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Masking Ability of Subtractively and Additively Manufactured Dental Ceramic Restorations: A Systematic Review. 减法和加法制造牙科陶瓷修复体的掩蔽能力:系统综述。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-01-08 DOI: 10.1111/jerd.13406
Karen Du, Teuila Muao, Polina Plaksina, Sharon Tsz-Han Hung, Andrew B Cameron, Joanne Jung Eun Choi

Objective: To conduct a systematic review on the masking ability of subtractively and additively manufactured dental ceramics.

Materials and methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The electronic search was carried out through MEDLINE, Scopus, and Website of Science databases with a date restriction being from 2001 onwards. Publications in English, in vitro studies, and studies regarding the evaluation of the masking ability of crown materials that were subtractively and additively manufactured were included.

Results: Out of 619 eligible articles, 13 were included. A thickness of 1.5 mm for lithium disilicate (LD) resulted in a dramatic decrease in ∆Eab/∆E00 across all substrates compared to a 1 mm thickness. Low-translucent LD appeared to have the best masking ability regardless of the shade of the try-in paste. Layering flowable composite over the substrates improved masking ability. Darker substrates were the hardest to mask no matter the type of restorative material, try-in paste used, and layering technique. Bilayered restorative materials proved to be superior to monolithic materials regarding masking ability.

Conclusion: Increasing the thickness of subtractively manufactured ceramics materials improves the masking ability. 1.5 mm thickness is found to provide the best masking ability for most ceramic materials. Darker substrates prove to be difficult to mask in comparison to lighter substrates and require either thicker materials and/or more opaque cements. Bilayered crowns are recommended for achieving optimal masking while preserving tooth structure. Despite the increasing demand, there is no study available on 3D-printed (additively manufactured) restoration's masking ability.

Clinical significance: This review provides a comparison of masking abilities of multiple subtractively manufactured ceramic materials and highlight the lack of current knowledge on additively manufactured crown materials. It also emphasizes the importance of having a universal approach to interpreting and communicating color changes between collaborative dental professionals to ensure the same shade predictions. In addition, when masking darker shades, clinicians should be aware that alternative material choice or clinical and technical procedures are essential.

目的:对减法和增材口腔陶瓷的掩蔽性能进行系统评价。材料和方法:本研究遵循系统评价和荟萃分析首选报告项目(PRISMA)声明。电子检索通过MEDLINE、Scopus和Website of Science数据库进行,检索日期限制为2001年以后。包括英文出版物,体外研究,以及关于减法和增材制造的冠材料遮蔽能力评估的研究。结果:619篇符合条件的文章中,13篇被纳入。与厚度为1mm的衬底相比,厚度为1.5 mm的二硅酸锂(LD)导致所有衬底上的∆Eab/∆E00急剧下降。无论试入膏体的色度如何,低半透明的LD都具有最好的遮盖能力。在衬底上分层可流动复合材料提高了掩蔽能力。无论修复材料的类型、使用的试入膏和分层技术如何,较暗的基材都是最难遮盖的。在掩蔽能力方面,双层修复材料优于单片材料。结论:增加减法制备的陶瓷材料的厚度可以提高掩蔽能力。对于大多数陶瓷材料来说,1.5 mm的厚度提供了最好的掩蔽能力。与较轻的基材相比,较深的基材难以遮盖,需要较厚的材料和/或更不透明的水泥。双层冠被推荐用于在保持牙齿结构的同时达到最佳的遮蔽效果。尽管需求不断增加,但目前还没有关于3d打印(增材制造)修复的掩蔽能力的研究。临床意义:本综述比较了多种增材制造的陶瓷材料的掩蔽能力,并强调了目前对增材制造冠材料的了解不足。它还强调了有一个通用的方法来解释和沟通合作牙科专业人员之间的颜色变化,以确保相同的色调预测的重要性。此外,当遮盖较深的阴影时,临床医生应该意识到替代材料的选择或临床和技术程序是必不可少的。
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引用次数: 0
Does Cigarette Smoke Affect Permanent Resin-Based Crown Materials? 香烟烟雾会影响永久性树脂基牙冠材料吗?
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-01-06 DOI: 10.1111/jerd.13403
Ezgi Sonkaya, Koray Soygun, Öykü Ceren Kahraman

Objective: The purpose of this study was to investigate how cigarette smoking affects the surface roughness (Ra) and stainability of additively and subtractively manufactured resins.

Materials and methods: Two additively manufactured definitive resins (Dentafab, DF and Formlabs, FL) and a subtractively manufactured resin nanoceramic (Cerasmart, CS) were used to fabricate 60 specimens (14 × 12 × 1 mm). After taking baseline Ra and color measurements (ΔE00), they were divided into two groups (n = 10). Using a programmable cigarette smoking simulation device, the study groups smoked 10 cigarettes a day for 30 days. The control groups were kept in artificial saliva for 30 days. The Ra and ΔE00 were performed again. Scanning electron microscope images were taken. Kruskal-Wallis test, Mann-Whitney U, Bonferroni, and Wilcoxon Signed Rank tests were used for statistical analyses (α = 0.05).

Result: Significantly less discoloration was observed in the FL group compared with the other groups (p < 0.001). The Ra of the DF study groups was statistically significantly higher than the control groups (p = 0.005).

Conclusion: All the tested materials had moderately unacceptable color change when previously reported threshold values were considered. There was not found to be any linear correlation between the Ra of materials and smoking-induced discoloration.

Clinical significance: The discoloration and surface roughness of three-dimensional (3D)-produced SLA definitive resin because of smoking are at acceptable levels. Optimized physical and chemical properties of definitive resins are clinically important to extend the life of the restoration. The application of 3D definitive resin can be recommended in clinical practice.

