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The upper lip frenum is a crease-shaped mucous membrane located in the oral region in the sagittal plane, often can present changes in its structure and shape, causing an interincisive diastema, problems in hygiene, speech and gingival recession, favoring vicious habits, and can generate compromised lip movement. This study aims to report a clinical case of upper lip frenectomy in a child patient highlighting the diagnosis, surgical treatment and prognosis. The clinical case refers to a seven-year-old female patient who, after the eruption of the upper central and lateral incisors, clinically presented the frenum with low insertion, causing interincisal diastema. After clinical and radiographic examination, upper labial frenectomy was planned, using the modified Archer technique. Therefore, we conclude that this technique is less traumatic to the infant patient, due to its simplicity and speed, with a positive result and good prognosis. [ABSTRACT FROM AUTHOR]

This case report aims to present the result of the association between dental bleaching, gingivectomy and esthetic remodelling with composite resin in a case of smile harmonization. Patient, female, showing a diastema between the two maxillary central incisors, inadequate restoration in tooth 21, and alterations on color, shape and size of the anterior maxillary teeth, attended the Group of Studies in Dentistry (UFC - Sobral) complaining about her smile's aesthetic. After anamnesis, diagnosis and acceptance of the treatment proposed, the staff performed buccal adequation through supragingival scalling and dental prophylaxis, followed by the gingivectomy, which included the external besel technique. After the healing period, the patient started the supervised dental bleaching protocol (carbamid peroxide 16%, 2h/day, 20 days). [ABSTRACT FROM AUTHOR]

(1) Background: Since ancient times, people have been concerned with the aesthetics and attractiveness of their own person. The present study aims to analyze the beauty of the smile according to the level of training in the field of dental aesthetics of the respondents.; (2) Methods: To test this hypothesis, a questionnaire with 22 questions was applied to which 306 participants voluntarily answered; (3) Results Several variables related to dental aesthetics were analyzed based on digitally modified facial photographs; (4) Conclusions: The study showed that the degree of training of the patients is a factor that influences the perception of the smile. [ABSTRACT FROM AUTHOR]

The article discusses the treatment of mesiodens in different stages of dentition. Topics include the clinical presentation and radiographic features of mesiodens; treatment approaches, including extraction methods using specialized forceps to prevent damage to adjacent permanent tooth germs; and post-extraction management, including follow-up care and the use of removable orthodontic appliances like Hawley's plates for diastema closure and alignment in older children.

Introduction: Malocclusion profoundly impacts a child's emotional well-being and affects an individual's quality of life. Early identification improves the chances of organising preventive and interceptive treatment to limit the intensity of developmental aberrations. The data for malocclusion among children of Visakhapatnam is lacking. Aim: To study and evaluate the prevalence of malocclusion and ascertain gender dimorphism among six- and nine-year-old school-going children of Visakhapatnam Materials and Methodols: A cross-sectional, double-stage sample study was conducted among 616 school-going children of Visakhapatnam, Andhra Pradesh, India, by a single calibrated examiner using a modified Index for Preventive and Interceptive Orthodontic Needs (IPION). IBM Statistical Package for the Social Sciences (SPSS), version 25.0, was used to analyse data and Pearson's chi-square test to elicit gender differences in the prevalence of malocclusion traits. Results: Prevalence among six-year-old children: interproximal caries-38.4%, premature tooth loss-10.1%, supernumerary teeth-0.3%, upper molar rotation-0.3%, lower molar tipping-2%, anterior crossbite-2.7%, posterior crossbite-0.7%, overjet more than 3 mm-5.1%, overbite more than 2/3rd-8.4%, open bite-2%, incompetent lips-13.8%. Prevalence among nine-year-old children: interproximal caries-49.5%, premature tooth loss-8.8%, active frenum-2.8%, supernumerary teeth-0.6%, diastema-3.4%, upper molar rotation-2.2%, lower molar tipping-5%, impended eruption of first permanent molar-1.3%, overjet more than 3 mm-11%, overbite more than 2/3rd-12.5%, open bite-2.2%, anterior crossbite-8.2%, posterior crossbite tendency-3.1%, Class I-75.6%, Class II-18.8%, Class III (functional shift)-0.6%, Class III (no functional shift)-3.76%, incompetent lips-16.3%. Conclusion: Children from both cohorts demonstrated malocclusion traits. The nine-year-old group had greater prevalence for all components examined except premature tooth loss. No statistically significant gender dimorphism was found in both cohorts. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this retrospective evaluation was to assess the short‐term outcome of two monoshade universal resin composites with high chameleon effect in anterior direct veneer and diastema closure restorations, and to investigate the possible reasons for failure. Material and Methods: Patients subjected to veneer and diastema closure restorations with two monoshade universal resin composites (Essentia Universal Shade; EU, GC Corp., and Omnichroma; OC, Tokuyama) operated between January 2018 and March 2019 were selected for the present retrospective evaluation. A total of 159 composite restorations (78 veneers and 81 diastema closure restorations) performed by a single operator in 44 patients (mean age: 33.6) were included in the study. Two blinded and calibrated examiners performed 1‐ and 2‐year assessments of the restorations with respect to FDI criteria, using medical/clinical history and dental photography records. Data were analyzed using Pearson Chi‐square with Continuity Correction, Fisher's Exact tests, and Cox regression (a < 0.05). Results: The cumulative overall survival rates of EU and OC restorations were 94.6% (97.3% for the first year) and 88.6% (95.3% for the first year), respectively, with no significant difference from each other (p = 0.316). The cumulative overall survival rates of direct veneer and diastema closure restoration types were 90.2% (95.1% for the first year) and 92.4% (97.4% for the first year), respectively, with no significant difference (p = 0.559). The reasons for failure were evaluated as fracture of the restoration, failure in esthetic anatomical form, and color mismatch. All the failed direct veneer restorations were due to fractures (FDI score of 5.4), whereas 5 of 6 failed diastema closure restorations were due to color mismatch (FDI score of 3.4). Regarding the composite materials, there were no significant differences between the success rates of the restoration types (p = 0.442 for EU, p = 1.000 for OC). With respect to the restoration types, there were also no significant differences between the success rates of the resin‐based composites (p = 1.000 for direct veneer restorations and p = 0.228 for the diastema closure restorations). In addition, no significant difference was observed between male and female patients regarding the acceptable and unacceptable scores (p = 1.000). Conclusions: The 2‐year clinical performance of the two monoshade universal composites in anterior veneer and diastema closure restorations were both considered successful and similar. Despite the lack of shade selection, both monoshade universal composites presented a successful color match. However, the diastema closure restorations might be more prone to color mismatch compared to the veneers over time, while veneer restorations presented more fractures than the diastema closure restorations. Clinical Significance: Monoshade universal composites presented successful short‐term clinical outcomes regarding both function and esthetics in anterior direct veneer and diastema closure restorations. [ABSTRACT FROM AUTHOR]

