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INTRODUCTION This study aimed to investigate the effects of the strong occlusal force on the hemodynamics of gingival microcirculation. METHODS Eleven adult volunteers with healthy periodontium and normal occlusion participated in this study. Using a noncontact laser Doppler flowmeter placed at the attached gingiva and the interdental papilla of the maxillary first premolar, changes in gingival blood flow (GBF) were examined during and after clenching. RESULTS When the strong occlusal pressure was applied on the maxillary first premolar by clenching, GBF in the attached gingiva on the buccal side decreased significantly compared with the resting GBF, with medians of 2.3 mL/min/100 g and 5.4 mL/min/100 g, respectively (P

A variety of shapes has been reported for the roots and root canals of maxillary first premolars. The purposes of the present study were to determine branching and shapes of the roots of maxillary first premolars, as well as age-related changes using slice images obtained with cone-beam computed tomography (CBCT) for dental use. CBCT-reconstructed images of 125 cases that included maxillary first premolars were used as subjects. Slice images at the cervical one-third, center, and apical one-third positions of the root were prepared. Root branching and number of root canals was determined at each measurement position in the images. The subjects were divided into three groups: younger than 30 years, 30 to 50 years, and over 50 years. The root canal morphology was compared among these age groups. Single-rooted premolars were the most frequent. As for number of root canals, a single-canal premolar was observed at the position of the cervical one-third in 33.6%, at the center in 35.2%, and at the apical one-third in 56.0%. Thereafter the subjects were divided into groups by age, namely, younger than 30 years, 30 to 50 years, and over 50 years old, and it was revealed that the ratio of the two-canal type increased with age. In regard to tooth morphology, it was confirmed that the two-canal type shows more frequent occurrence with aging in maxillary first premolar. Based on our findings, we consider that CBCT can be useful for determining the root canal morphology with complicated shapes.

Made available in DSpace on 2022-04-29T08:35:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Extrusion of sodium hypochlorite (NaOCl) is a very rare accident with the most common complications including pain, swelling, and hematoma. It can occur even if procedural guidelines, predisposing conditions, and risk factors are taken into consideration. A 59-year-old female patient was admitted to the endodontics department to treat a left maxillary first premolar (World Dental Federation tooth 24). The medical history included osteoporosis and systemic medication with alendronate. Initially, the diagnosis was “symptomatic irreversible pulpitis” with “normal apical tissues.” During instrumentation of the buccal canal, accidental extrusion of 2.5% NaOCl occurred into the periapical tissues, resulting from misinterpretation of the working length, and caused severe pain and bleeding. The canal was immediately flushed using copious irrigation with saline solution. An analgesic and corticosteroid were prescribed. At 3 and 7 days, ecchymosis and slight hematoma were observed extraorally in the area of the affected tooth and an intraoral ulceration at the apex of the affected tooth. At 15 days, minimal signs of ecchymosis were observed, and the treatment was resumed. At 30 days after the accident, there was complete remission of the sequelae. The clinical, radiographic, and tomographic assessment after 1 month, 1 year, and 8 years showed favorable case evolution. During the 8-year follow-up, the patient maintained the systemic use of alendronate. It can be concluded that NaOCl extrusion is an accident that causes patients and clinicians to experience an unpleasant consequence. The radiographic working length should always be determined carefully. A successful outcome can be achieved in patients who take alendronate. Department of Restorative Dentistry Araraquara School of Dentistry São Paulo State University Department of Endodontics Cayetano Heredia Peruvian University Department of Restorative Dentistry Araraquara School of Dentistry São Paulo State University

Background: Dental anomalies usually lead to complicated decisions having to be made in terms of the orthodontic treatment of permanent dentition; tooth rotation is the most common of these irregularities. The prevalence rate of this phenomenon is 2.1–5.1% in patients who have not received orthodontic treatment. Purpose: This case report aimed to manage the complete bilateral rotation of maxillary canines with couple force by using a Nance appliance modification. Case: A 17-year-old male patient came in wanting to straighten his teeth. He complained about his bilateral canines, which were not in a normal position. There was an impacted left maxillary second premolar and an ectopically erupted right maxillary first premolar. He also had protrusions in the upper and lower anterior teeth and crowding in the lower anterior teeth as well as upper and lower midline deviations. Case Management: A clinical examination showed a class I relationship between the dental and cephalometry measurements and highlighted a class I skeletal pattern. The upper right first premolar was extracted and the left second premolar had undergone an odontectomy to allay protrusion and correct crowding. Bilaterally rotated upper canines were derotated using a modified Nance appliance and an elastomeric chain with couple force. Conclusion: The success of the orthodontic treatment was influenced by the specific nature of the patient’s dental and medical history, extraoral and intraoral examination, diagnosis and treatment planning, which was followed by a systematic approach to treatment . The Nance appliance modification reduced the total treatment time by achieving controlled anchorage and derotation of the canines.

Aims: The main goal of the following case report was to shed the light on the importance of thorough clinical, radiological and histological examinations in order to elaborate a final diagnosis of asymptomatic dentigerous cysts detected in unusual locations. Presentation of Case: A case of dentigerous cyst was identified accidentally in the maxillary left premolar region of an asymptomatic 14-year-old female post an orthodontic consultation. Histological examination of the tissue specimens following enucleation confirmed the diagnosis of a dentigerous cyst. Discussion: Dentigerous cysts are the second most common odontogenic cysts after radicular cysts. They involve impacted, un-erupted, permanent, supernumerary, odontomas and rarely deciduous teeth. Dentigerous cysts are usually painless but may cause facial swelling and delayed tooth eruption. Extensive maxillary involvement and childhood presentation are rare. Radio-graphic and histological examinations should be done to confirm the diagnosis of a dentigerous cyst. Conclusion: In our case, we showed the presence of a maxillary premolar dentigerous cyst that was removed by enucleation. The presence of dentigerous cyst is not always associated with a syndrome and its removal is very important to avoid future complications.

Background: During canine retraction, orthodontic forces are applied away from the tooth’s center of resistance. This introduces canine distal tipping and mesiobuccal rotation. The correction of these unwanted movements will prolong treatment time. Applying the force closer to the center of resistance should decrease this unwanted tooth movement. Objective: Compare the canine angulation and rotation during canine retraction with and without the use of power arm. Materials and Methods: Twenty-four female orthodontic patients (age 19.32± 4.17 years) with dental Class II indicated for bilateral maxillary first premolar extraction and maximum anchorage were included in this study. The canines were retracted with elastomeric chains over 0.016” X 0.022” statinless steel arch wires to reduce friction. The retraction force was 150g. In twelve patients, the canines were retracted using a power arm fixed to the vertical slots of the canine brackets. For the other twelve patients, the elastic chains were attached to the bracket hooks. Results: Before treatment, the canine angulation and rotation was similar for the two groups. The canine angulation was 12.38± 8.27 and 14.5o± 9.41 for the group with the power arm and without, respectively. while canine rotation was 64.74o± 11.65 and 63.12o± 14.88, respectively. Post-retraction, there was no significant difference in the canine angulation or rotation between the groups. Conclusion: Compared to canine retraction with a power arm, conventional canine retraction with elastomeric chains attached to the bracket hook may provide similar control over distal tipping, provided a stiff 0.017” X 0.025” stainless steel arch wire is used.

Objective: To determine the frequency of the number of roots and root canals in a sample of 250 extracted maxillary first premolar teeth of patients visiting Peshawar Dental College and Hospital Khyber Pakhtunkhwa. Study Design: Cross Sectional. Setting: Department of Oral Biology, Peshawar Dental College and Hospital Khyber Pakhtunkhwa. Period: April 2016 to December 2016. Material & Methods: A total of 250 extracted human maxillary first premolars were collected from the Department of Oral & Maxillofacial Surgery, Peshawar Dental College, and Hospital Khyber Pakhtunkhwa. All teeth were visually inspected to count the number of roots. Subsequently, the access cavity was prepared, and pulp extirpated from each tooth. Endodontic explorer was used to locating the canal orifice(s) at the pulp chamber floor. Later the root canal orifices were injected with India ink to stain the canals. After that roots of teeth were sectioned at different levels to note down the number of canals. Data were analyzed using SPSS version 19. The statistical significance of the variations from mean values was considered significant if the p-value was less than 0.05. Results: Out of 250 maxillary first premolar teeth, 44.8% had one root, 40.4% had two separate and 12.8% had two fused roots. Three roots were seen in 2.0% teeth. Two root canals were present in the vast majority (70.4%), whereas one and three root canals were seen in 27.6% and 2.0% teeth, respectively. The correlation between the number of roots and root canals of maxillary first premolar teeth was highly significant. Conclusions: There was a high frequency of maxillary first premolars with two roots and two root canals.