目的:研究吸烟对加减法树脂表面粗糙度(Ra)和可染性的影响。材料和方法:使用两种增材制造的确定树脂(Dentafab, DF和Formlabs, FL)和一种减材制造的树脂纳米陶瓷(Cerasmart, CS)制造60个样品(14 × 12 × 1 mm)。在进行基线Ra和颜色测量(ΔE00)后,将他们分为两组(n = 10)。使用可编程的吸烟模拟装置,研究小组每天抽10支烟,持续30天。对照组用人工唾液喂养30 d。再次进行Ra和ΔE00检查。拍摄扫描电镜图像。采用Kruskal-Wallis检验、Mann-Whitney U检验、Bonferroni检验、Wilcoxon sign Rank检验进行统计学分析(α = 0.05)。结果:与其他组相比,FL组明显减少变色(DF研究组的p = 0.005显著高于对照组)。结论:当考虑先前报告的阈值时,所有测试材料的颜色变化都是中度不可接受的。没有发现材料的Ra与吸烟引起的变色之间有任何线性相关。临床意义:三维(3D)生成的SLA确定树脂因吸烟引起的变色和表面粗糙度处于可接受的水平。优化确定树脂的物理和化学性质对延长修复体的使用寿命具有重要的临床意义。在临床实践中可推荐应用三维确定树脂。
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引用次数: 0
Immediate Pre-Endodontic Dentin Sealing (IPDS) Improves Resin-Dentin Bond Strength. 即刻牙髓前牙本质密封(IPDS)提高树脂-牙本质结合强度。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-01-06 DOI: 10.1111/jerd.13395
Marco A Carvalho, Priscilla C Lazari-Carvalho, Paulo E T Maffra, Thábata F Izelli, Marco Gresnigt, Carlos Estrela, Pascal Magne

Objective: Chemicals used during canal disinfection and endodontic sealers have a deleterious effect on dentin bond strength. The aim of this study was to evaluate a novel clinical sequence to improve the resin-dentin microtensile bond strength (μTBS) to endodontically treated teeth.

Materials and methods: Twenty human molars were distributed in four experimental groups (n = 5, N = 20): C-control group without exposure to any endodontic chemical substances (2.5% sodium hypochlorite, 17% EDTA and endodontic cement); LDh-late dentin hybridization (Dh) with Dh at the time of final restoration, after exposure to chemical substances; IPDS-immediate pre-endodontic dentin sealing, with Dh before exposure to chemical substances; and PLDh-late Dh after exposure to chemical substances and after dentin repreparation with ultrasonic diamond tip. Teeth were restored with resin composite and the microtensile test was performed after 24 h.

Results: The highest bond strength values were found in the PLDh, IPDS, and C groups, without statistically significant differences among them. The lowest value was found in the LDh group. The LDh group presented a decrease of 70% when compared with the control group.

Conclusion: The resin-dentin microtensile bond strength was significantly improved by dentin hybridization before exposure to chemicals used during endodontics. Otherwise, substantial dentin repreparation is necessary to restore the bond strength after this exposure.

Clinical significance: Early dentin hybridization (IPDS) before endodontic treatment not only improves the microtensile bond strength to dentin but also omitting this procedure would require significant repreparation of the exposed dentin after endodontic treatment to restore the bond strength. Hence, it allows the preservation of healthy tooth structure (no need for repreparation), as well as the reinforcement of weakened cusps and improvement of isolation (if combined with deep margin elevation, when necessary).

目的:根管消毒和根管封闭时使用的化学药品对牙本质结合强度有不良影响。本研究的目的是评估一种新的临床序列,以提高树脂-牙本质与根管治疗后牙齿的微拉伸结合强度(μTBS)。材料与方法:20颗人磨牙分为4个实验组(n = 5, n = 20): c -对照组不接触任何根管化学物质(2.5%次氯酸钠、17% EDTA和根管水泥);暴露于化学物质后,ldh -晚期牙本质杂交(Dh)与最终修复时的Dh;ipds -即刻牙髓前牙本质密封,在接触化学物质前使用Dh;化学物质暴露后和超声金刚石尖牙本质再制备后的pldh -后期Dh。采用树脂复合材料修复牙体,24h后进行微拉伸试验。结果:PLDh组、IPDS组、C组粘结强度值最高,差异无统计学意义。LDh组最低。LDh组与对照组相比下降了70%。结论:牙本质杂交可显著提高牙本质与树脂的微拉伸结合强度。否则,大量的牙本质重新准备是必要的,以恢复这种暴露后的结合强度。临床意义:根管治疗前早期牙本质杂交(IPDS)不仅可以提高与牙本质的微拉伸结合强度,但如果不进行这一步骤,则需要在根管治疗后对暴露的牙本质进行大量的重新制备以恢复结合强度。因此,它可以保存健康的牙齿结构(无需重新准备),以及加强减弱的尖牙和改善隔离(如果必要时与深缘抬高相结合)。
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引用次数: 0
Substituting the Conventional Facebow With an Extraoral Scan Body System for Transferring the Maxillary Cast Into the Virtual Articulator: Manufacturing Procedures and Digital Clinical Protocol. 用口外扫描体系统代替传统的脸弓将上颌铸造体转移到虚拟关节器:制造程序和数字临床方案。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-01-06 DOI: 10.1111/jerd.13399
Marta Revilla-León, Jonathan M Zeitler, John C Kois

Clinical considerations: Conventional facebow records are used to transfer the maxillary cast into the analog articulator. Different reference planes have been described, including the true horizontal or gravity reference plane. A conventional facebow (Kois Dentofacial Analyzer; Panadent) allows the recording of the gravity plane for transferring the maxillary cast into the analog semi-adjustable articulator. Clinical procedures should also allow the maxillary scan transfer into the virtual articulator by using the true horizontal reference plane.

