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Ferlias N, Gjørup H, Doherty MA, Pedersen TK. Pycnodysostosis: Characteristics of teeth, mouth and jaws. Orthod Craniofac Res 2024; 27:656-664. [PMID: 38532649 DOI: 10.1111/ocr.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES To describe the clinical and radiographic oro-dental characteristics of patients with pycnodysostosis (PDO). MATERIALS & METHODS A short interview and clinical examination of seven patients with PDO were performed as well as assessment of the temporomandibular joints and masticatory muscles using the diagnostic criteria for temporomandibular disorders, DC-TMD form. A full set of records were taken including photos and intraoral scan. Finally, existing cone beam computed tomography (CBCT) images and radiographs were also studied. RESULTS All patients presented with bimaxillary micrognathia, five had a convex profile, and two had a straight profile. In addition, posterior open bite, Angle Class III molar relation with accompanying anterior crossbite and a grooved median palate were common findings. No patient showed symptoms of temporomandibular disorder (TMD) apart from some clicking. Finally, the main radiographic findings were the obtuse mandibular angle, the frontal bossing, the elongation of the coronoid/condylar process and the presence of hypercementosis with obliterated pulp chambers. CONCLUSION The examined patients with PDO were characterized by dental crowding, malocclusion (anterior crossbite, posterior open bite), hypercementosis, obliterated pulp chambers and deviations in mandibular morphology. In conclusion, patients with PDO have a specific need for dental and orthodontic monitoring with focus on crowding and posterior open bite. The patients will benefit from a long-term orthodontic plan including extractions.
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Affiliation(s)
- Nikolaos Ferlias
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Hans Gjørup
- Department of Oral and Maxillofacial Surgery, Center for Oral Health in Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Mia Aagaard Doherty
- Childhood Cancer Research Group, Danish Cancer Research Institute, Copenhagen, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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2
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Reis INR, Damin GB, Pereira CR, Ichigi MDA, Sant'Anna LOC, Spin-Neto R, Romito GA. Digital Planning to Enhance Diagnosis and Precision in Correcting Excessive Gingival Display in the Presence of Asymmetrical Maxillary Position: A Case Report. Eur J Dent 2024. [PMID: 38744324 DOI: 10.1055/s-0044-1785535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
This case report addresses the treatment of excessive gingival display (EGD) in the context of maxillary asymmetry, zenith irregularities, and occlusal plane inclination. Digital planning was pivotal in formulating a precise treatment strategy by incorporating facial photographs, digital models, and cone-beam computed tomography data. Parameters, including occlusal plane inclination, teeth position, and lip-to-gingival margin relationships, were considered to ensure treatment alignment with the patient's facial characteristics. Notably, during the planning phase, it was evident that the conventional approach using the cementoenamel junction as the apical limit for incisions would result in asymmetry. Consequently, the gingival margin position was defined in accordance with facial and lip features. The chosen treatment, flapless crown lengthening, was tailored to the patient's thin phenotype and guided by measurements derived from digital planning. Postsurgery, the patient experienced a swift and painless recovery. A harmonious smile with a stable gingival margin position was achieved at the 1-year follow-up, seamlessly complementing the patient's facial attributes. This case underscores the importance of personalized EGD treatment and the value of digital planning in enhancing diagnostic accuracy and precise treatment planning, ultimately facilitating optimal treatment strategies.