Objective To assess the rate of tooth movement and the periodontal tissue status over a period of 90 days with and without micro-osteoperforation (MOP). Method Thirty-three adults of the 19 to 25 age group undergoing labial fixed orthodontic treatment with bilateral maxillary first premolar extraction, requiring individual canine retraction as a part of the treatment plan, were recruited for this split-mouth randomized clinical trial. While performing micro-implant–assisted canine retraction in the maxillary arch, the experimental side received three MOPs each on the mesial and distal aspects of the canine root. The amount of tooth movement was measured clinically at every 15 days interval for 90 days; the periodontal status was assessed clinically (probing depth, relative attachment level) and tomographically (canine root length, alveolar bone level) at the 1st day and 90th day of retraction. The data were subjected to appropriate statistical analyses. Results A statistically significant difference in tooth movement on the MOP side was observed in the first 45 days, amounting to 1.5 times more than that of the control side. However, during 45 to 90 days, the difference in the rate of tooth movement between the sides was not statistically significant. Changes in periodontal variables were also insignificant between the sides except for the distal alveolar bone level. Conclusion An increase in the rate of tooth movement can be achieved without any periodontal adverse effects in the first 45 days of the MOP procedure. The effectiveness of the MOP procedure on the rate of tooth movement gradually declined thereafter. Trial Registration: CTRI/2019/07/020403.

Objective The aim was to investigate the effect of mechanical vibration on root resorption with or without orthodontic force application. Material and methods Twenty patients who required maxillary premolar extractions as part of orthodontic treatment were randomly divided into two groups of 10: no-force group and force group. Using a split-mouth procedure, each patient’s maxillary first premolar teeth were randomly assigned as either vibration or control side for both groups. A buccally directed vibration of 50 Hz, with an Oral-B HummingBird device, was applied to the maxillary first premolar for 10 min/day for 12 weeks. After the force application period, the maxillary first premolars were extracted and scanned with micro-computed tomography. Fiji (ImageJ), performing slice-by-slice quantitative volumetric measurements, was used for resorption crater calculation. Total crater volumes were compared with the Wilcoxon and Mann–Whitney U tests. Results The total crater volumes in the force and no-force groups were 0.476 mm3 and 0.017 mm3 on the vibration side and 0.462 mm3 and 0.031 mm3 on the control side, respectively. There was no statistical difference between the vibration and control sides (P > 0.05). There was more resorption by volume in the force group when compared to the no-force group (P < 0.05). Conclusion Mechanical vibration did not have a beneficial effect on reducing root resorption; however, force application caused significant root resorption.

Introduction This study sought to assess the effect of miniscrew insertion angle (vertical and oblique) on its clinical survival under shearing forces in orthodontic patients undergoing canine retraction. Materials and methods In this split-mouth randomized controlled clinical trial, 50 miniscrews were placed bilaterally in 25 patients with 45° and 90° insertion angles relative to a line perpendicular to the occlusal plane distal to the maxillary first premolar extraction site. Allocation of insertion angles to the right/left side was random using the Random Allocation Software. The patients, clinician, and statistician were blinded to the allocation of miniscrews to the side of jaw. The patients were followed-up monthly for 6 months. The primary outcome was the clinical survival of miniscrews, which was evaluated at each follow-up session. The secondary outcomes were the miniscrew stability based on the Periotest value (PTV) and the level of pain experienced by patients at 1, 12, and 24 h, and 7 days after miniscrew placement using a visual analog scale (VAS). Data were analyzed using paired t-test, repeated measures ANOVA, and McNemar’s test. Results The clinical survival rate of miniscrews placed at 90° and 45° angles was 76% and 88%, respectively. This difference was not statistically significant (P = 0.375). No significant difference was noted between the two groups regarding the PTV or the pain score either (P > 0.05). Conclusion Clinically, the insertion angle of miniscrews (90° versus 45° relative to a line perpendicular to the occlusal plane) has no significant effect on the miniscrew survival rate or stability during orthodontic treatment. Trial registration This trial was registered at www.irct.ir (IRCT20190901044659N1). Protocol The protocol was published after trial commencement.

Objectives: to evaluate possible cytotoxic effects of titanium alloy (Ti alloy) orthodontic mini-screw implants on the surrounding oral mucosal cells. Materials and Methods: Thirty orthodontic mini-screw implants (MSIs) installed to serve as anchorage for maxillary canine retraction after maxillary first premolar extraction. Fifteen female orthodontic patients with mean age of 16.11 ± 1.68 years were consented to participate in the study, which ran for four months. The orthodontic appliance consisted of direct-bonded Roth monocrystalline ceramic brackets, and teflon-coated preformed archwires. Clinical evaluation of MSIs and oral hygiene condition were evaluated throughout the study period. Percentage of oral mucosa cells’ DNA fragmentation were analyzed before insertion of MSIs, after one week, one month, three months and four months of MSIs insertion with the Comet assay analysis. Results: ANOVA test showed statistically significant decrease in oral hygiene condition during the study period. Statistically insignificant difference was evident in DNA fragmentation index of the collected oral mucosal cell in different time intervals. Conclusions: Orthodontic titanium alloy MSIs were biocompatible and demonstrated no cytotoxic effects on oral mucosal cells.

The computer-aided design/computer-aided manufacturing (CAD/CAM) virtual orthodontic system produces customized brackets, indirect bonding jigs, and archwires based on a three-dimensional virtual setup. In surgical cases, this system helps to visualize the final occlusion during diagnosis and to efficiently plan individualized presurgical orthodontic treatments. A 20-year-old female patient with a skeletal Class III malocclusion, maxillary protrusion, and lip protrusion was successfully treated with orthognathic surgery and orthodontic treatment with maxillary first premolar extractions. The CAD/CAM system was applied for efficient treatment, with a total active treatment time of 16 months. In this case report, the applicability of the CAD/CAM virtual orthodontic system for orthognathic surgery cases is demonstrated. Suggestions are also made to overcome the limitations and to maximize the advantages of this system during orthodontic treatment of patients undergoing orthognathic surgery.

Objectives. This study is aimed at investigating the root and root canal morphology by cone beam computed tomography (CBCT) and palatal furcation groove of the buccal root by microcomputed tomography (micro-CT) of maxillary first premolars in a Chinese subpopulation. Methods. This study assessed CBCT images of 440 patients aged 14-80 years. Based on Vertucci’s classification, the number of roots and the canal configuration were determined. Forty-eight maxillary first premolars with furcation grooves were analyzed by micro-CT in patients aged 18-25 years. Results. Based on the CBCT assay, 70.22% and 29.32% of maxillary first premolars were 1 root and 2 roots, respectively. The configuration indicated statistical difference ( P < 0.05 ) between male and female patients. The most common canal type was type IV and was found in 44.32% of cases, followed by type I in 27.84%, and then type II in 20.57%. Root bifurcations had 40.13% prevalence which was distributed more in the middle third than in the cervical and the apical third. For the micro-CT study, 95.83% of the furcation groove configuration was found in the bifurcated maxillary first premolars. The length varied from 1.02 to 7.63 mm. The mean depth of this groove was 0.57 mm in the root coronal, 0.47 mm in the root middle, and 0.22 mm in the root apical level. Palatal dentin width was smaller than 1 mm. Conclusion. The anatomy of the root and root canal system and the irregular wall width of maxillary first premolars with furcation grooves may help dentists to understand the anatomical morphology and improve the outcomes of endodontic treatment.

Fusion is a developmental dental anomaly in which asingle large tooth is formed from the germs of two normally adjacentteeth. The incidence of fused teeth is 0.1-0.3% in the permanent and0.5-2.5% in the primary dentition, and fusion is usually unilateral. Anot her dental developmental anomaly, dens evaginatus, is defined as anaccessory tubercle, consisting of enamel, dentine, and pulp. A 17-year old female patient was referred to our clinic with a complaint of painand swelling in the maxilla bilateral premolar regions. After the eva luation of clinical, two, and three-dimensional radiological findings,bilateral complete and incomplete fusion of the maxillary first premo lar and impacted supernumerary teeth was diagnosed, which is a rarecondition. Also, the left impacted supernumerary tooth had another de velopmental anomaly, dens evaginatus, that makes the case more inte resting. Treatment options were recommended to the patient, whorequested the extraction of the teeth, and the relevant teeth were ext racted. Careful clinical and radiographic examinations should be per formed for the diagnosis and treatment of fusion that may causefunctional and esthetic problems.