Objective: The present manuscript describes the step-by-step protocol to record the gravity plane and to transfer the maxillary scan into the virtual articulator by using an extraoral scan body system.

Conclusions: The extroral scan body device enables the substitution of the conventional facebow procedure. Additionally, this extraoral scan body is fabricated by using additive manufacturing technologies and eases the complete digital workflow for transferring the maxillary scan into the virtual articulator.

临床考虑:使用传统的脸弓记录将上颌铸造体转移到模拟关节器中。不同的参考平面已被描述,包括真正的水平或重力参考平面。传统的面弓(Kois牙面分析仪;Panadent)允许记录重力平面,用于将上颌铸造转移到模拟半可调关节器中。临床程序也应该允许上颌扫描通过使用真实水平参考平面转移到虚拟关节。目的:本文描述了使用口外扫描体系统记录重力平面并将上颌扫描转移到虚拟关节器的逐步方案。结论:体外扫描体装置可以替代传统的脸弓手术。此外,这种口腔外扫描体是通过使用增材制造技术制造的,并且简化了将上颌扫描转移到虚拟关节器的完整数字工作流程。
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引用次数: 0
The Influence of Surface Treatment on the Color of Enamel and Dentin: An In Vitro Study Using Machine Learning-Based Analysis. 表面处理对牙釉质和牙本质颜色的影响:基于机器学习分析的体外研究。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-01-06 DOI: 10.1111/jerd.13404
Zhen-Yu Wang, Fei-Yu Hu, Chao-Qiang Wu, Fei Liu, Du Chen, Jun-Fei Shen, Jie-Fei Shen

Objective: To investigate how surface treatment affects the color of enamel and dentin, and to evaluate whether the color differences are acceptable.

Materials and methods: Freshly extracted premolars were prepared using diamond burs (blue, red, and yellow tapes). Tooth surfaces were divided into control and acid-etched areas and treated with phosphoric acid (5, 15, 30, 45, and 60 s). Adhesives were applied and light-cured. Hyperspectral images were captured to analyze reflectance spectra, calculating L, a, b, and ΔE2000 values under the D65 illuminant. Enamel and dentin slices underwent atomic force microscopy for surface roughness. A random forest model was trained to assess the effects of multiple factors on color differences. Statistical analyses included one-way ANOVA, Tukey tests, and independent-sample t-test.

Results: Extended acid-etching times notably increased ΔE2000 values for enamel, surpassing acceptable thresholds in all groups except for the 5-s acid-etching followed by adhesive application. Dentin ΔE2000 remained stable regardless of surface treatment. Machine learning highlighted the influence of acid etching and surface roughness on enamel. Bur tape color had minimal impact.

Conclusions: The effects of acid etching on the color vary between enamel and dentin. Greater attention should be focused on enamel surface. Acid-etching time should be appropriately reduced.

Clinical significance: Comprehending the varying impacts of surface treatment on the color of enamel and dentin could contribute to achieving superior esthetic outcomes.

目的:探讨表面处理对牙本质和牙釉质颜色的影响,并评价其颜色差异是否可接受。材料和方法:用金刚石毛刺(蓝、红、黄带)制备新鲜的前磨牙。将牙齿表面分为对照区和酸蚀区,分别用磷酸处理5、15、30、45和60 s。涂上胶粘剂并光固化。采集高光谱图像,分析反射光谱,计算D65光源下的L、a、b和ΔE2000值。用原子力显微镜观察牙釉质和牙本质切片的表面粗糙度。训练随机森林模型来评估多种因素对色差的影响。统计分析包括单因素方差分析、Tukey检验和独立样本t检验。结果:酸蚀时间的延长显著增加了牙釉质的ΔE2000值,除了酸蚀5 s后使用粘合剂外,所有组的值都超过了可接受的阈值。无论表面处理如何,牙本质ΔE2000都保持稳定。机器学习强调酸蚀和表面粗糙度对牙釉质的影响。但胶带颜色的影响很小。结论:酸蚀对牙本质和牙釉质颜色的影响存在差异。更要注意的是牙釉质表面。酸蚀时间应适当缩短。临床意义:了解不同表面处理对牙釉质和牙本质颜色的影响,有助于获得更好的美观效果。
{"title":"The Influence of Surface Treatment on the Color of Enamel and Dentin: An In Vitro Study Using Machine Learning-Based Analysis.","authors":"Zhen-Yu Wang, Fei-Yu Hu, Chao-Qiang Wu, Fei Liu, Du Chen, Jun-Fei Shen, Jie-Fei Shen","doi":"10.1111/jerd.13404","DOIUrl":"https://doi.org/10.1111/jerd.13404","url":null,"abstract":"<p><strong>Objective: </strong>To investigate how surface treatment affects the color of enamel and dentin, and to evaluate whether the color differences are acceptable.</p><p><strong>Materials and methods: </strong>Freshly extracted premolars were prepared using diamond burs (blue, red, and yellow tapes). Tooth surfaces were divided into control and acid-etched areas and treated with phosphoric acid (5, 15, 30, 45, and 60 s). Adhesives were applied and light-cured. Hyperspectral images were captured to analyze reflectance spectra, calculating L, a, b, and ΔE2000 values under the D65 illuminant. Enamel and dentin slices underwent atomic force microscopy for surface roughness. A random forest model was trained to assess the effects of multiple factors on color differences. Statistical analyses included one-way ANOVA, Tukey tests, and independent-sample t-test.</p><p><strong>Results: </strong>Extended acid-etching times notably increased ΔE2000 values for enamel, surpassing acceptable thresholds in all groups except for the 5-s acid-etching followed by adhesive application. Dentin ΔE2000 remained stable regardless of surface treatment. Machine learning highlighted the influence of acid etching and surface roughness on enamel. Bur tape color had minimal impact.</p><p><strong>Conclusions: </strong>The effects of acid etching on the color vary between enamel and dentin. Greater attention should be focused on enamel surface. Acid-etching time should be appropriately reduced.</p><p><strong>Clinical significance: </strong>Comprehending the varying impacts of surface treatment on the color of enamel and dentin could contribute to achieving superior esthetic outcomes.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of Gingival Thickness With Incisor Morphological Characteristics and Papilla Height: A Cross-Sectional Study. 牙龈厚度与切牙形态特征和乳头高度的关系:一项横断面研究。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-01-06 DOI: 10.1111/jerd.13402
G Koukos, E Kyriakou, G A Malamoudi, R J Wierichs, N Pandis, D Kloukos

Objective: The aim of the current study was to examine possible associations between gingival thickness and other parameters, such as crown length and width, papilla height and patient's age and gender.

