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Purpose: To assess the impact of implant placement at different time intervals on the esthetic and clinical outcomes in the esthetic zone. Materials and Methods: A literature screening was conducted in PubMed (MEDLINE), ScienceDirect, and Cochrane databases. Relevant articles were included according to selection criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was collected from studies published from 2017 to 2022 in English. Results: Nine articles were included, in which a total of 495 implants were placed; 250 of the implants were immediate, 109 were early, and 136 were delayed. Immediate implant placement (IIP) showed no statistically significant difference in Pink Esthetic Score (PES) compared with delayed implant placement (DIP). IIP showed significantly higher PES in comparison with early implant placement (EIP) (mean difference [MD] = -0.76; 95% CI = -1.50 to -0.02; P = .04). The probing depth (PD) was considerably greater for immediate implants than for delayed implants (MD = -0.62; 95% CI = -1.05 to -0.18; P = .005), and the Plaque Index (PI) was statistically greater for early implants compared with immediate implants (MD = 0.15; 95% CI = 0.11 to 0.19; P < .00001). All other soft tissue outcomes showed equal results. The marginal bone loss (MBL) was statistically higher in early implants compared with immediate implants (MD = 0.09; 95% CI = 0.02 to 0.16; P = .02). Conclusions: IIP had significantly superior PES, MBL, and PI results when compared with EIP. The PD was significantly higher for immediate implants compared with delayed implants. All other outcomes showed no significant difference between the three implant groups. It is important to highlight the limitations of this review such as the small number of studies included and the few reports on esthetic indices. [ABSTRACT FROM AUTHOR]

BACKGROUND: Facial feminization may be performed to alleviate gender dysphoria among transfeminine patients. The upper third of the face has several characteristics, including hairline shape and position, brow position, and forehead protrusion, that may confer feminine identity. The purpose of this study is to conduct a scoping literature review of techniques performed for forehead feminization and to additionally study clinical outcomes within an institutional cohort. METHODS: A systematic literature review was conducted to review articles that discussed techniques and clinical outcomes associated with procedures performed for feminization of the upper third of the face. A retrospective review of patients undergoing such procedures by the senior author was then conducted. Variables collected included demographic factors, operative details, and postoperative outcomes such as complications, revisions, and re-operations. RESULTS: Initial review yielded sixty-seven articles. Title and abstract review followed by standardized application of inclusion and exclusion criteria resulted in a total of twenty-two studies for analysis. Priorities of forehead feminization entail frontal bossing reduction, frontonasal angle widening, orbital contouring, brow lifting, and hairline advancement. Eighty-five patients were included for analysis. The majority were of Caucasian race (56%) and had type 3 forehead classification (92%). The average planned setback of the anterior table was 4.12 mm. CONCLUSIONS: The core tenets of the feminization of the forehead lie in the overall creation of a harmonic curvature of the forehead with other facial features. Our multi-pronged analysis presents an updated review of these principles, which may help plastic surgeons in performing procedures to feminize the upper third of the face. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.

Objective: Currently, there is no established treatment protocol to treat interdental papillary loss. This research aimed to evaluate the outcomes of interdental papillary reconstruction using minimally invasive surgery, with injectable hyaluronic acid gel. Method and materials: Seventeen patients were included, each with five sites of class 1 papillary recession (40 sites in the maxilla and 45 sites in the mandible). Subperiosteal tunneling was performed through a horizontal incision made apical to the base of the papilla without penetrating it. The free gingival sulcus was sealed by 000 retraction cord. A total of 0.2 to 0.6 mL hyaluronic acid was injected gradually. The incision was sutured with poly-glycolic sutures. Treated sites underwent clinical and digital evaluation at three follow-up time points (1 month, 3 months, and 6 months). Results: The interdental papillary defect height in the maxillary sites significantly reduced by 60%, 66%, and 42% at 1,3, and 6 months, respectively. In mandibular sites, the reduction was 54%, 55%, and 40% at the same follow-up time points. Regarding interdental papillary defect surface area in the maxilla, the reduction was 65%, 71%, and 45% at 1, 3, and 6 months. In the mandible, a reduction of 60%, 64%, and 48% was noticed at the same time points. Regarding patients' pain level score, during the day of surgery, 16 patients reported pain; the average pain score out of 10 was 3.94, and 11 patients (64.7%) needed to take analgesics. The pain generally subsided in the following days. At the day of treatment, 12 out of the 17 patients (70.6%) reported mild difficulty in speaking and eating. No complication, hypersensitivity, or allergy was noted in any patient. Conclusion: Subperiosteal tunneling with hyaluronic acid injection demonstrates clinical improvements in papilla height and papillary recession surface area reduction after 3 months of follow-up, with reduction in improvement after 6 months. Clinical significance: Adjunctive use of hyaluronic acid injection with minimally invasive surgery in interdental papillary management may improve clinical and esthetic outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Scalp reconstruction requires knowledge of scalp anatomy and reconstructive options. Advances in the field have led to numerous procedures being at the disposal of the reconstructive surgeon, expanding treatment options for patients. OBJECTIVE: To provide an algorithmic approach and general guidelines to consider when deciding on which scalp surgery will optimize cosmetic and functional outcomes. METHODS & MATERIALS: Previous literature was searched for the last 20 years to provide an updated guide. RESULTS: Taking into consideration the location, size and local scalp anatomy of a presenting defect will lead to optimal surgical outcomes. Other confounding factors such as bone exposure and extremely large defects will affect decision making. An algorithmic approach has been provided in this review. CONCLUSION: While many reconstructive surgical options are available, the best ones will depend on individual presentation of scalp defects. Location and size are first line considerations while local scalp anatomy will allow for tailoring of reconstructive options. This will help to maximize cosmetic and aesthetic considerations.

What psychological mechanisms underlie aesthetic judgements? An influential account known as the Hedonic Marking of Fluency, later developed into a Processing Fluency Theory of Aesthetic Pleasure, posits that ease of processing elicits positive feelings and thus enhances stimulus evaluations. However, the theory faces empirical and conceptual challenges. In this paper, we extend it by integrating insights from predictive processing frameworks (PPF) and the epistemic motivation model (EMM). We propose four extensions. First, fluency of a stimulus depends on perceivers expectations-their internal model of the world. Second, perceivers also form expectations about fluency itself and thus can experience surprising fluency. These expectations can come from the individuals history, their current task and their environment. Third, perceivers can value fluency but also disfluency, reflecting their non-directional epistemic goals. Fourth, perceivers also have directional epistemic goals, preferring specific conclusions or belief content. Consequently, affective reactions depend on whether the stimulus satisfies those goals. These directional epistemic goals may override concerns about fluency or change the value of fluency associated with specific content. We review supporting evidence and introduce novel predictions. By integrating insights from PPF and EMM, our framework can better capture established fluency effects and highlights their limitations and extensions. This article is part of the theme issue Art, aesthetics and predictive processing: theoretical and empirical perspectives.

