Rosenstiel Stephen F, Pappas Maria, Pulido M Teresa, Rashid Robert G
Division of Restorative and Prosthetic Dentistry, The Ohio State University, College of Dentistry, Columbus, OH 43210-1267, USA.
J Dent. 2009;37 Suppl 1:e64-9. doi: 10.1016/j.jdent.2009.05.003. Epub 2009 May 14.
The purpose of this study was to measure dentists' before and after restorative treatment photographs to identify four metrics to describe the esthetic improvement: (a) central incisor width-to-height ratio; (b) central-to-lateral incisor width ratio; (c) lateral incisor-to-canine width ratio; and (d) lateral incisor percentage offset.
Internet searches for "before after" and "veneers" and "prosthodontic" were used to obtain 198 before and after photographs of patient treatments showing the restoration of the six maxillary anterior teeth with porcelain veneers, crowns or a combination. The four metrics were measured using Adobe Photoshop. Groups were compared with repeated measures ANOVA followed by a post hoc Tukey-Kramer test with the variables of "Before or After Treatment"; "Treatment Type" (veneers, crowns or a combination) and "General Dentist or Prosthodontist".
Mean central incisor width-to-height ratio was 91.7% before treatment, 80.8% after; mean central-to-lateral incisor width ratios were 69.9% and 64.7%; mean lateral incisor-to-canine width ratios were 85.3% and 81.4% and lateral incisor percentage offsets were 9.6% and 8.7%. There were significant (p<0.05) differences for before and after treatment for all variables except central-to-lateral incisor width ratio. Differences between specialist and general dentist were not statistically significant.
On average, esthetic prosthetic treatment resulted in reduced central incisor width-to-height ratio, increased proportional width of the mesially positioned tooth of adjacent anterior teeth and reduced lateral incisor offset. The mean values of treatments by GPs and prosthodontists were not statistically significantly different.
Knowledge of dentists' optimal restorative treatments provides insight on the esthetic outcome of extensive prosthodontic therapy.
本研究旨在测量牙医在修复治疗前后拍摄的照片，以确定四个指标来描述美学改善情况：（a）中切牙宽高比；（b）中切牙与侧切牙宽度比；（c）侧切牙与尖牙宽度比；（d）侧切牙偏移百分比。
通过在互联网上搜索“治疗前后”“贴面”和“口腔修复学”，获取了198张患者治疗前后的照片，这些照片展示了使用瓷贴面、牙冠或两者结合对上颌六颗前牙进行修复的情况。使用Adobe Photoshop测量这四个指标。采用重复测量方差分析对各组进行比较，随后进行事后Tukey-Kramer检验，变量包括“治疗前或治疗后”“治疗类型”（贴面、牙冠或两者结合）以及“普通牙医或口腔修复医生”。
治疗前中切牙平均宽高比为91.7%，治疗后为80.8%；中切牙与侧切牙平均宽度比分别为69.9%和64.7%；侧切牙与尖牙平均宽度比分别为85.3%和81.4%，侧切牙偏移百分比分别为9.6%和8.7%。除中切牙与侧切牙宽度比外，所有变量治疗前后均存在显著差异（p<0.05）。专科医生和普通牙医之间的差异无统计学意义。
平均而言，美学修复治疗导致中切牙宽高比降低，相邻前牙中位置靠中的牙齿比例宽度增加，侧切牙偏移减少。全科医生和口腔修复医生的治疗平均值在统计学上无显著差异。
了解牙医的最佳修复治疗方法有助于深入了解广泛口腔修复治疗的美学效果。
