Vlatka Lajnert

Coronally advanced flap alone or with connective tissue graft in the treatment of single gingival recession defects: a long-term randomized clinical trial.

BACKGROUND Numerous surgical approaches for the treatment of single gingival recession (GR) defects are documented in the literature. The aim of this 5-year, split mouth-design, randomized clinical trial was to evaluate the effectiveness of coronally advanced flap (CAF) alone versus CAF with connective tissue graft (CAF+CTG) in the treatment of single Miller Class I and II GR defects. METHODS Thirty-seven patients with 114 bilateral, single Miller Class I and II GR defects were treated with CAF on one side of the mouth and CAF+CTG on the other side. Clinical measurements (GR length [REC], keratinized tissue width [KT], complete root coverage [CRC], and percentage of root coverage [PRC]) were evaluated before surgery and after 6, 12, 24, and 60 months. RESULTS There was a significant reduction of REC and increase of KT after surgery in both groups. CAF+CTG showed significantly better results for all evaluated clinical parameters in all observed follow-up periods. Miller Class I defects showed better results in terms of REC, CRC, and PRC, whereas Miller Class II showed better results in KT, both in favor of CAF+CTG. Miller Class I defects showed better results than Miller Class II GR defects regardless of the surgical procedure used. CONCLUSIONS Both surgical procedures were effective in the treatment of single Miller Class I and II GR defects. The CAF+CTG procedure provided better long-term outcomes (60 months postoperatively) than CAF alone. Long-term stability of the gingival margin is less predictable for Miller Class II GR defects compared to those of Class I.

Gender, age, and psychosocial context of the perception of facial esthetics.

OBJECTIVE To explore the effects of gender, age, and psychosocial context on the perception of facial esthetics. METHODS The study included 1,444 Caucasian subjects aged 16 to 85 years. Two sets of color photographs illustrating 13 male and 13 female Caucasian facial type alterations, representing different skeletal and dentoalveolar components of sagittal maxillary-mandibular relationships, were used to estimate the facial profile attractiveness. The examinees graded the profiles based on a 0 to 10 numerical rating scale. The examinees graded the profiles of their own sex only from a social perspective, whereas opposite sex profiles were graded both from the social and emotional perspective separately. RESULTS The perception of facial esthetics was found to be related to the gender, age, and psychosocial context of evaluation (p < 0.05). The most attractive profiles to men are the orthognathic female profile from the social perspective and the moderate bialveolar protrusion from the emotional perspective. The most attractive profile to women is the orthognathic male profile, when graded from the social aspect, and the mild bialveolar retrusion when graded from the emotional aspect. The age increase of the assessor results in a higher attractiveness grade. CONCLUSIONS When planning treatment that modifies the facial profile, the clinician should bear in mind that the perception of facial profile esthetics is a complex phenomenon influenced by biopsychosocial factors. CLINICAL SIGNIFICANCE This study allows a better understanding of the concept of perception of facial esthetics that includes gender, age, and psychosocial context.

Translation and validation of the Croatian version of the Oral Impacts on Daily Performances (OIDP) scale

Background/Aim Among numerous sociodental indicators the Oral Impacts on Daily Performance (OIPD) is one of the most broadly applied. The aim of this study was to develop and test psychometric properties of a Croatian version of OIDP scale. Methods The OIDP instrument was translated from English to Croatian in a forward-backward method. The Croatian version was tested for reliability, construct validity and responsiveness on a sample of 702 participants (255 men), aged 18-86 years. Results Internal consistency of Croatian version of the OIDP was acceptable (alpha = 0.80) and 69.4% of the examinees had oral impacts relating to one or several performances. The most frequently affected performance was eating (53.7%). The test-retest reliability was high (r = 0.99; 95% CI: 0.97-0.99), the mean difference between the OIDP summary scores in two-week interval was not statistically significant. In construct validity testing there was statistically significant correlation between OIDP and self-assessed general and oral health, somatisation, depression and Oral Health Impact Profile ranging from 0.157 to 0.516. Responsiveness was confirmed by a significant reduction of oral impacts on daily performances in subjects before and after treatment of acute dental pain (p < 0.001). Conclusion The Croatian OIDP index showed good psychometric properties in terms of construct validity, internal consistency, test-retest reliability and responsiveness confirming its appropriateness for use among Croatian population.

