to solve occlusal, dental, functional, and esthetic problems, offering the possibility of obtaining the best possible outcome. This paper aims to describe the Finishing Analysis of Dental Outcome (FADO) guide as a tool to improve orthodontic treatment results. METHODS: A literature review of finishing procedures and orthodontic treatment outcomes was made. Moreover, current parameters of the esthetics of the smile were considered. The information was systematized to produce a protocol applicable to practice. This guide includes the assessment of mini-esthetic, micro-esthetic, and occlusal results using the Cast Radiographic Evaluation of the American Board of Orthodontics. Treatment options for each item were also suggested. Clinical cases were used to illustrate the application of the guide. RESULTS: The FADO Guide is presented and explained to give the clinician a systematic and orderly guide to achieve the best possible results in orthodontic treatment. To fulfill the FADO Guide, cast models, a panoramic radiograph, smile photographs (frontal and lateral), and an intraoral frontal photo are needed. The FADO Guide includes four sections: mini-esthetic evaluation (the evaluation of the smile), micro-esthetic evaluation, occlusal analysis, and radiographic analysis. CONCLUSION: The FADO guide presents a systematic approach to the application of a finishing protocol in orthodontics. Furthermore, this guideline can improve clinical practice and be used as a checklist to optimize clinical outcomes.

Impact of Social Media on Aesthetic Dentistry: General Practitioners' Perspectives.

The objective of this study was to investigate general dentists' observations of various aesthetic dental procedures among social media users. A cross-sectional study was conducted at the Department of Prosthodontics, Altamash Institute of Dental Medicine, over a duration of six months. Data were collected using a well-structured questionnaire comprising 21 predefined responses. The questionnaire was uploaded and disseminated through Google Surveys by forwarding web page links through emails and WhatsApp. The data collected were analysed through Statistical Package for Social Sciences (SPSS-Version 25). The majority (90.7%) of the dental practitioners surveyed believed that there is an increase in the demand for aesthetic dental procedures and social media is a major contributor to it. Moreover, most of the 377 (81.8%) participants agreed that social media is a beneficial platform enabling them to educate, advertise, and communicate with patients. Concerning popular aesthetic procedures, teeth whitening (54.7%), Hollywood smile (17.1%), dental veneers (11.9%), and Invisalign (10.4%) were the most commonly demanded aesthetic procedures. The patients showed desire for these procedures because they were trending on social media platforms. Almost half of the general dental practitioners used social media to post their content related to aesthetic dentistry and to promote their work. They preferred using before and after pictures (48.6%) for advertising their content related to aesthetic dentistry. Within the limitations of the study, it is concluded that the demand for aesthetic dentistry is rapidly growing, and social media is the main driving force behind this revolution as the general population has direct access to the profiles of celebrities and influencers, who all appear to have 'the perfect smile'. This shift in people's self-image has created a surge in patients seeking cosmetic treatments.

Diagnostic Mock-Up as a Surgical Reduction Guide for Crown Lengthening: Technique Description and Case Report.

Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient's primary concern was improving her smile due to her "gummy smile" and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient's maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. Results: A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. Conclusions: The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening.

Efficacy of platelet-rich fibrin and connective tissue graft in papilla reconstruction.

PURPOSE: To evaluate efficacy of platelet-rich fibrin (PRF) or connective tissue graft (CTG) in papilla reconstruction (PR) with the semilunar incision (SI) technique. MATERIALS AND METHODS: The analysis consisted of 55 sites (27 CTG and 28 PRF) from 20 patients who underwent PR with either PRF or CTG placed in the maxillary anterior region with SI technique. Baseline (BL) and follow-up (T1 , first month, T3 , third month, T6 , sixth month) clinical data including periodontal evaluations (gingival index (GI), plaque index (PI), pocket depth (PD), keratinized tissue width (KTW), gingival recession), papilla-associated recordings (alveolar crest-interdental contact point [AC-IC], alveolar crest-papilla tip [AC-PT], papilla tip-interdental contact point [PT-IC], papilla height loss [PHL], interdental tissue stroke [ITS] and papilla presence index [PPI]) and patient satisfaction were analyzed. RESULTS: CTG provided better PR outcomes. GI, PI, and PD showed a slight increase at T1 and then, turned to their BL levels. The other periodontal parameters showed significant improvement after both treatment modalities. No inter-group difference was found except for KTW, which was in favor of CTG. CONCLUSION: Based on the results, CTG is recommended over PRF in PR treatment due to its superior outcomes with less recurrence risk. CLINICAL SIGNIFICANCE: Connective tissue graft provides superior results than platelet-rich fibrin in papilla reconstruction with the semilunar incision technique.