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Affiliation(s)
- Isabella Neme Ribeiro Reis
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gabriel Bittencourt Damin
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Camilla Rodrigues Pereira
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Matheus de Alencar Ichigi
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luiza Orsi Caminha Sant'Anna
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, School of Dentistry, Aarhus University, Aarhus, Denmark
| | - Giuseppe Alexandre Romito
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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3
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Tatakis DN, Paramitha V, Lu WE, Guo X. Upper lip characteristics and associated excessive gingival display etiologies in adults: Race and sex differences. J Periodontol 2024; 95:74-83. [PMID: 37436716 DOI: 10.1002/jper.23-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND This cross-sectional study aimed to examine upper lip (UL) and smile characteristics and soft tissue excessive gingival display (EGD) etiologies (hypermobile upper lip [HUL], altered passive eruption [APE], and short upper lip [SUL]) in a nondental adult population and to analyze interracial (Black and White) and intersex differences. METHODS Community participants, non-Hispanic Blacks (NHB) and non-Hispanic Whites (NHW), were recruited and examined for UL vertical dimensions at rest and maximum smile and for HUL, APE, and SUL. Associations between gingival display (GD) or EGD and UL anatomical characteristics, HUL, APE, and SUL were analyzed. RESULTS Participants included 66 NHB and 65 NHW adults. Ergotrid height (greater among NHW; p = 0.019) averaged 14.0 mm. Upper lip vermilion length (ULVL), total UL length, internal lip length, total UL length during smile, and UL mobility averaged 8.6, 22.5, 23.1, 16.6, and 5.9 mm, respectively (all significantly greater in NHB; p ≤ 0.012). SUL prevalence was 4.6%, found only among NHW. Lip length change from rest to smile (LLC) averaged 26.2% (significantly greater in females; p = 0.003). HUL prevalence was 10.7% (NHB 13.1%, NHW 3.5%; p = 0.024). NHB had significantly greater GD (p ≤ 0.017). EGD and APE prevalence (6.9% for both) showed significant interracial and intersex differences (p ≤ 0.014). Multivariate logistic regression analyses indicated that LLC and HUL were the most consistently significant EGD determinants. CONCLUSIONS UL anatomical and functional characteristics and soft tissue-related EGD etiologies exhibit significant interracial and intersex differences, with UL mobility/hypermobility being the most consistently significant determinant of GD.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Vanessa Paramitha
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
- Private Practice, Jakarta, Indonesia
| | - Wei-En Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Xiaohan Guo
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
- Global Biometric and Data Management, Pfizer, New Jersey, USA
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Adel N. Modified Lip Repositioning Surgery with and without Dual-layered Suturing for Treatment of Gummy Smile Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5521. [PMID: 38264443 PMCID: PMC10805458 DOI: 10.1097/gox.0000000000005521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/07/2023] [Indexed: 01/25/2024]
Abstract
Background The present study was performed to evaluate the differences in the efficacy of treating excessive gingival display with the standard modified lip repositioning surgery or the modified lip repositioning surgery with dual-layered suturing. Methods This study included 20 female patients who had a gummy smile resulting from upper lip hypermobility or short upper lip. Preoperative measurements of the amount of gum exposure were taken during involuntary smiling. The patients were randomly divided into two groups; the first group was treated with the standard technique, whereas the second group was treated with the double-layered suturing method. All patients were followed up at 14 days, 3 months, and 6 months; postoperative assessment was done by measuring the changes in the gingival display during spontaneous smiling. Results Postoperative measurements at 14 days follow-up showed a significant reduction in the amount of gingival exposure in both groups. However, at 3 months, there was a complete relapse for the first group of patients, whereas the second group showed a slight regain in the amount of gum exposure, though the latter group showed a complete relapse at 6 months postoperative. Conclusions The dual-layered suturing for the modified lip repositioning surgery did not provide any long-term improvement for treating gummy smile patients; however, it did delay the relapse to a certain extent for the first 3 months postoperative in some of the patients.
