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Symmetry
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Symmetry in Dentistry: From the Clinic to the Lab
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Symmetry in Dentistry: From the Clinic to the Lab

A special issue of Symmetry (ISSN 2073-8994). This special issue belongs to the section "Life Sciences".

Deadline for manuscript submissions: closed (20 June 2022) | Viewed by 50324

Special Issue Editors

Dr. Carlos Miguel Marto

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Guest Editor
1. Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
2. Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
3. Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
4. Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
5. Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
6. Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
Interests: experimental pathology; stem-cells; regeneration; animal models; dentistry; biocompatibility; evidence-based medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Mafalda Laranjo

E-Mail Website
Guest Editor
Faculty of Medicine, Area of Environment Genetics and Oncobiology (CIMAGO), Institute of Biophysics and Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
Interests: dentistry; dental biomaterials; photodynamic therapy; cancer; in vitro and animal models
Special Issues, Collections and Topics in MDPI journals
Dr. Ana Cristina Gonçalves

E-Mail Website
Guest Editor
Faculty of Medicine, Laboratory of Oncobiology and Hematology, Institute for Clinical and Biomedical Research (iCBR)—Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, 3000-548 Coimbra, Portugal
Interests: oncobiology; genetics; molecular biology; nutrition; drug resistance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

Although not always evident, symmetry is present in all aspects of our lives, from nature to human built structures, from macrostructures to the smallest components of our cells. The human body is no exception, and symmetry plays a fundamental role in human morphology, aesthetics and function.

In the field of dentistry, symmetry is responsible for the perfect balance between the oral structures, the beauty of the face and the smile, and the adequate function of the stomatognathic system. Due to its importance, we aim for symmetry in our daily practice, performing treatments and developing materials to restore the lost tissues, functions and aesthetics. Many of these materials present a symmetrical structure, which directly influences their properties.    

In this Special Issue of Symmetry, we will focus on symmetry in dentistry, from the clinic to the laboratory. We are interested in the application of symmetry in modern dentistry, covering the face, smile and teeth aesthetics and morphology, smile design, applications of symmetry for orthodontic and surgical treatments, symmetry on human development of the craniofacial region, and symmetrical patterns on oral diseases, among others. Importantly, papers discussing the role of natural asymmetry are welcome, since beauty is not always symmetrical. 

At the same time, we are focused on discussing the role of symmetry and asymmetry in the development and evaluation of biomaterials, such as ceramics, composites or polymers. This includes their design and structure, but also a strong focus on their biological behavior, from in vitro to in vivo models. Particularly, their effect at the tissue and cellular level is of great interest, from the impact on protein expression and function, DNA and RNA synthesis, cell membranes alterations, or cytoskeletal modifications, among others.

Lastly, the importance of symmetry on cell division and behavior, mainly stem cells from dental origin or for oral tissues regeneration, presents an exciting topic to be discussed.

Dr. Carlos Miguel Marto
Dr. Mafalda Laranjo
Dr. Ana Cristina Gonçalves
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Symmetry is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • symmetry
  • dentistry
  • dental biomaterials
  • aesthetics
  • stem cells
  • in vitro models
  • in vivo models
  • smile design

Published Papers (11 papers)