Introduction This single-centered, parallel-groups trial aimed to evaluate the efficacy of traditional corticotomy vs flapless corticotomy in accelerating en-masse retraction. In addition, to assess the skeletal, dental, and soft-tissue variables, as well as the external apical root resorption (EARR) of the maxillary anterior teeth. Methods Forty patients with Class II Division 1 malocclusion aged >18 years at the beginning of treatment, requiring maxillary first premolar extractions, were randomly distributed into 2 groups (n = 20 each): 1 group was treated using traditional corticotomy, and the other group was treated with flapless corticotomy in en-masse retraction with anchorage based on miniscrews placed between maxillary second premolars and first molars bilaterally. Randomization was implemented with a computer-generated list of random numbers; allocation was concealed in sequentially numbered, opaque, sealed envelopes. The study was single-blinded (outcomes' assessor). The primary outcome was the en-masse retraction duration. Secondary outcomes were the skeletal, dental, and soft-tissue changes on lateral cephalometric and the EARR of maxillary anterior teeth on digital panoramic radiographs. Results The en-masse retraction duration in the flapless corticotomy group was longer than the traditional corticotomy group. The average retraction duration was 4.04 ± 1.10 months for the flapless corticotomy group and 3.75 ± 2.14 months for the traditional corticotomy group, with no significant difference between the 2 groups (95% confidence interval [CI], −0.81 to 1.39; P = 0.59). No significant differences were observed between the 2 groups regarding changes in several lateral cephalometric variables (eg, SNA angle [95% CI, −2.55° to 1.66°; P = 0.67], SN-U1 angle [95% CI, −1.70° to 1.32°; P = 0.80], and UL-E [95% CI: −1.33 to 1.00 mm; P = 0.78]) or in the amount of EARR in the maxillary anterior teeth (P = 0.31). The proportion of the observed EARR ranged from 1% to 6% of root length in both corticotomy groups. No serious harms were observed in both groups. Conclusions No significant differences between the flapless and traditional corticotomies were found in terms of the skeletal, dental, and soft-tissue variables as well as in the amount of EARR. Corticotomy-assisted en-masse retraction led to improvements in skeletal structures and facial profile and resulted in sufficient retraction of maxillary anterior teeth, slight distal movement of maxillary first molars, and an intrusion movement for both anterior and posterior teeth. Both corticotomy techniques did not cause significant EARR. Registration ClinicalTrials.gov (Identifier: NCT03279042 ). Protocol The protocol was not published before the trial commencement.

Introduction. Inadequate root canal preparation and obturation are potential causes of endodontic failure. Failed root canal treatment with intrinsic discoloration requires root canal re-treatment and intracoronal bleaching. Due to the extensive loss of hard tissues on occlusal area, the restoration requires intracanal retention with short fiber-reinforced composite. Case report. A 17-year-old male patient came to the Clinic of Conservative Dentistry Dental Hospital Prof. Soedomo. He reported pain and discomfort on maxillary first premolar while chewing after root canal procedure had been performed few months before. He felt unconvinience with the discoloration happened on those tooth. Patient had endodontic treatment one year ago and the tooth was restored with glass ionomer cement. Objective examination showed glass ionomer restoration was still in good condition, the tooth was sensitive to percussion but not to palpation, and showed no mobility. Periapical radiograph showed incomplete obturation with radioluscent around periapical region. Retreatment followed by intracoronal bleaching was performed under rubber dam isolation. Tooth was restored with short fiber reinforced composite and composite resin. After 3 month, patient was recalled for examine the previous sign and symptomps. Periapical radiograph showed diameter of periapical lesion was smaller and tooth functioned normally. Conclusion. Root canal retreatment and intracoronal bleaching are suitable options for teeth with failed root canal treatment and intrinsic discoloration

This case report is of a 31-year-old female who presented with splinted and faulty metalloceramic prosthesis on maxillary anterior teeth, which was responsible for localised periodontal disease and poor aesthetics. At multiple sites the ceramic had chipped off and the prosthesis colour did not match with the adjacent healthy teeth. A multidisciplinary approach of endodontics, periodontics and prosthodontics was employed for this case. The treatment plan consisted of removing the faulty prosthesis, endodontic retreatment of inadequately root-treated teeth and endodontics in the other coronally prepared abutment teeth. Crown lengthening surgery was performed for the correction of periodontal pockets and high smile line and maintenance of an adequate biological width. After periodontal healing, all-ceramic individual crowns were placed on the maxillary anterior teeth along with a three-unit all-ceramic bridge for the replacement of the left upper maxillary first premolar. The final results were aesthetically pleasing with good marginal fit. The patient was extremely satisfied with the outcome as all her concerns were addressed. It is, therefore, advisable to consider placing individual crowns rather than multiunit splinted prosthesis whenever possible.

Aim: The aim is to compare the effects of diode laser, GC tooth mousse, and sodium fluoride (NaF) varnish on dentinal hypersensitivity by scanning electron microscopic (SEM) evaluation. Materials and Methods: Forty extracted human maxillary first premolar teeth were selected to prepare dentin disc of 2 mm thickness. The specimens were divided into four groups of 10 discs each-Group 1: Negative control, Group 2: Diode laser, Group 3: GC tooth mousse, and Group 4: NaF varnish. Diode laser and NaF was exposed on dentin disc for three consecutive days. GC tooth mousse was applied twice a day for 1 week. All the specimens were examined under SEM at a magnification of ×1500. The standardized SEM microphotographs were analyzed according to the scoring criteria. Statistical Analysis: Friedman test with post hoc Wilcoxon sign rank test for pair wise comparison at different time intervals within the group was computed using SPSS version 20. A P < 0.05 was regarded as statistically significant. Results: The results showed that the use of diode laser was able to achieve complete occlusion of dentinal tubules followed by the use of GC tooth mousse and that of NaF varnish while control group showed completely open tubules. Conclusions: Irradiation of dentinal tubules using diode laser could be effective for routine clinical treatment of dentinal hypersensitivity compared to NaF and GC tooth mousse.

OBJECTIVES The purpose of this in vitro study was to compare the effect of simulated endodontic access preparation on the failure loads of lithium disilicate crowns and resin-matrix ceramic (RMC) crowns. MATERIALS AND METHODS Eighty maxillary first premolar crowns were manufactured by using four different CAD/CAM blocks (n = 20): lithium disilicate (LD; IPS e.max CAD), resin nanoceramic (RNC; Lava Ultimate), flexible nanaoceramic (FNC; GC Cerasmart), and polymer-infiltrated ceramic (PIC; VITA Enamic). Half of each group was accessed and repaired to simulate endodontic treatment. After cyclic loading, all specimens were loaded to failure. Data were analyzed with two-way ANOVA followed by Tukey-HSD test (α = .05). RESULTS The load to failure results showed significant differences for material types (P

To evaluate the changes of maxillary expansion and upper airway structure after microimplant assisted rapid palatal expansion (MARPE) using cone-beam computed tomography (CBCT).This retrospective study included 19 subjects (15 females and 4 males) aged 15-29 years old (mean, 19.95±4.39 years) with maxillary transverse deficiency treated with MARPE. CBCT was performed at the initial diagnosis and 3 months after MARPE treatment. Measurements were taken to evaluate the amount of total expansion, skeletal expansion, and dental expansion at the maxillary first premolar (P1), second premolar (P2), first molar (M1), second molar (M2) regions and upper airway changes.After MARPE treatment, the maxillary skeletal base expansion, skeletal expansion, alveolar expansion and dental expansion were achieved at the P1, P2, M1, M2 region. The nasopharyngeal volume significantly increased 8.48% after MARPE treatment compared with that before the treatment (P 0.05). The change of nasal lateral width (NLW) was also significantly different before and after MARPE (P 0.05). However, there were no statistically significant change in the oropharyngeal, palatopharyngeal, glossopharyngeal and airway total volume (all P 0.05).MARPE can produce more transverse bone expansion, relieve maxillary transverse deficiency and improve upper airway ventilation.