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Affiliation(s)
- Noury Adel
- Oral and Maxillofacial Surgery Specialist, Private Practice, Cairo, Egypt
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Adel N. Botulinum Toxins and Lip Repositioning Surgery with Repeated Botulinum Toxin Injection: A Combined Approach for Gummy Smile Treatment. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5198. [PMID: 37588474 PMCID: PMC10427068 DOI: 10.1097/gox.0000000000005198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023]
Abstract
This study was conducted to evaluate the longevity and efficacy of neurotoxin injection before lip repositioning surgery in addition to reinjection of two sustaining doses along three different postoperative intervals (2, 4, and 8 months). This experimental study included 10 female patients who had a gummy smile resulting from upper lip hypermobility or short upper lip. Preoperative measurements were taken during spontaneous smiling: the interlabial distance and the amount of gingival exposure. IncoBotulinum Toxin A was injected into the elevator muscles of the upper lip followed by performing the lip repositioning surgery after 2 weeks of IncoBotulinum Toxin A injection. IncoBotulinum Toxin A was then reinjected at three different postoperative intervals (2, 4, and 8 months). All patients were followed up at 14 days, 4 months, 8 months, and 12 months. Postoperative measurements at 14 days follow-up showed a significant reduction in the amount of gum exposure and in the interlabial distance during smiling. Both changes remained stable up to 1 year, despite the minimal relapse that was observed; all the patients reported a high degree of satisfaction. Combining neurotoxins before and after the lip repositioning surgery may provide long-lasting results up to 1 year and better stability for the success rate of the surgery, where the use of each approach alone (IncoBotulinum Toxin A alone/surgery alone) may offer a temporary improvement.
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Affiliation(s)
- Noury Adel
- Oral and Maxillofacial Surgery Specialist, Private Practice, Cairo, Egypt
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6
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Su ED, Chen YH, Zhang CY, Yu H. Effect of smile esthetics on the quality of life in a Han Chinese population. J ESTHET RESTOR DENT 2023; 35:303-308. [PMID: 36573304 DOI: 10.1111/jerd.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study aimed to explore the influence of smile esthetics on the quality of life in a Han Chinese population. METHODS A total of 110 Han Chinese volunteers (52 males and 58 females, mean age 26.7 years) were recruited, and frontal images of their smiles were collected. A photoediting program was used to evaluate the following components of smile esthetics: the buccal corridor ratios, the angle between the interpupillary and commissural lines, the number of visible teeth, and width-to-length ratios of the maxillary central incisors. Oral health-related quality of life (OHRQoL) in these volunteers was evaluated using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile-14 (OHIP-14). Statistical analyses were performed by using Pearson's correlations and multiple linear regression (α = 0.05). RESULTS Compared to males, females scored higher on psychological impact (p = 0.017). Moreover, the number of visible teeth had a significant effect on social impact, psychological impact and esthetic concern (all p < 0.05). However, the buccal corridor ratios, the angle between the interpupillary and commissural lines, and the width-to-length ratios of the maxillary central incisor did not correlate with the OHRQoL (all p > 0.05). CONCLUSIONS The number of visible teeth significantly influenced the quality of life in a Han Chinese population. Smile esthetics had a significantly greater psychological impact on females than males. CLINICAL SIGNIFICANCE This study highlights the effects of smile esthetics on the quality of life in a Han Chinese population. Female patients may raise more esthetic concerns in clinical practice.
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Affiliation(s)
- En-Dian Su
- Department of Implantology, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ying-Hui Chen
- Department of Stomatology, Fujian Provincial Hospital, Fuzhou, China.,Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Chang-Yuan Zhang
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Hao Yu
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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7
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Calvert G, Cocozza PG, Elsayed Ahmed K. Clinical factors to consider in definitive treatment planning for patients with tooth wear. Br Dent J 2023; 234:375-384. [PMID: 36964358 DOI: 10.1038/s41415-023-5618-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 03/26/2023]
Abstract
Diagnosis, disease control and prevention are the precursors to successful definitive restorative treatment of pathological tooth wear. This case series illustrates how proposed key clinical features can influence treatment complexity and provide the clinician with a logical sequence of treatment options for definitive management of tooth wear.