Introduction: The midline diastema is space or gap between the maxillary central incisors. it is a common esthetic complaint of patients. Aim: The aim of this article is to know the knowledge and awareness of dental students in the management of Midline diastema. Materials and Methods: A questionnaire of 16 questions was created and entered in the online survey creator 'Google Forms' and shared among each student of about 100 individually and privately and data were collected subject to statistical analysis using SPSS software. Statistical tests used were descriptive statistics and Chi square tests. P value less than 0.05 was considered statistically significant. p value was found to be 0.261 which statistically insignificant Conclusion: Results of this study suggest that Preclinical dental students were lacking some knowledge in management of Midline diastema, so they need an effective education and awareness campaign to increase their knowledge and awareness on management of Midline diastema. [ABSTRACT FROM AUTHOR]

Ceramics have greatly evolved since they came into the eye of the dental community. Currently, there is a demand for a highly aesthetic as well as strong restoration and high translucent zirconia fits that criteria pretty well. This has significantly increased the applicability of zirconia as a restorative material in aesthetically demanding cases. Veneers have an innate disadvantage of lack of strength, decreased fracture resistance and chipping. Using these highly translucent zirconia veneers will help overcome these disadvantages. Therefore, the objective of the case series was to test the effectiveness of adhesively bonded highly translucent zirconia veneers using resin cement. This type of veneers provides satisfactory aesthetic outcomes and decreases the risk of fracturing during the trial and clinical use. However, further studies with long-term follow-ups are needed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect magnitude of different parameters on smile attractiveness. Materials and methods: A reference and 13 images were produced by manipulating 13 parameters. Image rating was performed with a 4‐point Likert scale from least attractive (1) to most attractive (4). Image raters included laypeople, dental students, dentists, and dental specialists. Friedman and Wilcoxon image were used for estimate of effect size. Parameters were classified into small (0.10‐ < 0.30), medium (0.30‐ < 0.5), or large (≥0.50). Results: A total of 1040 people participated with good consistency (α = 0.861), and moderate reliability (0.64–0.7). The reference image had the highest rank (laypeople:11.79, dental background: 12.55). For effect size; gingival margin level (−0.11, −0.01), teeth width proportion (−0.09, −0.10), inverted smile arch (−0.09, −0.21), commissure line cant (−0.15, −0.17) and low smile (−0.24, −0.23) had small effect size; occlusal plane cant (−0.36, −0.49), midline cant (−0.36, −0.48), and midline shift (−0.37, −0.49) had medium effect size; diastema (−0.55, −0.54) and color (−0.56, −0.56) had large effect size for the laypeople and dental groups. High smile (−0.42, −0.51), incisor edge symmetry (−0.46, −0.54) had medium effect size in laypeople group and large effect size in the dental group. Width to length tooth proportion (−0.26, −0.39) had small effect size in the laypeople group and medium effect size in the dental group. Conclusions: Smile parameters had different effect magnitude on smile attractiveness and were classified into small, medium, or large parameters. Neither laypeople nor professionals have a collective judgment on what constitutes a beautiful smile. Clinical significance: This study investigated the effect magnitudes of 13 smile parameters and presented a small, medium, and large smile parameters classification. It should provide the clinician with an insight into the expected effect each parameter has on the smile. [ABSTRACT FROM AUTHOR]

A common consequence of moderate to extreme periodontitis is pathologic migration. This denotes tooth movement when the periodontal disease interjects the equilibrium among the elements that preserve physiological tooth position. The balancing factors can migrate the teeth in any direction. The etiology of pathological migration tends to be multifactorial, thus achieving early diagnosis is imperative, which will ultimately lead to the prompt removal of the etiological factors while avoiding severe bone destruction. In this case maxillary central incisors had diastema due to pathological migration with mobility grade I in maxillary left central incisor. Many cases of moderate to severe pathological migration need a suitable, interdisciplinary approach. Nevertheless, since it is possible to detect mild cases of Pathological tooth migration (PTM) at an early stage, spontaneous correction of migrated teeth can be accomplished by periodontal therapy alone. Regardless of the treatment selected, maintenance of stable results should be considered as an aim of treatment. [ABSTRACT FROM AUTHOR]

