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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]

This case report emphasizes on esthetic rehabilitation of maxillary anterior teeth with porcelain laminate veneers. A male patient aged 24 years reported with a chief complaint of spacing between teeth in the upper front teeth region. The patient was unwilling for orthodontic correction since time was the major constraint. A complete intraoral and extraoral examination was performed, preoperative photographs were taken, and study models were prepared. Tooth component, i. e., dental midline, incisal lengths, tooth dimensions, zenith points, axial inclinations, interdental contact area and point, incisal embrasure, symmetry, and balance, was observed. The soft-tissue examination included gingival health, interdental embrasure, and smile line. Clinical examination revealed diastema between 11, 12, 21, and 22. Discoloration was noted in 21 teeth, and the patient reported a history of root canal treatment for the same. Considering the esthetic need of the patient and the duration of treatment, porcelain veneers were planned for the correction of diastema. Tooth preparation for veneers was made with incisal overlap design with respect to 12, 11, and 22, and e-max crown was planned for 21. The advantages of this treatment include quick results, minimal tooth structure removal, long-term solution, better esthetics, and firm fit. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to analyze the content and quality of clinical diastema closure videos related to the direct resin composite restoration technique available on YouTubeTM. Materials and Methods: The videos were determined using the words "diastema closure," "teeth gap fill," and "teeth gap close" in the YouTube™ search section. 300 videos were reviewed, and 55 of them were included in the study. Demographics of videos, interaction index, and viewing rates were evaluated. The videos were analyzed in three parameters in terms of content score (CS), technical features (TF), and global quality scale (GQS). Results: The dentist accounts took the first place (51%) in the distribution of those who uploaded the videos. The mean values of the videos from the evaluation criteria were 8.3/15p for CS, 3.1/5p for TF, and 2.7/5p for GQS. There was a statistically significant positive correlation between the viewing rates, TF, and GQS values (P < 0.05). Conclusion: Operational videos of diastema closure with direct composite resin restoration treatments should be uploaded to YouTube™ after approval by experts. In addition, the TF of operational videos needs to be better. Students should be warned about videos which contain insufficient information. [ABSTRACT FROM AUTHOR]

The use of digital smile designing simplifies the restoration of esthetics. In this article, a case of diastema and incisal notching in anterior teeth was rehabilitated with porcelain laminate veneers using combination of digital and analog workflow. [ABSTRACT FROM AUTHOR]

Introduction: A modified frenal treatment for aberrant frenum is presented in this report to reduce scar tissue formation and maintain the attached gingiva. Description: The case report describes two cases in which a V-shaped incision removed the aberrant frenum and then the flaps of the frenum were sutured at the mid line. Results: The results showed reduced scar tissue in the mid line and the tissue healed with adequate attached gingiva. Take-Away Lessons: The modified frenotomy technique presented here is ideal for a large frenum that could expose the underlying connective tissue that could reduce the scar tissue formation. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to identify the prevalence and etiological factors of maxillary midline diastema among a sample of adult patients undergoing orthodontic treatment in orthodontic private clinics in Qaloubya, Fayoum, and Giza governorates. Patients and methods: Three hundred seventy-five patients (199 females and 176 males) were included in this study. The full records (intraoral photographies and radiographs) of all patients were examined and surveyed for the presence or absence of maxillary midline diastema and the possible etiological factors. Results: 17.3% of the studied patients showed maxillary midline diastema, while 82.7% of them did not show diastema. There was no significant difference between the prevalence of midline diastema in different sexes (P = 0.079). The most common etiological factors were 38.5% congenitally missed laterals, 33.8% highly attached frenum, 20.0% generalized spaces, and 26.2% had flared incisors. Conclusion: Prevalence of midline diastema in the studied patients was 17.3%, while 82.7% of patients did not have diastema. [ABSTRACT FROM AUTHOR]

Diastema between the teeth negatively affects the patients' smile, psychology and daily activities by creating a disharmony in the patients' face. The development of diastema has been attributed to several factors such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Patients often present with complex problems that require a multidisciplinary treatment approach which includes determination of the aetiological factors, soft tissue morphology, occlusion, patient demands and aesthetic consideration to achieve satisfactory outcomes. Lack of current literature on classification of diastemas and multi-disciplinary approach of management led to the proposal of a new classification the ATAC (Anatomic and Therapeutic Classification) for management of the diastema. This case report highlights the use of the proposed classification for management of diastemas, requiring a perio-restorative intervention using a Chu's proportion gauge to achieve ideal aesthetics. [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]

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]

The purpose of this case report is to describe the efficacy of a modified Whale's tail technique to achieve primary closure and thereby aid in regeneration of an interdental osseous defect between maxillary central incisors complicated by an aberrant frenal attachment. A healthy 32-year-old female patient reported with the complaint of spacing between her upper front teeth. Clinical examination revealed an aberrant frenum extending into the interdental papilla in relation to the central incisors. There was a 6 mm periodontal pocket in relation to the mesiopalatal aspect of maxillary left central incisor. Intraoral periapical radiograph showed vertical bone loss in relation to mesial aspect of maxillary left central incisor. A modified Whale's tail flap was employed to access the area. The defect was filled with an alloplastic graft. Six months postoperative review showed complete elimination of the pocket along with radiographic bone fill of the defect. [ABSTRACT FROM AUTHOR]

