Transforming Adolescent Smiles:Correcting Skeletal Mandibular Retrusion and Bimaxillary Protrusion with Clear Aligners

Maxillary protrusion combined with mandibular retraction is a highly prevalent but extremely complex maxillofacial deformity that can have a serious negative impact on patients’facial aesthetics and mental health.The traditional orthodontic treatment strategy often involves extracting 4 first premolars and conventional fixed techniques,combined with mini-implant screws,to retract the anterior teeth and improve facial protrusion.In recent years,an invisible orthodontic technique,without brackets,has become increasingly popular.However,while an invisible aligner has been used in some cases with reasonable results,there remain significant challenges in achieving a perfect outcome.This case report presents an adolescent patient with bimaxillary protrusion and mandibular retrognathia.Based on the characteristics of the invisible aligners and the growth characteristics of the adolescent’s teeth and jawbone,we designed precise three-dimensional tooth movement and corresponding resistance/over-correction for each tooth,while utilizing the patient’s jawbone growth potential to promote rapid development of the mandible,accurately and efficiently correcting bimaxillary protrusion and skeletal mandibular retrognathia.The patient’s facial aesthetics,especially the lateral morphology,have been greatly improved,and various aesthetic indicators have also shown significant changes,and to the patient’s great benefit,invasive mini-implant screws were not used during the treatment.This case highlights the advantages of using invisible aligners in adolescent maxillary protrusion combined with mandibular retraction patients.Furthermore,comprehensive and accurate design combined with good application of growth potential can also enable invisible orthodontic technology to achieve perfect treatment effects in tooth extractions,providing clinical guidance for orthodontists.

The Aesthetic Inheritance of the Mao Dun Literature Prize in the Flux-Take Xu Mao and His Daughters and A Tale of the Wind as Examples

The Mao Dun Literature Prize is one of the well-known literary awards in China,and in the process of selection over the years,the Mao Dun Literature Prize has developed its own aesthetic orientation.A comparison is made between the early generation of Xu Mao and His Daughters and the recent award-winning work,A Tale of the Wind,to discover the aesthetic heritage in its flux,which is enlightening for the literary criticism and an orientation for the literary creators.

Papillae alterations around single-implant restorations in the anterior maxillae:thick versus thin mucosa

To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration. According to the inclusion criteria, 32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included. The patients were assigned to two groups according to the mucosal thickness： （i） group 1, 1.5 mm≤mucosal thickness≤3 mm; and （ii） group 2, 3 mm〈mucosal thickness≤4.5 mm. Assessments of interproximal papillae at the time of crown placement （baseline） and at 6-month postloading （follow-up） were made by two prosthodontists using papilla fill index （PFI）. The mean mucosal thickness was （2.49±0.31） mm （group 1） and （3.81±0.31） mm （group 2） for the two groups respectively. A significant difference in PFI between the groups was detected at the baseline （P〈O.O01）. PFI improvements over time occurred after 6-month follow-up irrespective of the groups. When compared to group 1, the likelihood to obtain papilla fill was significantly higher for group 2 with an odds ratio of 6.05 （P〈O.O01）. The interproximal papilla level around single-implant restorations could improve significantly over time after 6-month restoration according to PFI assessment. The thicker mucosa before implant placement implied a more favorable esthetic outcome in papilla alteration.

Immediate implant placement in combination with platelet rich-fibrin into extraction sites with periapical infection in the esthetic zone:A case report and review of literature

BACKGROUND In this case,platelet-rich fibrin(PRF)was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.CASE SUMMARY With the history of endodontic failure in maxillary central incisor,a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation.Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue.Before operation,cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone.The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration.The barrier was a three-layer structure of PRF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing.At 6 mo postoperatively,the definitive crown was placed after accomplished finial impression.One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue.CONCLUSION The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome.

Facial microcystic adnexal carcinoma-treatment with a “jigsaw puzzle” advancement flap and immediate esthetic reconstruction: A case report

BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histological invasiveness,clinical inexperience and inadequate procedure design,immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARY This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip.She declined the recommended treatment plan,which included two-stage reconstruction,skin grafting,or surgery that could have resulted in obvious facial dysfunction or esthetic deformity.We accurately designed a personalized procedure involving a“jigsaw puzzle advancement flap”for the patient based on the lesion location and the estimated area of skin loss.The procedure was successful;both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSION This study suggests that when treating facial MAC or other skin malignancies,a surgical team should have sufficient plastic surgery-related knowledge and skills.An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.