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Affiliation(s)
- Gareth Calvert
- Glasgow Dental Hospital and School, Department of Restorative Dentistry, Glasgow, G2 3JZ, UK
| | - Paul Guerino Cocozza
- Glasgow Dental Hospital and School, Department of Restorative Dentistry, Glasgow, G2 3JZ, UK.
| | - Khaled Elsayed Ahmed
- School of Medicine and Dentistry, Griffith University, Queensland, 4215, Australia
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8
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A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment. Int J Dent 2022; 2022:3972150. [PMID: 36284524 PMCID: PMC9588359 DOI: 10.1155/2022/3972150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/01/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022] Open
Abstract
A new technique is proposed in this study to correct the gummy smile (GS) with myotomy, combining lip repositioning with the insertion of polyester threads at the surgical site to act as a physical barrier and control relapse. 11 patients were clinically assessed (30.2 ± 7.43 years old, 90.9% females and 9.10% males). All patients presented gingival display (GD) greater than 4 mm. Hypermobile upper lip (HUL), vertical maxillary excess (VME) + HUL, altered passive eruption (APE) + HUL, and VME + APE were the etiologies identified. Three polyester threads were inserted in each patient one month after the surgery. The GS was measured before, 6 months, and 12 months after the surgery. The results showed a reduction in the mean GD of the patients, 4.42 mm after 6 months (p value = 0.000) and 4.13 mm after 12 months (p value = 0.000). The largest relapse was 0.29 mm and was not statistically significant (p value = 0.07). The Friedman test with pairwise comparisons was used to determine the existence of statistically significant differences in GD between the periods analyzed. The results showed that the proposed technique was successful in treating GS, presenting significant reductions in the GD 12 months after surgery and controlling the relapse.
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9
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Gingivectomy with high-power laser for correction of the gummy smile resulting from altered passive eruption-a case series. Lasers Med Sci 2022; 37:2999-3009. [PMID: 35661938 DOI: 10.1007/s10103-022-03586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
Abstract
To compare the efficacy between the surgical techniques of gingivectomy with high-power laser (HPL) and conventional gingivectomy for correction of a gummy smile (GS) due to altered passive eruption (APE). This was a case series of six female patients diagnosed with GS associated with APE. For the conventional gingivectomy procedure and for the one using the diode laser (808 nm, 2 W, in continuous mode), the six upper anterior teeth were divided into two groups (control (CG)-# 11, # 12, # 13, and test (TG)-# 21, # 22, # 23). Analyses of intraoperative bleeding and levels of pain and postoperative tissue repair were performed. The thermal pattern analysis was performed using infrared thermography. The level of significance was set at p < 0.05. There was no intraoperative bleeding in the TGs (p = 0.002). The CG showed tissue repair significantly better than the TG on the 14th postoperative day (p = 0.004). There were no statistically significant differences regarding the level of postoperative pain between the groups (p > 0.05). Regarding the thermographic analysis, there were also no statistically significant differences (p > 0.05). HPL gingivectomy was more effective, regarding the absence of intraoperative bleeding, while the conventional technique promoted better tissue repair. No significant differences were observed in the other parameters, possibly due to the minimal damage caused by gingivectomy, with either HPL or the conventional procedure, as there was no removal of bone tissue.
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10
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Flórez PRB, Guzmán JA, Orozco Páez J. Laser-Assisted Lip Repositioning Surgery: A Modification to The Conventional Technique. J Lasers Med Sci 2022; 13:e22. [PMID: 35996488 PMCID: PMC9392887 DOI: 10.34172/jlms.2022.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/08/2022] [Indexed: 09/22/2023]
Abstract
Introduction: The lip repositioning surgical technique arose with the objective of correcting and harmonizing the act of smiling. Since the conventional technique was published, some modifications of the technique have been proposed in order to counteract postoperative recurrence and to achieve the best esthetic appearance of the smile. The objective of this paper was to describe the laser-assisted lip repositioning technique (laser-assisted LRS) with a 940nm diode laser and 2780nm Er,Cr: YSGG, as a modification to the conventional lip repositioning technique, for the treatment of a gummy smile. Case Report: The proposed technique consists in achieving the descent of the upper lip by removing the intraoral mucosal band through the laser peeling of oral mucosa, preserving the connective tissue intact for healing by secondary intention. The technique was implemented in two patients with a diagnosis of a gummy smile caused by a short and hyperactive upper lip; the healing process was satisfactory, and there was no bleeding or postoperative edema. Postoperative controls were performed at 3 and 10 months, and no recurrence was found. Conclusion: the 940nm Diode laser or 2780nm Er,Cr: YSGG laser-assisted lip repositioning technique described here is less invasive than that performed with a conventional scalpel, offers aesthetic results, lower risk of infection and recurrence of the gummy smile in the long term.
