Maxillary lateral incisor agenesis and microdontia: Minimally invasive symmetric and asymmetric esthetic rehabilitation

Maxillary lateral incisor agenesis is a condition that significantly compromises smile esthetics, which is particularly worrying in young patients. This article shows how the combination of non-invasive treatments and current restorative options may improve clinical outcomes following orthodontic treatment for symmetric and asymmetric maxillary lateral incisor agenesis and microdontia. Teeth were treated with conservative resin restorations in three separate cases: two of congenitally missing maxillary lateral incisors (i.e., unilateral and bilateral) and one of microdontia. After presenting the clinical results, this article summarizes how bleaching, enameloplasty, and bonding with composite resin can enhance esthetics and functions following orthodontic space closure. The cases reveal that carefully planned, methodically executed orthodontic and restorative approaches can achieve predictable, esthetic outcomes that will improve the patient’s self-esteem with a minimally invasive solution.

Detailed three-dimensional orthodontic tooth repositioning to improve restorative outcome:

ABSTRACT The case describes the interdisciplinary treatment of a 23-year-old woman with a Class III malocclusion, missing an upper right lateral incisor, abrasion of the maxillary incisal edges, anterior gingival margin discrepancies, and gingival recession. Initially, the patient was treated with fixed appliances combined with orthognathic surgery. The extraction of the upper left lateral incisor and bilateral canine substitution plan was chosen. At the end of the surgical and orthodontic treatment, the restorative treatment with six veneers was accomplished to improve smile esthetics. Despite the missing lateral incisors, the patient showed a natural, good-looking final result. A symmetric incisal plane was established, a functional occlusion with average vertical and horizontal overlap was set, and the bone scallop and consequently the gingival margins were leveled. The interdisciplinary approach hid all of the initial esthetic defects of the case. The result highlights how to obtain a remarkable improvement of the smile outcome with a well-functioning masticatory system.

Application of Visagism Concept to Assess the Co-Relation between the Temperament and Smile Esthetics: A Clinical Study

Background: Ability of a person to express a wide range of emotions with the movement of teeth and lips is called as a smile. Dentogenic concept considers gender, personality, age in harmonizing shapes of teeth with the face. Personality is unique for an individual. Unveiling personality traits, desires of the individual, translating them into natural tooth shapes to maintain the psychodentofacial harmony poses a major challenge to the clinician in designing a smile. Visagism is a novel concept that helps the dentists in providing restorations that involve esthetics psychological and social features of the created image, which influences the individual’s emotions. It involves the customization of an image. Aim and Objectives: To assess the co-relation between the smile esthetics and mental temperaments or personalities through the application of the concept of visagism. Methodology: A Digital camera (DSLR) for capturing the photographs and smile designing software will be used. Each subject will be instructed to occlude the teeth while capturing photographs. A validated questionnaire study will be conducted that will help to discover temperament of the subject. The answers will be evaluated and maximum score of the responses out of the list will be dominant temperament in that individual. Expected Outcome: Co-relation between this study might help clinicians to accurately assess the correlation between the temperament and the smile esthetics and eventually develop proper customisation of a smile with respect to the personality of the patient. Conclusion: If computer-assisted smile design and application of visagism concept would be accurate and reproducible, this might help and improve the planning of smile designing, the oral rehabilitations.

Perception about Importance of Buccal Corridor and its Width in Smile Esthetics

Aim: To assess the perception of dental students and house officers regarding role of buccal corridor in smile esthetics and to determine the most esthetically pleasing buccal corridor width. Methods: A photograph of the patient’s face, smiling with the teeth visible up to the first molar was modified digitally to create smiles with no buccal corridor, increasing buccal corridors widths of 5%, 10%, 15%, 20 % and 25% respectively compared with the width of inner oral commissure. A total of 376 dental students and HOs participated in the study and data was collected in questionnaires. Results: Buccal corridor is considered to affect the smile esthetics of an individual by 72.4% of house officers, 67.6% of second year students, 48.7% of 3rd year students and 52.4% of fourth year students(P value: 0.002). Visibility of around 5-10% of buccal corridor was considered most esthetically pleasing, however, the result was not significant. Conclusion: Buccal corridor is an important component in smile esthetics considered by students and house officers of dental colleges. Buccal corridor width of 5-10 % was considered most esthetically pleasing among participants. Keywords: Buccal corridor, Esthetics, perception

Effect of Buccal Corridors Width on Smile Quality and Esthetics

OBJECTIVE: To assess the perception of buccal corridor width on smile esthetics by Orthodontic residents, General dentists and Laypersons. METHODOLOGY: A smile photograph was taken of an adult female. The image was modified to obtain five different buccal corridor widths and were assessed by different evaluators grouped into general dentist, orthodontic resident and laypersons who rated the attractiveness of each smile by means of a visual analog scale (VAS). Sample size was 97 participants to rate the picture. Non-probability purposive sampling was done The data was analyzed and mean and SD were calculated for the scores of rating. ANOVA and Tukey's post hoc test was applied to compare the different ratings of buccal corridors in three groups. The data of this cross sectional study was collected from general population belonging to different communities, general dentists and orthodontic residents of different dental colleges of Karachi, Pakistan from August 2019 to March 2020. RESULTS: There were 97 participants who responded to the images. Highest scores were obtained for Image 1 having buccal corridor width ratio of 16% followed by image no. 3 having buccal corridor width ratio of 10% and lowest scores were obtained for Image no. 6 having least buccal corridor widths ratio that is 34% followed by image no 5 having 26% buccal corridor widths. Among the groups of participants, the highest scores were given by laypersons for all images. Significant differences were observed between evaluation of groups of Orthodontic resident and layperson in most images. CONCLUSION: There was a remarkable influence of buccal corridor width on smile esthetics, with the 16% ratio group being rated as the most attractive by all three groups. KEYWORDS: Buccal corridors, Smile, esthetics, Attractiveness

Smile microesthetics as perceived by dental professionals and laypersons

ABSTRACT Objectives To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated. Materials and Methods A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model. Results The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P < .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons. Conclusions The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.

Effect of anterior overbite malocclusion on smile esthetics in adult patients

Objective To investigate whether overbite affects smile esthetics. Methods This study involved 106 patients with complete pretreatment records. Lateral cephalometric tracings were used to measure hard tissue variables. Frontal smile and upper occlusal photographs were used to measure nine smile esthetic variables: arc ratio, number of teeth, upper incisor exposure, upper midline, buccal corridor ratio, smile index, archform index, lower teeth exposure, and interlabial gap. The patients were classified into three groups according to their overbites (B1: 0–4 mm, B2: >4 mm, and B3: <0 mm). Analysis of variance was performed to compare 14 cephalometric measurements and the 9 smile esthetic variables. Multiple linear regression analysis was performed to determine the influencing cephalometric factors. Results Only upper incisor exposure was significantly different among the groups. In the multiple linear regression analysis, upper incisor exposure was positively associated with the distance from the upper incisor to the palatal plane in Group B2. No significant correlations were observed between cephalometric measurements and smile variables in Groups B1 and B3. Conclusions Smile variables were not significantly different among patients with various overbite malocclusions with the exception of upper incisor exposure. Overbite malocclusions do not appear to influence smile esthetics in adult patients.