Dento-facial aesthetics in the eyes of adolescent patients during the Covid-19 pandemic.

Introduction: Dental malocclusions are considered a major issue in adolescence, and are often the main reason for which patients go to the dentist. Adolescents′ option to start an orthodontic treatment is questioned in the light of the restrictions imposed in the context of the Covid-19 pandemic. Aim of the study: The aim of this study was to assess adolescents’ perceptions of facial aesthetics and the impact of the Covid-19 pandemic on the decision to start an orthodontic treatment during this time, when a number of restrictions, such as face mask wearing, were imposed. Material and methods: A 15 items questionnaire was applied in the city of Oradea, Romania and distributed to orthodontic adolescent patients, with a previously diagnosed malocclusion, with ages between 12 and 17.9 years. The questionnaires were correctly filled in by 76 participants. Results: Patients tend to be affected by the aspect of their teeth (50%), and most patients considered that the aspect of their teeth forces them to socialize less (44.8%), and to avoid smiling (44.8%). 39.4% of the respondents considered that wearing a face mask is useful because it covers all dental malocclusions, and 31.6% of the respondents were not bothered that they had to wear a face mask. Conclusions: Patients declared that they were affected by the aspect of their teeth, and have a generally positive attitude regarding face masks.

Three-dimensional biomodel in the treatment of bilateral mandibular fracture sequelae: a case report

Mandibular fractures lead to changes in occlusion, aesthetic deformities and functional alterations, when untreated, their sequelae may cause permanent problems, leading to a more complex treatment than the acute trauma. The treatment offers challenges that can be minimized with the aid of biomodels, printed by 3D technology. This article aims to report a biomodel-assisted surgical procedure for mandibular reconstruction, arguing how these prototypes may help to achieve better outcomes. The patient was involved in an automobile accident and sought treatment for the sequelae of mandibular fractures two years after the initial trauma. The biomodel printing of her mandible allowed for the execution of surgery on the model, reestablishing correct occlusion and facial aesthetics, and helping shorten the surgical time through the pre-bending of reconstruction plates. The patient improved uneventfully. The use of biomodels must be encouraged, especially in cases where the patient shows sequelae, when the anatomical landmarks are compromised, they offer more predictability for treatment outcomes, as described on this case report.

Validating a Series of Photo-Numeric Rating Scales for Use in Facial Aesthetics Using Statistical Analysis of Intra- and Inter-Rater Reliability

Background Growing demand for minimally invasive aesthetic procedures to correct age-related facial changes and optimize facial proportions has been met with innovation, but has created an unmet need for objective assessment tools to evaluate results empirically. Objectives The purpose of this study is to establish the intra- and inter-rater reliability of ordinal, photonumeric, 4- or 5-point rating scales for clinical use to assess facial aesthetics. Methods Board-certified plastic surgeons and dermatologists (3 raters) performed live validation of jawline contour, temple volume, chin retrusion, nasolabial folds, vertical perioral lip lines, midface volume loss, lip fullness, and crow’s feet dynamic- and at rest- rating scales over 2 rounds, 2 weeks apart. Subjects selected for live validation represented the range of scores and included 54-83 subjects for each scale. Test-retest reliability was quantitated through intra- and inter-rater reliability, determined from the mean weighted kappa and Round 2 Intraclass Correlation Coefficients (ICC), respectively. The clinical significance of a one grade difference was assessed through rater comparison of 31 pairs of side-by-side photographs of subjects with the same grade or a different grade on the developed scales. Results The study demonstrated substantial to near-perfect intra-rater and inter-rater reliability of all scales when utilized by trained raters to assess a diverse group of live subjects. Furthermore, the clinical significance of a 1-point difference on all the developed scales was established. Conclusions The high test-retest reliability and intuitive layout of these scales provide an objective approach with standardized ratings for clinical assessment of various facial features.

Prong maxillary complete denture for better facial aesthetic: A case report

Denture teeth and denture flange are two very important aspects of a complete denture. For aesthetic purpose while fabricating the complete denture prosthesis, restoring the labial fullness is a sensitive procedure. There are some clinical situations where the labial flange gives poor facial aesthetics. It is more occur in proclined maxillary anterior ridge or thick labial cortical plate with severe labial undercut. In this article we are presenting a case with thick labial cortical plates and severe labial undercut. So, we have modified the complete denture and delivered a prong (flangeless) denture to give more aesthetic appearance to the patient.

Safe Midline Diastema Closure in the Presence of Porcelain Veneered Central Incisors

Midline maxillary diastemas have been known to have a detrimental effect on facial aesthetics. Orthodontics can successfully close a diastema using fixed appliances. Porcelain restorations bonded with fixed appliances may suffer damage. A case is presented where a fixed appliance was used to close a midline maxillary diastema bypassing porcelain veneered central incisors. Palatal attachments were used to optimise tooth movements and the porcelain veneers were left intact.

Orthognathic Surgery—LeFort I Osteotomy

Orthognathic surgery is a complex type of facial surgery that can have a profound impact on a patient's occlusal function and facial aesthetics. Close collaboration between the maxillofacial surgeon and an orthodontist is required, and the surgical team must have a strong foundation in facial analysis and firm understanding of the maxillofacial skeleton to achieve surgical success. Herein, we review the maxillary LeFort I osteotomy as it pertains to orthognathic surgery, with particular attention to the indications, contraindications, preoperative assessment, surgical technique, and possible complications encountered.