Clinical Case Reports For The Application Of Systematic Esthetic Analysis In Anterior Esthetic Restoration

Objective:Systematic esthetic analysis and treatment of patients who need anterior esthetic restoration,and preliminary determination of the effects.Method:6 patients were selected,who needed anterior esthetic restoration and finally treated in prosthodontics department of Dalian Stomatological Hospital from March 2015 to January 2016.Inclusion Criteria:1.No system history,no loosened teeth 2.Prosthetic cases of anterior area which merely need indirect fixed r estorations 3.Patients who can cooperate well and follow advicesResearch Method : 1.Understand the chief complaint,esthetic requirements,expectations as well as the economic condition of the patients,and establish good communication.2.Clinical examination,prognosis and history-taking 3.Esthetic analysis and treatment plan.The common esthetics theory,“two-factors”,is referred as “law of line and plane”in form and “law of infinite adjacency” in color.Analysis method of “law of line and plane”include facial analysis,lips-teeth analysis,teeth analysis,gingival analysis and speech analysis.Facial analysis is completed according to horizontal & vertical guides,facial proportion and E angle.Lip-teeth analysis is represented as gingival exposure and positional relation between lips and teeth when in postural position and smile position.Teeth analysis includes analysis of teeth proportion,width-length ratio,axis,contact area and angle between incisal edges.Gingival analysis includes analysis of gingival margin lines,vertex,and gingival papilla.Speech analysis means determinating incisor length and position assisted by pronunciation.4.Mock-up was produced on the basis of diagnostic wax-up.Treatment plan was developed and oral health instruction was made after the patient was satisfied with the predictive effect.5.Pre-restoration treatment,including periodontal and pulpal treatment,was conducted to make sure the healthy state of teeth and periodontium tissue.6.Shade selection by using VITA 3D-Master shade guide.7.Teeth preparation was instructed by silicone guide created from wax-up to reserve enough space for ceramic layer,then precise impression was made,and provisional restorations were finally produced.8.Try-in of the final restorations,evaluation of esthetic effects and function and cementation.9.Follow-up after treatment,re-evaluation of esthetic effects.Results: Esthetic analysis and design was made for every patient who needs anterior esthetic restorations,and appropriate restoration plan was carried out based on their own situation.Comprehensive assessment of the esthetic effect and function of the final prostheses indicated that 6 patients considered prostheses esthetic,comfortable and satisfactory,and displayed their charming smile.Conclusion: Effective communication,esthetic analysis and design before treatment played a key role in anterior esthetic restoration.Based on understanding of the esthetic requirements and expectations of patients,esthetic analysis,difficulty assessment,appropriate plan,and clear recognition and acceptance of postoperative effects were important guarantees of postoperative satisfaction.On the other hand,standard clinical operation was another factor,which ensured successful restorations.In addition,function should not be neglected while esthetics was taken into account.The most comfortable prosthesis and best esthetic effects would be achieved only if both function and esthetics were considered.