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Silva CO, Rezende RI, Mazuquini AC, Leal VC, Amaral GSA, Guo X, Tatakis DN. Aesthetic crown lengthening and lip repositioning surgery: Pre- and post-operative assessment of smile attractiveness. J Clin Periodontol 2021; 48:826-833. [PMID: 33745186 DOI: 10.1111/jcpe.13461] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/04/2021] [Accepted: 03/09/2021] [Indexed: 12/20/2022]
Abstract
AIM To assess the effect of aesthetic crown lengthening (ACL) and lip repositioning surgery (LRS) on perception of smile attractiveness. MATERIALS AND METHODS Preoperative and 6-month postoperative smile photographs of ACL- or LRS-treated patients were evaluated by 100 raters (five gender-balanced groups of ten per procedure) of diverse background (dental students, general dentists, periodontists and laypersons with and without any aesthetic concerns about their own smile). Smile attractiveness was rated by visual analogue scale (VAS). Multivariate mixed-effect models were applied to determine the effect of procedure, rater (age, gender and group) and case (gingival display and GD) on smile attractiveness rating. RESULTS Average preoperative and postoperative VAS scores for ACL patients were 3.8 ± 2.0 and 6.2 ± 1.9, respectively. Corresponding LRS patient values were 4.8 ± 2.0 and 6.4 ± 1.9. Treatment, baseline GD and rater age were significant determinants (p < .001) of smile attractiveness for both procedures. Rater gender was not significant. Rater group was significant (p < .032) only for ACL. Procedure (p < .001), baseline VAS (p < .001), change in GD (p ≤ .002) and rater age (p ≤ .017) were significant determinants of smile attractiveness change from preoperative to postoperative. CONCLUSIONS ACL and LRS are two periodontal plastic surgery procedures that deliver significant smile attractiveness improvements, in the eyes of both laypersons and dental professionals.
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Affiliation(s)
- Cléverson O Silva
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | - Robson I Rezende
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | | | - Vinicius C Leal
- School of Dentistry, Ingá University (UNINGÁ), Maringá, Brazil
| | | | - Xiaohan Guo
- Department of Statistics, College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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Martos J, Gomes G, Oliveira Corbellini A, Rotta W, Boeira G. Interdisciplinary esthetic approach in clinical dental rehabilitation. J Conserv Dent 2021; 24:519-523. [PMID: 35399760 PMCID: PMC8989164 DOI: 10.4103/jcd.jcd_441_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/22/2021] [Accepted: 11/09/2021] [Indexed: 11/04/2022] Open
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13
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Baldo Moraes R, Knorst JK, Brondani B, Baldo Marques B, de Sousa Reis M, Henriqson D, Ardenghi TM. Relationship between gingival bleeding and associated factors with reports of verbal bullying in adolescents. J Periodontol 2020; 92:225-233. [PMID: 32716571 DOI: 10.1002/jper.19-0745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/29/2020] [Accepted: 06/06/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Dentofacial features are related to increased bullying episodes in young people. The aim of this study was to assess the association between gingival bleeding and reports of verbal bullying among adolescents. METHODS This is a cross-sectional study conducted with a representative sample of 608 12-year-old adolescents from southern Brazil. The occurrence of verbal bullying was verified through adolescents' self-report. Oral health measurements included the presence of gingival bleeding, dental fracture, dental fluorosis, and dental caries experience. Gingival bleeding was assessed through adolescent self-perception by the following question: "Did you notice any bleeding in your gums?" Demographic, socioeconomic, and psychosocial variables were also evaluated. Poisson regression models with robust variance were used to evaluate the influence of gingival bleeding on the occurrence of verbal bullying. Results are presented as prevalence ratio (PR) and 95% confidence interval (95% CI). RESULTS Out of 608 adolescents evaluated, 577 answered bullying questions. The prevalence of self-reported verbal bullying was 12.8%. Adolescents who presented gingival bleeding had an 80% higher prevalence of verbal bullying than their counterparts (PR 1.80; 95% CI 1.01 -3.19). Dental shame, speech difficulties and influence of dental condition on studies also impacted the higher prevalence of bullying. CONCLUSION Our results suggest that the presence of gingival bleeding negatively impacts the social life of adolescents, causing more episodes of verbal bullying. These findings encourage public health policies aimed at reducing oral health inequities, thus reflecting on the well-being and quality of life of this target population.