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Research

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15 pages, 952 KiB  
Article
Analysis of Lower Facial Third and Dental Proportions to Predict Maxillary Anterior Teeth Width in the Pakistani Population
by Naseer Ahmed, Mohamad Syahrizal Halim, Gotam Das, Zuryati Ab-Ghani, Jawad Safdar, Abhishek Lal, Shahabe Saquib, Abdul Ahad Ghaffar Khan and Mohammad Khursheed Alam
Symmetry 2022, 14(4), 723; https://doi.org/10.3390/sym14040723 - 02 Apr 2022
Cited by 1 | Viewed by 1963
Abstract
Obtaining the size of the maxillary anterior teeth when performing an esthetic smile rehabilitation can be a difficult task. Metrics based on dental proportions to assist in the process are required. This study aimed to evaluate the lower facial third proportions i.e., the [...] Read more.
Obtaining the size of the maxillary anterior teeth when performing an esthetic smile rehabilitation can be a difficult task. Metrics based on dental proportions to assist in the process are required. This study aimed to evaluate the lower facial third proportions i.e., the interalar, interphiltral, and intercommisural distance with dental proportions in predicting maxillary anterior teeth width in Pakistani citizens. This analytical study was conducted on 230 participants. Front face and retracted smile photographs were captured for all the participants, followed by maxillary impression making. The cast was then converted to 3D models for analysis. The data were entered into SPSS-25. Descriptive statistics were carried out for frequency, mean, standard deviation, and percentage calculation of gender, teeth widths, horizontal mid facial proportions, and age of the participants. Independent t-test was applied for analysis of gender and arch side disparity. Regression analyses were performed to analyze the relationship between independent variables (gender, age, weight, and height) and dependent variables (horizontal facial proportion, dental proportion). A p-value of ≤0.05 was considered statistically significant. The interphiltral distance (IPLD) modified with Preston proportion (PRP) showed no significant difference with combined central incisor width, whereas a significant difference was found with golden proportion (GP), 70% recurrent esthetic dental (RED) proportion, and golden percentage (GM) modification. However, the interalar (IAD) and intercommisural distance (ICoD) modified with dental proportions showed a significant difference with maxillary anterior teeth width. The width of maxillary anterior teeth determined by plaster dental cast and 3D dental cast showed no significant difference. The ICoD, IAD, and IPLD could not be used to determine combined central incisor and intercanine width directly. The interphiltral distance modified with Preston proportion is a reliable method to predict combined central incisor width in the population studied. There was a significant difference in gender disparity when ICD, IAD, and IPLD were modified with dental proportions, except in the case of IPLD by the Preston proportion group. The golden proportion, 70% RED proportion, and golden percentage by lower facial third facial proportions are not reliable methods to predict maxillary anterior teeth width. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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11 pages, 1707 KiB  
Article
Direct Restorations for Anterior Esthetic Rehabilitation and Smile Symmetry Recovery: Two Case Reports
by Inês Amaro, José Saraiva, Ana Catarina Gomes, Ana Araújo, Carlos Miguel Marto, Ana Coelho, Manuel Marques Ferreira, Anabela Paula and Eunice Carrilho
Symmetry 2021, 13(10), 1848; https://doi.org/10.3390/sym13101848 - 02 Oct 2021
Cited by 2 | Viewed by 3255
Abstract
Esthetics is an increasing concern for patients, particularly in anterior teeth. The current approaches to manage the esthetic demands include options such as prosthodontic rehabilitation, orthodontic treatment, and direct restorations. Direct restorative procedures for anterior teeth have become a reliable alternative, since current [...] Read more.
Esthetics is an increasing concern for patients, particularly in anterior teeth. The current approaches to manage the esthetic demands include options such as prosthodontic rehabilitation, orthodontic treatment, and direct restorations. Direct restorative procedures for anterior teeth have become a reliable alternative, since current composite materials can mimic teeth’s esthetics and function perfectly. This article describes two clinical cases of anterior esthetic rehabilitations where the direct reshaping of the four maxillary incisors was performed using the buccolingual layering technique with the help of a silicone index. In Case 1, a diastema closure was also performed, whereas in Case 2, the replacement of old restorations was also carried out. It was possible to achieve excellent final esthetic results in both cases, recovering the smile symmetry, and both patients were satisfied. The literature supports the use of direct restorations in the anterior region with very good long-term prognosis. It is a minimally invasive approach that is reversible, repairable, cost-effective, and when combined with layering techniques and adequate restorative materials, it is possible to achieve good esthetic and functional outcomes. However, regular maintenance appointments are mandatory, and all cases should be carefully planned to ensure predictable and long-lasting results. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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13 pages, 3445 KiB  
Article