Introduction: Orthodontic treatment of class II division 1 malocclusion by extracting the maxillary first premolar causes vertical dimensional change is still a matter of debate. The purpose of this research was to determine the vertical changes of the lower anterior facial height and maxillary incisor vertical dimensions in class II division 1 malocclusion after orthodontic treatment with Edgewise technique. Materials and Methods: This study was conducted on the cephalometry of 24 patients before and after orthodontic treatment with inclusion criteria as follows: Angle Class II division 1 malocclusion, aged 18-30 years old. Measurements were taken for the lower anterior facial height (ANS - Me) and maxillary incisor vertical dimensions by performing an Upper Anterior Dental Height (UADH). Data analysis used was the Wilcoxon test for unpaired data. Results: The result of p-value = 0.195 > 0.05 for lower anterior face height showed no significant difference; and p-value = 0.878 > 0.05 for UADH also showed no significant difference. Conclusion: Orthodontic treatment for class II division 1 malocclusion with the removal of two premolars does not change the lower anterior facial height and maxillary incisor vertical dimensions.

Aim and objective To evaluate the marginal adaptation at the tooth-restoration interface at enamel and cementum margins using composite restoration reinforced with novel enamel inserts/biofillers. Materials and methods Standardized class V box-shaped cavities were prepared in 40 extracted maxillary first premolar teeth which were divided randomly into four experimental groups consisting of 10 samples each. Group I: Bulk placement. Groups II: Horizontal incremental technique. Group III: Restoration with precured composite balls (megafillers). Group IV: Restoration with biofillers. All the cavities were restored with visible light-activated direct restorative nanocomposite. The specimens were thermocycled for 24 hours. After thermocycling, the samples were immersed in a 1% methylene blue for 4 hours and subsequently evaluated for microleakage. Microleakage scores (0–4) were obtained from gingival margins of class V restorations and analyzed by statistical analysis. Evaluation of the data was performed by Kruskal–Wallis one-way analysis of variance (ANOVA), and Mann–Whitney U tests. Results Microleakage scores have indicated restorations with biofillers showed best results followed by megafillers, incremental horizontal build-up, and bulk filling. Conclusion Biofillers provide a novel approach in improving microleakage and marginal adaptability of composite resin restorations. Clinical significance Incorporation of inserts, which are capable of adequate bonding to resin and tooth, may provide improved marginal adaptability and reduce microleakage around restorative margins. How to cite this article Biradar N, Allappanavar KS, Shetty NK, et al. Evaluation of Marginal Adaptation of Composite Restorations Reinforced with Novel Enamel Inserts (Biofillers) in Class V Cavities. J Contemp Dent Pract 2020;21(12):1368–1373.

Background: Dimension and location of pulp chamber are important during access cavity preparation. It allows clinician in instruments selection, orientation and depth of cutting dur­ing the process. Analysis of these has been done in preoperative intraoral periapical radio­graph that gives two-dimensional image. The radiograph has been blamed now and then for the inaccurate results and iatrogenic damage occurred due to the inaccurate results. Cone-Beam Computed Tomography (CBCT) provides three-dimensional images and is taken as standard. Hence the aim of the study is to compare intra-oral periapical (IOPA) radiograph and CBCT to determine the landmarks for accurate results Methods: 50 intact two-rooted maxillary first premolars were collected and numbered. Peri­apical radiograph Images and CBCT images of these 50 teeth were taken and divided as; Group I: 50 IOPAR and Group II: 50 CBCT images. Landmarks marking and measurement was done using tracing paper and x-ray viewer for IOPA images and Planmeca Romexis software for CBCT images. Data were collected and analysed with descriptive and inferential statistics by using Statistical Package of Social Science (SPSS) software version 16. Results: The averages of group I are 7.44, 10.23mm 14.33mm, 4.1mm, 6.89mm and 2.79mm respectively. The averages of in group II are 6.95mm, 9.58mm, 14.03mm, 4.45mm, 7.07mm and 2.63mm respectively. There is statistically significant difference in measurement A and measurement B between group I and group II. Conclusions: This indicates that there are chances of overestimation of measurement A and B with IOPAR.

Background The objective of this study was to use CBCT to look into the root canal morphology of maxillary premolars in a Saudi Arabian subpopulation and associate the results to existing canal morphology classifications. Methods The sample size for this analysis was 500 right and left untreated maxillary first and second premolars with fully formed roots from 250 Saudi residents (125 male and 125 female). The following observations were made using CBCT on the teeth related: (1) The number and morphology of roots; (2) The canal morphology for each root according to Vertucci's classification. The frequency and similarities between the right and left sides, as well as between females and males, were studied. The Chi-square test was used to assess the results. Results Of the 500 maxillary first premolars studied, 199 teeth had one root (39.8%), whilst 293 (58.6%) were two-rooted. Three-rooted maxillary first premolars were found in 8 (1.6%). For maxillary second premolars, 416 premolars had one root (83.2%), whilst 79 (15.8%) had two roots and the rest 5 (1.0%) were three roots. There were significant differences of number of root were found between groups (p > 0.05). For maxillary first premolar, Type IV was the most frequent, accounting for 57.8% of the sample (n = 289), followed by type II (32.8%, n = 164). For maxillary second premolar, Type I was mainly occurrence 302 (60.4%), followed by Type II (16.4%, n = 82). Conclusions The majority of maxillary first premolars had two roots and two root canals, while one root and one root canal was the most common anatomical configuration for maxillary second premolars. Additional canal forms do occur on occasion, and clinicians should pay close attention to them.

Summary Introduction This randomized controlled clinical trial aimed to assess the effect of LED 5 and LLLT 6 in a three-arm parallel setting. Methods Sixty patients who needed the maxillary first premolar extraction were allocated to three groups using the stratified block randomization method. In the LED group, a custom-made device with a wavelength of 640 nm and a power density of 40 mW/cm2 was used 5 min/day. In the laser group, Ga Al As 7 laser with a wavelength of 810 nm and a power of 100 mW was used on days 0, 3, 30, and 60 each time for 18 seconds. Patients in the control group received placebo treatment as the laser group protocol, using a coated light cure device. Models were made at baseline and monthly until the end of the retraction. The rate of canine retraction was the primary outcome, while canine rotation and pain were secondary outcomes. The final data were anonymous for the outcome assessor and statistical consultant. Data were analyzed per protocol using a linear mixed model. Results The rate of canine retraction significantly increased by 60.8% in the laser group, while it increased not significantly by 26% in the LED group compared with the control group. There was no significant difference among the groups in terms of tooth rotation and pain. Conclusions LLLT can accelerate orthodontic tooth movement (OTM). LED with the present setting couldn’t increase the rate of OTM. LLLT and LED did not affect canine rotation or pain. Trial registration IRCT20120220009086N4. On 1 June 2019 was retrospectively registered.

Summary Aim Acceleration of orthodontic tooth movement (OTM) can decrease the rate of complications. This study aimed to assess the efficacy of micro-osteoperforation (MOP) of the alveolar bone for acceleration of OTM by using mini-screws. Materials and methods This split-mouth randomized clinical trial evaluated 25 patients (11 females, 14 males, 16–25 years) with class II division I malocclusion who required canine retraction following the extraction of maxillary first premolar. The patients received similar orthodontic treatment at both sides with MOP on one side (MOP group) and no MOP on the other side (control side). Allocation of MOP to the side of jaw was random using Random Allocation Software in 1:1 distribution and equal numbers. Blinding was not applicable. The rate of canine movement was measured monthly for 5 months and considered as the main outcome. The degree of canine tipping was measured at the end of the intervention as the secondary outcome. All measurements were repeated for 12 patients by the two observers and the intra- and inter-examiner correlation coefficients were found to be 0.946 and 0.925, respectively. Data were analysed by paired t-test and repeated measures ANOVA. Results Twenty-five patients (11 females, 14 males, 16–25 years) were evaluated. No significant difference was found between the two groups at different time points in the rate of canine movement (P > 0.05). The degree of canine tipping in the MOP group was significantly lower than that in the control group (5.34 ± 3.11° versus 7.08 ± 3.70°; P = 0.040). Gender had no significant effect on OTM in any group (P > 0.05). Conclusions MOP could not accelerate canine retraction but decreased the degree of canine tipping.