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Affiliation(s)
- Renita Baldo Moraes
- Department of Nursing and Dentistry, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Bruna Brondani
- Department of Pediatric Dentistry and Orthodontics, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Beatriz Baldo Marques
- Department of Nursing and Dentistry, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Magda de Sousa Reis
- Department of Nursing and Dentistry, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | | | - Thiago Machado Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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14
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Hexsel D, Dal'Forno T, Camozzato F, Valente I, Soirefmann M, Silva AF, Siega C. Effects of different doses of abobotulinumtoxinA for the treatment of anterior gingival smile. Arch Dermatol Res 2020; 313:347-355. [PMID: 32725500 DOI: 10.1007/s00403-020-02096-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/13/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
Botulinum toxin type A (BoNT-A) is an easy and fast treatment for gingival smile (GS). The objective of the study was to compare the reduction of gingival exposure using three different doses of abobotulinumtoxinA (ABO) in patients with different severities of anterior GS, and to assess treatment safety and patients' satisfaction. A prospective, single-center, randomized, double-blind study was conducted. Mild GS (2 to < 3 mm) was treated with 2.5 U of abobotulinumtoxinA (ABO) per side, moderate GS (3 to < 4 mm) with 5 U of ABO per side, and severe GS (4 mm or more) with either 2.5 U, or 5 U or 7.5 U of ABO per side. All the 41 enrolled patients completed the study. The mean gingival exposure reduced significantly 4 and 12 weeks after treatment. The average reduction of gingival exposure with 5 U was significantly larger than that obtained with 2.5 U, (3.46 ± 1.39 vs. 2.05 ± 1.29 mm; p = 0.004). All groups of GS severity presented statistically significant reduction in the gingival exposure 4 and 12 weeks after ABO injections. Twelve weeks after treatment, more than 80% of the patients were satisfied or very satisfied. There were no treatment-related adverse events reported by the patients or noticed by the investigators. Gingival smile can be safely and effectively managed with BoNT-A injections and specifically with ABO injections to target the LLSAN muscle. Further and larger studies may determine the exact influence of each factor on BoNT-A treatments of GS.
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Affiliation(s)
- Doris Hexsel
- Brazilian Center for Studies in Dermatology, Dom Pedro II 1592, Porto Alegre, RS, 90550-141, Brazil.