Laboratory Characterization of In-Service Full-Mouth Rehabilitation with Monolithic Translucent Zirconia Restorations
by Susana M. Salazar Marocho, Mary Beth VanLandingham, Firas Mourad, Andres Pappa and Sreenivas Koka
Symmetry 2021, 13(9), 1755; https://doi.org/10.3390/sym13091755 - 20 Sep 2021
Viewed by 1609
Abstract
The chance to critically and microscopically inspect the quality of bonded restorations once they are delivered to the patient after several pre-cementation steps is rare or nonexistent. Replicas of in-service restorations can provide a wealth of information on the integrity of the restorations [...] Read more.
The chance to critically and microscopically inspect the quality of bonded restorations once they are delivered to the patient after several pre-cementation steps is rare or nonexistent. Replicas of in-service restorations can provide a wealth of information on the integrity of the restorations and moreover make it possible to bring this information to the laboratory for further detailed analysis. This study aimed to characterize the epoxy replicas of 27 cemented monolithic yttria-stabilized zirconia crowns of the maxillary and mandibular arch to assess surface roughness, topography, and symmetry. The topography of the facial, lingual, and occlusal/incisal surfaces of each crown was observed under the optical microscope and further characterized using the scanning electron microscope. Surface roughness measurements were performed using the atomic force microscope. The optical microscope was used to measure the golden proportion and visible width of the anterior maxillary crowns. Surface damage consistent with unpolished adjustment was identified mostly in the occlusal surface of the posterior teeth. Other irregularities, such as scratch marks, small pits, and coarse pits were also found. The surface roughness had great variability. Not all of the anterior maxillary and mandibular teeth followed the golden proportion concept. This study design allows in vitro characterization of in-service restorations. It provides a framework for using replicas for early identification of patterns or features that can trigger fracture and for analysis of morphology and symmetry. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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13 pages, 4010 KiB  
Article
Quantitative Asymmetry Assessment between Virtual and Mixed Reality Planning for Orthognathic Surgery—A Retrospective Study
by Yu-Ching Hsiao, Chen-Jung Chang and Jing-Jing Fang
Symmetry 2021, 13(9), 1614; https://doi.org/10.3390/sym13091614 - 02 Sep 2021
Cited by 1 | Viewed by 2643
Abstract
Orthognathic surgical planning compromises three clinical needs: occlusal balancing, symmetry, and harmony, which may result in multiple outcomes. Facial symmetry is the ultimate goal for patients and practitioners. Pure virtual planning and mixed reality planning were two innovative technologies in clinical practices compared [...] Read more.
Orthognathic surgical planning compromises three clinical needs: occlusal balancing, symmetry, and harmony, which may result in multiple outcomes. Facial symmetry is the ultimate goal for patients and practitioners. Pure virtual planning and mixed reality planning were two innovative technologies in clinical practices compared to conventional model surgery used for decades. We proposed quantitative asymmetry assessment methods in both mandibular contour (in 2D) and a midface and mandible relationship in 3D. A computerized optimal symmetry plane, being the median plane, was applied in both planning methods. In the 3D asymmetry assessment between two planning methods, the deviation angle and deviation distance between midface and mandible were within 2° and 1.5 mm, respectively. There was no significant difference, except the symmetry index of the anterior deviation angle between the virtual and mixed reality planning in the 3D asymmetry assessment. In the mandible contour assessment, there was no significant difference between the virtual and mixed reality planning in asymmetry assessment in the frontal and frontal downward inclined views. Quantitative outcomes in 3D asymmetry indices showed that mixed reality planning was slightly more symmetric than virtual planning, with the opposite in 2D contouring. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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8 pages, 7618 KiB  
Article
The Effect of Absorbable and Non-Absorbable Sutures on Nasal Width Following Cinch Sutures in Orthognathic Surgery
by Po-Fang Wang, Dax Carlo Pascasio, Soo Ha Kwon, Shih-Hsien Chen, Pang-Yun Chou, Chuan-Fong Yao, Ying-An Chen, Cheng-Hui Lin and Yu-Ray Chen
Symmetry 2021, 13(8), 1495; https://doi.org/10.3390/sym13081495 - 15 Aug 2021
Cited by 2 | Viewed by 4420
Abstract
Background: Non-absorbable materials (nylon) are always used in cinch sutures to maintain nasal width and to improve harmonious facial symmetry in orthognathic surgery. However, a few drawbacks of nylon materials have been clinically reported following orthognathic surgery, such as nasal irritation and exposure [...] Read more.
