• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.249-256
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• 2022

The implant prosthesis of anterior maxilla requires careful consideration in planning. In order to satisfy both esthetic and functional needs of a patient, fusion of intra-oral scan in Cone-beam computed tomography (CBCT) and facial scan can be considered. Bony structures and soft tissues captured in CBCT and occlusal surfaces of intra oral scan were incorporated into personal characteristics from facial scan. The patient had insufficient buccal bone on maxillary anterior area. The maxillary implants could not be placed on the most ideal position. However, the "top down" approach completed by computer-generated arranging of teeth in implant planning and surgery with surgical guide resulted in esthetically and functionally satisfying result regardless of the limitation. Careful diagnosis with digital technique and the usage of surgical guide resulted in successful surgery and esthetic restoration. The temporary fixed prostheses were designed, restored and evaluated. The patient was not satisfied with the first design of temporary prosthesis, which showed uneven space distribution between teeth due to the position of maxillary implant. The design was modified by changing proximal emergence contours and line angle to alter the perceived since of incisors. The patient was satisfied with the new design of provisional restoration. A digital occlusion analyzer (Arcus Digma II, KaVo, Leutkirch, Germany) was used to measure inherent condylar guidance and anterior guidance of a patient to provide a definitive prosthesis.

• Journal of Korean Dental Science
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• v.6 no.2
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• pp.78-86
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• 2013

Purpose: The purpose of this study was to assess the effects of lip anteroposterior position based on esthetic line on the perceived attractiveness. Materials and Methods: We selected a 20s female standard lateral photograph which was within average range of cephalometric analysis, modified lips anteroposterior position based on esthetic line into 5 pictures. This study investigated and compared the preference of facial profile among the groups; male : female and dental relevance: non-dental relevance. Total 255 judges (male : female=138 : 117, relevant : non-relevant=159 : 96) who were 20s to 30s were asked to rate these photographs based in lip attractiveness using visual analogue scale (VAS). Result: All groups had similarity the average of VAS of moved backward lips 2 mm were highest and moved forward lips 4 mm were lowest. Comparing between male group and female group, there were significant differences in all pictures except for original which was not modified. In the dental groups, moved forward lips 2 mm had significant difference and the average in dental relevant group were lower than non-relevant group in lip protrusion. Conclusion: The preference about lip protrusion was similar irrespective of dental knowledge or gender. All groups preferred retrusion of lips to protrusion of lips. In female group, they had higher the average of VAS. In relevant group, they disliked protrusion rather than retrusion of lips significantly.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.347-353
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• 2018

Gradual attrition is a normal process of aging, but severe attrition causes occlusal disharmony, functional disorder and esthetic problems. The collapse of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). And it induces the pathologic change of the TMJ, unaesthetic facial appearance and decreased masticatory function. In this case, 70 year-old male presented with decreased vertical dimension and esthetic problems due to worn dentition. Based on assessment of intraoral findings, diagnostic cast and radiographic examination, full-mouth rehabilitation with increase of OVD was planned. After 10 month follow-up, occlusal stability is maintained and through this procedure, satisfactory outcomes were achieved in esthetic and functional aspects.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.314-320
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• 2017

In the treatment of esthetically important areas such as maxillary anterior teeth, they should be corresponded with surrounding tissues, and shape of the smile line, soft tissue, and hard tissue, also the anatomical shape and proportion of the teeth should be considered as well. Esthetic analysis includes facial analysis which evaluates the proper parallelism between the occlusal plane and the horizontal reference line, dentolabial analysis which assesses the position of the incisal edge and the coherence between the occlusal plane and the commissural line, tooth analysis which evaluates not only esthetics but also morphology and appearance for proper function, and gingival analysis which forms ideal outline of gingival margins. A maxillary anterior diastema can be esthetically restored through the systematic diagnostic approach and treatment planning, and orthodontic, prosthetic, and conservative treatment can be applied for the treatment.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.28 no.2
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• pp.74-85
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• 2019

The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. A newer technique, VIP-CT (Vacularized Interpositional Periosteal Connective Tissue) graft has been introduced as an alternative to these technique which allows the clinicians perform large volume soft tissue augmentation in esthetic sites with a single procedure. The advantages of the VIP-CT graft technique are that it allows the reconstruction of large soft tissue deficiency, with little constriction postoperatively. Furthermore, it facilitates improved hard tissue augmentation due to the additional blood supply and improved bone healing by mesenchymal cells. Moreover, this technique reduces patient discomfort and treatment time. This clinical report describes the procedure of bone augmentation during immediate implantation in facial dehiscence defect, especially Vascularized Interpositional Periosteal Connective Tissue(VIP-CT) graft for aesthetic anterior soft tissue.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.249-257
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• 2012