The aim of this study is to investigate the effect of photobiomodulation therapies on root resorption compared with the placebo group. Thirty patients who were admitted to the Gaziantep University Faculty of Dentistry Orthodontics Department for treatment, with an indication of upper right first premolar tooth extraction were included. Before the individuals’ orthodontic treatment, 0.022 slot MBT brackets and tubes were placed on the maxillary first premolar and molar. A 150-g buccal tipping force was applied to the first premolar. Cantilever spring with 0.017 × 0.025 Beta Titanium wire was used for force application. Individuals were then randomly divided into three groups. For the first group, laser application was performed with an 810-nm GaAlAs laser device at 0, 3, 7, 14, 21, and 28 days to 8 J/cm2. For the second group, an LED application according to the manufacturer’s instructions with an 850-nm wavelength and 20 mW/cm2 output power for 10 min per day during the experiment. For the third group, a placebo therapy was completed whereby a laser device that did not make active pulses was used. At the end of 4 weeks, the amount of root surface resorption was compared using micro-CT imaging after the extraction of the teeth. No significant difference was found between the groups in terms of regional and total crater volumes. It was observed that photobiomodulation therapies were not different from the control group in terms of forming root resorption. It is seen that laser and LED photobiomodulation therapies used for accelerate orthodontic tooth movement do not differ from the control group in terms of forming root resorption. According to the results of this pilot study on this subject, which needs to be clarified with new findings in the future, LED and laser applications may not increase the risk for root resorption.

The purpose of this study was to investigate the expansion of the maxillary sinus and the inclinations of posterior teeth in orthodontic patients with maxillary second premolar agenesis. A total of 30 subjects with one or two congenitally missing maxillary second premolars and retained maxillary deciduous second molars (a agenesis group) were selected and divided into a unilateral agenesis group (20 subjects with one maxillary second premolar missing) and a bilateral agenesis group (10 subjects with two maxillary second premolars missing). As controls, 30 sex- and age-matched subjects without agenesis of the maxillary second premolars were selected. Oblique cephalograms were used to investigate the association of maxillary second premolar agenesis and lower maxillary sinus size and posterior tooth inclinations. Agenesis of the maxillary second premolars induced significantly large lower maxillary sinus length, depth, area and mesial inclination of the maxillary first premolar, a significantly small anterior maxillary length, and a significantly more distal position for root apex of the maxillary first premolar. There were no significant differences in any measurements of the lower maxillary sinus and posterior teeth between the non-agenesis side in the unilateral agenesis group and the control group. Maxillary second premolar agenesis caused inferior and anterior expansion of the lower maxillary sinus and the mesial inclination of the maxillary first premolars with a distal position of root apex. Unilateral agenesis of the maxillary second premolar did not affect on the lower maxillary sinus size or posterior tooth inclinations of the unaffected antimere.

PURPOSE The purpose of this in vitro study was to investigate the fracture loads and modes of failure for the full range of natural teeth under simulated occlusal loading. MATERIALS AND METHODS One hundred and forty natural teeth were taken from mandibles and maxillas of patients. There were 14 groups of teeth with 10 teeth in each group (5 males and 5 females). Each specimen was embedded in resin and mounted on a positioning jig, with the long axis of the tooth at an inclined angle of 30 degrees. A universal testing machine was used to measure the compression load at which fracture of the tooth specimen occurred; loads were applied on the incisal edge and/or functional cusp. RESULTS The mean fracture load for the mandibular first premolar was the highest (2002 N) of all the types of teeth, while the mean fracture load for the maxillary first premolar was the lowest (525 N). Mean fracture loads for the mandibular and maxillary incisors, and the first and second maxillary premolars, had significantly lower values compared to the other types of teeth. The mean fracture load for the teeth from males was significantly greater than that for the teeth from females. There was an inverse relationship between age and mean fracture load, in which older teeth had lower fracture loads compared to younger teeth. CONCLUSION The mean fracture loads for natural teeth were significantly different, with dependence on tooth position and the sex and age of the individual.

الملخص: تُظهر ضواحك الفك العلوي اختلافات تشريحية في أعداد الجذور والقنوات، ويشكل ذلك تحديا خلال علاج قناة الجذر. في تقرير الحالة هذا، نصف معالجة ضاحك الفك العلوي ذي ثلاثة جذور. أُحيل مريض يمني عمره ٤٧ عاما إلى كلية طب الأسنان بجامعة طيبة للمعالجة اللبية للضاحك العلوي الأول الأيمن (١٤#). لم يقدم التصوير الشعاعي التشخيصي الذروي نتائج كافية فيما يتعلق بتشكل نظام قناة الجذر وعدد الجذور. بعد ذلك، تم التقاط صورة مقطعية مخروطية ثلاثية الأبعاد أظهرت أن ضاحك الفك العلوي يحتوي على ثلاث جذور. أُجريت معالجة قناة الجذر تحت التكبير باستخدام مجهر جراحي للأسنان، وباستعمال نظام ''ريسبروك بلو'' ونظام تسليك نيكل – تيتانيوم، وتم الحشو الثلاثي الأبعاد للقنوات الجذرية بجهاز ''كلاموس''.ينبغي على الأطباء أن يكونوا قادرين على توقع الاختلافات التشريحية في الضواحك الفكية، كما ينبغي أن يكون لديهم المعرفة والمهارات الكافية للتعامل مع مثل هذه الحالات. Abstract: Maxillary premolars exhibit anatomical variations in the numbers of roots and canals, which pose a challenge during root canal therapy. In the present case report, we describe the endodontic management of a three-rooted maxillary premolar. A 47-year-old Yamani man was referred to the College of Dentistry, Taibah University for endodontic treatment of his right maxillary first premolar (#14). Periapical diagnostic radiography did not provide adequate information about the morphology of the root canal system and number of roots. Subsequently, a 3D cone-beam computed tomographic (CBCT) image was obtained, which revealed three roots in the aforementioned premolar. Root canal treatment was performed under magnification using a dental operating microscope, R25 RECIPROC blue NiTi single file system, and the Calamus dual 3-D obturation system. Clinicians should be able to predict the anatomical variations in maxillary premolars and have adequate knowledge and skills for managing such situations. Keywords: Anatomical variations, Endodontics, Maxillary premolars, Root canal, Three-rooted, الكلمات المفتاحية: الاختلافات التشريحية, المعالجة اللبية, الضواحك العلوية, القناة الجذرية, ثلاثي الجذور

Objective: To evaluate the rate of canine retraction, mesial movement of molar and pain perception in maxillary first premolar extraction patients with or without flapless cortical perforations (FCPs). Methods: Thirty adult patients with class II div I malocclusion were randomly allocated with the help of SPSS software to either perforation or conventional group for carrying out this randomized parallel group-controlled trial in 1:1 ratio. Maxillary first premolars were extracted and after canine retraction, distance between the tip of the canine and midpoint of incisal edge and the distance between the cervical midpoints on the height of contour of respective cinguli was measured. Also, mesial movement of molar and pain perception were assessed in both groups. Three bilateral cortical FCP of 1.5 mm diameter were made in the perforation group. Data were analyzed with the help of SPSS software with an intention-to-treat the FCP approach. Results: Significant canine retraction in patients with FCP (mean retraction of 6.68 ± 0.60 [measured at crown tip level] and 5.97 ± 0.71 mm [measured at mid cervical level]) was revealed, while patients with conventional mechanics had mean retraction of 2.54 ± 0.49 and 2.33 ± 0.46 mm. Mesial movement of molar also showed significant difference (FCP = 0.48 ± 0.11 mm and Conventional = 0.65 ± 0.19 mm). Pain perception in control group was significantly lower in day 1 and 2. Conclusion: FCPs are an effective method of accelerating the rate of canine retractions by 2–3 fold of tooth movement, however, pain perception was high in day 1 and 2. Keywords: Flapless cortical perforations, Canine retraction, Tooth movement

Objective: The prevalence of non-carious cervical lesions (NCCLs) has increased in the recent years, especially in the elderly population. The successful prevention and treatment of those lesions requires an understanding of the biomechanics of aged teeth. Considering the importance of such aspect, the impact of the age-related dentin deposition on the stress distribution of NCCLs was evaluated by means of finite element analysis. Material and Methods: A 2-dimensional model of a sound maxillary first premolar was created using CAD software. Two tooth geometries (sound, aged) and two lesion shapes (wedge, saucer) were simulated to the model. The mesh was built with 35,000 triangle and square elements of 0.1 mm in length. All tissues were considered isotropic, homogeneous and linear. Occlusal surfaces were loaded with 300 N for simulating normal chewing forces. The stress distribution was analyzed by a color scale and by the maximum principal stress at the cavosurface line angle. Results: The aged models presented lower stress concentration in the overall system in comparison to sound models. The sharp angle of wedge shaped lesions promoted higher stress concentration at the center of cavosurface angle, favoring the lesions progression. Conclusion: Considering the limitations of the current methodology, it is possible to conclude that aged tooth is a more compact structure that can better respond to stress loadings. This protective intrinsic mechanism should be considered when adopting preventive and restorative measures for NCCLs for the elderly.KeywordsAging; Finite element analysis; Non-carious; Cervical lesions.

