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The author discusses her treatment of a patient who was in need of resolving anterior spacing of the front teeth, and the resulting use of intraoral scanners and Bioclear composite restorations on the patient's maxillary and mandibular anterior teeth.

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When a patient presents with congenitally missing teeth, early diagnosis and comprehensive treatment planning are critical to effective restorative management. Interdental space allocation must be identified to accommodate proper clinical crown proportion(s) through a surgical-prosthetic solution. This article, which presents two case reports describing situations that clinicians may commonly face, demonstrates the management of atypical tooth spacing caused by congenitally missing teeth. The implementation of interdisciplinary therapy resulted in successful outcomes from both functional and esthetic perspectives. [ABSTRACT FROM AUTHOR]

Orthodontic intrusion can be utilized to assist clinicians in meeting various esthetic, functional, and biomechanical problems. In this full-mouth reconstruction case, such therapy was used to initiate a multiphase treatment approach for an adult patient who presented with numerous concerns about her function and appearance, including a significant diastema, active wear on her lower anterior teeth, and chipped crowns. A variety of procedures conducted over a period of 6 years that comprised implant placement, gingival recontouring, orthodontic repositioning, and crown lengthening, along with the use of a Kois deprogrammer to equilibrate the final restorations, were utilized to achieve a successful outcome. [ABSTRACT FROM AUTHOR]

The aim of this study was to clarify the effect of attachment on tooth movement produced by a plastic aligner. Closing of a diastema, in which the maxillary right and left central incisors moved bodily, was simulated using a finite element method. Long-term orthodontic movements of the maxillary dentition were simulated by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament. The incisor tipped and rotated just after placement of the aligner irrespective of the attachment. After a sufficiently long time, the incisor was upright and moved bodily in the aligner with attachment, but the incisor remained tipped in the aligner without attachment. It was demonstrated that the attachment was effective for achieving bodily movement. [ABSTRACT FROM AUTHOR]

Background: In the past, cephalometric-based diagnosis and treatment planning were considered to be the gold standard in orthodontic treatment and the outcome was to achieve ideal occlusion. At present, individuals opting for orthodontic treatment desire enhancing facial esthetics and a beautiful smile. Smile perception differs widely among professionals in dentistry. The general dental practitioner first attends individuals seeking orthodontic treatment, and his/her perception of smile may be different from that of an orthodontist. Objective: The objective of this study was to determine the perception of smile by orthodontists and general dental practitioners. Materials and Methods: In this questionnaire study, 100 questionnaires were distributed among 50 orthodontists and 50 general dental practitioners. Their responses were obtained, data analyzed, and results evaluated. Results: This study showed that the mean scores given by orthodontists are lesser than that of the general dental practitioners. The factors that had an impact on smile by non-orthodontists include crowding of lower anterior and diastema of 3-4 mm. Among orthodontists, the various factors that had an impact include diastema, midline deviation, and reverse smile arc. Conclusion: Different parameters have impact on the smile perception. Diastema smile and reverse smile were regarded as unattractive and received the lowest score in this survey. The presence of midline shift was not considered unesthetic by non-orthodontists. [ABSTRACT FROM AUTHOR]

Objective: Midline diastema most commonly occurs in children during mixed dentition. Midline diastema always creates an unpleasant appearance and interferes with speech depending on its width. If it continues even after the ugly duckling stage, then the effective treatment is required to correct the diastema. The study is carried out to assess the prevalence of midline diastema in school children of age group from 15 to 19 years old in Chennai city. Materials and Methods: A cross-sectional study was done in 400 school children of 15-18 years in various schools of Chennai 15-18 years old, after providing prior information. Measurements were recorded by measuring the gap between two central incisors for maxilla and mandible. Results: Of the 400 school children who were screened, only 39 of them presented with midline diastema. Hence, the incidence of maxillary midline diastema in this population is 9%. The prevalence type had no gender difference. Conclusion: The present study showed that midline diastema is a rare dental anomaly in Chennai population which shows increased awareness of the dental anomaly and early treatments obtained for it. [ABSTRACT FROM AUTHOR]

In this work, the structural designs of triatomine's stylets (Hemiptera: Reduviidae, Triatominae), and their functional implications, were studied based on the morphological descriptions elaborated by high-resolution optical microcopy and scanning electron microscopy (SEM). The following species were selected (according to their diverse feeding habits): Belminus ferroae (entomophagic), Rhodnius prolixus (euryphagic), Panstrongylus geniculatus (commonly feed on armadillos) and Triatoma maculata (ornitophagic and stenophagic). All of these species showed mandibular and maxillary stylets with a ventral grooved face, denticulate mandibular stylets and more chitinized at their distal end, as well as lamellar maxillary stylets which are more flexible than mandibular stylets. Length between maxillary and mandibular stylets varied between species; and robustness, size and spaces between teeth at the distal end of mandibular stylets also varied. Based on the observation of these four species, we propose a general morphoconstructional model of mandibular and maxillary stylet design for the subfamily Triatominae. [ABSTRACT FROM AUTHOR]

