• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.3
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• pp.170-179
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• 2019

The prosthodontic treatments in maxillary anterior teeth focus on achieving esthetic appearances. It is possible to improve the esthetic appearance by adjusting the shape, arrangement, and color of the maxillary anterior teeth. For anterior teeth restoration, it is necessary to evaluate the relationship of teeth, lip and gingival architecture with the facial profile of patient. Also, clinician needs to fully understand what the patient wants to. DSD (digital smile design) concept can be applied as a tool to improve communication with the clinician, technician and patient. In addition, DSD can help to meet the needs of the patient. In this case, it was impossible to achieve symmetry due to congenital missing of maxillary central incisor. The definitive treatment goal was to get the harmony of maxillary anterior teeth, lip and the patient's face. This case report describes that the patient and clinician got the satisfying esthetic outcome by using DSD.

• The Journal of the Korean dental association
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• v.57 no.3
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• pp.149-160
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• 2019

Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.5 no.1
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• pp.1-12
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• 1996

The arrangement of anterior artificial teeth is an important factor on the esthetics in the construction of complete dentures and prostheses. During construction of the complete denture the position of maxillary central incisor plays an important role in the arrangements of artificial teeth. The proper position of maxillary central incisor provides natural appearance of anterior teeth and the anterior reference point of occlusal plane. Many methods have been utilized to eatablish the position of the maxillary central incisor in complete denture prosthodontics. However, there has not been provided for the reference for Korean yet. This study was aimed to extablish a guide for the position of the maxillary central inciosr in Koreans. The horizontal and vertical distance between the maxillary central incisor and incisive papilla in Koreans were measured. 1. The mean value of horizontal distance from the maxillary central incisor to the incisive papilla had significant sexual difference, The average distance was 12.648mm in male and 11.385mm in female. 2. The horizontal distance of the incisive papilla had sexual difference, the average distance was 6.182mm in male and 5.622mm in female. 3. The vertical distance from the maxillary central incisor to the incisive papilla had not sexual difference, the average distance was 7.21mm. 4. The crown length of the maxillary central inciosrs from the distal interdental papilla had not sexual difference, the right central incisor was 6.40mm(mean) and the left central inciosr was 6.43mm(mean). 5. The clinical crown length of the maxillary central incisors had not sexual difference, the right central incisor 10.35mm(mean) and the left central incisor was 10.43mm(mean). 6. The shapes of the incisive papilla were pear(68.4%), oval(16%), triangular(6%), irregular(5%), rectangular(4%), and inverted pear(1%) shape.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.1
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• pp.85-97
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• 1995

The arrangement of anterior artificial teeth is an important factor on the esthetics in the construction of complete denture and prosthesis. During construction of the complete denture the position of maxillary central incisor plays an important role in the arrangements of artificial teeth. The proper position of maxillary central incisor provides natural appearance of anterior teeth and the anterior reference point of occlusal plane. Many methods have been utilized to eatablish the position of the maxillary central incisor in complete denture prosthodontics. However, there has not been provided for the reference for Korean yet. This study was aimed to extablish the position of the maxillary central inciosr in Korean. The horizontal and vertical distance between the maxillary central incisor and incisive papilla in korean were measured. The results were as follows : 1. The mean value of horizontal distance from the maxillary central incisor to the incisive papilla had significant sexual difference, the average distance was 12.648mm (male), 11.385mm(female). 2. The horizontal distance of incisive papilla had sexual difference, the average distance was 6.182mm(male), 5.622mm(female). 3. The vertical distance from the maxillary central incisor to the incisive papilla had not sexual difference, the average distance was 7.21mm. 4. The crown length of maxillary central inciosrs from the distal interdental papilla had not sexual difference, the right central incisor was 6.40mm(mean) and the left central inciosr was 6.43mm(mean). 5. The clinical crown length of the maxillary central incisors had not sexual difference, the right central incisor 10.35mm(mean) and the left central incisor was 10.43mm(mean). 6. The anatomic shapes of incisive papilla were pear(68.4%), oval(16%), triangular(6%), irregular(5%), rectangular(4%), and inverted pear(1%) shape.