The esthetic problems inherent to peripheral (PFP) are frequent causes of complaint. Make-up is advocated as a form of therapy and can alleviate symptoms of depression. The aim of the present study was to collect data on make-up habits in female PFP patients and assess links with esthetic and/or functional complaints. Two questionnaires were drawn up to compare make-up habits in female PFP patients and women in the general population. The first was sent out between September and December 2019, to 39 House-Brackmann grade III PFP patients (group A), and the second on-line questionnaire was sent to a control population of 1385 women (group B). PFP patients used make-up more often than controls at weekends (χ2 = 16.38; P = 0.0009) and while at home (χ2 = 8.21; P = 0.042), and more often with foundation (χ2 = 17.21; P = 0.0006) and lip make-up (χ2 = 59.31; P < 0.0001). The greater their functional complaint, the less they made up their eyes. The greater their self-confidence and the more they felt attractive, the less they made up their lips. The differences in make-up use found in the present study aimed to mask facial palsy and were related to the esthetic complaint, impacting social life. [ABSTRACT FROM AUTHOR]

The article describes the case of a ten-year-old boy who sought orthodontic treatment after dental trauma three years ago, which led to the avulsion of the upper right central incisor. Topics include factors to which the decision to open or close a space is attributed, orthodontic treatment, and restorative treatment.

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Objective: Quantify the cost benefits of otoplasty under local as opposed to general anaesthesia. Design: A cost analysis of all components of otoplasty surgery under local anaesthesia (LA) in a minor operating room (OR) and general anaesthesia in a main OR was performed. Setting: Our institution, compared to provincial/federal data, with costs converted into 2022 Canadian dollars. Patients, Participants: Patients undergoing otoplasty under LA in the last year. Interventions: An efficiency analysis was performed by means of an opportunity cost, and the cost of failure was added to the overall LA costs. Main Outcome Measure: Expenses for infrastructure, surgical and anaesthetic material, salaries, and personnel costs were derived from the literature, our hospital OR catalog and federal/provincial salary data, respectively. The cost of failure to tolerate local anaesthesia for such cases was also tabulated. Results: The true cost of LA otoplasty was computed as the absolute cost ($611.73) added to the cost of failure ($10.80), resulting in a total of $622.53/procedure. The true cost of GA otoplasty was calculated as the absolute cost ($2033.05) added to the opportunity cost ($1108.94), representing 3141.99$/procedure. The total savings when performing LA otoplasty to GA otoplasty are thus 2519.44$/case, with 1 GA otoplasty costing 5.05 LA otoplasties. Conclusion: Otoplasty under local anaesthesia offers significant cost savings when compared with the same procedure under general anaesthesia. Economic considerations must be given particular attention given the elective nature of this procedure, which is often publicly funded. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Overview Conclusions Clinical Significance This article explores the ongoing relevance of cement‐retained implant restorations, focusing on their contemporary rationales for their successful use. Comprehensive considerations include esthetic, positional, and occlusal factors alongside recent technological advancements designed to mitigate previous known challenges.In certain clinical scenarios, cement‐retained implant restorations offer distinct advantages such as eliminating access holes for improved esthetics, particularly for malpositioned implants. Modern advancements in materials and techniques have enhanced their predictability, safety, and overall outcomes while minimizing biological risks.When performed within appropriate protocols, cement‐retained implant restorations can effectively address diverse clinical challenges. Recent technical advancements further bolster their utility, supporting esthetic, technical, biomechanical, and biological outcomes in implant rehabilitation of the partially edentulous esthetic zone.Understanding the justifications and guidelines for cement‐retained implant restorations, along with recent technological advancements, enables clinicians to optimize treatment outcomes with greater flexibility while minimizing common limitations in practice. [ABSTRACT FROM AUTHOR]

The severe gummy smile and a skeletal class II profile pose challenges in treatment. This case report outlines an effective alternative for addressing these problems in a patient with skeletal class II division 2, class II molar relationship, retroclination of upper incisors, and lip protrusion. Treatment objectives included normalizing the overjet and overbite, improving the gummy smile, and establishing a satisfactory occlusion. A three-dimensional simulation was performed to consult with the patient, assess possible results, and predict treatment biomechanics. The treatment involved the use of two zygomatic and one inter-radicular temporary anchorage devices, along with botulinum toxin. After the 2-year follow-up, a satisfactory dental occlusion, aesthetic improvement, and adequate function were achieved. This approach offers a viable alternative to orthognathic surgery for adults with skeletal class II malocclusion and a severe gummy smile due to hypermobile lip. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single‐piece zirconia versus titanium narrow‐diameter implants. Additionally, clinical, radiological and patient‐reported outcome measures (PROMs) were analyzed. Materials and Methods: Thirty implants (tissue level implant) were placed in 30 patients in the maxillary esthetic sector. Depending on randomization, a zirconia (test) or titanium implant (control) was placed. Esthetic, clinical, and radiological parameters, including the implant crown esthetic index (ICAI), pink esthetic score (PES), probing pocket depth, bleeding on probing, plaque index, and marginal bone levels, were evaluated at 12, 36 and 60 months after loading. Results: Sixty months after crown placement, no significant differences were found between groups. The ICAI values were 5.25 ± 4.21 and 4.50 ± 2.98 for the test and control groups, respectively. The corresponding PES values were 7.44 ± 1.93 and 7.43 ± 1.74 for the test and control groups, respectively. There were no significant intergroup differences for the rest of the parameters evaluated. Conclusion: It can be suggested that monotype zirconia implants may serve as a potential alternative to titanium implants in selected clinical scenarios. While the results demonstrated comparable esthetic, clinical, and radiological aspects for zirconia implants as compared to titanium implants after a 5‐year follow‐up period, further research with larger sample sizes and longer‐term follow‐up is recommended. [ABSTRACT FROM AUTHOR]

In her 2010 article "Aesthetic Wit(h)nessing in the Era of Trauma", Griselda Pollock lamented the aperture between psychology, particularly that of PTSD, and esthetics in the search to bear witness to traumatic experience. This article explores the gray area that exists when the esthetic and the traumatic converge, arguing that such areas exist not only as direct representations of the difficulty of narrativizing trauma as described by such theorists as Cathy Caruth, Onno van der Hart, and Bessel van der Kolk, but also simultaneously as windows into the moments of what Dominick LaCapra calls "the sublime object of endless melancholia and impossible mourning". Postmodernism is argued to be the organic choice of voicing traumatic retellings, and close readings of John Hersey's proto-postmodern Hiroshima (1946), Tim O'Brien's The Things They Carried (1992), and David Foster Wallace's Infinite Jest (1996) work to highlight the intersections of trauma, postmodern literature, and esthetics; or, in Wallace's case, theoretical discussions of traumatic tropes as facilitated by the postmodern tradition. In drawing attention to this tripartite convergence, this article hopes to continue in the vein of scholarship that reaffirms the need for evermore research in the field of trauma studies as well as substantiate a claim of the heightened importance of postmodern literature in the 21st century—an epoch indelibly marked by trauma, as noted by Pollock. [ABSTRACT FROM AUTHOR]