The use of orthodontic extrusion can be advantageous for creating a favorable periodontal and restorative environment while avoiding extensive bone and soft-tissue grafting. This approach is demonstrated in the case of a young woman who presented with discomfort and concerns over her maxillary central incisors. Additionally, the orthodontic treatment corrected occlusal dysfunction and slight crowding. Interdisciplinary, facially generated treatment planning was critical to the final esthetic result and the reduction of biomechanical, functional, and dentofacial risk factors. [ABSTRACT FROM AUTHOR]

The article deals with a study which explored the applicability of orthodontic therapy to infrabony pockets. An opportunity to move a maxillary right central incisor into an osseous vertical lesion on its mesial surface was presented by a 1967 case. In this case, there was a need to analyze the maxillomandibular relationship to determine space closure. To eliminate the diastema, the bite plane was activated for tooth movement to correct the position of the anterior teeth. Another case showed the complete elimination of an osseous defect by orthodontic tooth movement. Eradication of the lesion was observed 10 months after orthodontic treatment. A study concluded that regeneration is possible when moving a tooth into an osseous lesion.

The article focuses on a study on the application of Bolton Index to determine anterior diastema closure. It reports on the use of Bolton analysis to various dental cases in order to attain esthetic periodontal restorative solutions. Bolton's measurements were taken from 55 cases in which an excellent occlusion existed. The Bolton Index was used to recognize the limitations of tooth movement for maxillary anterior space closure in Class I malocclusions with minimal overjet and overbite. It discussed the importance of enamel bonding in conjunction with orthodontics space closure. A diagnostic setup of anterior teeth in wax was used to evaluate a restorative solution to anterior tooth size discrepancy. The mean values for overall and anterior ratio, and overbite were calculated.

The article talks about interproximal areas of the human dentition. As reported, the size, shape, and position of roots determines to a large extent the anatomical form of their surrounding alveoli. It also plays an important role in four aspects of the alveolus namely facial, lingual, mesial and distal. As stated, root positions are determined by a number of variables including genetic guidelines, environmental factors and iatrogenic issues. But in the natural course of biologic events, the primary locations of tooth roots are guided by one's DNA codes, proximal wear, tooth loss, orthodontic repositioning etc. These are also affected by diseases such as periodontitis, occlusal traumatism and proximal caries which are capable of changing the original root positions also.

The article presents a case study of a 15-year-old girl suffering from the mobility of maxillary incisors and bone loss. The girl sought care for mobile maxillary central incisors following closure of a maxillary midline diastema with a directly placed orthodontic elastic band. The study concludes that a band that slips under the gingiva causes extensive tooth loss, luxation and exfoliation. Results show that direct placement of orthodontic elastic bands on teeth is contraindicated.

The article offers information on a study conducted in order to determine the degree of taper of tooth preparation. In a tooth preparation, taper is the relationship between two opposite and converging or diverging vertical surfaces of tooth structure. The research has revealed that the more widely separated the walls being prepared, the greater is the taper. Features such as grooves and boxes that are added to clinical preparations have less taper as compared to axial walls of the overall tooth preparations.

The article presents a case study of a 41-year-old man for the treatment of the maxillary left central incisor whose complaint was gingival recession and a complete alveolar dehiscence at the vestibular aspect of this tooth. It mentions that four procedures were undertaken for the treatment, including the free autogenous mucosal graft and the closing of the anterior diastema, and discusses the use of combined periodontal and restorative procedures in the esthetic treatment of anterior teeth.

The article focuses on research regarding abnormalities related to the eruption and positioning of permanent teeth within the dental arch. If there are mal-positioned teeth, they should be guided into proper positions in the arch. There are several obstacles to the eruption of teeth including supernumerary teeth, over-retained or ankylosed primary teeth, and traumatized primary teeth. Several preventive and interceptive modes of orthodontic treatment such as space maintenance, space regaining, and guidance in alignment and occlusion, can be used.