Tooth color assessment

Boja zuba u dentalnoj medicini znacajno utjece na doživljaj cjelokupne estetike zubi i lica. Percepcija boje ovisi o mnogim cimbenicima, kao sto

Development and validation of a new condition-specific instrument for evaluation of smile esthetics-related quality of life

OBJECTIVE Orofacial esthetics raises psychosocial issues. The purpose was to create and validate new short instrument for psychosocial impacts of altered smile esthetics. MATERIALS AND METHODS A team of an orthodontist, two prosthodontists, psychologist, and a dental student generated items that could draw up specific hypothetical psychosocial dimensions (69 items initially, 39 in final analysis). The sample consisted of 261 Caucasian subjects attending local high schools and university (26% male) aged 14 to 28 years that have self-administrated the designed questionnaire. Factorial analysis, Cronbachs alpha, Pearson correlation, paired samples t-test and analysis of variance were used for analyses of internal consistency, construct validity, responsiveness, and test-retest. RESULTS Three dimensions of psychosocial impacts of altered smile esthetics were identified: dental self-consciousness, dental self-confidence and social contacts that can be best fitted by 12 items, 4 items in each dimension. Internal consistency was good (α in range 0.85-0.89). Good stability in test-retest was confirmed. In responsiveness testing, tooth whitening induced increase in dental self-confidence (P = 0.002), but no significant changes in other dimensions. CONCLUSION The new instrument, Smile Esthetics-Related Quality of Life (SERQoL), is short and has proven to be a good indicator of psychosocial dimensions related to perception of smile esthetics. CLINICAL SIGNIFICANCE Smile Esthetics-Related Quality of Life questionnaire might have practical validity when applied in esthetic dental clinical procedures.

Changes in Quality of Life Induced by Tooth Whitening are Moderated by Perfectionism: A Randomized, Double-Blind, Placebo-Controlled Trial

PURPOSE To explore the influence of perfectionism on the short-term changes in satisfaction with smile esthetics and quality of life (QoL) induced by tooth whitening. MATERIALS AND METHODS A total of 60 subjects were analyzed: 30 in the active group, in which the subjects anterior teeth were whitened with a photoactivated gel, and 30 in the placebo group. The Smile Esthetics-Related Quality of Life and Multidimensional Perfectionism Scale questionnaires were administered to all participants. RESULTS The active group demonstrated an increase in dental self-confidence and a decrease in dissatisfaction with color (P < .05). The amount of color change did not correlate linearly with change in dissatisfaction or with QoL. In subjects with higher perfectionism, increasing the color change led to more decrease in dental self-consciousness. CONCLUSION Perfectionism moderates perception of smile esthetics.

Patients' general satisfaction with the appearance of anterior maxillary teeth

Background/Aim. Dental appearance plays an important role in practically all personal social interactions. The main factors that define the dental appearance are tooth colour, shape and position, quality of restoration, and the general position of the teeth in arch, especially in the anterior region. The aim of this study was to evaluate the impact of dental status (tooth shape, fracture, dental and prosthetic restorations and presence of plaque) on patients satisfaction with the dental appearance, controlling for the age and gender. Methods. A total of 700 Caucasian subjects (439 women) aged 18-86 (median 45 years) participated in the cross-sectional study. Study included clinical examination and self-administrated questionnaire based on self-perceived aesthetics and satisfaction with the appearance of their maxillary anterior teeth. Results. A regression analysis demonstrated that presence of dental plaque, tooth fracture, composite fillings and crowns had significant independent contribution and were negative predictors of satisfaction with teeth appearance. Participants with presence of plaque on upper teeth (p < 0.001), fractures (p = 0.005), composite fillings (p < 0.001) and crowns (p = 0.032) were less satisfied than those without it. Model explains 12% or variance of general satisfaction with the appearance of maxillary frontal teeth (p < 0.001) and the major contributors are composite fillings (5.3%) and plaque (3.2%). Tooth shape, age and gender were not significant predictors of satisfaction. Conclusion. Satisfaction with the teeth appearance is under the influence of many factors with significant negative influence of presence of dental plaque, fractures, composite restorations, and crowns.