Tooth loss causes resorption of the alveolar bone, a physiologic response to the disturbance of the functional and anatomical relationship between the periodontium and the alveolar wall. Their close relationships are determined by the unity of development, structure, function, and physiology.
Over the course of the last century, life expectancy has been increasing in a way that mankind has never experienced before. Not only are we living longer, but more relevant to health practitioners, we are living a more active life into our 70 s, 80 s, and even 90 s. On the other hand, oral health, oral function, and oral esthetics all have a direct impact on our quality of life. Recent studies have also demonstrated that in order to have good general health, it is important to maintain oral health at its best.
The Etruscans used dental crowns and bridges 2,500 years ago, but they fell out of use during the Middle Ages. Pierre Mouton reintroduced gold crowns in the 18th century, while accurate casting procedures for dental alloys were developed in the early 20th century. Metal that exhibits excellent mechanical properties for framework use, even for large dental prostheses, does not ensure a natural restoration appearance.
There is evidence that most people agree upon what is an attractive smile, but what actually guides and validates our judgment? The goal of this chapter is to review and illustrate the structural factors in dentition and jaw base relationships behind an attractive smile. The smile is the interaction of a set of factors observed at the same time. In modern orthodontics and orthognathics, smile attractiveness is an important topic and therefore a principal goal.
Esthetics and beauty are two different concepts that may be confused by many dentists. Beauty is a more subjective concept, related to cultural aspects, and is interpreted differently in different communities; while the perception of something as esthetically attractive is made up of a number of “golden rules”. On the one hand, esthetics is subject to influences from current events, culture, fashion, mentality, and many other factors.
Quality of life has become one of the main preoccupations of society in most countries and is one of primary goals of the World Health Organization (WHO). The WHO defines health not only as a lack of illness or health problem, but as complete physical, mental, and social wellbeing. People are indivisible beings, who cannot be understood by separate analysis of their different parts.
Historically, the dental profession has been centered on the treatment of dental diseases. However, the last three decades have seen a paradigm shift from a science dealing primarily with disease eradication to a therapy that encompasses health, function and beauty as its treatment goal.
Loss of teeth in the anterior maxillary area (the esthetic zone) is defined as Kennedy Class IV (bilateral bounded anterior partially edentulous): a single but bilateral (crossing the midline) edentulous area located to the anterior of the remaining natural teeth.
Implant dentistry is a symbiosis between art and science. It is a great challenge to put together biologic, biomechanical, anatomical, esthetic, and gnathologic knowledge into a treatment plan that offers the patient a satisfying, stable, and functional outcome in the long term.
Dentofacial esthetics, patient perception, and expectations regarding their appearance pose major issues in prosthodontic treatment and treatment outcome acceptance. The face and in particular the oral region is in the forefront when making contact during interpersonal communication. Some authors have identified the eyes and the mouth as the main features associated with facial attractiveness, where the eyes were said to contribute 34% and the mouth 31% in determining facial esthetics.
The treatment of arch collapse patients calls for a full-mouth reconstruction. In other words, to achieve an optimal occlusion, the procedure includes finding the vertical dimension, jaw relation, and a proper occlusal plane. This allows each tooth to find its physiologic position, thus arriving at a stable alignment, and ultimately a harmonious neuromuscular system.
“Treat one tooth” is the most important principle in dental work. However, we sometimes treat cases of occlusal collapse with edentulism. When treating such complex cases, an interdisciplinary approach is ideal. However, such a system is not yet established among Japanese practitioners. In general, each Japanese dentist provides treatment to patients from the start to the end by him/herself alone.