The article discusses three treatment techniques, orthodontic treatment, prosthetic treatment, and implantation, for missing teeth in the maxilla. The orthodontic therapy is the most preferred therapy, particularly when one tooth is missing. The prosthetic therapy is used particularly for replacing, missing teeth with diastemas. Implantation, as stated, is particularly used by dentist for treatment of edentulous patients. An important factor in the dental treatment with conventional fixed partial denture is the use of a modified adhesive bridge sound.

The article presents information on the nonparallel horizontal pin splinting technique in periodontal treatment. This technique is used to provide splinting and prosthetic replacement. The advantages of this technique includes permanent stabilization of loose teeth, esthetic improvement of teeth, and requirement of very few special instruments. For this treatment the teeth should fulfill a number of conditions including healthy peridontal tissues, good condition of teeth with few restorations and enough room between the incisal edge and the pulp.

The article presents a case report of treating diastemas or conspicuous space between anterior teeth through acid etch composite technique. Diastema treatment includes teeth reshaping, dental restoration and finishing procedures. Considerations and benefits of using this process in treating diastemas are also noted.

The article discusses the significance of the support zone during bite development. It mentions that the support zone can be endangered during the development of the dentition which became the most frequent case from a distal than from a mesial direction. It notes that the support zones in the late deciduous dentition are smaller in which the mandibular support zones undergo a great alteration. It then asserts that if the support zones are not maintained, the gap for the replacement teeth are to erupt later which would narrow and even closes.

The article presents a case study of an eight-year-old girl with a thumb habit that causes gingival pathology. The girl is also presented with diastema between the maxillary centrals and excess gingival tissue by the centrals. A frenectomy and gingivectomy are performed along with orthodontic therapy to correct the problems. The procedure resulted to healthy gingival tissue, closure of the diastema and end of the thumb habit.

Interdental space between anterior teeth is an aesthetic and a phonetic problem. While various treatment options are available, patients often have concerns regarding treatment invasiveness, duration of treatments, costs and long-term prognosis. This case report describes a step-by-step smile makeover with direct composite restorations in maxillary incisors and canines with interdental spaces, tooth size discrepancy and altered passive eruption. CPD/Clinical Relevance: Minimally invasive dentistry is an integral component of contemporary clinical practice With recent advances in innovative materials and improved clinical technique, attaining aesthetic results with a minimally invasive approach is highly achievable. [ABSTRACT FROM AUTHOR]

Dear Editor, Segmental odontomaxillary dysplasia (SOD) is a rare condition of unknown incidence, with approximately 60 cases reported (as reviewed in 2018).1 It presents at birth or during childhood with a constellation of ipsilateral facial signs: nonprogressive or slowly progressive overgrowth or undergrowth of soft tissues and/or bones (typically centred on the posterior maxilla, and leading to facial asymmetry), dental anomalies (missing teeth or abnormal dentition), gingival hyperplasia or abnormal gingivae, commissural lip fissures, hypertrichosis, cutaneous hyperpigmentation and/or erythema, cutaneous depression, and lip hypopigmentation. We present here that the genetic cause of SOD in four of four patients tested thus far with this rare disease is postzygotic missense variants in the gene I ACTB i . [Extracted from the article]

Introduction: Lingual orthodontics is gaining popularity day by day. However very few information is present in literature regarding physiologic reaction that occurs after force application, efficacy and rate of tooth movement in lingual orthodontics when compared with labial orthodontics. Aim: This study was designed for comparison of aforesaid parameters in midline diastema cases with both lingual as well as labial orthodontics. Materials and Methods: Cone-beam computed tomography scanning was used to create geometric models for maxillary central incisors. Two 3D finite element models of maxillary central incisors having diastema, bonded with 0.018" brackets, labially and lingually with 0.017"×0.025" SS arch wires placed was constructed. These models were then meshed and analysed with commercially available finite-element analysis software. Diastema closure was simulated by applying 50 gm of mesial force from maxillary right central incisor to maxillary left central incisor. Software was used to compare the stress in periodontium, efficacy and rate of the instantaneous displacement of tooth (maxillary right and left central incisor) under labial and lingual loading during the midline diastema closure retraction. Results: More stress and displacement of teeth for closing the gap can be observed for labial loading compared to the lingual loading. Conclusion: By applying equal force labially and lingually, more bodily movement is seen in labial mechanics whereas lingual mechanics shows mesial crown tipping as well as bodily movement. [ABSTRACT FROM AUTHOR]