Diastemas are interdental spaces that occur in the upper and lower arches, both in anterior and posterior teeth, being more frequent in the upper anterior teeth. The closure of these diastemas with composite resin stands out as a minimally invasive and conservative treatment, with a favorable and immediate aesthetic result, with the possibility of realistically reproducing the dental characteristics. The present study aims at reporting a clinical case in which direct composite resin restorations were used to close anterosuperior diastemas. To assist in treatment and facilitate the execution of the case, digital scanning was used, an intraoral system that prints a study model and creates a mock-up that enables the reproduction of dental features, giving the patient an idea of the result before the procedure is executed. Patient is 25 years old, underwent orthodontic treatment in the postgraduate course of Orthodontics at the Universidade Paranaense and after the treatment for size discrepancy of the anterior teeth, 21, 22, 11 and 12, the clinical examination suggested the manufacture of direct composite resin veneers to close the diastema. [ABSTRACT FROM AUTHOR]

Offering the whole orthodontic and surgical treatment to the patient as a single package in a one office can save them considerable time and the trouble. Diode laser enables orthodontists to do so while enjoying its benefits over the scalpel. [ABSTRACT FROM AUTHOR]

The case report of an 18 years patient is described. She went to Mártires del Moncada Teaching Provincial Stomatologic Clinic in Santiago de Cuba, due to persistence of temporary canine teeth. The participation of a multidisciplinary team integrated by specialists in: orthodontics, imaging, prosthesis and maxillofacial surgery was necessary for the successful diagnosis and treatment. They corroborated the retention of upper canine teeth. By means of the combined treatment of orthodontics and prosthesis, the patient cosmetic and functional rehabilitation was achieved. [ABSTRACT FROM AUTHOR]

Background: Frenula are fold-like structures of connective tissue that are inserted into the upper jawbone. This anatomical structure, which often goes unnoticed during the oral exam, presents insertion variations that are associated with diastemas, phonetic, periodontal, and orthodontic issues. Purpose: To identify the type of upper labial frenulum insertion associated with the presence of diastemas, in students aged 8 to 15 who attend the Vicente Anda Aguirre Educational Unit of the Mocha Canton, Ecuador. Methods: A descriptive study with a cross-sectional observational design, with a sample of 300 8-to-15-year-old children, who met the inclusion and exclusion criteria, was carried out. A clinical examination and photographic records of the upper labial frenulum were carried out/obtained to analyze the variables: type of insertion and presence of diastemas in relation to age and gender. Through Chi square test and linear regression, the association between these variables was evaluated (p = 0.05). Results: 44.67 % presented an upper lip frenulum with gingival insertion. Penetrating papillary insertion was found in 27.54% and was more closely related to the presence of diastema, with the mild type being the one that occurred most frequently (66.67 %) regardless of sex. Conclusions: Age showed a close relationship with the frenulum insertion site, being its most coronal location at an early age. Therefore, it could be a predisposing factor for the appearance of diastemas. [ABSTRACT FROM AUTHOR]

This paper aims to report a clinical case of closure of inter-incisive diastema by the technique of direct restoration with composite resin. A female patient attended the Integrated Adult Clinic complaining about the aesthetics of her smile due to the yellow color and a space between the upper incisor teeth. In the clinical examination, the presence of mesial diastema between teeth 11 and 21 was noted. A treatment plan was made, in which the patient was suggested to close the diastema by means of direct restorations with composite resin. After the patient's approval, the color of the teeth was selected with the aid of the Vita Scale and it was proposed to perform a whitening procedure before the restorative treatment. After bleaching and after waiting 21 days for color stabilization, the restorative stage began, which consisted of the acid attack followed by the application of the adhesive system. The composite resin was placed in 1mm increments with the aid of polyester tape in order to reestablish the palatal wall and interproximal contact. Subsequently, the resin was placed up to the buccal surface, respecting the dental anatomy. One week after the restoration, finishing and polishing was carried out with fine-grained cone-shaped diamond tips, sanding discs, felt disc and diamond paste. The satisfactory result after the closure of the diastema by the direct technique in composite resin proved to be a viable treatment option, since it restored the function and aesthetics of the patient's smile. [ABSTRACT FROM AUTHOR]

A striking new species of Diastema , D. fimbratiloba , is described from Ucayali Region, along the eastern Andean slopes in central Peru. The new species has a fimbriate lower corolla lobe, a feature not previously documented in the genus. We also provide a general comparison of the newly described species and morphologically related species in the context of the taxonomy and phylogeny of the poorly known genus Diastema. [ABSTRACT FROM AUTHOR]

Diastema is a latin term of greek origin incorporated into Terminologia Anatomica under the code A05.1.03.078. Odontologically, it is an interdental space located between teeth adjacent to the dental arch, its presence being normal in the period of mixed dentition. Dictionaries of the Spanish, Greek and Latin languages, of medical and etymological terms were consulted, in search of the initial occurrences of the term Diastema and its subsequent uses in history. The search reported that Diastema has been used to indicate a distance or interval, referring to places, times and even between musical tones. In the area of medical sciences, it is a term that has indicated the separation between the fingers or the virtual space created by insufflation of the lungs, being its closest approach to morphology in the veterinary area to designate the space that separates the incisors and molars tooth, especially in rodents and ruminants. To be consistent with the current guidelines of the International Federative Program of Anatomical Terminology and the terminological agreements of the Ibero-Latin American Symposia of Anatomical, Histological and Embryological Terminology, we suggest the replacement of the Diastema period with Spatium interdentale, as an advance in accuracy and description of the structure incorporated into Terminologia Anatomica. [ABSTRACT FROM AUTHOR]