Overview: This cross-sectional study included 238 consecutive white Caucasian consecutive patients in all stages of orthodontic treatment (before, in-course, and after orthodontic treatment). Measurements of gingival thickness were carried out at both central mandibular incisors, mid-facially on the buccal aspect of each tooth, and 2 mm apically to the free gingival margin, with an Ultrasound device. Each patient was scanned with an intraoral 3D scanner before gingival thickness evaluation, where papilla height, and central mandibular and maxillary incisor crown length and width were measured.

Conclusions: Significant (positive) association between gingiva thickness and patient's age and gender were found, with thicker gingiva being observed in older individuals and males. However, no significant association were found between gingival thickness and crown length, crown width, or papilla height.

Clinical significance: Variations in soft and hard tissue architecture significantly impact the long-term aesthetic outcomes of periodontal therapy, prosthetic and implant restorations, and root coverage treatments. Accurately assessing gingival biotype phenotype during treatment planning is critical to prevent complications, particularly in aesthetically sensitive areas.

目的:本研究旨在探讨牙龈厚度与冠长、冠宽、乳突高度、患者年龄、性别等参数之间的关系。概述:本横断面研究包括238例连续接受正畸治疗的白人患者(正畸治疗前、治疗中和治疗后)。使用超声仪测量下颌中央切牙的牙龈厚度,每颗牙齿的颊面中部和游离牙龈边缘的2毫米。每位患者在进行牙龈厚度评估前使用口腔内3D扫描仪进行扫描,测量乳突高度,下颌中央和上颌切牙冠长度和宽度。结论:牙龈厚度与患者的年龄和性别有显著(正)相关性,老年人和男性的牙龈厚度较厚。然而,没有发现牙龈厚度与冠长、冠宽或乳突高度有显著的关联。临床意义:软硬组织结构的变化显著影响牙周治疗、假体和种植体修复以及牙根覆盖治疗的长期美学结果。在治疗计划期间准确评估牙龈生物型表型对于预防并发症至关重要,特别是在美观敏感的区域。
{"title":"Association of Gingival Thickness With Incisor Morphological Characteristics and Papilla Height: A Cross-Sectional Study.","authors":"G Koukos, E Kyriakou, G A Malamoudi, R J Wierichs, N Pandis, D Kloukos","doi":"10.1111/jerd.13402","DOIUrl":"https://doi.org/10.1111/jerd.13402","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study was to examine possible associations between gingival thickness and other parameters, such as crown length and width, papilla height and patient's age and gender.</p><p><strong>Overview: </strong>This cross-sectional study included 238 consecutive white Caucasian consecutive patients in all stages of orthodontic treatment (before, in-course, and after orthodontic treatment). Measurements of gingival thickness were carried out at both central mandibular incisors, mid-facially on the buccal aspect of each tooth, and 2 mm apically to the free gingival margin, with an Ultrasound device. Each patient was scanned with an intraoral 3D scanner before gingival thickness evaluation, where papilla height, and central mandibular and maxillary incisor crown length and width were measured.</p><p><strong>Conclusions: </strong>Significant (positive) association between gingiva thickness and patient's age and gender were found, with thicker gingiva being observed in older individuals and males. However, no significant association were found between gingival thickness and crown length, crown width, or papilla height.</p><p><strong>Clinical significance: </strong>Variations in soft and hard tissue architecture significantly impact the long-term aesthetic outcomes of periodontal therapy, prosthetic and implant restorations, and root coverage treatments. Accurately assessing gingival biotype phenotype during treatment planning is critical to prevent complications, particularly in aesthetically sensitive areas.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Color Change and Cytotoxic Effects of a Bleaching Gel With 22% Carbamide Peroxide Catalyzed by Manganese Oxide. 氧化锰催化22%过氧化脲漂白凝胶的颜色变化及细胞毒作用。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-01-04 DOI: 10.1111/jerd.13401
Rafael Antonio de Oliveira Ribeiro, Victória Peruchi, Leonardo Novaes Gaeta Sônego, Igor Paulino Mendes Soares, Diana Gabriela Soares, Josimeri Hebling, Carlos Alberto de Souza Costa

Objectives: To evaluate the color change and trans-amelodentinal cytotoxicity of a 22% carbamide peroxide (CP) bleaching gel containing different concentration of manganese oxide (MnO2).

Material and methods: Enamel/dentin discs adapted to artificial pulp chambers were distributed according to treatments: CN-No treatment; CP22%-22%CP; CP22 + 2MnO2-22%CP + 2 mg/mLMnO2; CP22% + 6MnO2-22%CP + 6 mg/mLMnO2; CP22% + 10MnO2-22%CP + 10 mg/mLMnO2 applied for 2 h for 15 days. Color change-CC (ΔE00 and ΔWID) (n = 8) was determined at 5, 10, and 15-day periods (ANOVA/Sidak). Trans-amelodentinal cytotoxicity (TC) was assessed after applying the extracts to cultured MDPC-23 cells, which were analyzed concerning their viability (Vi) (n = 8) and oxidative stress (OxS) (n = 8). The amount of hydroxyl radical (OH) (n = 4) generated by H2O2 degradation (ANOVA/Sidak), and trans-amelodentinal diffusion of H2O2 (n = 8) (ANOVA/Tukey) were also evaluated.