Bone resorption is the cornerstone in bone remodeling affecting the rate of orthodontic tooth movement. RANKL has a direct effect on osteoclastogenesis. The aim of this study is to evaluate and compare the effect of low-level laser therapy (LLLT) and corticotomy-facilitated orthodontics (CFO) on RANKL release during orthodontic tooth movement. Twenty patients requiring orthodontic therapeutic extraction of the maxillary first premolar were randomly selected. A split-mouth study design was performed where corticotomy-facilitated orthodontics was randomly assigned to one side at the canine region (CG) before retraction, Laser group (LG) was assigned to the contralateral side using 940 nm diode laser irradiations (100 mW, 2.5 J, 3.9 J/cm2) at days 1, 3, 8, and 15. Canine retraction was done using nickel-titanium closed-coil spring applying a force of 150 g per side. Gingival crevicular fluid (GCF) samples were collected from distal surface of the canines on both sides, 1 day before the intervention treatment (T0), day 3 after the intervention (T1), and day 15 (T2). RANKL concentration levels were assessed using enzyme-linked immunosorbent assay. There was statistically significant increase in RANKL concentration levels in both groups (CG and LG) from T0 to T1, there was no statistically significant difference in concentration level from T1 o T2, but there was a statistically significant difference in RANKL concentration levels between T0 and T2 in both groups. CG and LG showed no statistically significant difference in RANKL concentration levels between them in T1 and T2. Low-level laser therapy and corticotomy-facilitated orthodontics can increase the RANKL release during orthodontic tooth movement which directly affects bone remodeling and the rate of orthodontic tooth movement.

Objective : The complex root canal anatomy is inherently colonised by microbial flora. Endodontic treatment success is always related to adequate disinfection of the root canal space, which ultimately affects the treatment outcome. A thorough understanding of the external and internal root canal anatomy by using adequately imaging modalities is essential before planning any treatment. The aim of this study was to investigate the number and morphology of the root canals of maxillary and mandibular premolars in Chennai population. Material and Methods : Full-size cone-beam computed tomographic images were randomly collected from 100 patients, resulting in a total of 200 first and 200 second maxillary premolars as well as 200 first and 200 second mandibular premolars. All the eight premolars were analysed in single patients, who underwent cone-beam computed tomography scanning during pre-operative assessment (before implant surgery, orthodontic treatment, diagnosis of dental-alveolar trauma or difficult root canal treatment). Total number of roots and root canals, frequency and correlations between men and women were recorded and statistically analysed by using chi-square tests. The root canal configurations were rated according to the Vertucci’s classification. Results : In the maxillary first premolar group (n = 200), 36.3% had 1 root, 56.7% had 2 roots and 7.0% had 3 roots, with most exhibiting a type IV canal configuration. In the maxillary second premolar group (n = 200), 60% had 1 root, 29.8% had 2 roots and 10.2% had 3 roots, with the majority of single-rooted second premolars exhibiting a type I canal configuration. In the mandibular first premolar group (n = 200), 80.5% had 1 root, 9.8% had 2 roots and 5% had 3 roots. In the mandibular second premolar group (n=200), 90.1% had 1 root, 6.4% had 2 roots and 3.5 % had 3 roots, with most exhibiting a type I canal configuration. No statistical correlation was found between number of roots, gender and tooth position. Conclusion : This cone-beam computed tomographic study confirmed previous anatomical and morphological investigations. Therefore, the possibility of additional root canals should be considered when treating premolars. Keywords: Cone-beam computed tomography; Mandibular; Maxillary; Premolar; Root canal; Morphology.

Aim: This study aimed to analyze incidence of three canals in human permanent maxillary first premolar teeth using cone beam tomographic techniques. Materials and Methods: The samples were divided into three groups namely Group (GP) I (single rooted [n = 255]), GP II (two rooted [n = 326]), and GP III (three rooted [n = 8)]. The teeth were processed, mounted in arches, coded, and subjected to cone beam tomographic scanning. Incidence of three canals was evaluated by cone beam tomography, compared, and statistically analyzed. Results: The percentage of incidence of three canals in human permanent maxillary first premolar teeth was 1.7% and there was no statistically significant difference of incidence of three canals between studies using cone beam and non-cone beam methodologies. Conclusion: Clinicians should be aware of the variations they may encounter when endodontically treating a maxillary first permanent premolar and should apply this knowledge in a clinical scenario systematically.

INTRODUCTION This study aimed to compare the skeletodental and soft tissue changes with total arch distalization using a modified C-palatal plate (MCPP) and maxillary first premolar extraction treatment in Class II malocclusion patients with severe overjet. SETTING AND SAMPLE POPULATION The sample consisted of 46 adult patients who had Class II Division 1 malocclusion with severe overjet; 25 of them received non-extraction treatment with MCPPs (age, 22.5 ± 7.2 years), and 21 received maxillary first premolar extraction treatment (age 23.4 ± 6.5 years). METHOD A total of 26 variables were measured on pre- and post-treatment lateral cephalograms. To evaluate the differences between pretreatment and post-treatment in each group, t tests and Wilcoxon rank-sum tests were used. To compare the amount of change between the two groups, MANOVA test was used. RESULTS The overjet was significantly reduced in the MCPP and extraction groups by 4.8 mm and 5.4 mm, respectively. However, the two groups had no significant difference in the sagittal, vertical and angular changes of the maxillary incisors. In addition, regarding soft tissue changes, the MCPP and extraction groups showed an increased nasolabial angle of 7.5° and 9.4°, decreased upper lip to the true vertical line of 1.8 mm and 2.2 mm, respectively (P

Introduction: This study sought to evaluate the efficacy of lasercision corticotomy for the acceleration of canine movement. Our secondary objectives were assessing the canine rotation, the rate of anchorage control, the level of pain, and the gingival index (GI). Methods: Twelve orthodontic patients (9 females and 3 males) referring to the School of Dentistry and one dental clinic from May 2019 to September 2019 participated in this split-mouth randomized clinical trial. The allocation of the test and control sides was performed by flipping a coin. The mean age of patients was 18.91±3.87 years (range 15-30 years). The treatment plan included maxillary first premolar extraction. Following the initial leveling and alignment phase, an initial impression was made. Corticotomy was carried out with the erbium, chromium-doped yttrium scandium gallium garnet (Er, Cr: YSGG) laser (3.5 W, 30 Hz, 40% air, 80% water) in one maxillary quadrant (the laser side). Canine retraction was immediately initiated following surgery using nickel-titanium closed-coil springs with 150 g force. The impression was repeated 1 month after the onset of retraction. The casts were scanned, and the distance between the canine cusp tip and the rugae line was measured to quantify the amount of anteroposterior canine movement. The molar anchorage control was also evaluated by measuring the distance between the mesial contact of the permanent first molar and the rugae line. Gingival health was evaluated using the GI. The modified McGill pain questionnaire was used to assess the level of patients' pain. Results: Lasercision corticotomy accelerated canine retraction with no adverse effect on gingival health. Anchorage loss in the posterior teeth and pain scores were not significantly different between the control and laser sides. Conclusion: Laser corticotomy can effectively accelerate canine retraction with no complications or discomfort for the patients.

Aims of Study: to evaluate and compare the retentive strength and the failure-modes of monolithic zirconiacrowns with different cement spacer thickness, cemented with two different types of luting agents.Materials and Methods: Forty sound maxillary first premolar teeth were divided into two main groups(n=20): Group A: cement spacer thickness of 80?m; Group B: cement spacer thickness of 120?m. Thegroups were further subdivided into two subgroups (n=10): (A1, B1) cemented with Panavia F2.0 resincement; (A2, B2) cemented with Riva luting plus RMGIC. All the teeth were prepared to receive monolithiczirconia crowns with the following features: (6o convergence angle, 0.8mm deep chamfer finishing line,4mm axial wall height with planar occlusal reduction). Afterwards, the teeth were scanned and the crownswere fabricated and cemented. Zirconia crowns were pulled-out along its path of insertion using universaltesting machine. Failure stresses were calculated in MPa. Failure-modes was assessed using magnifyinglens (2.5X).Results: The highest mean retentive values (in Mpa) was recorded by subgroup B1 (8.651); followed bysubgroup B2 (7.765); subgroup A1 (7.309) and subgroup A2 (6.875). Independent t-test showed a statisticallysignificant difference between A1 and B1 subgroups. Concerning the failure-mode, the majority of samplesrevealed adhesive failure between teeth and cement.Conclusion: All the tested crowns have mean retentive values within the clinically acceptable limit,increasing cement space resulted in a significant increase in the retention when Panavia F2.0 used as a lutingagent, while, it has no significant effect on the retention when RIVA luting plus was used.

