RESUMO
BACKGROUND: Botulinum toxin type A (BTX-A) is recent technique for the treatment of gummy smile. OBJECTIVES: The aim of this randomized controlled preliminary clinical trial was to evaluate the effects of BTX-A on excessive gingiva display (EGD) reduction, muscle activity, and patient satisfaction at 2, 8, 12, 16, 21, and 25 weeks. METHODS: Group 1 (G1) received 4 points of BTX-A application (2 U/point) for relaxation of the levator labii superioris alaeque nasi and levator labii superioris muscles; Group 2 (G2) received 2 points of BTX-A (2 U/point) for relaxation of only the levator labii superioris alaeque nasi muscle. RESULTS: A high dropout of patients from follow-up sessions occurred. Therefore, because of this data limitation, the results were considered a preliminary outcome. At 2 weeks, there was a significant difference between baseline regarding the reduction of EGD in G1 and G2, reduction in muscle activity in G1, and increased satisfaction in G1 and G2. At 2 weeks, there was no difference between the 2 groups. Statistically significant EGD reduction was maintained until 16 weeks in G2 and 25 weeks in G1. After 14 days there was a gradual recovery of muscle activity in both groups until recovery of baseline values by 25 weeks. Patients' satisfaction with treatment lasted 21 weeks in G1 and 16 weeks in G2. CONCLUSIONS: Increasing the number of BTX-A injection points resulted in a prolonged effect regarding EGD reduction and patient satisfaction but did not increase the intensity of the outcome. However, due to the high dropout of patients, this is a preliminary conclusion and further studies are necessary to confirm these results.
Assuntos
Toxinas Botulínicas Tipo A , Estética Dentária , Gengiva , Humanos , Lábio , Sorriso/fisiologiaRESUMO
RESUMO Introdução: Avanços no campo da Odontologia Estética têm proporcionado métodos cada vez mais inovadores na construção de um sorriso funcional e harmonioso. O elevado grau de exigência do paciente por detalhes e por sorrisos personalizados evidencia a necessidade do clínico em lançar mão de meios que facilitem a comunicação para o melhor entendimento de seus pacientes em relação ao tratamento proposto. Objetivo: Realizar uma revisão de literatura sobre Planejamento Digital do Sorriso em Odontologia. Métodos: Com caráter atual e integrativo, esta revisão de literatura foi realizada utilizando os descritores estética dentária, sorriso e fotografia dentária, em portugês, inglês e espanhol, obtendo 302 artigos, dos quais foram utilizados 51 artigos e 1 livro como base científica para o estudo, obedecendo os critérios de inclusão e exclusão. Análise e integração da informação: Os avanços na informática, fotografia digital e processamento de imagens, bem como a redução dos custos envolvidos, têm proporcionado que um planejamento tradicional em odontologia para tratamentos estéticos tenha evoluído para um planejamento digital, fornecendo uma visão ampla do diagnóstico, melhorando a comunicação entre paciente e equipe profissional envolvida, tornando o tratamento mais previsível, facilitando a compreensão e permitindo sua análise crítica e participação mais ativa no planejamento. Considerações finais: As técnicas utilizadas para realização do Planejamento Digital do Sorriso tornam os procedimentos mais previsíveis, melhorando a visualização e compreensão das etapas a serem realizadas. O conceito de Visagismo não apresenta embasamento científico suficiente. Aplicações de conceitos de proporção áurea na odontologia têm sido bastante estudadas, porém seu uso não é consensual por existirem outros parâmetros(AU)
RESUMEN Introducción: Avances en el campo de la Odontología Estética han proporcionado métodos cada vez más innovadores en la construcción de una sonrisa funcional y armoniosa. El alto grado de exigencia del paciente por detalles y por sonrisas personalizadas evidencia la necesidad de que el clínico use medios que faciliten la comunicación para una mejor comprensión de sus pacientes con respecto al tratamiento propuesto. Objetivo: Realizar una revisión de literatura sobre planificación digital de la sonrisa en odontología. Métodos: Esta revisión de literatura se realizó utilizando los descriptores "estética dental", "sonrisa" y "fotografía dentaria", en portugués, inglés y español. Se recuperaron un libro y 302 artículos, de los cuales, el libro y 51 artículos fueron utilizados como base científica para el estudio. Análisis e integración de la información: Los avances en la informática, fotografía digital y procesamiento de imágenes, así como la reducción de los costos involucrados, han permitido que una planificación dental tradicional en odontología para tratamientos estéticos evolucione hacia la planificación digital y proporcione una visión amplia del diagnóstico. Esto ha mejorado la comunicación entre los pacientes y los equipos de profesionales involucrados y ha hecho el tratamiento más previsible. Así se ha facilitado la comprensión del paciente, se ha permitido su análisis crítico y su participación más activa en la planificación. Consideraciones finales: Las técnicas utilizadas para realizar la planificación digital de la sonrisa hacen los procedimientos más previsibles y mejora la visualización y comprensión de cada etapa. El concepto de Visagismo no presenta un fundamento científico suficiente. Las aplicaciones de conceptos de proporción áurea en la odontología han sido bastante estudiadas, pero, por existir otros parámetros, su uso no es consensual(AU)
ABSTRACT Introduction: Advances in the field of aesthetic dentistry have provided increasingly innovative methods for building a functional and harmonious smile. The high degree of patient demand for details and for personalized smiles shows the need for clinicians to use means that facilitate communication for better understanding of their patients regarding the proposed treatment. Objective: To carry out a literature review on digital smile planning in dentistry. Methods: This literature review was performed using the descriptors estética dental [dental aesthetics], sonrisa [smile], and fotografía dental [dental photography], in Portuguese, English and Spanish. A book and 302 articles were retrieved, of which the book and 51 articles were used as scientific basis for the study. Information analysis and integration: Advances in computer science, digital photography and image processing, as well as the reduction of costs involved, have allowed traditional dental planning in dentistry for aesthetic treatments to evolve towards digital planning and to provide comprehensive diagnostic insight. This has improved communication between patients and professional teams involved and has made treatment more predictable. Thus, the patient's understanding has been facilitated, as well as is has permitted his or her critical analysis and more active participation in planning. Final considerations: The techniques used to carry out digital smile planning make the procedures more predictable and improve the visualization and understanding in each stage. The concept of visagism does not present a sufficient scientific basis. The applications of golden ratio concepts into dentistry have been extensively studied, but, due to the existence of other parameters, their use is not consensual(AU)
Assuntos
Humanos , Sorriso/fisiologia , Fotografia Dentária/métodos , Estética Dentária , Literatura de Revisão como AssuntoRESUMO
Resumen: Objetivo: Evaluar la percepción estética de la sonrisa según variación de la posición vertical y de la angulación del incisivo central superior (ICS) en estudiantes de odontología (EO) y personas comunes (PC) de las tres regiones del Perú. Materiales y Métodos: Diseño descriptivo, transversal. La muestra fueron 462 adultos, divididos en 77 para cada subgrupo de EO y PC de las regiones Lima (Costa), Junín (Sierra) y Loreto (Selva). Mediante el programa Photoshop se modificó una fotografía de sonrisa de mujer variando la posición vertical y angulación del ICS, obteniéndose imágenes que fueron evaluadas mediante la escala visual análoga. Resultados: Las PC calificaron mejor que los EO en la mayoría de las categorías (p<0,001). La sonrisa mejor valorada por EO en posición vertical fue a 1mm y 2mm; y para angulación 0°, mientras que para PC la de 1mm y de 0° respectivamente (p<0,05). Comparando por regiones los EO de Lima dieron la menor calificación para 0° con 52,63 y los de Junín la mayor para 4° con 45,90. Las PC de Loreto registraron el menor puntaje para las categorías de posición vertical (p<0,001), mientras que para angulación en Junín se calificó con un menor puntaje que en Loreto para -6° y 0°; y para 4° Lima brindó la menor calificación (p<0,001). Conclusiones: La percepción estética de la sonrisa es afectada por la variación de posición vertical y angulación del ICS en personas comunes y estudiantes de odontología en las tres regiones del Perú.
Abstract: Objective: To evaluate the esthetic perception of the smile according to the variation of the vertical position and the angulation of the upper central incisor (UPI) by dental students (DS) and common people (CP) of three regions of Peru. Materials and Methods: Descriptive cross-sectional design. The sample was 462 adults, divided into 77 for each subgroup of DS and CP of the Lima (Coast), Junín (Highlands) and Loreto (Rainforest) regions. Using the Photoshop® software, a photograph of a woman's smile was modified by varying the vertical position and angulation of the UPI, obtaining images that were evaluated using the analog visual scale. Results: The CP rated better than DS in most categories (p <0.001). The smile best valued by DS in a vertical position was 1mm and 2mm; and for angulation 0°, while for CP 1mm and 0° respectively (p <0.05). Comparing by regions, the DS of Lima gave the lowest rating for 0 ° with 52.63 and those of Junín the highest for 4° with 45.90. The PC of Loreto registered the lowest score for the vertical position categories (p <0.001), while for angulation in Junín it was rated with a lower score than in Loreto for -6 ° and 0°; and for 4° Lima provided the lowest rating (p <0.001). Conclusions: The esthetic perception of the smile is affected by the variation of vertical position and angulation of the ICS in common people and dental students in the three regions of Peru.
Assuntos
Humanos , Masculino , Feminino , Adulto , Sorriso/fisiologia , Dimensão Vertical , Peru , EstéticaRESUMO
O desenvolvimento de sistemas totalmente cerâmicos após restaurações metalocerâmicas permitiu a simulação da dentição natural devido à estética e resistência favoráveis. As cerâmicas reforçadas por dissilicato de lítio são uma alternativa quando a estética é primordial, assim como a resistência necessária na reabilitação. No entanto, um sorriso ideal está associado não apenas à forma, cor, textura e translucidez, mas também à harmonia com o tecido gengival. Assim, o objetivo deste trabalho é relatar um caso clínico de reabilitação estética anterior através de restaurações cerâmicas metal free dos tipos coroa total, faceta e lentes de contato dentais. Paciente do sexo feminino, 25 anos, apresentou fratura das unidades 11 e 12, sendo planejadas e confeccionadas uma coroa total e uma faceta indireta nestes elementos. Para uma melhor harmonização do sorriso, foram realizadas, também, lentes de contato nas unidades 21 e 22, sendo todas as restaurações confeccionadas com uma cerâmica reforçada por dissilicato de lítio (IPS e-max Press). O uso dessas restaurações cerâmicas associado a um plano de tratamento cuidadoso permitiu ao profissional integrar estética e função com resultados clínicos satisfatórios. (AU)
The development of all-ceramic systems following metalceramics restorations allowed simulation of natural dentition due to favorable esthetics and resistance. Ceramics reinforced with lithium disilicate are an alternative when esthetics is primordial as well as resistance required in rehabilitation. However, an ideal smile is associated to not only shape, color, texture and translucency but also harmony with gingival tissue. So, the aim of this study is to report a clinical case of anterior aesthetic rehabilitation with a ceramic crown restoration, veneer and dental contact lenses. A female patient, 25 year-old, presented fracture of units 11 and 12. A full crown and an indirect veneer were planned for these elements. For better smile harmonization, dental contact lenses were also performed in units 21 and 22, all restorations were made with a lithium disilicate reinforced ceramic (IPS e-max Press). The use of ceramic restorations with zirconia structures associated with a careful treatment plan allows the professional to integrate esthetic and function for satisfactory clinical results. (AU)
Assuntos
Adulto , Ligas Metalo-Cerâmicas , Coroa do Dente , Facetas Dentárias , Estética Dentária , Sorriso/fisiologiaRESUMO
AIM: This study aimed to evaluate the influence of labial and dentogingival characteristics on facial and smile attractiveness. MATERIALS AND METHODS: Four different close-up photographs each of six women models with different labial and dentogin-gival characteristics were obtained. One of the models was considered standard. Photographs were arranged in an album were evaluated by 100 laypersons, and 30 dentists who ranked each close-up of the models from according to the degree of attractiveness from first to sixth place, with first being the model considered most attractive and justified the reasons for choosing. RESULTS: The standard model received the best scores for both lips (7.75) and face (5.18). Medium-sized lips were preferred (p < 0.05), and the smile positively or negatively interfered with esthetic perception depending on the dentogingival alteration present. Diastema was the alteration that had the greatest negative influence. CONCLUSION: Not all dentogingival alterations interfere with esthetic evaluation. The lips are not decisive in facial attractiveness. Attraction is assessed significantly differently by laypeople than by dentists. The smile directly influences the analysis of facial beauty. CLINICAL SIGNIFICANCE: Dentogingival alterations may be imperceptible, especially when evaluating the facial joint, so its correction will not always be necessary.
Assuntos
Beleza , Dentição Permanente , Estética Dentária/psicologia , Face/anatomia & histologia , Face/fisiologia , Lábio/anatomia & histologia , Lábio/fisiologia , Sorriso/fisiologia , Estudos Transversais , Diastema , Face/diagnóstico por imagem , Expressão Facial , Feminino , Humanos , Lábio/diagnóstico por imagem , FotografaçãoRESUMO
Objetivo: Comparar la percepción de los padres de familia y Odontopediatras en relación a la sonrisa infantil ideal. Material y Métodos: 2 Grupos de evaluadores: 97 Padres de familia (grupo 1) y 99 Odontopediatras (grupo 2). Se realizaron observaciones fotográficas en 25 fotografías para determinar la percepción de ambos grupos con respecto a la sonrisa estética. Se compararon los grupos mediante la prueba chi cuadrada con p=0,05. Resultados: Respecto a las expectativas de los padres en cuanto a estética de la sonrisa infantil prefieren una exposición moderada de nivel de tejido gingival, diastemas y espacios interincisales; con una distancia vertical promedio. Los Odontopediatras prefieren una exposición mínima de tejido gingival, dientes juntos, sin diastemas ni espacios interincisales. Conclusiones: Se acepta la hipótesis ya que al comparar la percepción de los padres de familia y Odontopediatras en relación a la sonrisa infantil ideal existió una diferencia significativa entre la percepción visual de los padres de familia y los profesionistas con respecto a la sonrisa ideal.
Objetivo: Comparar a percepção de pais e odontopediatras em relação ao sorriso infantil ideal. Material e Métodos: 2 Grupos de avaliadores: 97 Pais (grupo 1) e 99 Odontopediatras (grupo 2). Imagens de 25 fotografias foram entregues, aos país e odontopediatras, para determinar a percepção em ambos os grupos quanto ao sorriso estético em crianças. Os resultados foram comparados usando o teste do qui-quadrado com p = 0,05. Resultados: Em relação às expectativas dos pais sobre a estética do sorriso infantil, estes prefiraram uma exposição moderada do nível do tecido gengival, diastemas e espaços interincisivos; com uma distância vertical média. Odontopediatras preferiram exposição mínima do tecido gengival, dentes sem diastemas ou espaços interincisivos. Conclusões: A hipótese encontrada sobre o sorriso das crianças do ponto de vista dos país e odontopediatras é que houve uma diferença significativa entre a percepção visual em relação ao sorriso ideal.
Aim: To compare the perception of parents and pedodontists in relation to the ideal child smile. Material and Methods: 2 Groups of evaluators: 97 parents (group 1) and 99 pedodontists (group 2). Photographic observations were performed in 25 photographs to determine the perception of both groups regarding the aesthetic smile. The groups were compared using the chi-square test with p = 0.05. Results: Expectations of the parents regarding the aesthetics of the children's smile, they prefer moderate exposure of gingival tissue, diastemas and interincisal spacings ; with an average vertical distance. Pedodontists prefer minimal exposure of gingival tissue, teeth together, without diastemas or interincisal spacings. Conclusions: The hypothesis is accepted because when comparing the perception of parents and Pedodontists in relation to the ideal child smile there was a significant difference between the visual perception of parents and professionals with respect to the ideal smile.
Assuntos
Humanos , Criança , Sorriso/fisiologia , Pais , Percepção , Odontólogos , DentiçãoRESUMO
Excessive gingival display (EGD) is a challenge for dentists attempting to provide their patients a pleasant smile. EGD associated with hyperactivity of the smile elevator muscles can be treated with various surgical techniques; regardless of which technique is used, to achieve a predictable result with long-term stability limiting upper lip movement when the patient smiles, a firm muscle containment is imperative. This report describes an innovative suture procedure associated with a lip repositioning technique aimed at maintaining the traction and containment of the smile elevator muscles. This case demonstrates a successful and stable result for excessive gingival exposure, addressing and satisfying a patient's esthetic concerns.