Results: CP22 + 10MnO2 presented higher CC than CP22 for both evaluated equations in all analysis periods (p ≤ 0.04). Among bleached groups, CP22 + 10MnO2 presented the highest OH generation (p ≤ 0.02) and the lowest trans-amelodentinal diffusion of H2O2 (p ≤ 0.0004). Therefore, MDPC-23 cells in CP22 + 10MnO2 exhibited the lowest OxS (p < 0.0001) and consequently the highest Vi (p ≤ 0.0146).

Conclusion: Besides increasing the bleaching efficacy, the strategy of adding 10 mg/mL of MnO2 to a 22%CP bleaching gel also reduces significantly the trans-amelodentinal diffusion of H2O2, diminishing the cytotoxicity caused by at-home bleaching therapy.

Clinical significance: The addition of MnO2 to a 22% carbamide peroxide bleaching gel improves the color change and reduces the cytotoxicity effects of the product, making at-home bleaching faster and biologically safer.

目的:评价含不同浓度氧化锰(MnO2)的22%过氧化脲(CP)漂白凝胶的颜色变化和反式角膜细胞毒性。材料和方法:搪瓷/牙质光盘适应人工髓腔分布根据治疗:CN-No治疗;cp22% - 22% - cp;CP22 + 2MnO2-22%CP + 2mg /mLMnO2;CP22% + 6MnO2-22%CP + 6mg /mLMnO2;CP22% + 10MnO2-22%CP + 10mg /mLMnO2处理2 h,连续15天。颜色变化- cc (ΔE00和ΔWID) (n = 8)在第5、10和15天测定(ANOVA/Sidak)。将提取物作用于培养的MDPC-23细胞后,评估其反糖色网膜细胞毒性(TC),分析其活力(Vi) (n = 8)和氧化应激(OxS) (n = 8)。对H2O2降解产生的羟基自由基(OH•)的数量(n = 4)(方差分析/Sidak)和H2O2的跨视网膜扩散(n = 8)(方差分析/Tukey)也进行了评估。结果:CP22 + 10MnO2在各分析时段的CC均高于CP22 (p≤0.04)。在漂白组中,CP22 + 10MnO2的OH•生成量最高(p≤0.02),H2O2跨视网膜扩散量最低(p≤0.0004)。结论:在22%CP漂白凝胶中加入10 mg/mL MnO2,除能提高漂白效果外,还能显著降低H2O2在视网膜上的扩散,降低家庭漂白治疗引起的细胞毒性。临床意义:在22%过氧化脲漂白凝胶中加入二氧化锰,改善了颜色变化,降低了产品的细胞毒性作用,使家庭漂白更快,生物更安全。
{"title":"Color Change and Cytotoxic Effects of a Bleaching Gel With 22% Carbamide Peroxide Catalyzed by Manganese Oxide.","authors":"Rafael Antonio de Oliveira Ribeiro, Victória Peruchi, Leonardo Novaes Gaeta Sônego, Igor Paulino Mendes Soares, Diana Gabriela Soares, Josimeri Hebling, Carlos Alberto de Souza Costa","doi":"10.1111/jerd.13401","DOIUrl":"https://doi.org/10.1111/jerd.13401","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the color change and trans-amelodentinal cytotoxicity of a 22% carbamide peroxide (CP) bleaching gel containing different concentration of manganese oxide (MnO<sub>2</sub>).</p><p><strong>Material and methods: </strong>Enamel/dentin discs adapted to artificial pulp chambers were distributed according to treatments: CN-No treatment; CP22%-22%CP; CP22 + 2MnO<sub>2</sub>-22%CP + 2 mg/mLMnO<sub>2</sub>; CP22% + 6MnO<sub>2</sub>-22%CP + 6 mg/mLMnO<sub>2</sub>; CP22% + 10MnO<sub>2</sub>-22%CP + 10 mg/mLMnO<sub>2</sub> applied for 2 h for 15 days. Color change-CC (ΔE<sub>00</sub> and ΔWI<sub>D</sub>) (n = 8) was determined at 5, 10, and 15-day periods (ANOVA/Sidak). Trans-amelodentinal cytotoxicity (TC) was assessed after applying the extracts to cultured MDPC-23 cells, which were analyzed concerning their viability (Vi) (n = 8) and oxidative stress (OxS) (n = 8). The amount of hydroxyl radical (OH<sup>•</sup>) (n = 4) generated by H<sub>2</sub>O<sub>2</sub> degradation (ANOVA/Sidak), and trans-amelodentinal diffusion of H<sub>2</sub>O<sub>2</sub> (n = 8) (ANOVA/Tukey) were also evaluated.</p><p><strong>Results: </strong>CP22 + 10MnO<sub>2</sub> presented higher CC than CP22 for both evaluated equations in all analysis periods (p ≤ 0.04). Among bleached groups, CP22 + 10MnO<sub>2</sub> presented the highest OH<sup>•</sup> generation (p ≤ 0.02) and the lowest trans-amelodentinal diffusion of H<sub>2</sub>O<sub>2</sub> (p ≤ 0.0004). Therefore, MDPC-23 cells in CP22 + 10MnO<sub>2</sub> exhibited the lowest OxS (p < 0.0001) and consequently the highest Vi (p ≤ 0.0146).</p><p><strong>Conclusion: </strong>Besides increasing the bleaching efficacy, the strategy of adding 10 mg/mL of MnO<sub>2</sub> to a 22%CP bleaching gel also reduces significantly the trans-amelodentinal diffusion of H<sub>2</sub>O<sub>2</sub>, diminishing the cytotoxicity caused by at-home bleaching therapy.</p><p><strong>Clinical significance: </strong>The addition of MnO<sub>2</sub> to a 22% carbamide peroxide bleaching gel improves the color change and reduces the cytotoxicity effects of the product, making at-home bleaching faster and biologically safer.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Polymer-Based Toothpastes and Their Ability in Control Tooth Extrinsic Stain. 聚合物基牙膏及其控制牙齿外源性染色的能力。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-27 DOI: 10.1111/jerd.13389
Raissa Manoel Garcia, Letícia Maria Balbino Rigo, Leonardo Custódio Lima, Leticia Oba Sakae, Vanessa Cavalli, Alessandra Buhler Borges, Taís Scaramucci