Achieving the Visual Perception and Gestalt Psychology in Sultan Hassan Mosque Building

The gestalt principles are perception and what is visually communicated by objects. These principles describe the visual language within which we work. Understanding how a designer realizes things visually will help designers communicate better. Many designers use Gestalt principles to have a structure visual stimulus, so as to create interfaces that are easy for users to understand. Because the understanding of visual perception is a critical item in any designer’s toolkit. Islamic heritage buildings also contain many architectural values, especially the Sultan Hassan Mosque in Cairo. Through this paper, we will verify the use of gestalt principles of visual perception in the building design. Because the psychological organization of the design, achieves the understanding and awareness of the current relationships between the elements, depending on the extent of regularity, accuracy, and consistency of the design elements. This makes us recognize the esthetic values of Sultan Hassan’s building and mosque. The visual delight we get from architecture begins with how we perceive it. So, in order to understand how visual delight arises, we must first understand how we perceive and interpret visual stimuli. Especially since the principles of gestalt confirm that the human brain tends to make tricks and illusions. Therefore, we found the mosque designer had exploited this fact during the design process, to exclude any possibility of the resulting misunderstanding. The designer achieved the psychological preparation of the visitor by using some principles of visual perception of the Gestalt theory, such as growth, continuity, and hierarchy.

Two bone blocks sandwich technique for horizontal reconstruction of severely atrophic alveolar ridge in anterior maxilla: A case report

BACKGROUND Severe horizontal bone deficiency of the maxillary anterior region is considered a major challenge in reconstruction and successful implant placement.Various approaches have been developed to augment bone volume.Of these approaches,onlay bone graft,alveolar bone splitting,and guided bone regeneration have been suggested.CASE SUMMARY A 22-year-old female patient,with no previous medical history,presented to the Department of Oral Implantology,Wuhan University due to a missing right maxillary incisor.The X-ray results showed severe horizontal bone deficiency,with an available bone width of 3.1-4.0 mm.The two bone blocks sandwich technique was performed to augment the bone volume.After 6 months healing,X-ray results showed that the newly formed alveolar ridge dimension increased to 4.7-9.5 mm horizontally.Implant insertion surgery was performed and allceramic restorations were fabricated.The implant was stable at the 1-year followup visit after restoration,and the X-ray showed a stable bone level around the dental implant.The scores for the pink esthetic score and white esthetic score were 12 and 8,respectively,and the patient was satisfied with the esthetic outcome.CONCLUSION The two bone blocks sandwich technique may be an alternative treatment option in augmenting severe horizontal bone deficiency of the anterior maxilla.

Enamel microabrasion: An overview of clinical and scientific considerations

Superficial stains and irregularities of the enamelare generally what prompt patients to seek dental intervention to improve their smile. These stains or defects may be due to hypoplasia, amelogenesis imperfecta, mineralized white spots, or fluorosis, for which enamel microabrasion is primarily indicated. Enamel microabrasion involves the use of acidic and abrasive agents, such as with 37% phosphoric acid and pumice or 6% hydrochloric acid and silica, applied to the altered enamel surface with mechanical pressure from a rubber cup coupled to a rotatory mandrel of a lowrotation micromotor. If necessary, this treatment can be safely combined with bleaching for better esthetic results. Recent studies show that microabrasion is a conservative treatment when the enamel wear is minimal and clinically imperceptible. The most important factor contributing to the success of enamel microabrasion is the depth of the defect, as deeper, opaque stains, such as those resulting from hypoplasia, cannot be resolved with microabrasion, and require a restorative approach. Surface enamel alterations that result from microabrasion, such as roughness and microhardness, are easily restored by saliva. Clinical studies support the efficacy and longevity of this safe and minimally invasive treatment. The present article presents the clinical and scientific aspects concerning the microabrasion technique, and discusses the indications for and effects of the treatment, including recent works describing microscopic and clinical evaluations.

The Research of Fine Arts Education with Cultivating Aesthetic Appreciation and Creativity as the Core Quality

In the process of art education and teaching,the improvement of students'aesthetic quality and creative ability is the main goal of art teaching.At the same time,it is also the fundamental basis and direction of teaching.In art teaching,aesthetic education is not only reflected by art skills and teaching basis,but also can not separate aesthetic education from basic knowledge and skills of art education.The cultivation of students'artistic quality and creative ability is the main content of the current development of art education and teaching.Colleges and universities should effectively improve and optimize the teaching courses and teaching contents from the aspects of teaching methods,teaching environment,teaching resources,so as to realize the effective cultivation of students'aesthetic quality and creativity.This paper mainly expounds the significance of cultivating students'aesthetic quality and creative ability,and effectively expounds the methods of improvement,aiming to promote the continuous development and reform of art education in colleges and universities,and improve the level of art education.

On Grillet's Short Story “The Secret Room”——in a Phenomenological Reading Approach

In this paper, the authortries to make a tentative analysis on the short story “The Secret Room” by Alain Robbe Grillet, a French novelist and a contemporary world famous experimentalist of “new novel” form, through reading in phenomenological approach so as to appreciate his novel style, realize the readers esthetic imagination, meanwhile, to deepen the understanding of the process of phenomenological reading.