| | - Taciana Dal'Forno
- Brazilian Center for Studies in Dermatology, Dom Pedro II 1592, Porto Alegre, RS, 90550-141, Brazil.,Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernanda Camozzato
- Brazilian Center for Studies in Dermatology, Dom Pedro II 1592, Porto Alegre, RS, 90550-141, Brazil
| | - Indira Valente
- Brazilian Center for Studies in Dermatology, Dom Pedro II 1592, Porto Alegre, RS, 90550-141, Brazil
| | - Mariana Soirefmann
- Brazilian Center for Studies in Dermatology, Dom Pedro II 1592, Porto Alegre, RS, 90550-141, Brazil
| | - Aline Flor Silva
- Brazilian Center for Studies in Dermatology, Dom Pedro II 1592, Porto Alegre, RS, 90550-141, Brazil
| | - Carolina Siega
- Brazilian Center for Studies in Dermatology, Dom Pedro II 1592, Porto Alegre, RS, 90550-141, Brazil
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15
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Abstract
Patient-based outcomes complement clinical data with patients' self-evaluation of their physical, psychological, and social well-being, and as such facilitate clinical decision-making, assessing the quality of care provided, and evaluating practices and policies. Some validated generic oral health-related quality of life measures used in recent research indicated a high performance. There is a proportional relationship between the quality of life and periodontitis, ie, the higher the level of periodontitis, the poorer the oral health-related quality of life. This relationship is heightened by the presence of symptoms such as bleeding, halitosis, and mobility. On the other hand, periodontal treatment has demonstrated the capability to improve quality of life substantially. Future research should focus on questionnaires that are able to explain the interlinked pathways between periodontal conditions, approaches to treatment approaches, and patients' well-being. The acquisition of new knowledge in the field is essential for the whole community, as we treat people not millimeters.
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Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, UCL, London, UK
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16
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Oliveira LM, de David SC, Ardenghi TM, Moreira CHC, Zanatta FB. Gingival inflammation influences oral health-related quality of life in individuals living in a rural area of southern Brazil. J Clin Periodontol 2020; 47:1028-1039. [PMID: 32558954 DOI: 10.1111/jcpe.13333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 12/25/2022]
Abstract
AIM The aim of the present cross-sectional study was to evaluate whether the extent levels of gingival inflammation (GI) in whole mouth or restricted to the anterior region are independently associated with oral health-related quality of life (OHRQoL) in individuals living in a rural area of southern Brazil. MATERIALS AND METHODS A probability sample of 688 individuals was submitted to a full-mouth periodontal examination at six sites on each tooth. Extent levels of GI in whole mouth and restricted to anterior region were dichotomously considered when bleeding on probing (BoP) occurred at 20% or more of whole-mouth sites and at 10% or more of anterior region sites, respectively, in individuals with probing depths ≤3 mm, totalling 121 individuals analysed, aged 15-82 years. OHRQoL was assessed using the simplified version of the Oral Health Impact Profile (OHIP14 ) questionnaire. Adjusted multilevel Poisson regression analysis was used with a conceptual hierarchical approach to calculate the rate ratio (RR) of OHIP14 scores. RESULTS In the adjusted model, higher extent levels of full-mouth GI (RR = 1.23; 95% confidence interval [CI]: 1.06-1.44; p = .004) and GI restricted to the anterior region (RR = 1.29; 95% CI: 1.11-1.51; p ≤ .001) were significantly associated with poorer OHRQoL. CONCLUSIONS The extent of GI in whole mouth (≥20% of sites with BoP) and in the anterior region (≥10% of sites with BoP) was independently associated with OHRQoL in individuals living in a rural area.
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Affiliation(s)
- Leandro M Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Silvia C de David
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Carlos H Cunha Moreira
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Fabrício B Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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17
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Abstract
Some tools can be used as an aid to the surgical planning for gummy smile correction, such as digital smile design (DSD), which allows to determine patterns of harmony and eventual asymmetries between teeth and gums. This work aims to report a gummy smile correction using DSD as reverse planning. The clinical examination revealed the presence of gummy smile and extensive bone exostosis in the premolar region. DSD was performed in the upper arch, determining the amount of gingiva to be removed, thus providing more safety and precision to the procedure. The surgery was performed by performing using an internal bevel incisions, detachment of a full thickness flap, and osteotomy and osteoplasty. After 6 months of preservation, there was an increase in the clinical crown of the teeth, with smile harmony, less exposure of the gingiva in the smile and a high level of patient aesthetic satisfaction.
