Objective: To investigate the effect of different visual angles on the accuracy of esthetic defect detection in the dental esthetic zone, clarify the differences in detection accuracy across different tooth positions, esthetic defect types and professional backgrounds of dentists, so as to provide reference for standardized clinical evaluation of dental esthetics. Methods: A total of 114 licensed dentists who participated in various continuing education programs at Peking University School and Hospital of Stomatology from January to December 2025 was enrolled as research subjects. They were divided into the prosthodontics and orthodontics group (n=49) and the other specialties group (n=65). The baseline maxillary anterior teeth photograph from a 26-year-old female volunteer was set as the control. Eleven images with 4 types of esthetic defects (incisal edge position, gingival margin position, tooth long axis and crown width-to-length ratio) were generated, bringing the total number of study images to 12. After rotation at 0°, 90° and 180°, 36 study images were obtained in total. The images were presented to the subjects via slides, with each image shown for 8s. Two evaluation indicators were adopted:defect detection rate and detection accuracy rate. Subjects were required to determine whether there was a esthetic defect in the image and identify the specific type of defect. A correct detection was defined as accurate judgment of both the existence of the defect and the defect type. The values of the two indicators were calculated, and data were analyzed using the chi-square test with SPSS 27.0 software. Results: The detection rate of aesthetic defects among the 36 images ranged from 23.7% (27/114) to 100.0% (114/114), and the accuracy rate ranged from 5.3% (6/114) to 79.8% (91/114). The difference in detection accuracy among different visual angles was statistically significant: the 0° angle had the highest detection accuracy [52.2% (714/1 368)], followed by the 180° angle [45.1% (617/1 368)], and the 90° angle had the lowest accuracy [26.8% (366/1 368)]. For different tooth positions, the detection accuracy of esthetic defects in central incisors [54.2% (741/1 368)] was significantly higher than that in other positions [34.9% (956/2 736)]. The differences in defect detection accuracy under different visual angles were all statistically significant for incisal edge position, gingival margin position, tooth long axis and crown width-to-length ratio (all P<0.017). There was no statistically significant difference in defect detection accuracy between the prosthodontics and orthodontics group and the other specialties group (P>0.05). Conclusions: Visual angle significantly affects the detection accuracy rate of dental esthetic defects, and the 0° angle is more conducive to the identification of aesthetic defects. Tooth position and defect type also have an impact on the detection accuracy rate.
Gingival recession is a common complication of orthodontic treatment, with its occurrence associated with multiple factors such as periodontal phenotype, the width and thickness of keratinized gingiva, alveolar bone morphology, and plaque control. This article first reviews the impact of orthodontic tooth movement, particularly labial tipping of anterior teeth, on periodontal hard and soft tissues. It emphasizes that the risks of orthodontic-related bone fenestration, bone dehiscence, and gingival recession are significantly increased in the presence of a thin gingival biotype, inadequate keratinized gingiva, as well as thinned or deficient buccal bone plates. Subsequently, through case integration, a phased clinical decision-making pathway is proposed: during the three stages of pre-, mid-, and post-orthodontics, baseline risk assessment, judgment of tooth movement direction and tissue volume on the pressure side, the timing and methods of preventive/therapeutic soft/hard tissue augmentation and root coverage procedures are respectively addressed. This approach aims to establish a comprehensive patient management strategy centered on "mucogingival consideration" for orthodontic patients, thereby providing practical guidance for the clinical diagnosis and treatment of orthodontic-related periodontal mucogingival deformities and conditions.
The rapid development of robot-assisted implant surgery in dentistry has led to a significant improvement in the precision and safety of dental implant surgery, and the ensuing problem of associated risk has attracted widespread attention. This article reviews the current status of the application of robot-assisted implant surgery, analyzes the progress of research on related risks, discusses the potential risks, and provides an outlook on the future direction of development.