Objectives: To synthesize experimental toothpastes (ETs) containing four different polymers (sodium linear polyphosphate [LPP]; chitosan [CHI]; sodium hexametaphosphate [HMP]; and sodium pyrophosphate [PP]) and test their ability in preventing and removing tooth extrinsic stain.

Methods: The tooth specimens were randomly assigned into six groups (n = 10): control (artificial saliva), regular toothpaste (RT-no whitening claim), ET 5% LPP, ET 0.5% CHI, ET 5% HMP, and ET 5% PP. Each cycle consisted of chlorhexidine (2 min), staining broth (30 min), artificial saliva (30 min), brushing (45 strokes), and artificial saliva (30 min). Color parameters (L*, a*, and b*) were assessed at baseline and after 21 cycles. ΔEab, ΔE00, ΔWID, ΔL, Δa, and Δb were analyzed through ANOVA and Tukey test, at a 5% significance level.

Results: ET 5% PP showed lower ΔEab and ΔE00 than the control and RT (p < 0.01). For ΔWID, PP showed a higher value. For ΔL (p = 0.265) and Δb (p = 0.119), there were no significant differences among the groups. For Δa (p = 0.01), ET 5% PP showed a difference with the control.

Conclusions: The ETs showed a similar effect in preventing and removing tooth extrinsic stains. However, the sodium pyrophosphate-containing toothpaste was the only one with a superior effect in comparison with RT or brushing without toothpaste.

Clinical significance: The use of toothpastes for managing tooth extrinsic stains is a common approach in dentistry. In addition to the abrasives, their effect can be further enhanced by the presence of some polymers. Toothpastes containing sodium pyrophosphate demonstrated a superior ability to control tooth extrinsic stains.

目的:合成含四种不同聚合物(线性聚磷酸钠[LPP];壳聚糖(气);六偏磷酸钠;和焦磷酸钠[PP]),并测试其预防和去除牙齿外源性染色的能力。方法:将牙齿标本随机分为6组(n = 10):对照组(人工唾液)、普通牙膏(RT-no美白声明)、ET 5% LPP、ET 0.5% CHI、ET 5% HMP和ET 5% PP。每个周期包括氯己定(2 min)、染色汤(30 min)、人工唾液(30 min)、刷牙(45次)和人工唾液(30 min)。在基线和21个周期后评估颜色参数(L*, a*和b*)。ΔEab、ΔE00、ΔWID、ΔL、Δa、Δb采用方差分析和Tukey检验,显著性水平为5%。结果:ET 5% PP低于对照组ΔEab和ΔE00, RT (p p, PP)高于对照组。对于ΔL (p = 0.265)和Δb (p = 0.119),组间差异无统计学意义。对于Δa (p = 0.01), ET 5% PP与对照组有差异。结论:ETs在预防和清除牙齿外源性污渍方面具有相似的效果。然而,含焦磷酸钠的牙膏是唯一一种与RT或不使用牙膏相比效果更好的牙膏。临床意义:使用牙膏治疗牙齿外源性色斑是牙科常用的方法。除了磨料外,它们的效果可以通过一些聚合物的存在进一步增强。含有焦磷酸钠的牙膏显示出控制牙齿外来污渍的优越能力。
{"title":"Polymer-Based Toothpastes and Their Ability in Control Tooth Extrinsic Stain.","authors":"Raissa Manoel Garcia, Letícia Maria Balbino Rigo, Leonardo Custódio Lima, Leticia Oba Sakae, Vanessa Cavalli, Alessandra Buhler Borges, Taís Scaramucci","doi":"10.1111/jerd.13389","DOIUrl":"https://doi.org/10.1111/jerd.13389","url":null,"abstract":"<p><strong>Objectives: </strong>To synthesize experimental toothpastes (ETs) containing four different polymers (sodium linear polyphosphate [LPP]; chitosan [CHI]; sodium hexametaphosphate [HMP]; and sodium pyrophosphate [PP]) and test their ability in preventing and removing tooth extrinsic stain.</p><p><strong>Methods: </strong>The tooth specimens were randomly assigned into six groups (n = 10): control (artificial saliva), regular toothpaste (RT-no whitening claim), ET 5% LPP, ET 0.5% CHI, ET 5% HMP, and ET 5% PP. Each cycle consisted of chlorhexidine (2 min), staining broth (30 min), artificial saliva (30 min), brushing (45 strokes), and artificial saliva (30 min). Color parameters (L*, a*, and b*) were assessed at baseline and after 21 cycles. ΔE<sub>ab</sub>, ΔE<sub>00</sub>, ΔWI<sub>D</sub>, ΔL, Δa, and Δb were analyzed through ANOVA and Tukey test, at a 5% significance level.</p><p><strong>Results: </strong>ET 5% PP showed lower ΔE<sub>ab</sub> and ΔE<sub>00</sub> than the control and RT (p < 0.01). For ΔWI<sub>D</sub>, PP showed a higher value. For ΔL (p = 0.265) and Δb (p = 0.119), there were no significant differences among the groups. For Δa (p = 0.01), ET 5% PP showed a difference with the control.</p><p><strong>Conclusions: </strong>The ETs showed a similar effect in preventing and removing tooth extrinsic stains. However, the sodium pyrophosphate-containing toothpaste was the only one with a superior effect in comparison with RT or brushing without toothpaste.</p><p><strong>Clinical significance: </strong>The use of toothpastes for managing tooth extrinsic stains is a common approach in dentistry. In addition to the abrasives, their effect can be further enhanced by the presence of some polymers. Toothpastes containing sodium pyrophosphate demonstrated a superior ability to control tooth extrinsic stains.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Different Esthetic Assessment of Anterior Restorations by Patient and Expert: A Prospective Clinical Study. 患者和专家对前牙修复体的不同审美评价:一项前瞻性临床研究。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-26 DOI: 10.1111/jerd.13398
Jonas Lorenz, Carolin Wilhelm, Julia Urich, Paul Weigl, Robert Sader

