Dermal Fillers for Facial Soft Tissue Augmentation
Nowadays, patients are demanding not only enhancement to their dental (micro) esthetics, but also their overall facial (macro) esthetics. Soft tissue augmentation via dermal filling agents may be used to correct facial defects such as wrinkles caused by age, gravity, and trauma; thin lips; asymmetrical facial appearances; buccal fold depressions; and others. This article will review the pathogenesis of facial wrinkles, history, techniques, materials, complications, and clinical controversies regarding dermal fillers for soft tissue augmentation.Abstract
Cross section of skin demonstrating differences between lines, wrinkles, and folds.
(a) Restylane syringe is placed within the submucosal region of tissues to correct deep nasolabial folds and marionette lines in a 60-year-old patient. (b) Immediate post-op of patient after Restylane injections in nasolabial fold and marionette lines.
(a) A deciduous canine is extracted. The patient had no permanent canine and therefore a lack of canine eminence. (b) After the AlloDerm is folded upon itself and shaped to the canine eminence, it is positioned under the labial mucosa of the canine site. (c) The canine eminence and implant in position. (d) After 6 months of healing, the canine eminence is present. (e) The final crown is inserted for the maxillary right canine implant.
(a) Dense hydroxylapatite is added to the labial aspect of the maxillary anterior bone and under the labial tissues, to help support the maxillary lip above the fixed implant restoration. (b) The fixed maxillary implant prosthesis after soft tissue healing. Note the labial soft tissue above the implant prosthesis is in a similar plane.
Contributor Notes
Sarosh F. Dastoor, DMD, is a resident, Carl E. Misch, DDS, is an adjunct clinical professor, and Hom-Lay Wang, DDS, is a professor and director of Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan. Address correspondence to Dr Wang at University of Michigan School of Dentistry, 1011 North University Avenue, Ann Arbor, MI 48109 (homlay@umich.edu).