Background Breast augmentation is one of the most common aesthetic procedures worldwide. Most studies have focused on evaluating the outcome with validated patient-reported outcome measures (PROMs) and factors that may influence them. However, the influence of care delivery, which can be measured with patient-reported experience measures (PREMs), is rarely considered in studies of breast augmentation patients. Objectives In this study we aimed to evaluate the associations between PREMs and PROMs in patients who underwent breast augmentation. Methods A multicenter cohort study was conducted in breast augmentation patients. Patients completed PREMs, including items such as communication between physician and patient, expectation management, welcome, and hygiene, and the BREAST-Q PROM (satisfaction with breasts and psychosocial, physical, and sexual well-being) preoperatively and 6 months postoperatively. Regression analyses were performed to investigate the associations between PREMs and PROMs. Results Overall, 329 patients were included between 2018 and 2022. Univariate regression analysis showed a positive association between PREM and PROM scales. The feeling of being heard (B = −38.39 and B = −18.90), the opportunity to ask questions (B = −9.21), and trust in their physician (B = −39.08) had the highest association with change in the 4 BREAST-Q scales. The multivariable regression analysis showed that the variance in PROMs related to changes in PREMs (19%) was little influenced by patient characteristics (1%). Conclusions Patient outcomes are more positive after breast augmentation when patients feel they are being heard, have the opportunity to ask questions, and have trust in their physician. Future studies should be targeted at optimizing patient-reported experience to investigate whether this improves patient-reported outcomes. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background Keloids are excessive formations of scar tissue that develop at the site of a skin injury. Due to their invasive nature, they have a negative impact on the skin's appearance and are prone to recurrence, making them a challenging condition to treat with regard to skin aesthetics. Objectives The objective of this article was to compare the long-term effects of dermatologic trephination with nonsurgical treatments for scars and evaluate the clinical value of the treatments. Methods A retrospective analysis was conducted of 48 patients who received keloid treatment in the Department of Dermatology and Department of Thoracic Surgery at our hospital from January 2021 to October 2023. Twenty-four patients received dermatologic trephination, and 24 patients received nonsurgical treatment. Outcome measures included scar appearance, scar healing time, pain and itching levels, and patient satisfaction. Results The healing time of patients receiving dermatologic trephination was significantly shorter than that of patients in the nonsurgical group. The degree of itching in patients undergoing dermatologic trephination was significantly lower than that of patients in the nonsurgical group. The satisfaction of patients who received dermatologic trephination was significantly higher than that of patients in the nonsurgical group. Conclusions In this study we demonstrated that trephination achieves better long-term results in keloid revision, including improved keloid appearance, itching symptoms, and patient satisfaction. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background In 2022, the US experienced a significant increase in demand for minimally invasive aesthetic procedures, underscoring its rising acceptance amid an unregulated educational environment for practitioners. The absence of standardized educational pathways and quality control in aesthetic medicine, primarily provided by nonacademic institutions, highlights a critical need for establishing educational standards to ensure practitioner competence and patient safety. Objectives The aim of this study was to identify levels of competency for the aesthetic practitioner and necessary achievement milestones during the educational path from novice to expert injector. Methods A total of n = 386 international study participants responded to an online questionnaire regarding their experience in aesthetic medicine practice. The questionnaire comprised 58 questions focusing on professional data, the perceived difficulty of injection, and risk for the occurrence of adverse events for specific facial regions in soft tissue filler and toxin injections. Results Regardless of medical specialty and experience level, averages of 3.85 (1.8) years, 786.4 (2628) filler injections and 549.9 (1543) toxin injections were estimated to progress from novice to advanced injector, while averages of 6.10 (3.7) years, 1842.2 (4793) filler injections, and 1308.5 (3363) toxin injections were estimated to advance from advanced to expert injector. The nose and the perioral region have been ranked as the facial regions where it is most difficult to achieve a perfect aesthetic outcome and with the greatest risk for the occurrence of adverse events for filler and toxin injections, respectively. Conclusions In this study we establish an educational framework in aesthetic medicine by defining the progression from novice to competent and expert injector levels, suggesting 4 years of practice and over 790 filler and 550 neuromodulator injections for competence, and at least 6 years with 1840 filler and 1310 neuromodulator injections for expertise. We also identify critical facial regions for targeted treatments by different expertise levels. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

Background Reduction mammaplasty relieves macromastia symptoms while improving breast aesthetics, although the ideal breast aesthetically has been shown to differ culturally in previous crowdsourcing studies. Better understanding these differences can aid in setting postoperative expectations. Objectives The aim of this study was to characterize the ideal reduction mammaplasty according to demographics such as gender, ethnicity, socioeconomic status, and education. Methods A crowdsourcing platform was utilized to collect 10,169 deidentified responses. Users completed 1 of 3 surveys, either a preoperative, postoperative, or preoperative and postoperative paired survey. The preoperative and postoperative surveys addressed 10 breast measurements, including upper breast slope, projection proportion, nipple position, breast width, and breast fullness. The paired preoperative and postoperative survey assessed the nipple-areola complex (NAC), chest fit, symmetry improvement, and scarring. Results Preoperative images were rated more aesthetic than postoperative images. This was consistent across all demographics evaluated. Females, African Americans, Asians, participants ages 55+, and participants with no high school degree or a graduate degree found the most improvement in breast symmetry (P =.001, P =.002, P =.027, P <.001, P =.01). Male and Hispanic participants were most likely to see no change in symmetry (P =.008, P =.04), and South Asian participants found breasts less symmetric postoperatively (P <.001). There were significant demographic differences in aesthetic ratings of the NAC, scarring, and breast fit. Conclusions Perceived breast aesthetics after reduction mammaplasty vary significantly across demographics, including gender, ethnicity, age, socioeconomic status, and educational achievement. Surgeons should consider demographics when planning each patient's reduction mammaplasty. Level of Evidence: 5 [ABSTRACT FROM AUTHOR]

Cryolipolysis (CL) is a noninvasive technique in which applicators cool tissue to temperatures that selectively destroy adipocytes. Since its introduction to the market, it has rapidly become one of the leading nonsurgical modalities to reduce fat in the aesthetic industry. Paradoxical adipose hyperplasia (PAH) is a rare adverse reaction to CL, in which there is initial reduction in fat volume, followed by abnormal fat growth exceeding the original volume in the treated area. The incidence of PAH is thought to be underreported, and its pathophysiology and management remains unclear. The objective of this study was to present a series of PAH cases and review efficacy of management modalities. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