We present the case of a 12 years-old male patient with maxillary diastema induced and maintained by labial frenum in which we performed a laser-assisted labial frenectomy. [ABSTRACT FROM AUTHOR]

Diastema in dentistry is the space between teeth. The most characteristic is maxillary midline diastema between upper central incisors. The aim of the paper was to present the prevalence of diastema and the attractiveness of diastema in different cultures and countries from ancient till contemporary times. In anthropoid apes, diastemas were present in the maxilla between the lateral incisors and canines and in the mandible the pre- and post-canine regions in connection with large elongated canines. The prevalence of individuals with diastema from Late Antique and Early Medieval period was approximately 5% and nowadays it is between 3.7% to as much as 36.8%. The perception of diastema has been the same for ages - it is a symbol of attractiveness. [ABSTRACT FROM AUTHOR]

Objective: Pathological tooth migration (PTM) is an esthetic and functional problem that may be associated with multiple etiological factors. The purpose of this cross-sectional epidemiological study is to determine prevalence of PTM among periodontitis patients and investigate the association of various contributing factors such as tongue thrusting, missing posteriors, trauma from occlusion, class II malocclusion, and aberrant frenum. Materials and Methods: A cross-sectional study was conducted with a total of 445 participants (age of 25-65 years) with chronic periodontitis. Results: Comparison of categorical values was done using Chi-square test and continuous variables were done using independent-sample t-test. Statistically significant results were seen in patients with tongue thrusting (P < 0.002), missing posteriors (P < 0.032), trauma from occlusion (P < 0.007). The results are not statistically significant with abnormal frenum, class II malocclusion. Conclusion: We conclude that tongue thrusting, missing posteriors, and trauma from occlusion are associated with PTM in periodontitis patients. Though class II malocclussion and aberrant frenum are seen in patients with pathological migration, significant association is not present. [ABSTRACT FROM AUTHOR]

Aesthetic dentistry is constantly evolving, mainly due to the development of new techniques and materials which seek to reproduce faithfully natural characteristics of dental elements. Due to this evolution, there is a growing demand for ideal aesthetic standards where diastema (gap between teeth) is one of the main complaints of patients and smile disharmony causes. Given the options of restorative interventions, the direct restoration procedure in composite resin becomes a great choice for rehabilitation, due to its conservative character and constant evolution in its chemical and physical properties, providing great durability, resistance and mimicry of the dental element in a natural way. Therefore, the goal of this work is to restore aesthetics satisfactory to the patient and functionality of the elements, as well to present the technique chosen for rehabilitation and the advantages of the material that will be used. [ABSTRACT FROM AUTHOR]

Mrs F, 55-year-old in good condition general, wishes to replace her superior power plant the replacement of which by a partial assistant prosthesis puts her an embarrassment of discomfort and esthetic. The patient wishes a joint restoration facilitating her measures of hygiene and improving her smile. The implantaire alternative is rejected for its case, and teeth lining her edentement are intact what directs us to the stuck bridge. However, her realization turns out to be difficult seen that we are obliged to restore a pre-existent diastème. In this situation, the bridge requires a specific shape by the realization of a handle of Palatine metallic connection allowing to keep the diastème. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the incidence of dental veneers from the total of dental aesthetic rehabilitation in a private dental office. [ABSTRACT FROM AUTHOR]

Introduction: a perfect smile is a common aesthetic complaint of patients and maxillary anterior diastema is one of the major problems. In some cases, a multidisciplinary approach is necessary to achieve an excellent result. Method: appropriate technique and material for effective treatment are based on time, psychological, and economical limitations. Direct composite resins in diastema cases allow dentist and patient complete control of these limitations and formation of natural smile. Conclusion: in this case report maxillary anterior diastemas were closed with direct composite resin restorations. Direct composite resins seemed to be highly aesthetic that can satisfy patients as under the conditions of case presented. [ABSTRACT FROM AUTHOR]

Objectives This retrospective study evaluated the survival rate of anterior direct resin based composite (RBC) build-ups in vital teeth made of microhybrid and nanofill RBC materials and the influence of bruxism, beverage consumption and smoking on the long-term performance of restorations. Methods Patients receiving anterior restoration between 2006 and 2011, with the diagnosis of fracture or diastema, were selected. A total of 65 adult patients (mean age: 25.2) with 163 restorations (78 Filtek Supreme XT and 85 Enamel Plus HFO) were evaluated using the USPHS criteria. Data were analyzed with Fisher’s Exact Test, Extended Cox-regression analysis and Kaplan–Meier method. Results Mean observation period was 7.2 (±1.4) years and the mean annual failure rate for this period was 1.43%. The reasons of failures included restoration fracture and color mismatch. Nanofill restorations had significantly higher rate of color mismatch (p = 0.002), microhybrids more frequently failed in fracture of restoration (p = 0.034). The overall difference in potential hazard of using Enamel Plus HFO or Filtek Supreme XT was not significant (p = 0.704). Chipping or fracture of the restoration was more frequent in the first year after placement (p = 0.036), while beverage consumption was significantly correlated with discoloration of the restorations (p = 0.005). Significance The application of direct RBC restorations provides an excellent treatment option for fractured teeth and for closing diastemas. The overall survival rate was 88.34% up to 10 years. Microhybrid and nanofill RBC restorations showed similar survival rates, however nanofills discolored at a higher rate, meanwhile chipping of the restoration occurred frequently with microhybrids. [ABSTRACT FROM AUTHOR]