Background Orthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure to shorten orthodontic treatment time. This prospective randomized clinical trial was aimed to compare the pulp volume changes of maxillary anterior teeth after en-masse retraction with or without piezocision-assisted orthodontics. Methods Patients who required orthodontic treatment with bilateral maxillary first premolar extractions and en-masse retraction were recruited. Patients were randomly divided into extraction with piezocision, or only extraction, serving as controls. Pulp volume and root length changes of the maxillary six anterior teeth were measured and compared between the two groups using a 3-Dimensional analytical software. Paired and independent sample t-tests were used to compare within and between groups. Bivariate correlation was done between the mean change in pulp volume and its corresponding root length. The significance level was set at α = 0.05. Results A total of 23 patients were included, 12 in the piezocision, and 11 in the control group. At the end of the en-masse retraction phase, (mean = 122.74 ± 3.06 days) pulp volume was significantly decreased in all six anterior teeth in both groups (P P > 0.05). There was a statistically significant but moderate correlation only between the pulp volume change of the right canine and its root length, r = 0.44, P = 0.034. Conclusions The effect of piezocision-assisted orthodontic tooth movement on the pulp volume was comparable to the conventional orthodontic treatment. The degree of change in pulp volume does not appear to be related to the amount of root resorption. Trial registration NCT03180151. Registered December 25, 2016, retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT03180151.

Purpose: The purpose of this study was to investigate the precise effects of a headgear (HG) on the maxillary first premolar (U4), maxillary second premolar (U5), and maxillary first molar (U6). Materials and methods: The participants were divided into two groups: HG group and control group. The HG group consisted of 25 patients who were treated with an HG and maxillary lateral expansion. The control group consisted of 21 patients who received maxillary lateral expansion treatment. Movements of U4, U5, and U6 were measured using cone-beam computed tomography (CBCT). The mesiodistal positions of U4, U5, and U6 were assessed based on the vertical reference plane (VRP) defined by the landmarks of the maxilla. Results: Distal movement of U4, U5, and U6 was observed in the HG group, while mesial movement of U4, U5, and U6 was observed in the control group. Moreover, the positions of U4 and U5 were more distal than that of U6 in the HG group, while the positions of U4 and U5 were less mesial than that of U6 in the control group. The amount of distal movement of U4 and U5 was strongly correlated with that of U6 in the HG group. Conclusions: Simultaneous distal movement of U4 and U5 can be achieved with U6 distal movement using an HG in the early mixed dentition period. Moreover, the amount of distal movement of U4 and U5 was larger than that of U6. Hence, early orthodontic treatment using HG appears to be effective for correcting Class II malocclusion.

The purpose of this study was to evaluate and compare dental and skeletal changes associated with the Damon and Rapid Maxillary Expander (RME) expansion using Cone-Beam Computed Tomography (CBCT). Eighty-two patients, from The University of Alberta Orthodontic Clinic, were randomly allocated to either Group A or B. Patients in Group A received orthodontic treatment using the Damon brackets. Patients in Group B received treatment using the Hyrax (a type of RME) appliance. CBCT images were taken two times (baseline and after expansion). The AVIZO software was used to locate 18 landmarks (dental and skeletal) on sagittal, axial, and coronal slices of CBCT images. Comparison between two groups showed that transverse movement of maxillary first molars and premolars was much greater in the Hyrax group. The lateral movements of posterior teeth were associated with buccal tipping of crowns. No clinically significant difference in the vertical or anteroposterior direction between the two groups was noted. Alveolar bone next to root apex of maxillary first premolar and molar teeth showed clinically significant lateral movement in the Hyrax group only. The comparison between two groups showed significantly greater transverse expansion of the first molar and first premolars with buccal tipping in the RME group.

Alveolar bone grafting is routinely performed in repair of alveolar clefts. When the alveolar cleft is wider than 11 mm, however, the survival rate of the bone graft and prognosis are poor. Here, we describe successful orthodontic treatment using interdental distraction osteogenesis (IDO) with a tooth-tooth type distractor to reduce the width of the alveolar cleft in a patient with unilateral cleft lip and palate. The patient was a 12-year-old girl with unilateral cleft lip and palate, maxillary dentition midline deviation, congenitally missing maxillary lateral incisors, a palatally-displaced right upper first premolar, a wide alveolar cleft (20 mm), and mandibular prognathism due to maxillary hypoplasia. Treatment comprised a combination of orthodontic treatment and IDO. After treatment, appropriate occlusion, space closure in the maxillary arch, coincidence of the maxillary and facial midlines, and incorporation of the right maxillary first premolar into the arch were obtained. These results suggest that IDO is effective in treating cleft lip and palate patients with a wide alveolar cleft.

Introduction: Ameloglyphics is the study of enamel print patterns on the tooth surface. Enamel print patterns are unique to each individual as they differ on each tooth. The similarity of tooth prints on buccal and lingual surfaces remains questionable as no research has been conducted thus far. The premolar was chosen in this experiment due to its low risk of damage because it is protected by cheek and rarely used compared to other teeth. Thus, the results obtained will be more precise and have higher accuracy than using other teeth. This research was aimed to investigate the differences between enamel print patterns on buccal and lingual surfaces of maxillary right first premolar. Methods: An analytic study was conducted by observing and analysing a total of 34 teeth samples using the purposive sampling method. The middle third of the buccal and lingual tooth surfaces was captured directly after magnified with a stereomicroscope. Photomicrographs of samples were then analysed using SourceAFIS biometric software. This software will process the image and shows patterns of enamel print. Afterwards, the enamel print patterns were observed and classified according to Manjunath Classification. Results: The results suggested that all 34 samples show a similarity of enamel print patterns on both the buccal and lingual surfaces. The interpretations of photomicrographs were statistically analysed using the Statistical Package of Social Science (SPSS) software. The similarity may be due to the same placement of developing tooth bud, temperature, environmental factor, genetics, pressure and nutrition to the ameloblasts cells in a tooth. Conclusion: Both buccal and lingual in the samples show high similarity due to the very high frequencies of similar sub-patterns occur on both surfaces. Tooth print can be used as a valuable tool in forensic science for personal identification with good prospects in the field of forensic dentistry.

Introduction: Surgical lasers have been used in periodontal therapy. The anti-pain mechanism of low level laser is not yet clear however, numerous studies have pointed out the physiological changes from light interference with various cells as the cause. Low-level laser can also modify the inflammatory process in a dose-related mechanism; and thus, it can reduce the inflammatory pain.2 Methodology: A sample of 10 systemically healthy subjects aged 30-60 years diagnosed with chronic periodontitis having a probing pocket depth ?5mm and clinical attachment loss ?4mm bilaterally in the region of the maxillary first premolar, second premolar and first molar were recruited from the out-patient, Department of Periodontics, A.B.Shetty Memorial Institute of Dental Sciences. The subjects were blinded as to which surgical site received the laser therapy following conventional periodontal flap surgery (Test Group). The subjects were recalled one week after scaling and root planing for the periodontal flap surgery. At the baseline visit, the contralateral surgical sites were randomly assigned to the control group or the test groups using a coin-flip. In the test group, following the removal of soft deposits through scaling and root planing, the laser probe of 0.8W CW diode was used in a light contact, sweeping mode to cover the entire inner surface of the flap. Ablation was carried out from base of the flap to its coronal portion. Results-Median pain score did not differ significantly between the test and the control at 0 day, 1day , 2day and 5 day (P>0.05) ,day7 (P=0.087). Friedman test showed overall there was significant difference in pain score from o day to day7test. Pain score differs significantly from day 0 to day7 (P0.05) within test group. Conclusion-Lasers currently have a variety of uses in dentistry, although low-level lasers have been found beneficial in reducing the pain response after periodontal surgery in present study, but studies with larger sample are required to see significant association.