This study investigated the influence of social media on patients regarding aesthetic dental treatments according to sex, type of treatment, and time since their last treatment. A cross-sectional study was conducted using a web-based survey. Participants were students over 18 years of age who were social media users and had undergone aesthetic dental treatment. 504 responses were included. Data evaluation was made using Pearson chi-square test. The level of significance was set at p <.05. 29.37% of the respondents indicated that social media influenced their decision to have their aesthetic treatment. Regarding the influence of social media, no differences were observed between males and females, nor by type of aesthetic treatment. Participants who had undergone an aesthetic dental treatment within the last year were more influenced by social media than those who had undergone it more than two years ago. Posts from dental clinics or dentists were the type of content that most influenced participants. Social media can influence some patients' decision to undergo aesthetic dental treatment, thus dental practices and dentists should consider the increasing importance of social media in their daily practice. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key points Plain language summary To analyze the evidence about the influence of the suturing technique and material in terms of the percentage of mean root coverage (%MRC) following root coverage therapy in teeth diagnosed with single/localized gingival recession defects (GRD) via a monolaminar coronally advanced flap.The protocol of this systematic review was registered in PROSPERO (CRD42024514043). A literature search was conducted to identify investigations that fulfilled the eligibility criteria. Variables of interest were extracted, subsequently categorized, and qualitatively analyzed.A total of 15 randomized clinical trials, including 301 localized GRD in non‐molar sites classified as Miller class I‐II/RT1, in 253 patients were included. The studies reporting the combination of sling and single interrupted sutures, or interrupted sutures alone showed an MRC of 70.2%±16.6%, and 74.1%±0.75%, respectively. The highest MRC was observed in the studies using polyglactin 910 with a pooled value of 76.6% ± 15.3%, and monofilament materials, with a pooled MRC of 74.8%±7.1%. When the suturing diameter was evaluated, the highest pooled MRC with values of 79.1%±9.8% was observed with the use of 5‐0.For the treatment of single/localized GRD in non‐molar sites via a monolaminar coronally advanced flap, the use of a combination of sling and single interrupted sutures, or single interrupted sutures, polyglactin 910 or monofilament materials, and material diameter of 5‐0 showed a higher MRC as compared to the use of expanded polytetrafluoroethylene, and silk with/without dressing, and other suture diameters. There were no differences in the percentage of root coverage achieved between the use of sling and single interrupted, versus single interrupted sutures alone on the treatment of single/localized GRD in non‐molar sites. Polyglactin 910 and monofilament sutures resulted in a higher percentage of root coverage achieved as compared to expanded polytetrafluoroethylene, and silk with/without dressing. The use of 5‐0 material diameter showed the highest percentage of root coverage achieved. This study was primarily aimed at evaluating how different suturing techniques and materials could affect the percentage of root coverage in single/localized recession defects, without the use of soft tissue substitutes or autogenous soft tissue grafts. After the pooled analyses of 15 randomized clinical trials that fulfilled the inclusion criteria, we observed that the adequate selection of suturing techniques, materials, and size could lead to a higher percentage of root coverage. Specifically, the use of single interrupted with or without sling sutures at the most coronal portion, Polyglactin 910 or monofilament materials, and size of 5‐0 showed a higher percentage of root coverage as compared to the use of expanded polytetrafluoroethylene, and silk with/without dressing, and other suture diameters. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key points Free gingival graft harvested from the palate is considered the most predictable method to augment the keratinized tissue (KT). However, the anatomical limitations of the palate, and associated patient morbidity and complications restrict clinicians from performing these procedures in adolescents. Color mismatch with the native tissues resulting in poor esthetic appearance is another concern. To overcome these limitations, this article reports a surgical approach known as labial gingival graft (LGG) as an alternative to palatal graft.Two adolescent patients presenting with absence of attached gingiva and shallow gingival recession in the mandibular incisor region were treated with LGG harvested from the labial KT of teeth adjacent to those requiring KT augmentation.The procedure was well tolerated by the patients. At the final follow‐up (3.5‐ and 2 years from baseline), a significant gain in KT with complete root coverage was achieved in both patients. Both professional and patient‐centered esthetic evaluations revealed excellent color match making the grafted area imperceptible from the adjacent mucosa.The proposed technique was found to be simple and predictable, and was associated with minimal morbidity and no complications. Clinicians may consider performing LGG procedure when sufficient KT can be harvested from adjacent donor site. The selection of such techniques is of particular relevance in children who are vulnerable to complications associated with more invasive procedures.Why are these cases new information? To the best of our knowledge, this article is the first to present the use of labial gingival graft harvested from adjacent keratinized mucosa in adolescent patients. What are the keys to successful management of these cases? Proper case selection in terms of sufficient amount of keratinized tissue to harvest as labial gingival graft from adjacent teeth. Use of smaller instruments, small‐sized needles, and sutures under magnification to minimize trauma to the tissues /graft. Preparation of an immobile periosteal bed and suturing protocol that minimizes the dead space and ensures revascularization of graft. What are the primary limitations to success in these cases? A prerequisite of the presence of thick gingiva and sufficient dimensions of KT around the adjacent teeth further limits its applicability in all cases. [ABSTRACT FROM AUTHOR]

Risks of esthetic complications have been reported following dental implant insertion; hence it was suggested that a customized healing abutment could improve the peri-implant tissue healing. Anatomically contoured healing abutments (also called customized healing abutments) help to contain and protect the slow – Resorbing bone grafts, resulting in bone and soft tissue volume augmentation. Even in healed sites, customized healing abutments have shown a favourable outcome as compared to standard healing abutments. This article describes a simple chairside fabrication of precisely contoured healing abutment which will eventually result in a natural contoured soft tissue enhancing the esthetics of the restoration. [ABSTRACT FROM AUTHOR]

Background: Contemporary fixed orthodontic appliances are shifting from non‐customized pre‐adjusted appliances to custom‐designed and printed appliances with novel digital setup systems. We are one step closer to precision dentistry and orthodontics using personalized mechanics and custom appliances. However, despite the evidential enhancement and other improvements to fixed appliances, tooth movement is still limited to five degrees of freedom. Opening or closing spaces still requires manually placing elastomeric chains or coil springs. Aim: In this article, we aimed to demonstrate how advancements in CAD/CAM technology, reverse engineering, and digital customization are helping orthodontics constantly evolve, enabling treatment with enhanced esthetics and minimal compliance. The clinical system (InBrace®, Irvine, CA) described in this article uses a patient‐specific, digitally designed multiloop NITI wire that delivers friction‐free, light, and continuous forces and activates automatically whenever the malocclusion deviates from the digital setup. Conclusion: Through digital customization, InBrace allows for automated tooth movement in all six degrees of freedom, including space opening or closure, via programmed non‐sliding mechanics. Clinical Significance: Precision orthodontics and personalized treatment have been significant developments in orthodontics recently. This article focuses on how a technologically advanced lingual appliance system could achieve targeted cosmetic results methodically via automation and personalization. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the impact of soft tissue structure on the psychosocial effects of malocclusions in women and men. Material and Methods: The severity of malocclusion was determined in 84 individuals with a Class I skeletal pattern. The Psychosocial Impact of Dental Aesthetics Questionnaire was administered to determine the malocclusion perceptions of the patients. Arnett's soft tissue analysis was performed to determine the soft tissue structure. The difference between the sociodemographic factors and severity of malocclusion averages of men and women was statistically examined. Subsequently, the impact of Arnett's soft tissue analysis parameters on the Psychosocial Impact of Dental Aesthetics Questionnaire scores of each gender was evaluated. Results: No statistically significant association was observed between women and men related to the sociodemographic factors and the severity of malocclusions. The number of Arnett's soft tissue analysis parameters affecting the Psychosocial Impact of Dental Aesthetics Questionnaire scores was higher in men than women. Women were more psychologically affected by malocclusions, while men were affected by soft tissue structure changes, and women were affected by dental factors. Conclusion: Although the soft tissue structure did not affect the perception of malocclusions in women, women experienced a more severe psychological effect of malocclusion. [ABSTRACT FROM AUTHOR]

