• The Journal of Korean Academy of Prosthodontics
• /
• v.53 no.3
• /
• pp.262-275
• /
• 2015

The treatment of areas demanding esthetic requirements, such as maxillary anterior teeth, should take into account the achievement of a healthy, harmonious to the surrounding tissue, and an attractive smile line. In this case report, smile line, soft tissue and hard tissue morphology, and the anatomy and proportion of the tooth, must be considered. In patients with unesthetic maxillary anterior ratio due to inadequate gingival contour and diastema caused by peg lateralis, it would be challenging to achieve an esthetic restoration by orthodontic treatment alone. In such case, after orthodontic treatment, dento-gingivo-facial compositional diagnosis and analysis, followed by gingivectomy and prosthodontic restoration is needed to improve the interdental mesial/distal, width/length ratio to achieve a satisfactory esthetic result. In addition, when improving the tooth proportion of peg lateralis by prosthodontic treatment, Porcelain laminate veneer (PLV), which results in less tooth structure loss, reproduction of similar shade to that of the proximal tooth and high transparency, is recommended. This case report demonstrates esthetic improvements by prosthodontic restoration through systematic diagnosis and treatment procedure in patients with unesthetic maxillary anterior proportion after orthodontic treatment due to peg lateralis by means of two female patients aged twenty years old.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.2
• /
• pp.333-338
• /
• 2008

Supernumerary teeth are characterized by an excess number of teeth, which can be responsible for a variety of irregularities in the primary and transitional dentition. Supernumerary teeth, especially in the maxillary anterior region, may prevent the eruption of adjacent permanent teeth and cause their ectopic eruption, diastema, root resorption, or formation of dentigerous cyst. Therefore, early diagnosis of supernumerary teeth is important for prevention of such complications, and adequate treatment should be given according to their location, number, and morphologic features. In this case, four supernumerary teeth in the maxillary anterior region were disturbing the eruption of adjacent permanent incisors. Two of them were located in proximity to the central incisor tooth germs that their immediate removal may injure the permanent tooth germs. In order to minimize such complications, surgical extraction of the four supernumerary teeth was performed in two stages. At first, only two inverted conical supernumerary teeth were extracted. The other two tuberculous supernumerary teeth, close to the permanent tooth germs, were extracted later after their natural dislocation. In that way, we could minimize affects on the neighboring permanent tooth germs and also the amount of alveolar bone removed during surgery.

• The Journal of Korean Academy of Prosthodontics
• /
• v.36 no.2
• /
• pp.245-257
• /
• 1998

This study was performed to measure the changes of the mandibular movement and the masticatory muscular activities - anterior temporal and masseter muscle of both side - reflected by intentional increase of anterior guidance angie. For this study, 5 volunteers (3 males and 2 females with average age of 24.0) were selected. Each volunteer had Angle's classification I and did not have any missing tooth except third molar and any extensive restorations. Metallic guide plate was made at volunteer's working model fabricated by improved dental stone and cemented to the palatal surface of maxillary central incisor using resin cement(Panavia $21^{(R)}$) and then adjusted not to give any occlusal interferences at intercuspal position. The activity of masticatory muscles and the changes of mandibular movement were recorded by EMG and Sirognathograph in Biopak analysing system(Bioresearch Inc., Milwaukee, Wisconsin, USA). Measurement was done at before experiment, immediatley after placement, 1 week after placement, immediately after removal, and 1 week after removal. The results were as follows: 1. Moderate phonetic disturbance and mild headache were occured to 3 volunteers for 2 days after setting and 1 volunteer had positive reaction to percussion and slight midline diastema. But all of these clinical signs were diappeared 1 week after removal and the other volunteer did not have any special clinical sign. 2. In the EMG of the mandibular rest position, the mean value of anterior tempotal muscle was increased immediately after placement(p<0.01) and then decreased 1 week after placement(p<0.05) and increased 1 week after removal(p<0.05) but not recovered as before experiment. The mean value of masseter muscle was decreased during the experiment period. 3. In the EMG during mandibular protrusive movement, all muscular activity was decreased during the experiment period. Reduced activity was not recovered 1 week after removal(p<0.03). 4. During the habitual opening, anteroposterior movement of mandible was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not statistically significant(p>0.1). Vertical movement was not shown significant difference during the experiment period(p>0.1). Lateral movement was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not recovered as before experiment. The opening and closing velocity of mandible was shown minor changes but not statistically significant. 5. During the habitual opening, anteroposterior movement of mandible was decreased 1 week after placement(p<0.05) and then increased immediately after removal and recovered 1 week after removal as before experiment. Vertical movement was not shown significant changes. Lateral displacement of mandible was increased continuously and recovered 1 week after removal. Opening velocity was temporarily increased immediately after removal but recovered and closing velocity was not shown significant changes. 6. During the right side chewing, anteroposterior movement of mandible was increased immediately after removal but recovered and vertical movement was not shown statistically significant results. Lateral displacement and velocity of mandible were not shown significant results. 7. During the left side chewing, the changes of mandibular movement pattern were not shown statistically significant results.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.10 no.1
• /
• pp.30-45
• /
• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.41 no.3
• /
• pp.207-217
• /
• 2014

The purpose of the present study was to evaluate the relationship between the malocclusion and dental caries in adolescents with permanent dentition. The subjects of the study were 385 adolescents aged 12 to 15 years. Dental Aesthetic Index (DAI) and DMFT index were recorded as clinical indicators of malocclusion and dental caries. The mean Dental Aesthetic Index (DAI) score of the subjects was 12.42 and the mean DMFT index of the subjects was 2.89. Four students (1.04%) were included in the group of orthodontic treatment mandatory, which signifies the handicapping malocclusion. Moreover, the result of gender-specific analysis of the DAI components observed that the prevalence of midline diastema and mandibular overjet were significantly higher among boys (p < 0.05). In 7 components (missing teeth, incisal segment crowding, maxillary anterior irregularity, mandibular anterior irregularity, mandibular overjet, anterior openbite, antero-posterior molar relationship) among the 10 DAI components, abnormal groups showed significantly higher DMFT index than normal groups (p < 0.05). The subjects in the group of definite to handicapping malocclusion (DAI ${\geq}$ 26) showed significantly higher DMFT index than the subjects in the group of minor or no malocclusion (p < 0.01). In addition, the DAI score had significant positive linear correlation with the DMFT index (r = 0.584, p < 0.01). Consequently, the current findings suggested a positive relationship between the malocclusion and caries prevalence. And several specific types of malocclusion were supposed to be significantly correlated with dental caries.