Cone Beam Computed Tomography (CBCT) is a radiographic imaging technique which provides accurate, high-quality, three-Dimensional (3D) images of various parts of head and neck. They deliver images with a spatial resolution of teeth required for diagnosis, treatment planning and postoperative evaluation. The aim of this case series is to describe the importance of determining the root canal morphology with the help of CBCT. This case series presents the endodontic management of a three rooted maxillary first premolar, maxillary first molar with single palatal root and three canals and mandibular first molar with five canals using CBCT. The axial images from CBCT show Gulabivwala K Type I (3-1) canal pattern in distal root of mandibular first molar (36) and palatal root of maxillary first molar (26) according to Al-Quadah Awawdeh showed Type XXII (3-2-1) canal configuration. Biomechanical preparations of all the teeth were done with hand as well as rotary file systems and lateral compaction obturation technique was used. With the advancing technology in imaging, there are possibilities to detect and treat a number of variations particularly in posterior teeth leading to successful endodontic treatment.

Introduction This split-mouth trial aimed to investigate the effect of low-level laser therapy (LLLT) on the amount of maxillary canine distalization when applied every 4 weeks over 12 weeks. Methods Twenty-two adolescents and young adults (15 female, 7 male; aged 13-25 years; n = 22) requiring bilateral maxillary first premolar extractions were recruited. After extractions and leveling-alignment, canines were retracted using closed-coil nickel-titanium springs delivering 150 g of force. LLLT was applied to 8 intraoral points on the buccal and palatal sides around the canine root for 10 seconds per point, on day 0, 28, and 56 with the control side receiving sham application. Alginate impressions were taken every 4 weeks on day 0, 28, 56, and 84. The amount of tooth movement, anchorage loss, and canine rotation were measured digitally. Randomization was generated using www.randomisation.com and allocation concealment through sequentially numbered, opaque, sealed envelopes. Participants, operator, and statistic assessor were blinded. Linear regression modeling accounting for clustering within each patient was used to identify differences between LLLT and control sides. Results Twenty-one patients completed the study. The total amount of tooth movement was similar in the LLLT (2.55 ± 0.73 mm) and control group (2.30 ± 0.86 mm), whereas 0.25 mm (95% confidence interval, –0.21, 0.71 mm) of difference was insignificant (P = 0.27). No significant differences were found for anchorage loss (P = 0.22) or canine rotation (P = 0.25). No harms were reported. Conclusions Application of LLLT every 4 weeks did not result in differences in the amount of tooth movement, anchorage loss, and canine rotation during extraction space closure.

Introduction The purpose of this 2-arm-parallel split-mouth trial was to investigate the effect of low-level laser therapy (LLLT) on the repair of orthodontically induced inflammatory root resorption (OIIRR). Methods Twenty patients were included in this study, with 1 side randomly assigned to receive LLLT, and the other side served as a sham. Eligibility criteria included need for bilateral maxillary first premolar extractions as part of fixed appliance treatment. OIIRR was generated by applying 150 g of buccal tipping force on the maxillary first premolars for 4 weeks. After the active force was removed, the teeth were retained for 6 weeks. LLLT commenced with weekly laser applications using a continuous beam 660-nm, 75-mW aluminum-gallium-indium-phosphorus laser with 1/e2 spot size of 0.260 cm2, power density of 0.245 W/cm2, and fluence of 3.6 J/cm2. Contact application was used at 8 points buccally and palatally above the mucosa over each tooth root for 15 seconds with a total treatment time of 2 minutes. After 6 weeks, the maxillary first premolars were extracted and scanned with microcomputed tomography for primary outcome OIIRR calculations. Subgroup analysis included assessment per root surface, per vertical third, and sites of heaviest compressive forces (buccal-cervical and palato-apical). Randomization was generated using www.randomization.com , and allocation was concealed in sequentially numbered, opaque, sealed envelopes. Blinding was used for treatment and outcome assessments. Two-tailed paired t tests were used to determine whether there were any statistically significant differences in total crater volumes of the laser vs the sham treated teeth. Results Total crater volumes were 0.746 mm3 for the laser treated teeth and 0.779 mm3 for the sham. There was a mean difference of 0.033 ± 0.39 mm3 (95% CI, −0.21 to 0.148 mm3) greater resorption crater volume in the sham group compared with the laser group; this was not statistically significant (P = 0.705). No harm was observed. Conclusions: No significant difference was found between LLLT and sham control groups in OIIRR repair.

Background: Nowadays, cosmetic dentistry has become an ever-increasing requirement with interest in it growing over time. Bleaching is one of the popular cosmetic treatments that has been proven to diminish the tensile bond strength (TBS) of orthodontic brackets attached to bleached teeth. Mangosteen peel (MP) extract contains antioxidants that may potentially reverse the reduction in TBS. Purpose: The purpose of this study was to evaluate the effect of MP extract on the post- bleaching TBS of brackets. Methods: The reported research constitutes an experimental in vitro study conducted on a total of 120 maxillary first premolar teeth randomly divided into six groups (n = 20) as follows: negative-control (NC: no bleaching), positive-control (PC: bleaching + no treatment), and the treatment groups (bleaching + 10% sodium ascorbate (SA), 10% (MP10), 20% (MP20) and 40% (MP40) MP extract gel). Post-treatment, the brackets were bonded using Transbond XT and TBS testing was performed using a Universal Testing Machine. The ARI was examined by means of a stereoscopic microscope, while enamel morphological changes were observed through a Scanning Electron Microscope. The TBS-generated data was analyzed by means of Anova and Tukey tests. For the Adhesive Remnant Index, a Kruskal-Wallis analysis test was performed. Results: There was a significant TBS difference (P = 0.001) between the various groups. The PC group showed the significantly highest TBS compared to the others (8.33 ± 3.92 MPa), whereas NC demonstrated the lowest (4.15 ± 2.27 Mpa). The TBS value of the MP40 group was considerably higher than other groups treated with antioxidants (7.87 ± 3.26 MPa). The failure of orthodontic brackets using MP extract mostly occurred at the adhesive-bracket interfaces. Conclusion: Topical application of 40% mangosteen peel (MP) extract as an antioxidant after bleaching was effective in reversing the reduced post-bleaching tensile bond strength (TBS) of orthodontic brackets.

O sucesso do tratamento endodôntico, depende do conhecimento da anatomia dental interna. O presente artigo relata um caso raro e o tratamento de um primeiro pré-molar superior apresentando três raízes separadas. Paciente do gênero feminino, 32 anos de idade, foi encaminhada para tratamento endodôntico do primeiro pré-molar superior direito. Ao exame clínico, o dente #14 não apresentava resposta após o teste de vitalidade e no exame radiográfico revelaram a presença de três raízes. Paciente foi submetida a tratamento endodôntico. O conhecimento da anatomia dental, assim como as possíveis variações é de suma importância para um clinico geral, através de uma radiografia de diagnostico ter uma noção do dente a tratar.

Background The effect of low-level laser therapy (LLLT) on accelerating orthodontic tooth movement has been extensively studied; however, there is limited knowledge on the use of LLLT on orthodontic root resorption. Objective To investigate the effect of LLLT on orthodontically induced inflammatory root resorption (OIIRR) and to compare the difference between pulsed and continuous LLLT on OIIRR. Trial design Double-blind, single-centre 3-arm parallel split-mouth randomized controlled trial. Participants Twenty adolescent patients who required bilateral maxillary first premolar (MFP) orthodontic extractions were recruited from the Sydney Dental Hospital between October 2014 and December 2014. Intervention All MFPs were tipped buccally for 28 days to induce OIIRR. The experimental premolars (n = 20) received LLLT and the control premolars (n = 20) received placebo-laser on days 0, 1, 2, 3, 7, 14, and 21. Ten experimental premolars received LLLT via continuous delivery and 10 received pulsed delivery. Laser parameter AlGaAs diode laser of 808 nm wavelength, 0.18 W power, 1.6 J per point, and duration of 9s for continuous mode and 4.5 s for pulsed mode. Outcome The difference in root resorption crater volume between LLLT and placebo-laser and continuous or pulsed laser delivery after 28 days. Randomization Randomization was computer-generated, with allocation concealment by opaque sequentially numbered sealed envelopes. Blinding The participants and operator were blinded. Results Eighty-eight patients were screened and 20 patients were randomized. Forty premolars were analysed. LLLT resulted in 23 per cent less root resorption compared to the placebo (P = 0.026). Pulsed laser delivery resulted in 5 per cent less root resorption than continuous; however, this was not statistically significant (P = 0.823). No harm was observed. Conclusion Teeth treated with LLLT had less total root resorption than placebo-laser. Furthermore, there was minimal difference between pulsed or continuous delivery of LLLT. Trial registration Clinical Trials Registry (ACTRN12616000829415). Protocol The protocol was not published before trial commencement.