Periodontal diseases may cause sequels, among them there are malocclusion of difficult correction. In the case presented is described causes and consequences of periodontal disease as well as the treatment of these malocclusion. This work has the objective to report the interdisciplinary approach for the treatment of a patient with reduce periodontium and generalized diastema, because the patient had moderate localized chronic periodontitis, deep bite and malocclusion class II-1st division-right subdivision. After the end of treatment there was the closing of diastema, reduction of depth pocketand malocclusion correction, showing that the interdisciplinary approach has become indispensable for treatment, returning the aesthetic, function and self-esteem for the patient. [ABSTRACT FROM AUTHOR]

The tooth agenesis is the absence of one or more teeth for lack of formation mainly affecting the permanent dentition that along with the early loss of molars is responsible for opening diastema. The aim of this study was present a case report for closing diastema in which the patient had agenesis of mandibular lateral incisor, lower dental losses, anterior diastema and hyperplasic gum. The treatment involved the installation of orthodontic appliances aiming to return the esthetics and proper function to the patient, the recovery of lost spaces due to losses, subsequent placement of containment with space maintainers and gingivectomy to removal of gingival excess. The diastema were reduced giving back esthetic and function to the patient, the maintainers installed allowing posterior prosthetic rehabilitation and surgery was held, with that we reached our goal and the perspectives of the patient leaving him satisfied with the treatment. [ABSTRACT FROM AUTHOR]

Ceramic laminates are a good alternative for patients with high aesthetic requirement, because its final result is very close to natural, returning to the patient a functional and harmonious smile, in addition to being biocompatible, durable and have an excellent optical property. The aesthetics in today's society is of utmost importance, since it interferes in social life and the individual's personal satisfaction. Dentistry in balancing item has been improving more and more, searching techniques and materials that provide a great result, satisfying both the professional and the patient. The aim of this study was to show a rehab in cosmetic area with several diastemas using ceramic laminates, in order to restore a harmonious and functional smile to the patient. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the medium-term clinical performance of direct composite build-ups for diastema closures and teeth recontouring using a nano and a nanohybrid composite in combination with three- or two-step etch-and-rinse adhesives following treatment with fixed orthodontic appliances. Materials and methods: A total of 30 patients (mean age, 19.5 years) received 147 direct composite additions for teeth recontouring and diastema closures. A nano and a nanohybrid composite (Filtek Supreme XT and CeramX Duo) were bonded to tooth structure by using a three-step (Scotchbond Multipurpose) or a two-step (XP Bond) etch and rinse adhesive. Ten out of 147 composite build-ups (composite addition) constituted tooth recontouring cases, and the remaining 137 constituted diastema closure cases. The restorations were evaluated by two experienced, calibrated examiners according to modified Ryge criteria at the following time intervals: baseline, 1, 2, 3, and 4 years. Results: The 4-year survival rates were 92.8 % for Filtek Supreme XT/Scotchbond Multi-Purpose Plus and 93 % for CeramX Duo/XP Bond. Only ten restorations failed (5 Filtek Supreme XT and 5 CeramX Duo). Statistical analysis revealed no significant differences between the two composite-adhesive combinations with respect to color match, marginal discoloration, wear/loss of anatomical form, caries formation, marginal adaptation, and surface texture on comparing the five time periods (baseline, 1, 2, 3, and 4 years) Conclusions: The 4-year survival rates in the present study were favorable. The restorations exhibited excellent scores with regard to color match, marginal adaptation, surface texture, marginal discoloration, wear/loss of anatomical form, and caries formation, after 4 years of clinical evaluation. Clinical relevance An alternative clinical approach for correcting discrepancies in tooth size and form, such as performing direct composite restorations following fixed orthodontic treatment, may be an excellent and minimally invasive treatment. [ABSTRACT FROM AUTHOR]

Bony anomaly caused by lip tie is not many reported yet. There was a case of upper lip tie wrapping into the anterior premaxilla. We represent a case of severe upper lip tie of limited lip motion, upper lips curling inside, and alveolar hypoplasia. Male patient was born on June 3, 2016. He had a deep philtral sulcus, low vermilion border and deep cupid's bow of upper lip due to tension of short, stout and very tight frenulum. His upper lip motion was severely restricted in particular lip eversion. There was anterior alveolar hypoplasia with deep sulcus in anterior maxilla. Resection of frenulum cord with Z-plasty was performed at anterior premaxilla and upper lip sulcus. Frenulum was tightly attached to gingiva through gum and into hard palate. Width of frenulum cord was about 1 cm, and length was about 3 cm. He gained upper lip contour including cupid's bow and normal vermilion border after the surgery. This case is severe upper lip tie showing the premaxillary hypoplasia, abnormal lip motion and contour for child. Although there is mild limitation of feeding with upper lip tie child, early detection and treatment are needed to correct bony growth. [ABSTRACT FROM AUTHOR]