This is the case of a 12 year old, male child who reported with a 9mm midline diastema due to two mesiodens. The diastema was unusual as the central incisors were displaced unequally from the midline. Tooth 21 and 22 were displaced more distally from the midline leaving inadequate space for eruption of tooth 23. The challenge in this case was to close this unequal diastema. Thus the conventional fixed appliance which relies on reciprocal anchorage could not be used to close the diastema. Hence the fixed appliance was modified by using a Nance palatal arch with a labial wire extension to close this unequal diastema. The presentation discusses this unusual presentation of diastema and the modified fixed appliance used to treat the case. Clinical Relevance: This case report explains the biomechanics during midline diastema closure where the space is unequally distributed across the midline. [ABSTRACT FROM AUTHOR]

Objectives: To compare perceptions on dental aesthetics of various malocclusions between schoolchildren and orthodontists with an orthodontic assessment of treatment needs. Methods: The prospective study was conducted between late March-December in 2017. A total of 32 orthodontists practicing in Shenyang, China and 116 schoolchildren (59 boys and 57 girls) aged 10-12 years (average= 11±0.60 years) from a 645 individual representing the population were selected via random sampling from a private primary school. Participants were questioned to assess 6 anterior dental photographs representing a variety degrees of aesthetic impairments, namely, reverse overjet (ROJ), anterior dental diastema and anterior open bite (OB) malocclusions. Results: Perceptions on dental aesthetics were identical among genders (p>0.05). Compared with the orthodontists, schoolchildren perceived significantly greater aesthetic impairment for severe anterior OB and severe ROJ, mild anterior OB malocclusions (p<0.01). Anterior dental diastemas were evaluated based on least aesthetic impairment and with no significant difference in perception between schoolchildren and orthodontists. Conclusion: Schoolchildren perceived greater aesthetic impairment in severe anterior OB, severe ROJ, and mild anterior OB malocclusions than orthodontists. Median aesthetic components (AC) scores of schoolchildren for severe anterior OB and severe ROJ malocclusions corresponded with the category of "definite need" for treatment. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: Dentofacial aesthetics plays an important role in social interaction and psychological well-being because it affects how people perceive themselves and how they are perceived by society. The maxillary labial frenum is a fold of tissue, usually triangular in shape, extending from the maxillary midline area of the gingiva into the vestibule and mid portion of the upper lip. Maxillary anterior spacing or diastema is a common aesthetic complaint of patients and is frequently seen in children especially in the mixed dentition stage.Aims and Objectives: 1. To estimate the prevalence of different morphologic types of maxillary labial frenum among children of age 3 - 12 years. 2. To find out the relationship between the level of insertion of the frenum and age of the child.3. To evaluate the correlation between frenum morphology, insertion and midline diastema in children.Materials and Methodology: The direct visual method under natural light was used and the upper lip was lifted with the index finger and thumb of both hands which allowed for the observation and classification of the labial frenum morphology according to Sewerin's typology and its attachment according to Placek et al. The midline diastema was determined by measuring the distance between the midpoints of the mesial surfaces of both central incisors with the help of divider and ruler. The values were recorded in the prepared schedule.Summary and Conclusions: The presence of an abnormal frenum can be a cause in persistent midline diastemas. Tooth movement usually is deferred until eruption of the permanent canines but can begin early in certain cases with very large diastemas. [ABSTRACT FROM AUTHOR]

The study aimed to assess the prevalence of malocclusions and its impact on oral health-related quality of life (OHRQoL) among early adolescents in Ndola, Zambia. It used a random sample of 384 primary school children aged 12–14 years. The Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) was used to assess OHRQoL, and the Dental Aesthetic Index (DAI) was used to examine dentofacial anomalies. The chi-square test was used to study whether there was a statistically significant association between variables and multivariate logistic regression for the influence of sociodemographic and malocclusions on OHRQoL. Statistical significance was set at p<0.05. Participants’ sociodemographics were 53.6% female, 41.7% aged 13 years, and 43.5% from grade six. The overall reported impact on OHRQoL was 11.7%, which was significant (p<0.001) by age and sex, and higher in females than males. The overall prevalence of malocclusions was 27.9%, which was significant (p=0.005) by sex, and higher in males than females. Children with malocclusions reported significant (p<0.001) negative oral health impact compared to the children without malocclusions. Spacing, diastema, and crowding were most prevalent malocclusions that showed clear inverse association with OHRQoL. The study findings provide indications that malocclusions are negatively associated with OHRQoL among Zambian early adolescents. [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]

Composite resin can provide patients with a conservative option for diastema closures and other treatments needed to restore function and esthetics. Improvements in materials have enabled better placement techniques and enhanced final outcomes. This case report discusses a conservative direct resin treatment on youthful dentition and confirms the suitability of direct restorative material for anterior applications. [ABSTRACT FROM AUTHOR]