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Affiliation(s)
| | | | - Luciana P Maia
- Dental School, University of Western São Paulo - UNOESTE, Presidente Prudente, Brazil
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18
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Boeira PO, De Rossi A, Caporossi LS, Lima GDS. Periodontal esthetic surgery to improve a natural smile: Report case with 2-year follow-up. J Indian Soc Periodontol 2019; 24:87-91. [PMID: 31983852 PMCID: PMC6961458 DOI: 10.4103/jisp.jisp_477_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 04/25/2019] [Accepted: 05/04/2019] [Indexed: 11/05/2022] Open
Abstract
The objective in this case report is to present a correction of excessive gingival exposure performed through periodontal esthetic surgery, using clinical crown lengthening and lip repositioning. The patient reported discomfort when smiling due to excessive gingival exposure, and clinical and photographic examinations of the patient showed vertical maxillary growth as the main diagnosis. In the digital smile design, the possibility of crown lengthening observed for teeth – upper left and right central incisors and upper left lateral incisor. A lip-repositioning procedure was also planned. An incision was performed at the mucogingival junction, and a parallel incision was realized at the top of the alveolar mucosa. Afterward, the incised gingival band was removed through vertical incisions in the planned border area. The muscular area was preserved. A simple suture was made, with the approach of the gingival margins around the surgical area. The crown-lengthening procedure was performed with the flapless technique. After 2-year follow-up, the periodontal esthetic surgery, comprising crown lengthening and lip repositioning, was noninvasive and can thus serve as an interesting alternative treatment for excessive exposure of the gingival smile, as it results in a harmonious and natural smile.
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Affiliation(s)
- Peterson Oliveira Boeira
- Department of Operative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alexandre De Rossi
- Department of Operative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Leonardo Stephan Caporossi
- Department of Operative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Giana da Silveira Lima
- Department of Operative Dentistry, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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19
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Altay MA, Sindel A, Tezerişener HA, Yıldırımyan N, Özarslan MM. Esthetic evaluation of implant-supported single crowns: a comparison of objective and patient-reported outcomes. Int J Implant Dent 2019; 5:2. [PMID: 30613918 PMCID: PMC6321832 DOI: 10.1186/s40729-018-0153-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/09/2018] [Indexed: 11/27/2022] Open
Abstract
Background This study investigated objective and patient-reported esthetic outcomes and their correlation for single-tooth implant restorations in the maxillary anterior region. Methods Nineteen patients were included. Gingival biotypes and smile lines were evaluated. Esthetic evaluation was performed according to the pink and white esthetic scores (PES and WES). Patients rated their satisfaction regarding the implant treatment using a subjective outcome questionnaire and a 10-cm visual analogue scale (VAS). Results The mean PES and WES were 10.7 (range 5–13, SD ± 2.24) and 8.6 (range 8–10, SD ± 0.60), respectively. The overall mean VAS was 8.54 ± 0.36 (range 3.8–9.8). No significant correlation was found between VAS and PES or WES (p = 0.475, p = 0.984, respectively). PES and WES scores for gingival biotypes failed to show any statistically significant difference (p = 0.701, p = 0.831). There was a significant negative correlation between the smile line and VAS; indicating that patients with lower smile lines expressed higher patient satisfaction (p = .001). Conclusions Professionally reported esthetic outcomes (PES and WES results) may not correlate with patient-reported outcomes. Smile line is a significant factor in patient satisfaction, which should be evaluated thoroughly prior to implant placement in the anterior maxilla.
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Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey.
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
| | - Hüseyin Alican Tezerişener
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
| | - Nelli Yıldırımyan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
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20
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Andijani RI, Tatakis DN. Hypermobile upper lip is highly prevalent among patients seeking treatment for gummy smile. J Periodontol 2018; 90:256-262. [DOI: 10.1002/jper.18-0468] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/23/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Reem I. Andijani
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH
| | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH
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21
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MARONEZE MC, GOERGEN LM, SOUZA RCLD, ROCHA JMD, ARDENGHI TM. Edema and gingival bleeding in anterior region have a negative influence on quality of life of adolescents. Braz Oral Res 2018; 32:e112. [DOI: 10.1590/1807-3107bor-2018.vol32.0112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/21/2018] [Indexed: 11/21/2022] Open
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