How the Duration and Mode of Photopolymerization Affect the Mechanical Properties of a Dental Composite Resin.

Composite materials are the most common materials in use in modern dentistry. Over the years, the methods of photopolymerization of composite materials have been improved with the use of various devices, such as quartz tungsten halogen lamps (QTHs), light-emitting diode units (LEDs), plasma-arc lamps and argon-ion lasers. This study aimed to compare the mechanical properties of a composite material, depending on the time and mode of photopolymerization. One hundred and forty rectangular specimens (25 × 2 × 2 mm) and forty-two disc-shaped samples (5 mm diameter and 2 mm thickness) were prepared from shade A2 Boston composite resin. Samples were cured using the following seven photopolymerization protocols: four fast-cure modes (full power for 3, 5, 10, and 20 s), two pulse-cure modes (5 and 10 shots of 1 s exposures at full power), and one step-cure mode (soft start with a progressive cycle lasting 9 s). Specimens were subjected to a flexural strength test, Vickers microhardness test, and FTIR spectroscopy test. A 2-factor ANOVA and post-hoc tests were carried out to assess the differences in the flexural strength parameter between the tested groups of samples before and after aging. A mixed-model ANOVA was carried out to assess the differences in the Vickers microhardness parameter between the tested groups of samples before and after aging. The lowest values of flexural strength (p < 0.001) and Vickers microhardness (p < 0.001) were obtained for the 3 s mode for the pre- and post-aging groups. The FTIR mapping tests showed a much more homogeneous chemical structure of the composite after 20 s of continuous irradiation, compared to the sample irradiated for 5 s in the continuous mode. The mode and cure time affects the mechanical properties of the composite resin. Appropriate selection of the cure mode and time ensures better mechanical properties of composite resin. This suggests that the survival of dental restorations within the oral cavity could be extended by using longer photopolymerization durations.

The Influence of Popular Beverages on Mechanical Properties of Composite Resins.

Currently, composite resins are used in many restorative procedures. Previous studies showed that drinking beverages may affect the mechanical properties such as microhardness or flexural strength of dental composite resins. The aim of the present study was to investigate the influence of common beverages on the mechanical properties of composite resins. Samples of the materials were prepared according to the ISO 4049:2010 standard and producer's recommendations. The samples were next conditioned in tested fluids: distilled water, sparkling water, Coca-Cola, Red Bull and orange juice for 7 days. Vickers microhardness and flexural strength testing was performed after 7 days. Performed statistic tests confirmed the significance of microhardness changes of the tested materials in terms of both different conditioning of the samples and different composite materials. The mean flexural strength of composites was highest in distilled water and it was reduced after one week in different beverages. We conclude that all tested beverages influenced on Vickers microhardness of tested composite resins. Flexural strength only in one material was statistically significantly influenced by tested beverages. The results of this study should be taken into consideration by a dentist preparing recommendations for the patients after dental treatment with usage of composite material or after cementing composite based fixed dentures.

The Use of Botulinum Toxin and Dermal Fillers to Enhance Patients' Perceived Attractiveness: Implications for the Future of Aesthetic Dentistry.

Physical appearance and attractiveness consciously and subconsciously, affect patients' quality of life. Traditionally, dentists were tasked with improving a patient's smile, a central aspect of facial aesthetics and physical appearance. More recently, as the scope of practice of the aesthetic dentist has broadened to potentially include other components of facial cosmesis that go hand-in-hand with a patient's smile, new options have emerged with which modern aesthetic dentists should familiarize themselves. As laws surrounding their use in dental offices continue to evolve, Botox and dermal fillers represent natural next steps in aesthetic dentistry.

Analysis of different characteristics of smile.