Background: Esthetically pleasing, bright teeth and a symmetrical dental arch are of great importance. There are only a few scientific studies that compare the evaluation of anterior restorations by experts and patients. Additionally, there are hardly any studies that deal with the weighting of esthetic parameters.

Objective: The current study was performed to test the hypothesis that patients and experts evaluate anterior restorations differently and place their emphasis differently. Therefore, aim of this prospective study was to compare the evaluation of the red and white esthetics of anterior restorations by patients and an expert and to find out which parameters play an important role in the evaluation of the esthetic appearance of anterior restorations.

Material and methods: Anterior restorations of 21 patients were analyzed. All patients evaluated their own restorations using a questionnaire of ten defined parameters (pink esthetic score, PES and the white esthetic score, WES). Additionally, the questionnaire was used to determine how important the individual parameters are for them in relation to the assessment of the esthetic result. An expert also gave her assessment and weighting for all 21 patients.

Results: The statistical analysis of the questionnaires shows that the expert assigned lower values, particularly in the evaluation of the PES. The expert weighted individual parameters of the PES to be more important than the patients. The type of abutment of the restoration (tooth or implant) had no influence on the evaluation of the restorations.

Discussion/conclusion: The study shows that patients and experts have different assessments of the esthetics and the weighting of the various parameters. Nevertheless, patients are sensitive to esthetic deviations and patient preferences should be taken into account in anterior restorations.

背景:美观,明亮的牙齿和对称的牙弓是非常重要的。只有少数科学研究比较专家和患者对前牙修复的评价。此外,几乎没有任何研究处理审美参数的权重。目的:本研究旨在验证患者和专家对前牙修复的评价和侧重点不同的假设。因此,本前瞻性研究的目的是比较患者和专家对前路修复体的红白美学评价,并找出哪些参数在前路修复体的美学外观评价中起重要作用。材料与方法:对21例患者的前牙修复体进行分析。所有患者使用包含10个定义参数(粉红色美学评分,PES和白色美学评分,WES)的问卷来评估自己的修复体。此外,调查问卷被用来确定个人参数对审美结果的评估有多重要。一位专家还对所有21名患者进行了评估和加权。结果:对问卷的统计分析显示,专家的评价值较低,特别是在PES的评价中。专家对PES个体参数的权重大于患者。修复体的基台类型(牙或种植体)对修复体的评价没有影响。讨论/结论:研究表明,患者和专家对美学和各参数的权重有不同的评价。然而,患者对审美偏差很敏感,在前牙修复时应考虑患者的偏好。
{"title":"Different Esthetic Assessment of Anterior Restorations by Patient and Expert: A Prospective Clinical Study.","authors":"Jonas Lorenz, Carolin Wilhelm, Julia Urich, Paul Weigl, Robert Sader","doi":"10.1111/jerd.13398","DOIUrl":"https://doi.org/10.1111/jerd.13398","url":null,"abstract":"<p><strong>Background: </strong>Esthetically pleasing, bright teeth and a symmetrical dental arch are of great importance. There are only a few scientific studies that compare the evaluation of anterior restorations by experts and patients. Additionally, there are hardly any studies that deal with the weighting of esthetic parameters.</p><p><strong>Objective: </strong>The current study was performed to test the hypothesis that patients and experts evaluate anterior restorations differently and place their emphasis differently. Therefore, aim of this prospective study was to compare the evaluation of the red and white esthetics of anterior restorations by patients and an expert and to find out which parameters play an important role in the evaluation of the esthetic appearance of anterior restorations.</p><p><strong>Material and methods: </strong>Anterior restorations of 21 patients were analyzed. All patients evaluated their own restorations using a questionnaire of ten defined parameters (pink esthetic score, PES and the white esthetic score, WES). Additionally, the questionnaire was used to determine how important the individual parameters are for them in relation to the assessment of the esthetic result. An expert also gave her assessment and weighting for all 21 patients.</p><p><strong>Results: </strong>The statistical analysis of the questionnaires shows that the expert assigned lower values, particularly in the evaluation of the PES. The expert weighted individual parameters of the PES to be more important than the patients. The type of abutment of the restoration (tooth or implant) had no influence on the evaluation of the restorations.</p><p><strong>Discussion/conclusion: </strong>The study shows that patients and experts have different assessments of the esthetics and the weighting of the various parameters. Nevertheless, patients are sensitive to esthetic deviations and patient preferences should be taken into account in anterior restorations.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Perception of Unilateral Recessions in the Maxillary Esthetic Zone: A Survey Among Dentists and Non-Professionals. 上颌审美区单侧衰退知觉:一项牙医和非专业人员的调查。
IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-25 DOI: 10.1111/jerd.13392
Nikolaus Fürhauser, Rebecca Rosen, Lukas Fürhauser, Rudolf Fürhauser

Statement of problem: Esthetic dental features, especially the maxillary anterior teeth, significantly influence perceived attractiveness. Gingival recessions can negatively affect smile esthetics, particularly when asymmetrical.

