Australasian Dentist Magazine March April 2021

Category 78 Australasian Dentist to be hyperanimated, with the lip being pulled toward the normal side, creating a highly asymmetric smile that almost appears like a snarl (Fig.3). In other cases, patients can develop “synkinesis,” or involuntary facial movements or spasms, that occur during intended voluntary movements. For example, when trying to smile, the muscles that lift the corner of the mouth also result in the simultaneous and unintentional activation of the muscles that draw the face and the corner of the mouth down. This tug of war distorts the face and often results in a frozen smile. Dentists who have completed AADFA’s comprehensive structured pathway of learning and possess advanced tools, beyond just basic Botox and Filler, can confidently blend various techniques to provide more complex facial rehabilitation in cases that can be truly life-changing. For example, Botulinum toxin injections can be used to treat either the affected or the unaffected side of the face in patients suffering from the aforementioned facial contortions resulting from Bell’s Palsy. By relaxing facial muscles that have become restricted, or reducing muscle activity of the unaffected side, Dentists can successfully balance the movement of the face, creating a more harmonious aesthetic appearance and improving a patient’s self-esteem (Fig.3). to the mid and upper portions of the left side of her face. Subsequent reconstructive surgery left her with prominent scarring and the complete removed of certain fat compartments from beneath her left eye (e.g the Sub-Orbicularis Oculi Fat). These compartments of fat provide necessary volume, structure and support to the mid-face and as a result of losing these, a pronounced mid-face ledge and substantial depressive infra-orbital hollow was visible and became the source of ridicule during schooling years and deflated self-esteem. Utilising a keen knowledge of facial anatomy and advanced techniques learnt during AADFA programs, Dentists were able to restore the lost structure, facial contour and quality of life in under 15 minutes and without anaesthesia! Dermal Filler materials are also extremely useful when Dentists wish to create substantial changes to facial contours and profiles in cases where surgical intervention is either not possible or not desired. The techniques can be successfully blended with traditional orthodontics to create the illusion of a more Class I soft tissue profile by either advancing the mid-face in Class III individuals, or the chin in Class II patients (Fig.5). Finally, perhaps the most advanced aesthetic cases, demanding the use of a multi-pronged treatment approach, are those involving patients with marked unilateral flaccid paralysis resulting from stroke. As in previous examples, BOTOX ® can be used to balance muscle function/ dynamics; dermal filler can be used to improve facial contours, structure and proportion; while innovative techniques, introduced to Australia by AADFA, called PDO Thread Lifts (essentially sutures), are able to reposition flaccid tissues with a great degree of control. These procedures can easily be combined in the dental chair under simple local anaesthetic. To learn more or to refer AADFA’s catchphrase is that, “A Smile doesn’t end with beautiful teeth” and this is certainly true in cases where marked asymmetries, deficiencies or deterioration present major aesthetic challenges. In order to achieve the best results for patients, Dentists MUST have more than just intra-oral tools at their disposal and know how to blend intra and extra-oral techniques to achieve harmonious results. It is certainly astonishing to see what is now possible in a Dental Practice, with AADFA’s comprehensive training pathway, leading to an international Fellowship, a world-first, recognised by regulatory bodies, insurers and product manufacturers as being the pre-eminent education in the industry. AADFA’s pioneering work equips Dentists with the tools, skills and understanding to safely and effectively tackle even the most complex cases, enabling them to achieve life-changing results like never before. For Dentists wishing to incorporate these techniques in to their practice, AADFA run training programs throughout Australia and New Zealand, as well as internationally. For further details, visit the AADFA website or email: admin@ AADFA.net If you are looking to refer a patient for procedures using BOTOX ® , Dermal Filler or a plethora of other facial rehabilitation therapies but you’re not sure who to trust, AADFA has a handy “Directory” on the website (www.AADFA.net/ directory), which lists Member Dentists in your local area, alongside their clinical competencies. By referring to an AADFA Member, you can be assured that your patients will be in the hands of a well- trained, highly skilled practitioner who is bound by a stringent Code of Conduct and best practice guidelines. u For further details, visit the AADFA website or email: admin@AADFA.net Dermal Filler injections are also much more useful than for just an aesthetic lip enhancement. Fig.4 shows the case of a young women who was involved in a motorcycle accident, during which she suffered extensive and disfiguring trauma Fig.3: A “snarled” smile due to the functional mis-match resulting from Bell’s Palsy. Strategic application of BOTOX®injections (black dots) by a Dentist with advanced AADFA training, results in a harmonious and life-changing outcome. Fig.4: Motor accident resulting in significant facial deformity was corrected by Dentists using Dermal Filler injections. Fig.5: A Dentist treating a Skeletal Class II patient, has been able to achieve a Class I soft- tissue profile by advancing the chin & jawline, while also strengthening the nasal dorsum clinical