Background Abdominoplasty procedures continue to evolve because combining techniques such as suction-assisted lipectomy or direct subscarpal lipectomy have proven to be powerful adjuncts to achieve optimal aesthetic results. However, concern has been expressed about combining techniques simultaneously given the potential to damage the vascularity of the abdominoplasty flap. Objectives The aim of this study was to assess the safety and efficacy of simultaneous direct subscarpal lipectomy combined with liposuction in abdominoplasty patients. Methods A 4-year retrospective review of consecutive abdominoplasties (n = 200) performed by a single surgeon was conducted. Liposuction of the abdominal flap and flanks was performed in all patients. After raising the abdominoplasty flap, undermining was performed to just beyond the xyphoid, the lower rib margins superiorly, and the anterior axillary line laterally. Fat deep to Scarpa's fascia was then removed by direct tangential excision in all zones of the abdominal flap. Results The patients had a mean age of 42.19 years and BMI of 28.10 kg/m2; the mean follow-up time was 7 months. Seroma occurred in 13 patients (6.5%), superficial wound dehiscence treated with local wound care in 16 patients (8%), hypertrophic scarring in 16 patients (8%), partial umbilical necrosis in 1 patient (0.5%), and partial umbilical epidermolysis in 6 patients (3%). No patients experienced major or minor full-thickness tissue loss. No patients needed reoperation. Conclusions Simultaneous direct excision of subscarpal fat with liposuction of the abdomen and flanks does not appear to subject any zone of the abdominoplasty flap to increased risks of vascular compromise. No flap necroses were observed. The technique described is safe and may provide superior abdominoplasty results. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background Nanotextured implants, an innovation in implant technology, are designed to enhance tissue interaction, reduce inflammation, and mitigate complications of traditional implants. Objectives The aim of the study was to evaluate the aesthetic potential and safety profile of nanotextured breast implants in breast augmentation from a single-surgeon experience. Methods This prospective cohort study included 1000 patients who underwent breast augmentation with nanotextured implants. Aesthetic outcomes were assessed with direct measurements and BCCT.core software, focusing on breast projection, symmetry, and upper pole fullness. Patient satisfaction was measured with BREAST-Q and overall satisfaction surveys. Safety profiles were evaluated based on the incidence of complications such as infection, hematoma, capsular contracture, and implant rupture. Statistical analyses were conducted to assess the outcomes. Results The study found significant improvements in aesthetic outcomes, with 92.8% of cases achieving substantial aesthetic enhancements. Patient satisfaction was high, with 96.4% of patients reporting enhanced self-esteem and contentment. The safety profile was favorable, with a low incidence of complications (0.7% requiring revisional surgery) and no major complications reported. Long-term follow-up data indicated sustained aesthetic outcomes and a stable safety profile. Conclusions The synergistic quality of nanotextured implants in relation to the natural breast gland tissue is defined by a significantly wider range of aesthetic options. The findings of this study underscore the positive impact of nanotextured breast implants on enhancing the aesthetic potential of breast augmentation and their contribution to a low incidence of complications. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background Hyaluronic acid injections are increasingly administered for correction of infraorbital hollows (IOHs). Objectives The objective of this study was to examine the effectiveness (IOH correction) and safety of Restylane Eyelight hyaluronic acid (HAEYE) injections. Methods Patients with moderate/severe IOHs, assessed with the Galderma infraorbital hollows scale (GIHS), were randomized to HAEYE injections (by needle/cannula) (Day 1 + optional Month 1 touch-up) or no-treatment control. The primary endpoint was blinded evaluator–reported Month 3 response, defined as ≥1-point GIHS improvement from baseline (both sides, concurrently). Other endpoints examined investigator-reported aesthetic improvement on the Global Aesthetic Improvement Scale (GAIS), patient-reported satisfaction (FACE-Q satisfaction with outcome; satisfaction questionnaire), and adverse events. Results Overall, 333 patients were randomized. Month 3 GIHS responder rate was significantly higher for HA-EYE (87.4%) vs control (17.7%; P <.001), and comparable between HA-EYE-needle and HA-EYE-cannula groups (P =.967). HAEYE GAIS responder rate was 87.5-97.7% (Months 3-12). Mean FACE-Q Rasch-transformed scores were 64.3-73.5 (HAEYE) vs 14.1-16.2 (control) through Month 12. Patients reported looking younger (≥71%) and less tired (≥79%) with reduced undereye shadows (≥76%) and recovered within 3-5 hours posttreatment. Efficacy was maintained through Month 12 (63.5% GIHS responders) and through Month 18, after Month 12 retreatment (80.3% GIHS responders; 99.4% GAIS responders; FACE-Q scores 72.5-72.8). Forty patients (12.7%) reported typically mild adverse events (4.9% HAEYE-needle; 20.9% HAEYE-cannula). Conclusions HAEYE treatment was effective in correcting moderate/severe IOHs at the primary endpoint (Month 3). Efficacy was sustained through Month 12 after first treatment for 63.5% and through Month 18 for 80.3% (after 1 retreatment) with needle or cannula administration. Safety outcomes were reassuring. Level of Evidence: 1 [ABSTRACT FROM AUTHOR]

Background Despite increasing demand for breast capsular surgery to treat various benign and malignant implant-related pathologies, high-quality evidence elucidating complication profiles of capsulectomy and capsulotomy is lacking. Objectives The aim of this study was to provide the largest-scale analysis of associated outcomes and complications using the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) database, and to investigate clinical scenarios that may subject patients to increased risks for complications, most notably extent of capsular surgery (complete vs partial) and index indication of implantation (aesthetic vs reconstructive). Methods An analysis of the TOPS database from 2008 to 2019 was performed. CPT codes were used to identify complete capsulectomy and partial capsulectomy/capsulotomy cases. Breast implant exchange procedures constituted procedural controls. Results In total, 7486 patients (10,703 breasts) undergoing capsulectomy or capsulotomy were assessed. Relative to controls, capsulectomy (4.40% vs 5.79%), but not capsulotomy (4.40% vs 4.50%), demonstrated higher overall complication rates. Both capsulectomies (0.83% vs 0.23%) and capsulotomies (0.56% vs 0.23%) also had greater rates of seroma relative to controls. Subgroup analyses demonstrated that reconstructive patients, relative to aesthetic patients, experienced greater overall complications (6.76% vs 4.34%), and increased risks for seroma (1.06% vs 0.47%), dehiscence (0.46% vs 0.14%), surgical site infections (1.03% vs 0.23%), and implant loss (0.52% vs 0.23%). A detailed synthesis of 30-day outcomes, including all patient- and breast-specific complications, for both capsulectomy and capsulotomy, stratified according to all potential confounders, is presented herein. Conclusions Surgeries on the breast capsule are safe overall, although complete capsulectomies and reconstructive patients are associated with significantly increased operative risks. The present findings will enhance patient selection, counseling, and informed consent. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background Extending the duration of effect of botulinum toxins—by administering doses beyond those of the approved labels—has been an area of increasing interest in the field of aesthetics. Objectives The aim of this study was to investigate the safety and duration of effect of 40-unit (U) prabotulinumtoxinA-xvfs (twice the approved dose and concentration) for the treatment of moderate-to-severe glabellar lines. Methods A total of 154 adult patients were randomized 1:1:1 to a single treatment of either 40 U prabotulinumtoxinA-xvfs (PRA 40, 5 injections of 8 U/0.05 mL), or 20 U of either prabotulinumtoxinA-xvfs (PRA 20) or onabotulinumtoxinA (ONA 20). Both 20-U controls were administered as 5 injections of 4 U/0.1 mL. Efficacy and safety were assessed on days 2, 7 (by telephone), 30, and every 30 days thereafter up to 365 days or until the patient had returned to baseline. The primary effectiveness endpoint was the duration of effect (estimated by Kaplan-Meier analysis), defined as the number of days from treatment day (baseline) to the day that glabellar line severity at maximum frown by investigator assessment returned to the baseline value. Results Patients had a mean age of 47 years (20-72 years); 69.5% had severe glabellar lines at baseline. Of the 36 adverse events, 32 (88.9%) were mild and 4 (11.1%) were moderate in severity; none were serious. The median durations of effect were estimated to be 183, 149, and 148 days for PRA 40–, PRA 20–, and ONA 20–treated patients, respectively. Conclusions In this phase 2 pilot study, 40 U prabotulinumtoxinA-xvfs was observed to be safe and had a duration of 6 months. Level of Evidence: 1 [ABSTRACT FROM AUTHOR]