Background: Non-absorbable materials (nylon) are always used in cinch sutures to maintain nasal width and to improve harmonious facial symmetry in orthognathic surgery. However, a few drawbacks of nylon materials have been clinically reported following orthognathic surgery, such as nasal irritation and exposure of the sutures. An absorbable material (PDS) has been proposed in cinch sutures, not only to avoid the complications of nylon but also to stabilize the nasal width for a long-term follow-up. Methods: Fifty-seven patients with Angle’s malocclusion classification III receiving orthognathic surgery were enrolled in this study. A non-absorbable material (nylon) and an absorbable material (PDS) were utilized for the cinch sutures. Pre-operative (T1) and post-operative six-month (T2) craniofacial 3D images were collected for all patients to measure the alar curvature (Ac) width and the alar base (Al) width. A significance level of p < 0.05 was applied in the statistical analysis. Results: With the approval of IRB, cinch suturing was performed with nylon in 29 patients and with PDS in 28 patients. Pre-operative Ac and Al distances showed no significant difference between these two groups. There were also no significant differences between the suture materials in the peri-operative change in nasal width, including Ac (nylon: 1.999 ± 1.40; PDS: 1.484 ± 0.97; p = 0.112) and Al (nylon: 1.861 ± 1.66; PDS: 1.115 ± 0.92; p = 0.056). Conclusions: For cinch sutures in orthognathic surgery, PDS can maintain the peri-operative nasal width similarly to nylon; additionally, it can be absorbed in a timely manner without the drawbacks of non-absorbable materials. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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11 pages, 2162 KiB  
Article
The Influence of the Implant Macrogeometry on Insertion Torque, Removal Torque, and Periotest Implant Primary Stability: A Mechanical Simulation on High-Density Artificial Bone
by Margherita Tumedei, Morena Petrini, Davide Pietropaoli, Alessandro Cipollina, Castrenze La Torre, Maria Stella Di Carmine, Adriano Piattelli and Giovanna Iezzi
Symmetry 2021, 13(5), 776; https://doi.org/10.3390/sym13050776 - 30 Apr 2021
Cited by 6 | Viewed by 2863
Abstract
Background: The primary stability is a determinant clinical condition for the success of different dental implants macro-design in different bone density using a validated and repeatable in vitro technique employing solid rigid polyurethane blocks. Materials and Methods: Five implants 3.8 × 13 mm [...] Read more.
Background: The primary stability is a determinant clinical condition for the success of different dental implants macro-design in different bone density using a validated and repeatable in vitro technique employing solid rigid polyurethane blocks. Materials and Methods: Five implants 3.8 × 13 mm2 for each macro-design (i.e., IK—tapered; IC—cylindric; and IA—active blade shape) were positioned into 20- and 30- pounds per cubic foot (PCF) polyurethane blocks. Bucco-lingual (BL) and mesial-distal (MD) implant stability quotient score (ISQ) was assessed by resonance frequency analysis while, insertion/removal torques were evaluated by dynamometric ratchet. Results: IC implants shown better primary stability in terms of ISQ compared to IA and IK in lower density block (20 PCF), while IK was superior to IA in higher density (30 PCF). IC shown higher removal torque in 30-PCF compared to IA and IC. Conclusions: The study effectiveness on polyurethane artificial bone with isotropic symmetry structure showed that the implants macro-design might represent a key factor on primary stability, in particular on low-density alveolar bone. Clinicians should consider patients features and implant geometry during low-density jaws rehabilitation. Further investigations are needed to generalize these findings. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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13 pages, 1364 KiB  
Article
Biophysical and Fluoride Release Properties of a Resin Modified Glass Ionomer Cement Enriched with Bioactive Glasses
by Ascensión Vicente, Francisco Javier Rodríguez-Lozano, Yolanda Martínez-Beneyto, María Jaimez, Julia Guerrero-Gironés and Antonio J. Ortiz-Ruiz
Symmetry 2021, 13(3), 494; https://doi.org/10.3390/sym13030494 - 17 Mar 2021
Cited by 9 | Viewed by 2831
Abstract
The aim of this study was to evaluate the bond strength, microleakage, cytotoxicity, cell migration and fluoride ion release over time from a resin-modified glass-ionomer cement (RMGIC) enriched with bioactive glasses (BAGs) and a nanohybrid restorative polymer resin agent used as adhesion material [...] Read more.
The aim of this study was to evaluate the bond strength, microleakage, cytotoxicity, cell migration and fluoride ion release over time from a resin-modified glass-ionomer cement (RMGIC) enriched with bioactive glasses (BAGs) and a nanohybrid restorative polymer resin agent used as adhesion material in the cemented brackets. One hundred and twenty bovine lower incisors were divided into three groups: (Transbond Plus Self Etching Primer (TSEP)/Transbond XT (TXT), TSEP/ACTIVA, orthophosphoric acid gel/ACTIVA) and brackets were bonded. A bond strength test and microleakage test were applied. A fluoride release test was applied after 60 days for the TXT and ACTIVA group. To evaluate cytotoxicity and cell migration, a cell viability and scratch migration assay were done for each group. p values < 0.05 were considered significant. Regarding bond strength and microleakage test, no significant differences were found between TSEP/TXT and TSEP/ACTIVA. At 6.4 pH, ACTIVA showed a higher degree of fluoride ion release, which increased with acid pH (3.5), with a maximum fluoride secretion at 30 days. MTT assay revealed that TXT reduces the viability of gingival cells with significant differences (p < 0.001) compared to the untreated cells (control group). ACTIVA provides optimal adhesive and microfiltration properties, releases substantial amounts of fluoride ions in both acid and neutral media, and its biocompatibility is greater than that of traditional composite resin adhesive systems. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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Review