INTRODUCTION: Analysis of smile is imperative in the diagnosis and treatment planning phases of aesthetic dentistry. AIM: To evaluate the components of smile among students of a dental institution. METHODS: Frontal view digital photographs with posed smile of 157 dental students were assessed using Adobe Photoshop7.0. Smile characteristics evaluated included; smile line, smile arc, smile design, upper lip curvature, labiodental relationship and number of teeth displayed. Data were analyzed using SPSS version 23.0. Pearson chi-square test was used to determine the gender based differences for various parameters. RESULTS: Average smile line (43.3%), consonant smile arcs (45.2%), cuspid smiles (45.9%), upward lip curvature (43.9%), maxillary anterior teeth not covered by lower lip (60.5%) and teeth displayed up to first premolars (35.7%). Gender based differences were not statistically significant except for smile arc (p value = 0.02) and number of teeth displayed (p value < 0.001). There was a significant relationship between lip curvature and smile pattern (p value < 0.001) and lip curvature and smile arc (p value = 0.01) revealing that upward lip curvature was associated with commissure type smiles and consonant smile arcs. CONCLUSIONS: The smile characteristics should be considered before beginning the aesthetic treatment of the patient to obtain adequate results in oral rehabilitation.

An fMRI Study on Self-Perception of Patients after Aesthetic Implant-Prosthetic Rehabilitation.

OBJECTIVES: In this functional magnetic resonance (fMRI) study, we investigated the activation of cerebral pathways involved in the elaboration of self-retracting photos (SELF) and the same pictures of others (OTHER). Each of the photographs showed one of the participants during different stages of the rehabilitation: pre-treatment (PRE), virtual planning using "Smile-Lynx" smile design software (VIR), and post-rehabilitation (POST). METHODS: We selected eighteen volunteers, both male and female, between 22 and 67 years of age, who previously underwent prosthetic rehabilitation. Each of them was subjected to an fMRI acquisition. Various stimuli were then shown to the subjects in the form of self-retracting photographs and photographs of other participants, all in pseudo-randomized order. We then carried out a two- stage mixed-effects group data analysis with statistical contrast targeting two main effects: one regarding the main effect of Identity (SELF vs. OTHER) and the other regarding the effect of the prosthetic rehabilitation phase (PRE vs. VIR vs. POS). All the effects mentioned above survived a peak-level of p < 0.05. RESULTS: For the effect of identity, results reported the involvement of dorsolateral frontoparietal areas bilaterally. For the phase by identity effect, results reported activation in the supplementary motor area (SMA) in the right hemisphere. A stronger activation in observing self-retracting photos (SELF) post-treatment (POST) was reported compared to the other phases considered in the experiment. CONCLUSIONS: All the collected data showed differences regarding the main effect of Identity (SELF vs. OTHER). Most importantly, the present study provides some trend-wise evidence that the pictures portraying the subject in their actual physiognomy (POST) have a somewhat special status in eliciting selectively greater brain activation in the SMA. This effect was interpreted as a plausible correlate of an empathic response for beautiful and neutral faces. The present research suggests a possible way to measure self-perception of the subject after an appearance-altering procedure such an implant-prosthetic rehabilitation. However, future clinical studies are needed to investigate this matter further.

Impacto da correção do sorriso gengival na qualidade de vida: relato de um caso clínico com gengivectomnia suficientemente invasiva e guiada / Impact of correction of gengival smiling on quality of life: report of a clinical case with sufficiently invasive and guided gengivectomy

Introduction: The gingival smile is one of the most common complaints related to aesthetics, having a varied etiology, its most common cause being altered passive eruption. To achieve better results, prior planning is required using photographs, plaster models, diagnostic waxing, allowing anticipation of the results without performing surgery. Objective: to report a clinical case of gingival smile correction through gingivectomy and osteotomy without flap displacement, assisted by a surgical guide, to assess the degree of postoperative pain and the impact of this treatment on the quality of life of the patient. Case report: A female patient presented a flat, thick periodontal biotype with a wide range of keratinized mucosa, short and square clinical crowns, a flat cervical line and gingival exposures greater than 3.0 mm, with no loss of insertion, establishing a ratio of 80% in the width / length ratio of crowns to their surgical planning. Results: After 60 days of surgery, the increase of the elements was as planned, and the periodontal tissues presented regular contours, cervical line of the convex smile, zinith of the canines and central incisors positioned more apically and distal to the lateral incisors. Conclusion: The surgical correction of the gingival smile by the gingivectomy technique with osteotomy without flap displacement had a positive impact on the quality of life of the patients in this study, generating a mild discomfort only in the first five hours postoperatively (AU)