Clinical Application of CAD/CAM Customized Zirconia Abutment in Maxillary Anterior Region

[Objectives]To explore the difference between the CAD/CAM customized zirconia abutment and the finished titanium abutment in the maxillary anterior region.[Methods]A total of 60 implants were selected from 60 patients who had undergone maxillary single anterior implant implantation in the Department of Oral and Maxillofacial Surgery,Affiliated Hospital of Qingdao University from July 2017 to July 2018.They were randomly divided into an observation group and a control group(30 patients/group).The observation group used CAD/CAM customized zirconia abutment and all-ceramic crown,while the control group used finished titanium abutment and all-ceramic crown.Twelve months after the crown restoration,mechanical complications,pink esthetic(another spelling of aesthetic)score(PES)and white esthetic score(WES),and patient satisfaction were used as clinical observation indicators to evaluate the restoration effect.[Results]For 12 months after crown restoration,the implant survival rate of the two groups of patients was 100%,and there was no abutment breakage,loosening,falling off,or screw loosening and breakage.The PES and WES of the observation group were significantly higher than those of the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than those of the control group(P<0.05).[Conclusions]CAD/CAM customized zirconia abutment implant restoration in the maxillary anterior region can obtain good esthetic restoration effect in a short term,and has good clinical application effect.

Computer-Aided Design and Fabrication of Finger Prosthesis

Custom-made esthetic finger prostheses, which are used for rehabilitation of patients with missing or impaired fingers, have been fabricated manually. However, such fabrication is time-consuming and requires manual skill. Here we propose a computer-aided method for fabricating finger pros-theses to save time and allow fabrications that do not require considerable manual skill. In this method, the dimensions of a patient’s healthy finger on the contralateral hand are first measured using a caliper. Using these dimensions, a three-dimensional model is constructed for fabricating a prosthesis for the patient’s impaired finger. Using the 3D model, a mold is designed using 3D modeling tools and a computer-aided design system. The resulting mold is then fabricated using a 3D printer. A finger prosthesis is fabricated by pouring silicone resin into the mold. A finger prosthesis for a volunteer was experimentally fabricated according to the proposed method. To evaluate the size and shape of the finger prosthesis, the difference between the finger prosthesis and the original finger of the volunteer was analyzed. Because the average difference between them was 0.25 mm, it was concluded that the proposed method could be used to fabricate a finger prosthesis of adequate size and shape.

Controversy of silver amalgam as a restorative material

Silver amalgam contains mercury leading to concerns about the potential toxic effects of amalgam on the health of dental patients. The debate over the toxicity of silver amalgam restorations has divided the dental profession for over a century. The use of amalgam restorations for anterior teeth have been declining worldwide due to patient's safety concerns and preference for tooth colored restorations. Nevertheless, amalgam has served the dental profession for decades and benefited hundreds of millions of patients because of its longevity as a dental restorative material. Amalgam is still the World's most widely used restorative material for posterior teeth.

Sub-Epithelial Connective Tissue Graft to Increase the Volume of Residual Alveolar Bone in the Upper Anterior Sector and Fixed Rehabilitation with Zirconia

Background: The collapse of the alveolar ridge in an edentulous area in patients who will undergo oral rehabilitation impedes the harmonic relationship between pontic and ridge. To correct this type of defect there are several surgical techniques that aim to achieve soft tissue augmentation, allowing the conformation of an ideal profile with the use of a pontic. The aim was to demonstrate how the technique of tissue modification in an area with a class b defect of Allen allows the correction of aesthetics in the anterior dental sector. Case presentation: A 41-year-old Mexican woman. Extra and intraoral examination was performed, the dental treatment included connective tissue graft and rehabilitation with Zirconia. Conclusion: Surgery of residual alveolar ridge augmentation with connective tissue graft gives the patient favorable aesthetic results in the anterior area when it will be rehabilitated.

Psychosomatic Medicine and Evidence-Based Surgery:Reflections and Perspectives

This article reflects on the need for psychosomatic medicine research in the field of surgery by complementing psychological/psychiatrist approaches with a physician’s(particularly surgeon’s)point of view.Focusing on esthetic/cosmetic surgery,a broader notion of“psychosomatic surgery”is also used regarding plastic surgery as well as examples of vascular and general surgery.Relevant literature reviews are utilized to gain a more comprehensive bio-psycho-social perspective.By providing a deeper understanding in the specialty areas,it makes a case for evidence-based practice by shedding light on psychosomatic medicine research on surgery in the United States with cross-cultural implications.