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19 pages, 80402 KiB  
Review
Symmetry and Aesthetics in Dentistry
by Christoph Runte and Dieter Dirksen
Symmetry 2021, 13(9), 1741; https://doi.org/10.3390/sym13091741 - 19 Sep 2021
Cited by 6 | Viewed by 6096
Abstract
Animal bodies in general and faces in particular show mirror symmetry with respect to the median-sagittal plane, with exceptions rarely occurring. Bilateral symmetry to the median sagittal plane of the body also evolved very early. From an evolutionary point of view, it should [...] Read more.
Animal bodies in general and faces in particular show mirror symmetry with respect to the median-sagittal plane, with exceptions rarely occurring. Bilateral symmetry to the median sagittal plane of the body also evolved very early. From an evolutionary point of view, it should therefore have fundamental advantages, e.g., more effective locomotion and chewing abilities. On the other hand, the recognition of bilaterally symmetric patterns is an important module in our visual perception. In particular, the recognition of faces with different spatial orientations and their identification is strongly related to the recognition of bilateral symmetry. Maxillofacial surgery and Dentistry affect effective masticatory function and perceived symmetry of the lower third of the face. Both disciplines have the ability to eliminate or mitigate asymmetries with respect to form and function. In our review, we will demonstrate symmetric structures from single teeth to the whole face. We will further describe different approaches to quantify cranial, facial and dental asymmetries by using either landmarks or 3D surface models. Severe facial asymmetries are usually caused by malformations such as hemifacial hyperplasia, injury or other diseases such as Noma or head and neck cancer. This could be an important sociobiological reason for a correlation between asymmetry and perceived disfigurement. The aim of our review is to show how facial symmetry and attractiveness are related and in what way dental and facial structures and the symmetry of their shape and color influence aesthetic perception. We will further demonstrate how modern technology can be used to improve symmetry in facial prostheses and maxillofacial surgery. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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20 pages, 1132 KiB  
Review
Acquired Facial, Maxillofacial, and Oral Asymmetries—A Review Highlighting Diagnosis and Management
by Janaki Iyer, Arvind Hariharan, Uyen Minh Nha Cao and Simon D. Tran
Symmetry 2021, 13(9), 1661; https://doi.org/10.3390/sym13091661 - 09 Sep 2021
Cited by 9 | Viewed by 8291
Abstract
Facial asymmetry refers to the absence of, or the deviation from the regular mirror image of facial structures, relative to a referenced midline axis. It can be attributed to a wide spectrum of deformities, including congenital, developmental, or acquired conditions, which can originate [...] Read more.
Facial asymmetry refers to the absence of, or the deviation from the regular mirror image of facial structures, relative to a referenced midline axis. It can be attributed to a wide spectrum of deformities, including congenital, developmental, or acquired conditions, which can originate either prenatally or postnatally. Though highly prevalent, asymmetry commonly goes undiagnosed due to its subtle or relative nature. Among the spectrum of conditions, acquired cases are triggered postnatally, in previously normal individuals, thus subjecting them to sudden, eventful psychological and psychosocial disharmony. When detected early, timely management may help intervene progressive growth of these conditions. This, therefore, emphasizes the need for a thorough diagnostic workup including medical/dental history, clinical examinations, study models, photographic and radiographic records for a case-by-case basis to prevent severe functional and aesthetic complications. Recently, advanced diagnostic procedures, such as stereophotogrammetry, 3D stereolithographic models, skeletal scintigraphy (radionucleotide scans), 3D computed tomographic scans, cone-beam computed tomography, and magnetic resonance imaging, have provided innovative diagnostic instruments for numerous craniofacial defects. This descriptive review aims at focusing on the factors leading to frequently encountered conditions of acquired facial asymmetry and highlights their clinical evaluation, conservative and surgical interventions by a multi-disciplinary team of clinicians. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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Other