• The Journal of Advanced Prosthodontics
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• v.4 no.1
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• pp.13-17
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• 2012

PURPOSE. We aimed to identify a more esthetic width-to-length ratio by analyzing maxillary central incisor of Korean adult population. Information regarding tooth ratio in the Korean population may be useful to clinicians when restoring anterior teeth. MATERIALS AND METHODS. A total of 40 men and 40 women were included in this study. The NON-MEDIA group included 40 non-celebrities, who were healthy and 25 to 39 years old, with normal dentofacial appearance. The MEDIA group consisted of 40 celebrities selected only on the basis of their soft-tissue facial appearance. The facial photographs of 40 celebrities were collected from the Internet websites. The width and length of the maxillary central incisor were measured using Adobe $Photoshop^{(R)}$ 7.0, a software for analysis, measurement and edition of photographs. Data were analyzed statistically using the Independent t-test at 5% statistical significance level. RESULTS. The mean ratio for the MEDIA group was 0.77, whereas that of the NON-MEDIA group was 0.88. The difference between the two groups was statistically significant. No significant gender differences were found in the width-to-length ratio in MEDIA group. In NON-MEDIA group, however, there were significant differences between female and male. CONCLUSION. After analyzing maxillary anterior teeth of Korean adults, our results were in accordance with the general Western standards of esthetics. A dentist restoring the natural look and beauty of teeth will have to consider those standards.

• Journal of dental hygiene science
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• v.7 no.3
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• pp.201-205
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• 2007

This study was designed to compare the perception of dental hygiene students and general public with respect to minor variations in maxillary anterior tooth size, alignment and their relation to the surrounding soft tissues. Maxillary anterior teeth were intentionally diagrammed in varying degree of deviation with respect to one of three common anterior esthetic discrepancies including variations in crown length, shape of gingival margin, and length of interproximal contact. Seventeen images were generated to be preferentially selected by 2 groups consisting of dental hygiene students and lay people in Busan(total of 216). The obtained results were as follows; 1. Both group preferred gingival margin of lateral incisor to be 0.5mm lower than that of central incisor. 2. Both group preferred the gingival margin shape of central incisor has 1/9 horizontal component of the crown width. 3. Both group preferred length of the interproximal contact has 1/2 of the crown length. The results of this study may be considered to influence the decision making process by dental professionals with respect to designing the anterior esthetic gingival line.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.242-250
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• 2004

In general, the skeletal class III has the characteristics of mandibular overgrowth with a normal maxillary growth or maxillary undergrowth with a normal mandibular growth And clinical and radiographic evaluations of the patient are needed. However, the treatment plan is not dependent on these evaluations alone, because patient's general condition and hope for aesthetics varies. The aim of this report is to consider the treatment of a medically compromised patient with an anterior open bite and skeletal class III, which showed a severe mandibular overgrowth. In 2003, a 17-year-old boy with epilepsy, mental retardation presented at our clinic complaining of concave profile. A clinical examination showed severe mandibular prognathism with an anterior open bite. The radiographic examination revealed a short cranial base, a moderate maxillary overgrowth, severe mandibular overgrowth and skeletal open bite tendency. In 2004, he was verified to have no potential of growth by hand-and-wrist radiographs and an endocrine examination. He completed the preoperative orthodontic treatment and orthognathic surgery (sagittal split ramus osteotomy, genioplasty). He was evaluated on the first visit, the preoperative period and the postoperative period with a clinical and radiographic examination. At the first visit, the patient showed moderate overgrowth of the maxilla, severe overgrowth of the mandible, and a subsequential skeletal open bite. After the preoperative orthodontic treatment (preoperative period), the patient showed the same skeletal problem as before and a decompensated dentition for orthognathic surgery. After orthognathic surgery, his profile had improved, but he had still a skeletal openbite tendency because the maxillary orthognathic surgery was not performed. Severe mandibular prognathism with a maxillary overgrowth and anterior open bite should be treated by bimaxillary orthognathic surgery. However, one-jaw orthognathic surgery on the remaining the skeletal open bite tendency was performed for his medical problem and facial esthetics. This subsequential open bite should be resolved with a postoperative orthodontic treatment.

• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.2
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• pp.105-111
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• 2005

It is essential to establish the suitable position for artificial maxillary anterior teeth, because of not only esthetics, phonetics, mastication, but also optimal position of artificial posterior teeth for the construction of functional and esthetic prostheses. Anatomic landmarks have been used in the arrangement of artificial teeth. Such as incisive papilla and palatal rugae are useful landmarks for positioning occlusal rim and upper anterior artificial teeth because they are relatively stable and to be identified on master cast. Therefore, if average distance between maxillary anterior teeth and landmarks in dentate subjects are measured and applied, appropriate position of occlusal rim can be initially established. In this study, to present a guide to the position of the occlusal rim for upper anterior teeth of edentulous patients, horizontal distance between anatomic landmarks were measured. Maxillary casts were made in 72 Korean dentate subjects. Horizontal distance between central incisor and incisive papilla, between incisive papilla and intercanine line, and between primary palatine rugae and gingival margin of canine were measured on each cast. The results of this study were as follows ; 1. The mean distance from the incisal edge of central incisor to the posterior border of incisive papilla was 12.1 mm (Male 12.2 mm, Female 11.9 mm). 2. The mean distance between posterior border of incisive papilla and intercanine line was 3.5 mm (Male 3.4 mm, Female 3.6 mm / Left 3.6 mm, Right 3.4 mm). 3. The mean distance from the palatal gingival margin of canine to the lateral border of primary palatine rugae was 2.4 mm (Male 2.4 mm, Female 2.4 mm / Left 2.4 mm, Right 2.3 mm). 4. On all measured items, there were no significant differencies in measured values between male and female, and between left and right sides. (P>0.05).

• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.111-120
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• 1995

This case report presents two maxillary anterior cases for clinical crown lengthening by forced eruption. In the first case, clinical crown of maxillary right lateral incisor was almost lost by fracture. Forced eruption using intracoronal splint and elastic thread accomplished vertical root movement successfully. Then, post & core was inserted and final restoration was harmonious with adjacent teeth. In the second case, the crown portion of maxillary right central incisor was almost mutilated by secondary caries. Forced eruption using removable Hawley appliance and elastic accomplished vertical root movement successfully. Then, post & core was inserted and final restoration was placed. In conclusion, clinical crown lengthening by vertical root movement can be accomplished by a simple appliance without any sacrifice of periodontal support in selected patients. A clinical crown so created can be restored to adequate function and arch integrity without compromising adjacent teeth. Therefore, forced eruption is preferred in the anterior region of the dentition where esthetics is of major concern.

• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.188-193
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• 2010

Purpose: The aim of this study is to assess the influence exerted by the observer's dental specialization and compare patients' opinion with observers' opinion of the esthetics of maxillary single-tooth implants in the esthetic zone. Methods: Forty-one adult patients, who were treated with a single implant in the esthetic zone, were enrolled in this study. Eight observers (2 periodontists, 2 prosthodontists, 2 orthodontists and 2 senior dental students) applied the pink esthetic score (PES)/white esthetic score (WES) to 41 implant-supported single restorations twice with an interval of 4 weeks. We used a visual analog scale (VAS) to assess the patient's satisfaction with the treatment outcome from an esthetic point of view. Results: In the PES/WES, very good and moderate intraobserver agreements were noted between the first and second rating. The mean total PES/WES was $11.19{\pm}3.59$. The mean PES was $5.17{\pm}2.29$ and mean WES was $6.02{\pm}1.96$. In the total PES/WES, the difference between the groups was not significant. However, in the WES, the difference between the groups was significant and prosthodontists were found to have assigned poorer ratings than the other groups. Periodontists gave higher ratings than prosthodontists and senior dental students. Orthodontists were clearly more critical than the other observers. The statistical analysis revealed statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth. However, the correlation between the total PES/WES and the VAS score for the first premolar was not statistically significant. Conclusions: The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth.