Search

Objective: This prospective case series aimed to clinically evaluate the bleaching effect, spontaneous tooth sensitivity, and variation in the thermal sensation threshold of different groups of teeth undergoing in-office bleaching. Method and materials: Ten patients received conventional bleaching treatment: 35% hydrogen peroxide with three bleaching sessions of 45 minutes, evaluating color change (ΔE and ΔE00), Whitening Index (WID), and tooth sensitivity (visual analog scale). Thermal stimulus-generating devices were used to simulate sensitivity caused by low temperatures through quantitative sensory tests. Analyses were conducted individually on different teeth groups (n = 20) (mandibular incisors, maxillary incisors, canines, maxillary first premolars). Results: Regarding color change, mandibular and maxillary incisors did not statistically differ from each other but showed significant difference and greater bleaching potential compared to canines and maxillary first premolars (P = .018). Regarding sensitivity, mandibular and maxillary incisors presented the highest spontaneous sensitivity values (P = .032), while maxillary first premolars did not display painful symptoms, also observed in provoked sensitivity analysis (P = .025). Conclusions: The general analysis of the results indicates that the tooth type affects the response to the whitening treatment, both in relation to the esthetic benefit and the occurrence of tooth sensitivity. It was observed that mandibular incisors reach the degree of chromatic saturation before canines and premolars, in addition to presenting greater bleaching sensitivity. Personalizing the treatment, based on prior knowledge of the degree of saturation, anatomical factors, and the risk of sensitivity, can provide considerable advantages in the whitening technique. [ABSTRACT FROM AUTHOR]

Objective: The present clear aligner therapy (CAT) research focuses on isolating and reporting the biomechanical performance for three separate teeth, three translational movements and two flat trimlines at different heights. By identifying key patterns, the research seeks to inform the development of improved aligner designs, ultimately enhancing the effectiveness of clinical orthodontic treatments. Materials and Methods: In an in vitro setting using the Orthodontic Force Simulator (OFS), the biomechanical response of 30 aligners was investigated on three different teeth of a straight symmetric maxillary dentition (central incisor, canine and first molar). Each tooth was tested under two flat trimline conditions (trimmed at gingival margin, TL0; extended 2.0 mm below, TL2) and for three types of translational movements (palatal translation, mesial translation and intrusion). Forces and moments were reported at the centre of resistance for each displaced tooth as well as the two neighbouring teeth, evaluating a total of 18 distinct scenarios. Results: Findings indicate significant variability in the biomechanical responses based on tooth location in the arch, trimline height and movement performed. For palatal translations, the palatal force required to perform the movement was observed highest in molar cases, followed by canine and incisor cases, with a notable difference in the distribution of side effects, indicating a strong influence of tooth anatomy and position in the arch. Similarly, in mesial translations and intrusions molars experienced greater forces and moments than the corresponding movements applied on canines and incisors, but uniquely dispersed for each configuration tested. Regarding the shape of the aligner, TL2 consistently showed improved control over orthodontic movements compared to TL0. Neighbouring teeth frequently displayed compensatory reactions up to about half of the intensity observed on the tooth being moved, with notable variations from case to case. Conclusions: This research supports fundamental factors impacting CAT: Characteristic patterns in the direction and intensity of forces and moments are associated with each of the three translational movements tested.Tooth anatomy and arch location significantly influence the biomechanical performance of aligners, with an observed trend for molars to display higher forces and moments over canines and incisors, but distributed differently.The height of a flat trimline, specifically TL2, shows enhanced control over orthodontic movements.Additional findings revealed a compensatory activity of neighbouring teeth, which varies based on tooth region and movement type. It potentially could influence CAT outcomes negatively and merits attention in future investigations. These results support a tailored CAT method that improves aligner design for better force application. This method needs to be used alongside, and confirmed by, clinical knowledge. Future research should extend these findings to a wider range of clinical conditions for greater applicability in the day‐to‐day orthodontic practice. [ABSTRACT FROM AUTHOR]