Medial canthal widening due to aging is a frequent concern among elderly individuals, often resulting in cosmetic dissatisfaction. This condition commonly involves caruncle exposure and elongation of the medial canthus, sometimes requiring surgical intervention. While medial epicanthoplasty is commonly used to address medial canthal deformities, age-related changes call for a modified approach to optimize aesthetic results. We present two cases of elderly patients whose medial canthal widening was corrected using a modified V-Y advancement flap combined with medial canthal tendon tightening. This technique involves elevating a V-flap and suturing the pretarsal orbicularis oculi muscle and medial canthal tendon to restore medial canthal contour. In one case, an 85-year-old man with unilateral caruncle exposure experienced marked cosmetic improvement post-surgery. In the second case, a 71-year-old woman with bilateral medial canthal widening also reported significant improvement. Both patients had no complications and expressed satisfaction with their postoperative appearance. This surgical approach effectively reduced caruncle exposure and enhanced eye shape with no recurrence or wound healing problems. Medial canthal widening from aging can be successfully treated with a V-Y advancement flap and medial canthal tendon tightening, offering elderly patients a dependable solution with favorable cosmetic results.

Abstract This study investigated the influence of social media on patients regarding aesthetic dental treatments according to sex, type of treatment, and time since their last treatment. A cross-sectional study was conducted using a web-based survey. Participants were students over 18 years of age who were social media users and had undergone aesthetic dental treatment. 504 responses were included. Data evaluation was made using Pearson chi-square test. The level of significance was set at p

The rising demand for aesthetic interventions reflects a broader cultural trend toward enhancing physical appearance and rejuvenation, fueled by technological advancements and increased accessibility of invasive and non-invasive cosmetic procedures. Skin aging, driven by a combination of genetic, hormonal, and environmental factors, results in visible changes such as wrinkles and reduced skin elasticity. The growing availability of cosmetic procedures, including botulinum toxin injections, dermal fillers, and surgical options like rhinoplasty and liposuction, underscores a shift in public attitudes toward cosmetic enhancement and concealing of visible signs of aging. Social media platforms play a crucial role in influencing treatment decisions, changing perceptions and practices of cosmetic procedures. However, uncontrolled expansion of these procedures is associated with risks, including psychological distress and physical complications. Technological innovations, such as ultrasound-guided injections and 3D facial modelling, are improving procedural accuracy, patient safety, and satisfaction. This review examines the driving factors behind the surge in cosmetic procedures, addresses some issues in the field, and evaluates how emerging advanced technologies are enhancing outcomes and safety.

Aim of the Study: The aim of this study is to provide a comprehensive analysis of dental cementation techniques, focusing on the advantages and disadvantages of various approaches, as well as their impact on esthetics in restorative dentistry. Material and Methods: This study employed a systematic approach to gather relevant information, conducting extensive research using electronic databases such as PubMed, Google Scholar, and Web of Science. Articles released from April onwards were targeted, focusing exclusively on English-language publications. A comprehensive set of keywords, including “dental cementation,” “advantages,” “disadvantages,” and “esthetic outcomes,” were utilized to ensure thorough coverage of the topic. Results: The analysis of dental cementation techniques revealed a range of advantages and disadvantages associated with different approaches. These findings provide valuable insights into the impact of various cementation methods on esthetic outcomes in restorative dentistry. Dental cements are engineered to secure restorations, appliances, and post-and-core systems in a stable and durable manner within the oral environment. Conventional glass ionomer and zinc phosphate cements are among the most widely used materials for luting metallic restorations and posts. In contrast, resin-based cements are favored for esthetic applications. The successful cementation of esthetic restorations largely depends on the proper treatment and silane application to the internal surface of the restoration. Conclusions: The findings of this study highlight the importance of carefully considering the advantages and disadvantages of dental cementation techniques in restorative dentistry. Understanding the impact of these methods on esthetic outcomes is crucial for optimizing patient care and treatment outcomes. Further research in this area is warranted to continue improving dental cementation practices and enhancing esthetic results for patients.

Oncoplastic breast-conserving surgery (OBCS) has revolutionized breast cancer treatment, aiming to achieve optimal oncological outcomes while preserving an aesthetically favorable appearance. This review explores the evolution, techniques, and outcomes of OBCS, with a particular focus on the emerging role of acellular dermal matrix in volume replacement techniques. We conducted a comprehensive literature review using PubMed, Medline, and Cochrane databases, focusing on studies published between 2010 and 2024. OBCS demonstrates comparable oncological safety to traditional breast-conserving surgery, with local recurrence rates ranging from 2.7% to 5.7% at 5 years. Patient satisfaction rates are consistently high, with 85% to 95% reporting good to excellent aesthetic outcomes. Volume replacement techniques using acellular dermal matrix show promising results, with one study reporting that 94% of patients were highly satisfied with cosmetic outcomes. Although the current results are encouraging, future advancements in OBCS may require innovative approaches, including the integration of robotic surgery and artificial intelligence technologies.

Purpose: To determine whether immediate implant placement and loading renders different outcomes from delayed loading with respect to midfacial mucosal level in the maxillary esthetic area. Materials and Methods: A literature search was conducted in four electronic databases (PubMed, Web of Science, Embase, and Cochrane), identifying eligible clinical studies published prior to December 2021. Only randomized controlled trials (RCTs) comparing immediate implant placement with or without immediate loading in the maxillary esthetic zone with a mean follow-up of at least 12 months were selected for qualitative analysis and meta-analysis. The Cochrane Risk of Bias tool was adopted to assess the quality of the evidence. The heterogeneity between the pooled literature was analyzed through the chi-square test (P < .05) and quantified by the I2 index. A mixed-effects model was applied if it appeared that there was noteworthy heterogeneity; otherwise, a random-effects model was chosen. For continuous outcomes, the estimate of relative effect was presented to display the standardized mean differences (SMDs) and 95% CIs. For dichotomous variables, the Mantel-Haenszel statistical method was applied with effect sizes expressed as risk ratios (RRs) and 95% CIs. This study is registered on PROSPERO with number CRD42017078611. Results: Out of 5,553 records, 8 RCTs were involved, providing data for 324 immediately placed implants (immediate implants subjected to immediate loading [IPIL]: 163; immediate implants subjected to delayed loading [IPDL]: 161) that had been in function within 12 to 60 months. Meta-analyses revealed significantly lower midfacial mucosal level changes for IPIL compared with IPDL, pointing to 0.48 mm (95% CI: -0.84 to -0.12; P = .01), as well as more significant papillary recession after IPDL (SMD -0.16; 95% CI: -0.31 to 0.00; P = .04). The differences regarding implant survival and marginal bone loss between the two loading groups showed no statistical significance. The result of metaanalyses revealed similar plaque score (SMD 0.03; 95% CI: -0.22 to 0.29; P = .79) and probing depth (SMD -0.09; 95% CI: -0.23 to 0.05; P = .21) for IPIL and IPDL. On the other hand, IPIL induced a trend toward more bleeding on probing (SMD 0.22; 95% CI: 0.01 to 0.42; P = .04) and less change in facial ridge dimension (SMD 0.94; 95% CI: -1.49 to --0.39; P < .01). Conclusion: After a follow-up ranging from 12 to 60 months, midfacial mucosa level change was 0.48 mm lower following IPIL compared with IPDL. Immediate implant placement and loading is conducive to the preservation of physiologic soft and hard tissue architecture, appearing to offer considerable benefits in the anterior zone. In summary, IPIL should be considered in the esthetic zone if the primary implant stability permits. [ABSTRACT FROM AUTHOR]

For women with extremely ptotic breasts, achieving optimal aesthetic outcomes with implant-based breast reconstruction following nipple-sparing mastectomy presents significant challenges. Traditional mastopexy designs may be considered; however, they often lead to nipple-areola complex necrosis due to inadequate blood supply. We propose a novel approach to breast reconstruction that involves skin de-epithelialization to minimize excess mastectomy skin flap, combined with simultaneous contralateral reduction mammoplasty. This technique effectively preserves circulation to the nipple-areola complex while delivering satisfying aesthetic results, offering a viable solution for managing the complexities associated with large, ptotic breasts in patients undergoing nipple-sparing mastectomy.