Purpose of the Study: The aim of this study was to evaluate clinically the performance of composite resin used to restore midline diastema between the maxillary and mandibular central incisors. Methodology: Direct composite restorations were done for 45 patients with midline diastema between the maxillary and mandibular central incisors. Standard protocols were followed for the placement of composite resin for the diastema closure, and recall visits were made for every 6 months for a period of 60 months for evaluation of the success of these restorations made. Qualified dental personnel examined the restorations made. Results: Clinical evaluations were done after the restorations had been in place for an average of 6 months. Results indicate that none of the restorations were totally lost, and resulting in a 91% overall retention rate for the period of 60 months. About 62% of the restorations made had no noticeable color difference with that of the adjacent tooth, and gingival health indicated 73% of the sample was without any signs of inflammation. Conclusions: Composites restored for diastemas exhibit satisfactory survival rates placed with recommended placement protocols and without occlusal loading. [ABSTRACT FROM AUTHOR]

Diastema (pleural diastemata) is the most common disorder predisposing the horse to periodontal disease. These can affect the incisors or cheek teeth but pose more significant problems in the cheek teeth. Cheek teeth diastema can be congenital or develop secondary to other pathology. This condition is underdiagnosed in clinical practice due to lack of awareness of its seriousness and also due to poor dental examination techniques. A thorough dental examination requires both digital palpation and visual inspection of the oral cavity. Proper patient restraint and the use of a mouth speculum, bright light source, dental mirror or oral endoscope are required to fully inspect the equine oral cavity. Diastemata diagnosed early and managed properly can prevent the progression of periodontal disease and allow affected horses to preserve their dentition into old age. [ABSTRACT FROM AUTHOR]

Analysis for evaluating facial esthetics associated with the evolution of restorative materials and techniques allows solving dental changes by using direct restorations. Among the treatments to restore balance and harmony of the smile from the face of beauty is the treatment of diastema closure and reanatomização through direct restorations in conoid teeth, and misaligned girovertidos the dental arch. Based on the above, the purpose of this cstudy was to optimize a smile by direct restorations using composite resins. The patient, female, 14 years old, sought the Parana University (UNIPAR) complaining lack of space for her teeth. After clinical and radiographic evaluation, with the goal of improving quickly and conservatively, direct restorations in elements 11 and 21 were done to close diastema. Moreover, the proportioning restorer of the conoid lateral incisor (12) and canine (23) to supply the agenesis of element 22 was performed. Nanoparticulate composites were associated with conventional adhesive. The result demonstrated the possibility of effective direct restorative treatment to return the smile harmony harmed by changes in teeth shape and position, with the advantage of being a fast, conservative, reversible and less costly technique as compared to indirect restorations. [ABSTRACT FROM AUTHOR]

The article describes a clinical case of aesthetic rehabilitation using conservative ceramic laminates. A 21-year-old female patient sought dental treatment with an aesthetic complaint of vestibularized teeth and diastemas, but with healthy dental structure. Digital smile planning and the fabrication of lithium disilicate dental veneers using the IPS e.max CAD system with feldspathic ceramic stratification were performed. After the veneer try-in and cementation, aesthetic harmony and patient satisfaction were observed. The stratified IPS e.max CAD system is an excellent option for conservative aesthetic rehabilitation in cases of minor dental vestibularization. [Extracted from the article]

Introduction. Midline gap (diastema) is a space between two teeth, commonly between two incisors. The treatment can be provided by orthodontic, conservative (restorative) or prosthetic methods. Aim. The aim of the study was an assessment of using direct composite restoration in aesthetic closing of diastema. Material and methods. The space correction between teeth was performed among female and male adult patients with diastema of 3 to 6 mm. The microhybrid resin composite was used for the composite build-ups with a help of celluloid or silicon matrix due to its good handling properties and shade matching, and polishability properties. Results. Depending on the size of diastema, the partial or total closing was done to achieve the cosmetic effect. The obtained clinical results were highly assessed both by dentists and patients. It was possible to obtain optimal aesthetic results with resin composite restorations only. Conclusions. The simple closure of diastema with direct composite reconstructions can result in successful outcome and patient's satisfaction. [ABSTRACT FROM AUTHOR]

Pediatric otolaryngologists have seen an increased focus on upper lip frenum as a possible culprit for feeding difficulties and the development of maxillary midline diastema (MMD). This increase may be encouraged by parents' exposure to medical advice over the internet about breastfeeding and potential long-term aesthetic concerns for their children. Subsequently, there has been increased pressure on pediatric otolaryngologists to perform superior labial frenectomies. There has been a reported 10-fold increase in frenectomies since the year 2000. However, there is no consensus within the literature regarding the benefit of superior labial frenectomy in preventing midline diastema. To provide physicians and parents with the most updated information by systematically reviewing the available literature for the association between superior labial frenum and midline diastema. A literature search was performed in MEDLINE (PubMed), EMBASE, Web of Science, the Cochrane Library and Dental and Oral Sciences Source (DOSS). Using the Covidence platform, a systematic review was conducted. The initial 314 articles identified underwent systematic review and 11 studies were included in the final review. Available data, primarily from the dental literature, showed that two subtypes of frenum: papillary and papillary penetrating frenum, are associated with maxillary midline diastema. Superior labial frenectomy should be delayed until permanent lateral incisors have erupted, as this can spontaneously close the physiological MMD. Current literature recommends against frenectomy before addressing the diastema with orthodontics, which helps to prevent diastema relapse. It is also imperative to rule out other odontogenic and oral cavity causes of diastema, such as thumb sucking, dental agenesis, and other causes. Online information may not always be fully representative and should be interpreted in the full context of the patient's medical history before referral for surgical intervention. [ABSTRACT FROM AUTHOR]