Purpose: This study was designed to help to provide the criteria of the esthetic smile in oromaxillary region on twenties, fifties and sixties. Materials and methods: The facial straight photographs of 33 adults (male 15, female 18, mean age 27.2 years old) and 20 seniors (male 7, female 13, mean age 55.6 years old) in resting and smile position were taken. The measurements and proportion of lip-teeth relation during smile were statistically analyzed, and survey of freshmen and seniors who belong to School of Dentistry, Chonnam National University were taken to select the best esthetic smile among the photographs. Results: In the relationship between the upper lip and the teeth, average smile was the most frequent, and mean of smile line ratio was 1.090 in young group and 0.90 in old group. The correlation between the buccal corridor ratio and exposed teeth count was inversed. At smile, most frequently exposed tooth was the second premolar (63.64%) in young gourp and the first premolar (35.00%) in old group. The correlation between the upper lip change ratio and exposed clinical crown length of maxillary central incisor was inverse, but there was no correlation between the lower lip change ratio and exposed clinical crown length of maxillarycentral incisor. Conclusion: In the result of survey, the students selected the case exposed to the first premolar as the most esthetic smile. The most esthetic smile between full facial photograph and the lip only photograph by the freshmen was different, but that by seniors was identical.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.232-236
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• 1998

Fibrous dysplasia is a benign pathologic condition of bone which medullary bone is replaced and disturbed by poorly organized, structually unsound fibro-osseous tissue. When facial bones are involved, considerable esthetic deformity may result. The term monostotic fibrous dysplasia has been applied when one bone is involved : when more than one bone is affected, the term polyostotic used. The polyostotic form may be accomplished by pigmented skin lesion (Jaffe type), or by pigmented skin lesions with endocrine disturbance (Albright syndrome). No general agreement exists on the cause of fibrous dysplasia. A few authors have suggested that fibrous dysplasia as a result of trauma. It occurs predominantly in infant, adolescent females and runs a variable clinical coures. When several bones are involved, it tends to be unilateral. Involvements of alveolar bone may produce displacement of teeth with malocclusion, or loss of teeth, or both. Now, we will present a case of fibrous dysplasia on the left facial region treated by conservative contouring surgery.

• Archives of Plastic Surgery
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• v.44 no.3
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• pp.188-193
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• 2017

Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.2
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• pp.82-87
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• 1990

There are some methods of approach to the temporomandibular joint. The preauricular, the endaural and the postauricular incision are frequently used among those. The preauricular incision necessiates a preauricular scar, possible postopertive facial nerve damage and is the least cosmetically desirable incision. The endaural incision is more esthetic than preauricular incision, but it is not sufficient. The postauricular approach allows adequate exposure with decreased occurence of injury to facial nerve and excellent cosmetic results. The purpose of this report is to discuss the surgical approach of postauricular incision to the cases of TMJ ankyloses, internal derangement and condylar fracture of mandible.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.6
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• pp.707-716
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• 2005

Statement of problem. Collarless metal ceramic fixed partial dentures(FPDs) had an esthetic problem such as opaque reflection in cervical region. To overcome this, modified coping which removed its facial cervical metal could be used. The marginal quality could be worsen according to the amount of its facial metal reduction. Purpose. The purpose of this study was to evaluate marginal fits of collarless metal ceramic FPDs with retainers of modified copings. Material and method. Dentoform maxillary left central incisor and right lateral incisor were prepared for 3-unit collarless metal ceramic FPD and fixed in yellow stone. This model was duplicated to PBT resin dies via CAD/CAM and injection molding. Four different facial margin design groups were investigated. Group A was a coping with a thin facial metal collar, group B was a collarless coping with its facial metal to the shoulder, group C was a collarless coping with its facial metal 1 mm short of the shoulder, and group D was a collarless coping with its facial metal 2 mm short of the shoulder. Seven collarless metal ceramic FPDs per group were fabricated. They were cemented to PBT resin dies with resin cement. After removal of pontics, each retainers were separated and observed under Accura 2000 optical microscope. Then, retainers were embeded in orthodontic resin and cross sectioned faciopalatally. Internal marginal fits of midfacial porcelain margins were observed under FE-SEM. Result and conclusion. Within the limitations of this in vitro study. The following conclusions were drawn. 1. Mean marginal gaps of collarless FPDs were in the $50-60{\mu}m$ range. 2. In midfacial margin, marginal discrepancies were greater in group A than in the experimental groups(p<0.05). 3. In midpalatal margin, marginal gaps were greater in group C and D than in group A and B(p<0.05). 4. Marginal fits of porcelain margins were better than those of metal margins in collarless metal ceramic FPDs. 5. In both teeth, internal marginal gaps of group C and D were greater than those of group A and B(p<0.05).