Introdução: O sorriso gengival é uma das queixas mais comuns relacionada a estética, possuindo uma etiologia variada, sendo sua causa mais comum a erupção passiva alterada. Para melhor êxito nos resultados, é necessário um planejamento prévio utilizando de fotografias, modelos de gesso, enceramento diagnóstico, possibilitando antecipação dos resultados sem a realização cirurgica. Objetivo: relatar um caso clínico de correção de sorriso gengival por meio de gengivectomia e osteotomia sem deslocamento de retalho, auxiliada por um guia cirúrgico, avaliar o grau de dor no pós-operatória e o impacto deste tratamento na qualidade de vida da paciente. Relato de caso: Paciente do sexo feminino apresentava biótipo periodontal plano e espesso com larga faixa de mucosa ceratinizada, coroas clínicas curtas e quadradas, linha cervical plana e exposição gengival maior que 3,0 mm, com inexistência de perda de inserção, estabelecendo uma proporção de 80% na relação largura/comprimento das coroas para seu planejamento cirúrgico. Resultados: Após 60 dias da cirurgia o aumento dos elementos foi conforme ao planejado, e os tecidos periodontais apresentaram contornos regulares, linha cervical do sorriso convexa, zênites gengivais dos caninos e incisivos centrais posicionados mais apicalmente e para distal em relação aos incisivos laterais. Conclusão: A correção cirúrgica do sorriso gengival pela técnica de gengivectomia com osteotomia sem deslocamento de retalho impactou positivamente na melhora da qualidade vida da paciente deste estudo, gerando um leve desconforto somente nas cinco primeiras horas do pós-operatório. (AU)

Multidisciplinary approach for anatomical correction and diastema closure with laminates veneers: a clinical report / Abordagem multidisciplinar para correção anatômica e fechamento de diastemas com facetas laminadas: relato de caso clínico

Objective: multidisciplinary treatment has become increasingly common in dental offices and this treatment strategy is based on the achievement of a healthy, harmonious, and pleasant smile. In addition, the development of new ceramic systems and the possibility of making indirect restorations with a low thickness, such as laminates veneers, allowed combining highly satisfactory aesthetic properties, preserving the dental structure through minimally Invasive technique. Case report: this paper describes a multidisciplinary approach involving periodontics and restorative dentistry for the successful, functional, and aesthetic treatment in an adult patient. The digital smile design was performed as a guide to plan the clinical case considering factors such as tooth inclination and position, golden proportion, tooth size and shape. Discussion: based on these concepts, the present work reports, through a clinical case, the restoration of aesthetics and function with ceramic laminates veneers in lithium disilicate, in the case of anatomical correction and diastema closure. Conclusion: overall, the multidisciplinary treatment plan demonstrated to have greater advantages both for the aesthetics and function of the patient, as well as for the work team. During the 24-month follow-up, this case presented great functional and aesthetics results. (AU)

Introdução: o tratamento multidisciplinar tornou-se cada vez mais comum nos consultórios odontológicos, sendo uma estratégia baseada no tratamento da obtenção de um sorriso saudável, harmonioso e agradável. Além disso, o desenvolvimento de novos sistemas cerâmicos e a possibilidade de fazer restaurações indiretas com baixa espessura, como facetas laminadas, permitiram combinar propriedades estéticas altamente satisfatórias, preservando a estrutura dentária com o mínimo desgaste. Caso clínico: este artigo descreve uma abordagem multidisciplinar envolvendo Periodontia e Odontologia restauradora para um tratamento funcional e estético em um paciente adulto. O desenho digital do sorriso foi realizado como um guia para planejar o caso clínico, considerando fatores como inclinação e posição do dente, proporção áurea, tamanho e formato do dente. Discussão: com base nesses conceitos, o presente trabalho relata, através de um caso clínico, a restauração estética e funcional com laminados cerâmicos em dissilicato de lítio para correção anatômica e fechamento de diastemas. Conclusão: em geral, o plano de tratamento multidisciplinar demonstrou ter maiores vantagens tanto para a estética e função do paciente, quanto para a equipe de trabalho. Durante os 24 meses de acompanhamento, esse caso apresentou ótimos resultados funcionais e estéticos. (AU)

REANATOMIZAÇÃO DE DENTE CONÓIDE COM RESINA COMPOSTA POR MEIO DE TÉCNICA DE APLICAÇÃO SIMPLIFICADA / RESHAPING OF CONOID TOOTH WITH COMPOSITE RESIN USING A SIMPLIFIED APPLICATION TECHNIQUE