Objectives: Adhesive resin composite technology enables dentists to add composite material to tooth surfaces to close gaps and reshape tooth form without cavity preparation. This option creates new possibilities for minimally invasive dentistry as the tooth shape, position and colour can be altered without loss of tooth substance. However, evidence-based data on direct composite buildups are rare. Methods: The purpose of this study was to evaluate the outcome and to document the occurrence of unfavourable events and clinical findings of 176 direct composite buildups that had been performed in the Department of Conservative Dentistry, University Hospital Heidelberg, Germany, between 2002 and 2008. Outcome was categorised as failure (F), survival (SR) or success (S). Restorations still in place and without prior failure at followup were qualitatively rated using modified USPHS/FDI criteria. Results: During the follow-up period, 30 restorations were found to have had unfavourable events or clinical findings. All restorations were repaired, and they remained in situ (SR). No complete loss (F) was recorded. The overall survival rate was 84.6% after 60 months (95%, confidence interval [CI]: 78.5 and 90.6). Clinical quality was rated excellent or good for most (>90%) of the restorations examined. Conclusions: The direct composite buildups observed in this study were found to have promising clinical outcome and good quality parameters after 5 years. If a noninvasive or minimally invasive treatment approach is indicated, direct composite buildups provide an acceptable treatment alternative for the aesthetic correction and reshaping of anterior teeth. Clinical significance: The application of direct composite buildups in clinical cases in which a non- or minimally invasive treatment approach is indicated provides an excellent treatment alternative for gold-standard treatment options like laboratory-made crowns and porcelain veneers. Restorations in the present investigation showed a functional survival rate of 100%, an overall survival rate of 84.6% after 5 years. [ABSTRACT FROM AUTHOR]

Diastemas presence causes a disorder aesthetic dentistry. Therapeutic options vary by several factors such as etiology, size, socio-economic situation. This study presents the case of a patient with medium-sized diastemas was treated by direct veneering composite resin IPS Empress Direct thickness in order avoid (Ivoclar-Vivadent). Solution of choice therapeutic choice therapeutic management is linked to two central ideas that govern the present study. Conclusions. By using IPS Empress Direct (Ivoclar-Vivadent) adhesive system Adhese One-F (Ivoclar Vivadent), 7th generation and spatula Compothixo (Kerr) were superior aesthetic results obtained direct technique diastemas closure. [ABSTRACT FROM AUTHOR]

Although considered relatively common in horses, there is little information on the prevalence, distribution and aetiology of peripheral caries of the equine cheek teeth (CT). The objective of this study was to investigate a possible association between this lesion and diastemata or 'gaps' between the CT which facilitate the entrapment of food material. Video recordings of oroscopic examinations of all dental cases at an equine hospital over a 3-year period were reviewed, and the location of all diastemata, peripheral caries, trapped food, and of gingival recession were recorded. A total of 108 cases met study inclusion criteria and 298 diastemata and 445 CT with peripheral caries were noted. Diastemata were found predominantly in the mandibular arcades (80%) and 75% of animals had at least one diastema. Peripheral caries was uniformly distributed between the maxillary and mandibular CT, being most prevalent on the most caudal three teeth (87%). Overall, diastemata were not associated with peripheral caries at either a tooth or individual patient level. However, a highly significant association was found between the presence of trapped food within diastemata and gingival recession. [ABSTRACT FROM AUTHOR]

Introduction: Diastema mediale is quite a frequent phenomenon. At a certain stage of development of the jaws and eruption of teeth, it can be regarded as a physiological phenomenon. If diastema persists also in the permanent dentition, it becomes orthodontic anomaly. Many factors are applied in its etiology. Often is considered a cause the deep insertion of the upper lip frenum (frenulum labiale). Therefore, it is sometimes in its therapy suggested frenulectomy or frenotomy. Objective: To summarize the range of views on the importance frenum in the etiology of the diastema and on the importance of the frenulectomy in its treatment, which are reported in the literature. Material and methods: It was used for the searching for scientific articles Metalib program, through which were carried out searches in the databases: PubMed, Medline (Ovid), Lippincott Williams & Wilkins (LWWonline) (Ovid), Evidence-Based Medicine, Biological Abstracts. It also was used Google Scholar with granted access to electronic resources Masaryk University (MU). Additional sources were obtained by searching the bibliographies of available full-text articles and searching in journals and monographic publications available in the library at MU. Results: The survey includes 13 articles and 8 monographic publications corresponding to the required criteria. Conclusion: The literature review shows a great difference of opinion in view of the indication of frenulectomy in the treatment of diastema. Most authors recommend a prudent approach based on individual assessment of the causes of diastema, possibility of spontaneously modification of deep attachment of frenum during orthodontic tooth movement and growth of the alveolar process and the need of retention. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Irregular tooth shape and position in the anterior maxilla and mandible are major aesthetic problems for patients. In recent years such conditions have increasingly been treated minimally or even non-invasively by recontouring teeth with direct composite resin buildups. Although clinical experience with this treatment option is promising, evidence-based data about longevity are limited. Methods: The authors evaluated survival and quality of 327 composite buildups that were placed in 101 patients in the Department of Conservative Dentistry, University of Heidelberg, between 2002 and 2008. Follow-up intervals and failures were recorded. Quality was assessed by grading restorations (modified USPHS/Ryge critera) still in situ without adverse event during the follow-up period. Results: After a mean follow-up interval of 27.8 months, 284 restorations were in situ and had no event. Forty-two restorations were in situ but had events that were mostly minor fractures of the composite resin. One restoration had been lost. Analysis of the time from insertion to any event or end of follow-up yielded an estimated 5-year survival rate of 79.2% (95% CI, 70.5–87.9). Quality was assessed by grading in situ restorations without event. More than 90% of graded restorations were categorized as “clinically excellent” (1) or “clinically good” (2). A correlation between those rated “clinically sufficient” or worse (≥3) and the follow-up period was observed. Conclusions: Direct composite buildups are aesthetic, functional, and biologically sound treatment options for recontouring teeth and closing diastemas with clinically promising survival rates. Therefore, tooth shape correction can be recommended in cases in which minimally invasive or non-invasive procedures on healthy teeth are indicated. [ABSTRACT FROM AUTHOR]