Dental fluorosis is a subsurface hypomineralization condition, characterized by yellow to dark brown stains, with or without enamel porosity and pitting. Due to aesthetic concerns, children with discolored anterior teeth often experience negative impacts on their psychological, emotional, and social development. Treatment options include porcelain laminates or veneers, direct resin restorations, and crowns. However, these methods are invasive and require significant enamel reduction, making them unsuitable for children due to their enlarged pulp chambers. Microabrasion is the least invasive and safest treatment for children with fluorosis. This technique involves using a combination of 37% phosphoric acid gel with extra fine grain pumice, 18% hydrochloric acid in pumice, or 6.6% and 10% hydrochloric acid with silica carbide particles. The mixture is applied with a slowly rotating rubber cup to the areas of discoloration or white opacities. An additional benefit of microabrasion is that it leaves the enamel surface highly polished, reducing the growth of cariogenic bacteria and increasing resistance to demineralization. This case report describes two instances of dental fluorosis treated with microabrasion using different acidic compounds in two pediatric patients, resulting in clinically acceptable and aesthetically pleasing outcomes.

Esthetics play a very important role in dentistry. In the absence of teeth, the alveolar ridges resorb, causing the facial muscles to lose support, resulting in diminished facial muscle tone, and a slumped cheek. The authors present here a case of a 54-year-old male patient who reported missing upper and lower teeth. An intraoral examination revealed completely edentulous maxillary and mandibular arches. On extraoral examination, the cheeks were sunken, and the skin was wrinkled. For the patient, a complete denture with removable cheek plumpers was advised due to his hollow cheeks. This method accurately determines the space available for cheek plumpers.

Abstract Background The translucency of different zirconia generations at each time point after thermocycling aging is still lacking. Methods Four zirconia materials were used with a total of 60 samples produced from monolithic third generation (5Y) 5 mol% yttria-stabilized zirconia polycrystalline ceramic and fourth generation zirconia (4Y) 4 mol% yttria-stabilized zirconia polycrystalline ceramic, represented by [group1:[CM-5Y] Ceramill Zolid fx (3rd generation zirconia) (Amann Girrbach, Koblach, Austria), group 2:[CM-4Y] Ceramill Zolid HT + (4th generation zirconia) (Amann Girrbach, Koblach, Austria), group 3:[CC-5Y] Cercon XT/ML (Dentsply Sirona, Germany) (3rd generation), and group 4:[CC-4Y] Cercon HT/ML (Dentsply Sirona, Germany) (4th generation)]. The L*a*b* figures were measured by using a spectrophotometer at baseline and after 10,000, 30,000, and 50,000 cycles of thermocycling. At each interval, the translucency of the samples was estimated by using the translucency formula CIEDE2000. The Scheffe post-hoc compared differences among each of the four materials. The Repeated measures ANOVA tested the differences between the materials at each of the different thermocycling intervals (p

Abstract Objective To examine the patterns of pretreatment facial soft tissue shape in orthodontic cases with premolar extraction using artificial intelligence (AI) and to investigate the corresponding changes. Methods One hundred and fifty-two patients who underwent orthodontic treatment with premolar extraction were enrolled. Lateral cephalograms were obtained before and after the treatment. For each record, the outlines of the nose-lip-chin profile and corresponding 21 cephalometric variables were extracted. The AI method classified pretreatment records into three subject groups based on the feature variables extracted from the outline. Dentoskeletal and soft tissue facial form changes observed after treatment were compared statistically (P

This case report exhibits a heavy smoker female patient with a localized stage III periodontitis who has been under cessation smoking program during the pre-surgical period, followed by a strict maintenance program for the past twelve years, after being treated with guided tissue regeneration techniques and restored with zirconia prosthetic crowns. A 50-year-old, heavy smoker (> 40 cigarettes per day), systemically healthy female patient presented complaining of mobility and pain in the upper right central incisor which was temporarily splinted to the left central incisor using resin composite. After clinical and radiographic examination, significant damage of the attachment apparatus, deep periodontal lesions extending the middle portion of the root, and severe infrabony defect were noted. Following the initial hygienic phase, a guided tissue regeneration surgery using xynograft bone substitute covered by a resorbable collagen membrane was performed. After six months of healing, four zirconia crowns were cemented on the central and lateral incisors based on patient esthetic compliance. During the 12-year follow-up period, neither residual pockets nor gingival recession were observed, and perfect marginal bone stability, and esthetic and functional results were noted. This case shows the predictability of a conservative surgical technique, the guided tissue regeneration, based on appropriate treatment planning and a strict maintenance program, it also demonstrates the importance of at least a 6-month healing period after such surgeries, allowing complete tissue maturation and a re-establishment of the supra osseous gingival tissues in order to locate the prosthetic margins without interfering with the soft tissues integrity.

Stefan Stübinger,1 Stefanie Altenried,2 Qun Ren2 1Department of Oral and Cranio-Maxillofacial Surgery, Research Group MIOSTE University Hospital Basel, Basel, 4032, Switzerland; 2Laboratory for Biointerfaces, Empa - Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, SwitzerlandCorrespondence: Stefan Stübinger, Department of Oral and Cranio-Maxillofacial Surgery, Research Group MIOSTE University Hospital Basel, Spitalstrasse 21, Basel, 4032, Switzerland, Tel +41 61 265 70 70, Email stefan.stuebinger@unibas.chAbstract: Professional tooth whitening in the dental office is a popular cosmetic procedure and is performed under carefully monitored conditions. This allows the controlled application of a relatively high concentration of bleaching ingredients based on hydrogen peroxide or peroxide derivatives which produce reactive oxygen species, and consequently induce enamel erosion, alteration of the microhardness of the teeth, irritation of the gums, pain or post bleach sensitivity. This short communication describes the successful and reliable application of a new professional tooth whitening technique using a novel phthalimido peroxycaproic acid complex while avoiding reactive oxygen species.Keywords: in-office bleaching, SEM, composite gel, hydrogen peroxide, esthetics