O sorriso com aparência agradável exerce grande influência na harmonia facial, eleva a autoestima e produz nas pessoas um sentido de autoafirmação social. Assim, fatores que interferem de modo significativo no sorriso, como dentes conóides, podem contribuir negativamente para o bem-estar e autoafirmação provenientes de um sorriso harmônico e, portanto, requerem intervenção, desde que o paciente manifeste o desejo de corrigir o problema. Dentes conóides têm alteração de tamanho, estrutura e forma, o que causa desarmonia na composição do sorriso. O presente trabalho apresenta um caso clínico de reanatomização por meio de técnica adesiva direta de um incisivo lateral, a fim de auxiliar na instalação de aparelho para correção ortodôntica. A técnica utilizada foi a preconizada pelo grupo Styleitaliano ® , como o objetivo desta técnica é simplificar os passos operatórios, apenas duas resinas de cor e uma de efeito foram utilizadas para restabelecer tamanho e forma dental. O trabalho concluiu que foi importante a integração entre a ortodontia e a estética para finalização de casos clínicos com características de alteração de forma.

A beautiful smile is often considered to have an important role on people's lives, since it contributes to self-confidence and social relationships. Therefore, dental discrepancies such as conoid teeth could affect negatively one's life and, as long as the patient desires, intervention should take place. Conoid teeth have significant alterations of basic anatomy, size and shape, which lead to a non-proportional smile. This case report regards to a reshape of a conoid lateral incisor, using direct composites, in order to help the orthodontic work. The chosen technique to provide this reshape was developed by the Styleitaliano ® group, in order to simplify the restorative steps, using only three composite shades (one for dentin, one for enamel and one for optical effect). This case report emphasizes that different dentistry areas, such as Cosmetic Dentistry and Orthodontics must perform together in order to achieve good results, especially in cases that require shape changes.

Uso da toxina botulínica na correção do sorriso gengival / Use of botulinal toxin in the correction of gengival smile

Introdução: A beleza do sorriso representa uma expressão primordial na harmonização da face, e está diretamente ligada à autoestima do indivíduo. A atividade do sorriso é determinada pela contração de músculos específicos, e pode apresentar diferentes níveis de exposição gengival. Quando maior que 3mm é denominado sorriso gengival e gera uma condição esteticamente desagradável. Entre as suas diversas causas, a hiperatividade muscular se destaca. Objetivo: apresentar uma revisão de literatura a respeito da toxina botulínica, que se tornou uma ferramenta bastante utilizada como método complementar ou exclusivo na correção do sorriso gengival. Método: Para a pesquisa, foram utilizados os seguintes descritores: toxina botulínica tipo A, estética dentária e clostridium botulinum, utilizando os operadores booleanos AND e OR, inclusos artigos em língua portuguesa, inglesa e espanhola para descrever seu histórico, mecanismo de ação, durabilidade, indicações, contraindicações e técnica de aplicação. Conclusão: Conclui-se que o seu emprego como método de tratamento conservador pelo cirurgião-dentista é viável desde que possua conhecimento da anatomia facial, interações entre os músculos e farmacologia da neurotoxina, garantindo assim segurança, melhoria na estética do sorriso e satisfação do paciente.

Introduction: The beauty of the smile represents a primordial expression in the harmonization of the face and is directly linked to the self-esteem of the individual. Smile activity is determined by the contraction of specific muscles and may present different levels of gingival exposure. When bigger than 3mm, it is called gingival smile, and generates an aesthetically unpleasant condition. Among its many causes, muscular hyperactivity is highlighted. Objective: The objective of this work was to present a literature review about botulinum toxin, which has become a widely used tool as a complementary or exclusive method for gingival smile correction. Method: The following descriptors were used: Botulinum toxin type A, dental aesthetics and clostridium botulinum, using Boolean operators AND and OR, including articles in Portuguese, English and Spanish to describe their history, mechanism of action, durability, indications, contraindications and application technique. Conclusion: It is concluded that its use as a method of conservative treatment by the dental surgeon is feasible if it has a thorough knowledge of facial anatomy, interactions between muscles and neurotoxin pharmacology, thus ensuring safety, improvement in smile aesthetics and patient satisfaction.