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12 pages, 91703 KiB  
Case Report
Surgical-Orthodontic Diagnosis and Treatment Planning in an Asymmetric Skeletal Class III Patient—A Case Report
by Francisco Vale, Catarina Nunes, Adriana Guimarães, Anabela Baptista Paula and Inês Francisco
Symmetry 2021, 13(7), 1150; https://doi.org/10.3390/sym13071150 - 27 Jun 2021
Cited by 1 | Viewed by 3582
Abstract
The skeletal Class III pattern is characterized by a sagittal intermaxillary mesial discrepancy. This discrepancy may have an unfavorable impact on function and aesthetics, which can be aggravated by the presence of facial asymmetries. This case report describes the diagnosis and treatment planning [...] Read more.
The skeletal Class III pattern is characterized by a sagittal intermaxillary mesial discrepancy. This discrepancy may have an unfavorable impact on function and aesthetics, which can be aggravated by the presence of facial asymmetries. This case report describes the diagnosis and treatment planning of a 19-year-old male patient with a skeletal Class III, maxillary hypoplasia, anterior crossbite, and mandibular asymmetry. When the patient reached skeletal maturity at the end of puberty, the definitive diagnosis was skeletal Class III with hyperdivergent profile and mandibular asymmetry, and a surgical-orthodontic treatment was proposed. At the end of the treatment, bimaxillary surgical correction allowed a skeletal Class I with mandibular symmetry, improving the function of the stomatognathic system and facial aesthetics. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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14 pages, 8247 KiB  
Case Report
Direct Esthetic Composite Restorations in Anterior Teeth: Managing Symmetry Strategies
by Gaetano Paolone, Salvatore Scolavino, Enrico Gherlone and Gianrico Spagnuolo
Symmetry 2021, 13(5), 797; https://doi.org/10.3390/sym13050797 - 03 May 2021
Cited by 22 | Viewed by 10360
Abstract
A novel procedure for symmetric and consistent layer thickness management in esthetic direct restoration of anterior teeth is presented. For the purpose of obtaining a satisfactory final outcome of an esthetic direct restoration, it is crucial to standardize either margin preparation design and [...] Read more.
A novel procedure for symmetric and consistent layer thickness management in esthetic direct restoration of anterior teeth is presented. For the purpose of obtaining a satisfactory final outcome of an esthetic direct restoration, it is crucial to standardize either margin preparation design and dentin and enamel layer thickness. Leaving too much space for the final translucent layer may lead in fact to “low value—gray” restorations if not correctly managed. The most common tool used to check layer thickness is the sagittal silicone index, which is reliable but involves planning; therefore, it requires two stages appointments. In this clinical case, a novel procedure is used to prepare, to model and to check thickness of composite shades in a single appointment, thus providing a symmetric esthetic outcome. A healthy 21-year-old woman referred to our dental office for the esthetic rehabilitation of both maxillary central incisors. The correct composite bilateral and symmetric layer thickness management provided a predictable esthetic outcome of the restorations. The main objective of this case presentation is to describe a novel technique that is able to save chair-time and dental laboratory costs during direct restorations in anterior teeth. Full article
(This article belongs to the Special Issue Symmetry in Dentistry: From the Clinic to the Lab)
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