Shade selection is one of the most important factors that determines the satisfaction of the patient with the dental prosthesis and thus the overall success of the treatment. Conventional methods of shade selection require the presence of existing teeth or past dental/photographic records. In the absence of these, shade selection becomes challenging and must be done subjectively and arbitrarily based on the patient’s age and sex. This study aims to assess the prevalence, satisfaction, and preference of tooth shades, investigating their correlation with age, sex, and skin shade in a diverse sample of 120 participants. Methods A total of 120 participants, evenly distributed among 60 males and 60 females, were surveyed. Participants were categorized into age groups (n=15) and asked about their satisfaction with existing tooth shades and their preferences. Results The most common existing tooth shade was Value 2 (52.5%). Statistical analysis using Chi-square tests revealed that Value 2 was the most desired shade among males and females alike, particularly in the age group of 41 to 50 years (p < 0.001). Shade 2L1.5 was the most prevalent (n=26), with Value 2 (59.16%) being the most sought-after shade, followed by Shade 2L1.5 (n=21), Shade 2M1 (n=18), Shade 1M1 (n=15), and Shade 2R1.5 (n=14). Existing tooth shades of Value 0 were the least common. The highest satisfaction with existing shades was observed in males aged 41 to 50 (n=15), followed by males aged 51 to 60 (n=14) and females aged 31 to 40 (n=12) and 41 to 50 (n=12). Significant differences in satisfaction were noted among males (p < 0.001). Conclusions This study reveals a consistent and strong preference among both males and females for tooth shades classified as Value 2, following the VITA Tooth-Guide 3D Master shade guide. This universal preference suggests the relevance and acceptance of this shade category across diverse patient groups.

This study explores the effect of using dental brushes with or without metacrylate-based modeling resins on long-term color stability and surface topographies of resin-based composites. This study examined the effects of two variables: (1) the type of brush used (Art brush, Micro-brush, or Mylar strip) and (2) the application of a modeling resin (applied or not applied). The specimens were artificially aged through 10,000 cycles of thermocycling and subsequently immersed in coffee for 30 days. Measurements of color and surface roughness were taken at baseline and after the aging, using a non-contact profilometer for surface roughness and a spectrophotometer for color. Data were analyzed using paired t-tests and one-way ANOVA. Resin-based composites smoothed with dental brushes or micro brushes without modeling resins exhibited lower color change (ΔE) than other groups. Paired t-tests revealed significant differences in average surface roughness (Ra) and valley depth (Rv) for each surfacing technique before and after aging (p ⩽ 0.01). The root means square average of the profile heights (Rq) significantly increased in the control and micro-brush groups (p ⩽ 0.01). In conclusion, the use of brushes in resin-based composites placement does not increase the susceptibility to staining. Instead, the inclusion of resin modeling contributes to discoloration over time. [ABSTRACT FROM AUTHOR]

Tessier number 10 cleft is one of the rarest facial clefts. Surgical treatment of this type of cleft is challenging due to the complexity of periorbital and temporal soft tissue deformities. A 23-year-old male patient presented with typical facial deformities of Tessier number 10 cleft. The surgical procedure involved using a free anterolateral thigh flap to reconstruct the eye socket, while the superficial temporal artery pedicle scalp flap was used to reconstruct the eyebrow deformity. The patient had no complications and 16 months after surgery, the patient had good aesthetic results. A hair-bearing scalp flap with a pedicle of the frontal branch of the superficial temporal artery combined with an anterolateral thigh-free flap can effectively resolve most soft tissue deformities of Tessier number 10 cleft and reconstruct the orbital socket in a single surgery. At the same time, it augments the soft tissue of the frontotemporal area and provides good aesthetic results. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate the 5-year safety and efficacy of a narrow-diameter (3.0 mm) implant that was immediately provisionalized with a single crown in the maxillary lateral incisor or mandibular central or lateral incisor area. Materials and methods: An open, prospective, single-cohort, multicenter study was conducted, in which narrow-diameter implants were placed in fresh, healed extraction, or congenitally missing sites. All patients were required to meet strict criteria for immediate loading. The primary endpoints were marginal bone levels (MBL) and MBL changes (MBLC) from implant placement to 5-year follow-up. Secondary endpoints included cumulative 5-year survival and success rates, soft tissue health, and esthetic parameters. Results: A total of 91 implants were placed in 77 patients. The mean MBL remained stable from the 1-year (− 0.79 ± 0.73 mm, n = 75) to 5-year (− 0.74 ± 0.87 mm, n = 65) follow-up. A marginal bone gain of 0.11 ± 0.83 mm was observed from the 1-year to 5-year follow-up. The cumulative 5-year survival rate was 96.5%, and the cumulative 5-year success rate was 93%. The clinical parameters, including the modified plaque index, modified sulcus bleeding index, Jemt’s papilla index, and pink esthetic score improved throughout the 5-year study. Conclusions: The study demonstrated that narrow-diameter implants represent a safe and predictable treatment option for subjects suitable for immediate loading and with limited bone volume or limited inter-dental space. Clinical relevance: Narrow-diameter implants with immediate provisionalization can be considered for use to restore missing or damaged teeth with predictable functional and esthetic outcomes. This trial was registered with ClinicalTrials.gov (NCT02184845). [ABSTRACT FROM AUTHOR]

Background: Using a single‐blind, randomized, controlled, multicenter, practice‐based clinical trial, a volume‐stable collagen matrix (VCMX) was compared with connective tissue graft (CTG) for soft tissue augmentation around existing dental implants. Methods: Sixty patients (31 VCMX and 31 CTG) were included. The primary outcome was a soft tissue thickness change 3 mm below the gingival margin (GM). Secondary outcomes included clinical measures, such as keratinized tissue widths (KTw), probing pocket depths, and pink esthetic scores, and patient‐reported outcomes (PRO). Results: There were no significant differences between test and control patient demographics or clinical measures throughout the 1‐year study. VCMX "grafts" were by design larger than CTG, and surgery time was less (27% less, p = 0.0005). Three millimeters below the GM (primary endpoint), tissue thickness increase was noninferior for VCMX compared with CTG (0.93 ± 0.80 mm vs. 1.10 ± 0.51 mm, respectively), inferior (by 0.25 mm) at 1 mm, and noninferior at 5 mm. Postoperative pain was significantly less for VCMX patients (p < 0.0001), but all other PRO measures, including esthetics and satisfaction, improved similarly for both therapies. Conclusions: Given the inclusion criteria for this study, namely soft tissue augmentation around existing implants with some evidence of KTw and minimal recession, VCMX provided soft tissue thickness and volume increases similar (noninferior) to CTG. Clinical measures and PRO were similar between therapies—site sensitivity and esthetics improved similarly for both therapies—but surgery time and pain following surgery were significantly less for VCMX. [ABSTRACT FROM AUTHOR]

Dental fluorosis is a subsurface hypomineralization condition, characterized by yellow to dark brown stains, with or without enamel porosity and pitting. Due to aesthetic concerns, children with discolored anterior teeth often experience negative impacts on their psychological, emotional, and social development. Treatment options include porcelain laminates or veneers, direct resin restorations, and crowns. However, these methods are invasive and require significant enamel reduction, making them unsuitable for children due to their enlarged pulp chambers. Microabrasion is the least invasive and safest treatment for children with fluorosis. This technique involves using a combination of 37% phosphoric acid gel with extra fine grain pumice, 18% hydrochloric acid in pumice, or 6.6% and 10% hydrochloric acid with silica carbide particles. The mixture is applied with a slowly rotating rubber cup to the areas of discoloration or white opacities. An additional benefit of microabrasion is that it leaves the enamel surface highly polished, reducing the growth of cariogenic bacteria and increasing resistance to demineralization. This case report describes two instances of dental fluorosis treated with microabrasion using different acidic compounds in two pediatric patients, resulting in clinically acceptable and aesthetically pleasing outcomes. [ABSTRACT FROM AUTHOR]