Ceramic veneers are considered as an esthetic treatment option for anterior teeth with unusual positions or appearance, as they conserve tooth structure and offer predictable results when planned adequately. Anatomic wax mock-up is an important tool during the phase of treatment planning. It allows the dentist to effectively communicate with the patient regarding the final esthetic result. Esthetic preevaluative temporaries prepared from the anatomic wax mock-up will allow the clinician and the patient to assess the form and contour future restorations to be placed; and its effects on the lip posture, smile line, and function. The mock-up can also help in the fabrication of an index to aid in the conservation of the tooth structure, while veneer tooth preparation and also assist in temporization. The purpose of this case report is to highlight the importance anatomic mock-up for predictable esthetic smile design with ceramic veneers. [ABSTRACT FROM AUTHOR]

Pathological tooth migration is a characteristic sign of an advanced form of chronic periodontitis. The etiology of pathological tooth migration is complex and multifactorial. Usually treatment of pathological migration includes a multidisciplinary approach. However, in some cases, spontaneous repositioning of the pathologically migrated teeth has been reported following periodontal therapy alone. In the present report, following periodontal surgery, there was a spontaneous repositioning of the migrated teeth and restoration of dento-facial esthetics. The treatment options in cases of pathological tooth migration, based on the severity, are also discussed. [ABSTRACT FROM AUTHOR]

Spacing in dentition negatively interferes with harmony of the smile. A lot of literature has been devoted to prosthetic closure of such space(s) in the dentition; however, the only option for maintaining space(s) in tooth-supported fixed dental prosthesis (FDP) is with the aid of loop connectors. Eleven patients (seven males and four females) with mean age of 45.18 years (range 22-70 years), previously treated with porcelain fused to metal full coverage restorations joined with loop connectors, were evaluated clinically to assess the clinical status and longevity of treatment provided. All the patients were asked to fill a simple close-ended questionnaire to provide their perspective on the limitations and outcome of the treatment and rate their satisfaction level on the scale of 1-10. The cumulative survival of the FDPs with the aid of loop connectors was 90.9%. There was no reported esthetic failure and, at the time of responding to the questionnaire, none of the patients had active complaint with respect to the prosthesis and all but one of the patients were satisfied with the treatment provided. Clinical survivability and the patient feedback suggests that customized designing of loop connectors for each patient is an excellent treatment modality to successfully maintain excessive (single/generalized) spacing between teeth and effectively splint pathologically migrated and mobile teeth. The reported problems with this treatment option are all transient in nature. [ABSTRACT FROM AUTHOR]

Patients with a missing tooth along with diastema have limited treatment options to restore the edentulous space. The use of a conventional fixed partial denture (FPD) to replace the missing tooth may result in too wide anterior teeth leading to poor esthetics. The diastema resulting from the missing central incisors can be managed with implant-supported prosthesis or FPD with loop connectors. An old lady reported with chief complaints of missing upper anterior teeth due to trauma. Her past dental history revealed that she was having generalized spacing between her upper anterior teeth. Considering her esthetic requirement of maintaining the diastema between 12, 11, 22, and 21, the treatment option of 06 units porcelain fused to metal FPD from canine to canine with intermittent loop connectors between 21, 22, 11, 12 was planned. Connectors basically link different parts of FPDs. The modified FPD with loop connectors enhanced the natural appearance of the restoration, maintained the diastemas and the proper emergence profile, and preserve the remaining tooth structure of abutment teeth. This clinical report discussed a method for fabrication of a modified FPD with loop connectors to restore the wide span created by missing central incisors. [ABSTRACT FROM AUTHOR]

Patients with a missing tooth along with diastema have limited treatment options to restore the edentulous space. The use of a conventional fixed partial denture (FPD) to replace the missing tooth may result in too wide anterior teeth leading to poor esthetics. Loss of anterior teeth with existing diastema may result in excess space available for pontic. This condition presents great esthetic challenge for prosthodontist. If implant supported prosthesis is not possible because of inadequate bone support, FPD along with loop connector may be a treatment option to maintain the diastema and provide optimal esthetic restoration. Here, we report a clinical case where FPD along with loop connector was used to achieve esthetic rehabilitation in maxillary anterior region in which midline diastema has been maintained. [ABSTRACT FROM AUTHOR]

Abstract: Increased patient demand for optimal esthetics with less invasive procedure has resulted in the extensive utilization of freehand composite resin bonding in the anterior region. This case report presents the esthetic management of midline diastema by crown lengthening and composite resin restorations. [Copyright &y& Elsevier]

Drifting of teeth into the edentulous area may reduce the available pontic space; whereas a diastema existing before an extraction may result in excessive mesio-distal width to the pontic space. Although rarely used, loop connectors are sometimes required to address this problem of excessive mesio-distal width pontic space. The loop may be cast from sprue wax that is circular in cross section or shaped from platinum-gold-palladium (Pt-Au-Pd) alloy wire. Loop connectors offer a simple solution to the above mentioned dilemma, involving an anterior edentulous space albeit with the maintenance of the diastema. This article describes the procedure for the fabrication of a loop connector fixed partial denture to restore an excessively wide anterior edentulous space in a patient with existing spacing between all the maxillary anterior teeth. [ABSTRACT FROM AUTHOR]