Comparison of cosmetic outcomes between remote-access and conventional thyroidectomy:A review of the current literature

Objective:The pursuit of an esthetically pleasing scar following open thyroid surgery has led to the development of endoscopic thyroidectomy through remote incisions placed in several locations outside the neck.The objective of this study is to review the recent literature and compare the incision site appearance and patient satisfaction with the cosmetic outcome after extracervical and conventional thyroidectomy.Methods:The English literature published since 2010 was searched through the PubMed/Medline database for studies comparing the cosmetic outcomes between remote-access endoscopic and conventional thyroidectomy using a form of scar assessment scale.Results:A total of 9 relevant papers fulfilled the eligibility criteria including 1486 patients.Among them,595 patients underwent endoscopic thyroidectomy through several remote-access approaches and 891 patients were assigned to the conventional group.Only one randomized-controlled trial was identified,whereas among the rest,four were prospective and four were retrospective nonrandomized cohorts.Regarding the extracervical modifications performed in the endoscopic groups,the axillary approach was performed in three studies and the breast approach in four studies,while the retroauricular facelift technique and the transoral vestibular method were applied in one study,respectively.Conclusions:Evaluation of the wound appearance and patient satisfaction with the cosmetic outcome at various time points during the follow-up highlighted the superiority of the extracervical approaches over the conventional cervicotomy.Considering these findings,remote-access techniques could possibly be the ideal surgical method for patients with high esthetic requirements,providing an excellent appearance of the thoroughly exposed neck.

Adolescent male genitalia dissatisfaction:a surgical perspective

Genital dissatisfaction is well known in female and adults.Less is known about male adolescents and their genital satisfaction.The aim of this study was to investigate and report the role of surgery in male adolescents to improve the evaluation of their genitalia.We considered all patients treated for external genital pathology in the period of adolescence.Inclusion and exclusion criteria were created.Patients underwent an evaluation test before and after surgery.During the study period,137 patients were treated,and at the end of the study,98 cases were considered for analysis.The most frequent pathologies were webbed penis and penile curvature.A postoperative score improvement was noted and patients with concealed penis and webbed penis showed a better postoperative outcome.Overweight was considered an important factor associated with a worse preoperative score.Evaluation of the external genitalia is important in adolescents,and it is an understudied problem.Overweight may be associated with a worse evaluation of one’s genital and should be clinically considered to avoid related social problems in adulthood.Therefore,cosmetic genital surgery should be considered even in male adolescents.

Guo Moruo’s Early Esthetics and Western Romanticism

is an initial study of the influence of Western romanti- cism on Guo Moruo’s early esthetic views.Wang and Luo believe that Guo Moruo atthat time from his philosophical perspective on to his literary and artistic opinionswas under the influence of the romantic ideas of such Western poets as Shelley,Goethe,Whitman,Wordsworth and Coleridge,and these laid the foundation for hisearly esthetic views.The literary and artistic theories of such estheticians of thelate nineteenth and early twentieth century as Croce,Bergson,Nietzsche,Freud,Paterand Oscar Wilde as well as Western symbolists and expressionists also had some im-pact on Guo Moruo’s early views.However,since Guo Moruo assimilated theirtheories from his own romantic esthetic perspective,even though their influence addedsome different factors to his early esthetic views,they did not effect any qualitativechange in them.

An Overview of Recent Fiction with Rural Themes

covers fiction produced since the CPC’s Third Plenum in December 1978.It analyzes esthetic style,character formation and the authors’ theoretical levels.Relatingthese works to ideas prevalent in writing and criticism during the seventeen years be-fore the outbreak of the 'cultural revolution,' Zhang sums up both the positive andthe negative experiences of Chinese writers,and puts forward his own views on anumber of important theoretical issues concerning realism in literature.He concludesthat when judging their honesty and depth of realism,the complexity and historical senseof the characters,or the understanding of peasant psychology and their exploration ofthe national spirit,the fiction with rural themes published in the last few years hasgiven recent literature 'more profound intellectual insight into its historical content.'This gives revolutionary realism an even wider scope.

Conceiving Possibility： Kierkegaard and Zhuangzi

This paper examines two notions of possibility conceived by Kierkegaard and Zhuangzi respectively. Kierkegaard conceives of it with appeals to the feeling of anxiety, while Zhuangzi deals with it in terms of a type of aesthetic feeling. Based on these distinctions, the paper goes further to explore two types of human existence as fostered by these two corresponding concepts of possibility. According to Kierkegaard, in order to maintain a connection with possibility, which would provide freedom to human existence, one must have faith in the redeemer bringing back possibility so that an individual human being might renew his or her choice ceaselessly. Zhuangzi, on the other hand, advises staying in the realm of nothingness and letting go of all things to avoid being trapped by the struggle of discerning between good and evil.