Purpose: This study aimed to investigate the perception of dentists and non-professionals regarding subtle variations in the apically displaced soft tissue surrounding a lateral or central incisor.

Materials and methods: Based on an ideal image of the esthetic zone, asymmetrical modifications of either a central or lateral incisor in the maxillary anterior were created and used in a digital survey asking participants to assess the overall appearance of the smile, using a visual analog scale (VAS). The dental expertise, age, and gender of the participants were recorded. For each image, the question was posed to identify if any of the teeth caused a visible irritation. The mean results of each tooth alteration and the correlation between dental expertise were statistically analyzed.

Results: A total of 114 participants were polled. There was a significant difference in the esthetic perception between the central and lateral incisors (p < 0.001). The perception threshold for a noticeable asymmetrical recession was 1.2 mm for the central and 2.0 mm for the lateral incisor. Gender and age showed no significant difference in the esthetic evaluation, and dental expertise was only significantly different for larger recessions (p < 0.05).

Conclusion: The asymmetric changes were more noticeable for the central incisor than the lateral incisor. A unilateral recession change of 0.8 mm did not appear to influence the assessment of the overall smile. The dental expertise, age, or gender of the participants did not significantly correlate with a stricter esthetic perception.

Clinical implications: The present study highlights that the perception of unilateral recession changes in the anterior maxilla varies between central and lateral incisors, with lateral incisor recessions being less impactful on the overall appearance of the smile. These findings suggest that small gingival changes can be acceptable for the overall esthetic outcome, underscoring the importance of discussing patient expectations and treatment options before restoration or orthodontic treatment and prioritizing the gingival margin of the central incisor which appeared more noticeable.

问题陈述:美观的牙齿特征,特别是上颌前牙,显著影响感知吸引力。牙龈萎缩会对微笑的美感产生负面影响,尤其是在不对称的情况下。目的:本研究旨在调查牙医和非专业人士的看法,关于微妙变化的顶端移位软组织周围的侧切牙或中切牙。材料和方法:根据理想的审美区图像,在上颌前门牙的中门牙或侧门牙的不对称修改被创建并用于数字调查,要求参与者使用视觉模拟量表(VAS)评估微笑的整体外观。记录了参与者的牙科专业知识、年龄和性别。对于每张照片,问题都是为了确定是否有任何牙齿引起了可见的刺激。统计分析各牙变的平均结果及各牙专业知识的相关性。结果:共调查了114名参与者。结论:中切牙的不对称变化比侧切牙更明显。单方面的0.8毫米的衰退变化似乎不会影响对整体微笑的评估。参与者的牙科专业知识、年龄或性别与更严格的审美感知没有显著相关性。临床意义:本研究强调了上颌前牙在中门牙和侧门牙之间对单侧衰退变化的感知不同,侧门牙衰退对微笑整体外观的影响较小。这些发现表明,小的牙龈变化可以接受整体审美结果,强调在修复或正畸治疗前讨论患者期望和治疗方案的重要性,并优先考虑中切牙牙龈边缘,因为它看起来更明显。
{"title":"The Perception of Unilateral Recessions in the Maxillary Esthetic Zone: A Survey Among Dentists and Non-Professionals.","authors":"Nikolaus Fürhauser, Rebecca Rosen, Lukas Fürhauser, Rudolf Fürhauser","doi":"10.1111/jerd.13392","DOIUrl":"https://doi.org/10.1111/jerd.13392","url":null,"abstract":"<p><strong>Statement of problem: </strong>Esthetic dental features, especially the maxillary anterior teeth, significantly influence perceived attractiveness. Gingival recessions can negatively affect smile esthetics, particularly when asymmetrical.</p><p><strong>Purpose: </strong>This study aimed to investigate the perception of dentists and non-professionals regarding subtle variations in the apically displaced soft tissue surrounding a lateral or central incisor.</p><p><strong>Materials and methods: </strong>Based on an ideal image of the esthetic zone, asymmetrical modifications of either a central or lateral incisor in the maxillary anterior were created and used in a digital survey asking participants to assess the overall appearance of the smile, using a visual analog scale (VAS). The dental expertise, age, and gender of the participants were recorded. For each image, the question was posed to identify if any of the teeth caused a visible irritation. The mean results of each tooth alteration and the correlation between dental expertise were statistically analyzed.</p><p><strong>Results: </strong>A total of 114 participants were polled. There was a significant difference in the esthetic perception between the central and lateral incisors (p < 0.001). The perception threshold for a noticeable asymmetrical recession was 1.2 mm for the central and 2.0 mm for the lateral incisor. Gender and age showed no significant difference in the esthetic evaluation, and dental expertise was only significantly different for larger recessions (p < 0.05).</p><p><strong>Conclusion: </strong>The asymmetric changes were more noticeable for the central incisor than the lateral incisor. A unilateral recession change of 0.8 mm did not appear to influence the assessment of the overall smile. The dental expertise, age, or gender of the participants did not significantly correlate with a stricter esthetic perception.</p><p><strong>Clinical implications: </strong>The present study highlights that the perception of unilateral recession changes in the anterior maxilla varies between central and lateral incisors, with lateral incisor recessions being less impactful on the overall appearance of the smile. These findings suggest that small gingival changes can be acceptable for the overall esthetic outcome, underscoring the importance of discussing patient expectations and treatment options before restoration or orthodontic treatment and prioritizing the gingival margin of the central incisor which appeared more noticeable.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Esthetic and Restorative Dentistry
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