Abstract: Teeth develop in the mammalian embryo via a series of interactions between odontogenic epithelium and neural crest-derived ectomesenchyme of the early jaw primordia. The molecular interactions required to generate a tooth are mediated by families of signalling molecules, which often act reiteratively in both a temporal and spatial manner. Whilst considerable information is now available on how these molecules interact to produce an individual tooth, much less is known about the processes that control overall tooth number within the dentition. However, a number of mouse models are now starting to provide some insight into the mechanisms that achieve this. In particular, co-ordinated restriction of signalling molecule activity is important in ensuring appropriate tooth number and there are different requirements for this suppression in epithelial and mesenchymal tissues, both along different axes of individual jaws and between the jaws themselves. There are a number of fundamental mechanisms that facilitate supernumerary tooth formation in these mice. A key process appears to be the early death of vestigial tooth primordia present in the embryo, achieved through the suppression of Shh signalling within these early teeth. However, restriction of WNT signalling is also important in controlling tooth number, with increased transduction being capable of generating multiple tooth buds from the oral epithelium or existing teeth themselves, in both embryonic and adult tissues. Indeed, uncontrolled activity of this pathway can lead to the formation of odontogenic tumours containing multiple odontogenic tissues and poorly formed teeth. Finally, disrupted patterning along the buccal–lingual aspect of the jaws can produce extra teeth directly from the oral epithelium in a duplicated row. Together, all of these findings have relevance for human populations, where supernumerary teeth are seen in association with both the primary and permanent dentitions. Moreover, they are also providing insight into how successional teeth form in both embryonic and post-natal tissues of the jaws. [Copyright &y& Elsevier]

Abstract: This article describes alterations to equid lower second premolars and diastemata from a series of known life history equids and a number of archaeological horse specimens from the British Iron Age. Two new methods for recording bit wear are proposed involving the analysis of the extent and morphology of enamel/dentine exposure on the anterior edge of LP2s and analysis of the extent of new bone formation and bone loss to the diastema of the mandible. It is suggested that when a bit is used on a horse it acts more frequently on the anterior margin of the LP2 than has previously been thought and that repeated contact between the bit and the LP2s and diastemata results in recognisable damage to these areas of the mouth. [Copyright &y& Elsevier]

Summary: Rodents have a toothless diastema between the incisor and the first molar, which may contain rudimentary tooth germs. In the lower diastema region of mice at E13, the rudimentary tooth germs, which developed into the bud stage before its removal by apoptosis, was found. The immunoreactivity to tenascin was observed in the condensed mesenchyme around the normal tooth bud and was detected in only the basement membrane in the diastema bud. This result shows that the relationship between mesenchymal condensation and tooth development. The similar patterns of Msx-1 and Msx-2 expression between the tooth bud and the diastema bud show that the diastema bud may have some other genetic mechanism in the developmental arrest of the rudimentary tooth germs rather than the Msx-1 and Msx-2 expression. Strikingly, the induction of the tooth formation was possible using tissue recombination between the oral epithelium of the diastema bud and the dental mesenchyme of the molar tooth bud, which indicates the potential capability of the diastema in the tooth formation. In conclusion, it is suggested that the condensed mesenchyme may be the key to tooth development. [Copyright &y& Elsevier]

The signalling peptide encoded by the sonic hedgehog gene is restricted to localised thickenings of oral epithelium, which mark the first morphological evidence of tooth development, and is known to play a crucial role during the initiation of odontogenesis. We show that at these stages in the murine mandibular arch in the absence of epithelium, the Shh targets Ptc1 and Gli1 are upregulated in diastema mesenchyme, an edentulous region between the sites of molar and incisor tooth formation. This ectopic expression is not associated with Shh transcription but with Shh protein, undetectable in the presence of epithelium. These findings suggest that, in diastema mesenchyme, restriction of Shh activity is dependent upon the overlying epithelium. This inhibitory activity was demonstrated by the ability of transplanted diastema epithelium to downregulate Ptc1 in tooth explants, and for isolated diastema mesenchyme to express Ptc1. A candidate inhibitor in diastema mesenchyme is the glycosylphosphatidylinositol-linked membrane glycoprotein Gas1. Gas1 is normally expressed throughout mandibular arch mesenchyme; however, in the absence of epithelium this expression was downregulated specifically in the diastema where ectopic Shh protein was identified. Although Shh signalling has no effect upon Gas1 expression in mandibular arch mesenchyme, overexpression of Gas1 results in downregulation of ectopic Ptc1. Therefore, control of the position of tooth initiation in the mandibular arch involves a combination of Shh signalling at sites where teeth are required and antagonism in regions destined to remain edentulous. [ABSTRACT FROM AUTHOR]

I examine the use of the term diaste¯ma by Greek geometers in both plane and spherical constructions. I show that while diaste¯ma may be translated as radius in plane constructions, this will not work on the sphere. These investigations have some implications for how we think of construction in Greek mathematics in general. [Copyright &y& Elsevier]