ASPECTS OF ASSESSING AESTHETIC PARAMETERS IN PATIENTS
Authors: Ozhohan P.Z. , Ozhogan Z.R. 
Published: September 2023

Main goal. To study the state of the maxillofacial system in patients with defects in the hard tissues of the teeth and dentition for the presence of aesthetic problems and the prevalence of aesthetic treatment methods with indirect restorations.

Matherials and methods. To study the state of the maxillofacial system , we have created the “Map of determining the level of aesthetics” , which includes an analysis of the shape and colour of the teeth , the condition of the gums , the presence of restorations , the state of occlusal relationships and oral hygiene. 230 people aged 18-45 were examined, intraoral scanning and model scanning were used. General clinical examination methods were carried out, radiological methods were used. In order to evaluate metal-free restorations, clinical evaluation methods according to USPHS criteria (Ryge) were applied.

Research results. During the examination of patients, we found that 72.0% of the subjects were not satisfied with their aesthetic appearance. The reasons for this are the discrepancy between the color and shape of predominantly direct restorations, changes in tooth position, and different levels of gingival attachment. We found that in a significant part of patients, fixed metal-ceramic or metal-acrylic fixed structures and direct composite restorations for a period of 3 years or more prevailed, which led to the development of an inflammatory process in the marginal periodontal tissues and gingival bleeding. Significant causes of aesthetic dissatisfaction in the examined patients were changes in the color and shape of teeth or restorations in 67.2% of the examined patients, changes in the position of teeth in 35.6%, and unequal level of gingival attachment of the anterior teeth in 18.4%. In addition, the reasons for the aesthetic dissatisfaction of patients were the inappropriate shape of the cutting edge, the condition of the gums and oral hygiene, direct and indirect restorations. Based on the data obtained, we proposed the Aesthetics Index, which takes into account a set of factors: tooth color, tooth shape, tooth position, level of gingival attachment, shape of the cutting edge, gum condition, condition of direct restorations, condition of indirect restorations, state of oral hygiene, frequency of visits to the dentist. When examining patients according to 10 criteria, a high level (41-50 points) of aesthetics was found in 16.8%, and an average level (31-40 points) in 56.8%. It should be noted that a low level of aesthetic satisfaction (up to 30 points) was found in 26.4% of patients during subjective and confirmed by objective examination.

Conclusions. We have proposed the Aesthetic Index, which takes into account the main aesthetic parameters and the state of the hard tissues of teeth and restorations. This index is accessible and simple, and can be used by dentists in their practice. The obtained results indicate that only 16.8% of patients have aesthetic restorations that fully meet the requirements, and 26.4% have a low level of patient aesthetic satisfaction. The main reasons for this are changes in the color, shape, position of the teeth and the level of gum attachment.