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Background: Mixed dentition determines an important period of occlusion development in childhood. Objective: This study aimed to evaluate the aesthetic impact of the midline diastema cut‐off point in mixed dentition. Design: A cross‐sectional study was performed with 257 children aged 8‐10 years in late mixed dentition, with midline diastema of 1‐5 mm and normal maxillary overjet. Orthodontic Aesthetic Subjective Impact Score determined the aesthetic impact of the midline diastema. Four quartiles of diastema measurements and impact scores were considered as cut‐off points. Receiver Operating Characteristic curves were constructed, and the distances representing the distances to the ideal point were calculated. The Yuden index determined the efficiency of measuring the diastema to assess the aesthetic impact. The Kruskal‐Wallis test compared the groups of participants classified according to the diastema cut‐off by the sample quartile regarding the impact score. The analyses were performed with a significance level of 5%. Results: There was no significant difference between the four groups of measurement quartiles of the diastema regarding the aesthetic impact (P >.05). Conclusions: The perception of dental aesthetics in mixed dentition children was not affected by the midline diastema, regardless of the cut‐off point. [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]

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]

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]

Objective: This study aimed to use eye tracking to analyse people's visual perceptions of smiles with a diastema between the maxillary central and lateral incisors, based on different categories of observers.Setting and Sample Populations: An image of a diastema between the maxillary central and lateral incisors was shown to dental students and laypeople.Materials and Methods: Our null hypothesis was that there would be no difference in the visual perception of the different graduations of diastemas between the two groups. The diastemas were edited in Photoshop® to gradually increase the distance between the maxillary central and lateral incisors from no diastema to 1.5 mm and 3.5 mm diastemas. These diastemas were evaluated by using a TheEyeTribe© tracker in conjunction with OGAMA© 5.0 software. A total of 37 dental students and 33 laypeople looked at eight randomly arranged images of smiles. The data were analyzed using color coded maps, scanpaths, and the Kruskal-Wallis test with a level of significance of 5%.Results: Laypeople tended to observe the eyes, focusing more on the right than the left, and spent less time focusing on the diastema region than did the dental students. There were differences for the same magnitude of diastema within participant groups. As the width of the diastema increased, both students and laypeople focused more on the diastema region.Conclusions: The two groups of evaluators presented different perceptions of smiles in cases of diastema between the maxillary central and lateral incisors when evaluated using eye-tracking. [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]

Background: Tooth development is highly regulated in mammals and it is regulated by networks of signaling pathways (e. g. Tnf, Wnt, Shh, Fgf and Bmp) whose activities are controlled by the balance between ligands, activators, inhibitors and receptors. The members of the R-spondin family are known as activators of Wnt signaling, and Lgr4, Lgr5, and Lgr6 have been identified as receptors for R-spondins. The role of R-spondin/Lgr signaling in tooth development, however, remains unclear. Results: We first carried out comparative in situ hybridization analysis of R-spondins and Lgrs, and identified their dynamic spatio-temporal expression in murine odontogenesis. R-spondin2 expression was found both in tooth germs and the tooth-less region, the diastema. We further examined tooth development in R-spondin2 mutant mice, and although molars and incisors exhibited no significant abnormalities, supernumerary teeth were observed in the diastema. Conclusions: R-spondin/Lgr signaling is thus involved in tooth development. Developmental Dynamics 243:844-851, 2014. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Studies of health, survival, and development of juvenile Alaskan Steller sea lions ( Eumetopias jubatus, SSL) require accurate estimates of age for wild-captured animals. However, the value and accuracy of several potential predictors of age have not been assessed with data from known-age free-ranging animals. During 2001–2005, forty-six individual SSL originally branded or tagged at ≤6 mo of age were recaptured by the Alaska Department of Fish and Game (ADF&G). Using a series of general linear models, we evaluated the ability of morphometrics measurements: permanent canine tooth length (CTL), diastema (DIAS), whisker length (WHIS), and dorsal standard length (DSL) to predict the age of forty-six known-age juveniles ( n= 46 ≤23 mo of age). Permanent CTL was the strongest individual predictor ( r2= 0.80); followed by DSL, DIAS, and WHIS ( r2= 0.70, 0.56, and 0.45, respectively). The inclusion of a single sample from a 44-mo-old sea lion suggested quadratic relationships between age and all predictors for older animals. Only models including CTL predicted age to within 6 mo of known age. The equation Age = (−3.0112 +[0.6726 * CTL]+[0.4965 * DIAS]) allows for accurate age estimates of SSL ≤23 mo for both sexes. [ABSTRACT FROM AUTHOR]

The present article describes the resin infiltration technique to address white spots lesions presented on anterior and premolar teeth of a young patient after orthodontic treatment and the digital workflow for planning a diastema closure on the maxillary anterior teeth using facial photographs, an intraoral scanner, a facially driven diagnostic waxing using a dental computer-aided design (CAD) software, and 3-piece additive manufactured (AM) clear silicone indices. The virtual design of the silicone indices was completed using an open-source CAD software and included a flexible clear buccal piece, flexible clear lingual piece, and rigid clear custom tray. The unique 3-piece index design allows a horizontal path of insertion, controlled uniform thickness of the indices, flexible and rigid material properties combination, accurate translation of the diagnostic waxing into the patient´s mouth, and digital storage of the designs., (© 2019 by the American College of Prosthodontists.)