Assuntos
Estética Dentária , Músculos Faciais/cirurgia , Gengivectomia/métodos , Lábio/cirurgia , Sorriso/fisiologia , Técnicas de Sutura , Adulto , Feminino , Humanos , Lábio/anatomia & histologia , Satisfação do PacienteRESUMO
La toxina botulínica tipo A puede ser utilizada en diversas situaciones de interés odontológico, entre ellas, los trastornos temporo-mandibulares, hábitos parafuncionales, hipertrofia del músculo masetero, parálisis facial, asimetría de labios y, más recientemente, en los casos de hipermiotonía labial y sonrisa gingival. El objetivo de este trabajo es reportar el caso de un paciente con queja estética de sonrisa gingival. La aplicación de la toxina botulínica promovió la dehiscencia uniforme del labio superior y minimizó la molestia causada por la sonrisa gingival de forma rápida y poco invasiva, mostrando que esta puede convertirse en una alternativa terapéutica eficaz para el tratamiento de la sonrisa gingival, favoreciendo la estética facial y la autoestima del paciente.
Botulinum toxin type A could be used in various situations of dental interest including temporomandibular disorders, parafunctional habits, masseter muscle hypertrophy, facial paralysis, lip asymmetry and more recently in the cases of hyper myotonic lips and gummy smile. The aim of this paper is to report the case of a patient with complaint of gingival aesthetic smile. The application of botulinum toxin promoted the uniform dehiscence of the upper lip and minimized the discomfort caused by the gummy smile in a fast and little invasive way, showing that botulinum toxin can become an effective therapeutic alternative for the treatment of gummy smile, favoring facial aesthetics and patient self-esteem.
Assuntos
Humanos , Adulto , Feminino , Estética Dentária , Sorriso/fisiologia , Toxinas Botulínicas Tipo A/uso terapêutico , Coroa do Dente/anatomia & histologia , Lábio/anatomia & histologia , Fotografia Dentária , Resultado do TratamentoRESUMO
The aim of this research was to evaluate age-related changes in the smile of Brazilian women. The sample consisted of 249 Brazilian women who had not undergone previous orthodontic treatment or facial surgery. They were divided into four groups, according to age: G1 (20-29), G2 (30-39), G3 (40-49) and G4 (50 or older). Standardized front view photographs were taken while smiling and at rest. Measurements were evaluated by ANOVA and post-hoc Tukey. The Chi-square test was applied for qualitative variables. Upper lip thickness at rest and exposure of upper incisors on smiling decreased with age. Most individuals (60.9%) exhibited a medium smile. High smiles were more often seen in G1 (45%) and less frequently in G4 (18.8%), whereas the opposite occurred with the low smile, i.e., G4 (21.9%) and G1 (6.7%). Variations among the groups were observed in the transverse exposure of the teeth on smiling. In G1 and G3, there was a balance between tooth exposures, so that the teeth were exposed as far as the premolars and/or molars. Most of the women (56.3%) in G2 exposed their teeth as far as the first molars on smiling, whereas most of those (40.6%) in G4 exposed their teeth only as far as the first premolars on smiling. As age increased, there was decreased exposure of the upper incisors, decreased upper lip thickness and lower exposure of teeth vertically and transversely.
Assuntos
Envelhecimento/fisiologia , Face/anatomia & histologia , Sorriso/fisiologia , Adulto , Fatores Etários , Idoso , Brasil , Estética Dentária , Feminino , Humanos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Odontometria , Fotografação , Valores de Referência , Adulto JovemRESUMO
Abstract The aim of this research was to evaluate age-related changes in the smile of Brazilian women. The sample consisted of 249 Brazilian women who had not undergone previous orthodontic treatment or facial surgery. They were divided into four groups, according to age: G1 (20-29), G2 (30-39), G3 (40-49) and G4 (50 or older). Standardized front view photographs were taken while smiling and at rest. Measurements were evaluated by ANOVA and post-hoc Tukey. The Chi-square test was applied for qualitative variables. Upper lip thickness at rest and exposure of upper incisors on smiling decreased with age. Most individuals (60.9%) exhibited a medium smile. High smiles were more often seen in G1 (45%) and less frequently in G4 (18.8%), whereas the opposite occurred with the low smile, i.e., G4 (21.9%) and G1 (6.7%). Variations among the groups were observed in the transverse exposure of the teeth on smiling. In G1 and G3, there was a balance between tooth exposures, so that the teeth were exposed as far as the premolars and/or molars. Most of the women (56.3%) in G2 exposed their teeth as far as the first molars on smiling, whereas most of those (40.6%) in G4 exposed their teeth only as far as the first premolars on smiling. As age increased, there was decreased exposure of the upper incisors, decreased upper lip thickness and lower exposure of teeth vertically and transversely.