A maxillary midline diastema (MMD) is a common form of incomplete occlusion and often is a primary complaint of patients during dental consultations. MMD is considered to be a multifactorial phenomenon and can therefore be best restored with a multidisciplinary approach. This clinical report presents a multidisciplinary approach to the management of a 4.0-mm MMD by using limited orthodontics combined with periodontal and prosthodontic treatments., (© 2018 by the American College of Prosthodontists.)

Objective: To describe a novel technique that helps the clinician on promoting a midline diastema closure with appropriate width proportions based on previous wax up, avoiding excesses of the resin material on the gingival area, which could lead to possible inflammation., Materials and Methods: Two different silicone indexes were made over a wax up to perform a diastema closure., Results: The use of a silicone index made with putty polyvinyl siloxane (PVS) material and another index made with putty and light PVS materials performed over a modified wax up, helped on achieving esthetically pleasant diastema closure with appropriate proportional widths, respecting the gingival tissue., Conclusions: The use of a novel silicone index technique allowed for ensuring the same width for both upper central incisors in a midline diastema closure, improving gingival tissue's health., Clinical Significance: The main difficulties regarding diastema closure are related to reaching an appropriate width proportion of the central incisors and avoiding a ledge at the gingival aspect of the contact area, which could become a plaque and food trap. This article describes, step-by-step, how to avoid such diastema closure issues, ensuring the width proportions of the upper central incisors., (© 2018 Wiley Periodicals, Inc.)

Purpose: This study was undertaken to determine the public's preferences for five esthetic variations, with the goal of linking preferences to demographic data such as age, gender, country of residence, and race., Materials and Methods: Using photo-editing software, five pairs of images with anterior tooth variations were put on a Web page with forms to collect demographic data and ranking of the image pairs. Opinions were solicited by sending out a large number of e-mails with a short study description and an invitation to access the Web page. The responses were tabulated and analyzed with logistic regression (alpha = 0.05)., Results: Valid responses were received from 2185 computer users in 45 countries. Because of the small number of respondents from most countries, only the responses from the United States and Canada (n = 1934) were analyzed. Variables collected were birth date, gender, race or ethnic background, and last dental visit. Analysis indicated that different variables were significant for different questions. Last dental visit and the interaction of gender and race were not significant in any of the models. Strongest preferences concerned diastema and midline shift and the weakest concerned whiteness and proportion. The largest minority view was the straight embrasures. Statistically significant differences were attributable to age, gender, and race. Females had stronger preferences in all conditions. Respondents younger than 40 years of age had stronger preferences for whiteness and against diastema, and whites strongly rejected the diastema., Clinical Significance: This study provides guidelines about the public's preferences concerning some commonly encountered conditions in esthetic dentistry.

The purpose of the study was to examine the relationship between spacing and dental health in 15-year-old adolescents. The whole sample consisted of 156 subjects. Out of them, 74 females and 73 males with 6 anterior teeth made up the study group for examination of the upper jaw. 75 females and 75 males had 6 anterior teeth in the lower jaw and made up the study group for examination of the lower jaw. The Plaque Index (PlI) and the Gingival Index (GI) were recorded. Probing depths (PD) were measured as explained by Glavind & Løe. Filled surfaces (FS) were taken from the individual case sheets and controlled clinically. The spacing of the individuals was assessed by counting the number of proximal surfaces without visible contact with the adjacent proximal surfaces, on model casts. The sum of proximal surfaces without contact made up the Space Index (SpI) of the individual jaw. Parametric and non-parametric statistical methods were used to analyze the data. In both sexes and both jaws proximal surfaces without interdental contact had a more favourable periodontal condition than surfaces with contact. In the upper jaw of both sexes, proximal surfaces without interdental contact had a reduced number of filled surfaces compared to surfaces with contact. The linear relationship between SpI and FS was significant, i.e., an increased number of surfaces without contact was accompanied by a reduced number of filled surfaces. In the lower jaw, the differences between the SpI groups and the linear relationship between SpI and FS did not reach significance. In both sexes and both jaws, proximal surfaces without fillings had a more favourable periodontal state compared to surfaces with fillings. Indications are that the summation effect of the presence of interdental contact and the presence of fillings contributed to the differences in periodontal condition between surfaces with and without interdental contact.