Background: Establishing accurate, reliable, and convenient methods for enamel segmentation and analysis is crucial for effectively planning endodontic, orthodontic, and restorative treatments, as well as exploring the evolutionary patterns of mammals. However, no mature, non-destructive method currently exists in clinical dentistry to quickly, accurately, and comprehensively assess the integrity and thickness of enamel chair-side. This study aims to develop a deep learning work, 2.5D Attention U-Net, trained on small sample datasets, for the automatical, efficient, and accurate segmentation of enamel across all teeth in clinical settings. Methods: We propose a fully automated computer-aided enamel segmentation model based on an instance segmentation network, 2.5D Attention U-Net. After data annotation and augmentation, the model is trained using manually annotated segmented enamel data, and its performance is evaluated using the Dice similarity coefficient metrics. A satisfactory image segmentation model is applied to generate a 3D enamel model for each tooth and to calculate the thickness value of individual enclosed 3D enamel meshes using a normal ray-tracing directional method. Results: The model achieves the Dice score on the enamel segmentation task of 96.6%. This study provides an intuitive visualization of irregular enamel morphology and a quantitative analysis of three-dimensional enamel thickness variations. The results indicate that enamel is thickest at the incisal edges of anterior teeth and the cusps of posterior teeth, thinning towards the roots. For posterior teeth, the enamel is thinnest at the central fossae area, with mandibular molars having thicker enamel in the central fossae compared to maxillary molars. The average enamel thickness of maxillary incisors, canines, and premolars is greater than that of mandibular incisors, while the opposite is true for molars. Although there are individual variations in enamel thickness, the average enamel thickness graduallly increases from the incisors to the molars among all teeth within the same quadrant. Conclusions: This study introduces an automatic, efficient, and accurate 2.5D Attention U-Net system to enhance precise and efficient chair-side diagnosis and treatment of enamel-related diseases in clinical settings, marking a significant advancement in automated diagnostics for enamel-related conditions. [ABSTRACT FROM AUTHOR]

Introduction: Space closure is the most common treatment mechanic used in orthodontics in clinical practice. It can be done with friction and frictionless mechanics, and nowadays by using mini-implants. These mini-implants provide an absolute source of anchorage to obtain dental and soft tissue changes that are desired, thus helping to improve the patient's profile. Aims and Objectives: To evaluate the stress distribution patterns in the tooth, bone, and periodontal ligament in mini-implants placed at different heights and angulations for retraction and intrusion of maxillary incisors using finite element model (FEM). Materials and Methods: FEMs of maxillary teeth and periodontal ligament housed in alveolar bone with the first premolars extracted were constructed. These models were further divided into two groups based on the number of implants. In group I, two implants were placed bilaterally between the second premolar and first molar at variable heights (7, 10, and 13 mm) and at different angulations (45° and 60°) to the long axis of the occlusal plane. In group II, along with the two bilateral mini-implants, an additional mid-implant was placed between two central incisors. These models were simulated using ANSYS 19.2 version software. Results: The maximum distribution of stress (MPa) in hard bone, soft bone, and implant was seen in the FEM 7 model and was 17.65, 0.210, and 61.62 MPa, respectively, during the retraction and intrusion of maxillary anterior teeth. The highest stress distribution (MPa) was seen in the lateral incisor tooth in FEM 7 model (0.748 MPa) and also in the periodontal ligament around the lateral incisor in FEM 7 model (0.684 MPa). Conclusion: The stress distribution was found to be highest in the lateral incisor tooth, periodontal ligament of the lateral incisor, and hard bone. The stress distribution pattern showed variation with different heights and angulations of the mini-implant. As the angle of insertion of the mini-implant to the long axis of the occlusal plane increases, the stresses generated in the bone decrease. [ABSTRACT FROM AUTHOR]

Background: Molar–incisor hypomineralisation (MIH) is a frequently encountered dental condition in the clinical setting, and correct diagnosis can influence management outcomes. Aim: To assess the knowledge of and attitudes towards the management of MIH amongst dentists in the Netherlands. Design: The study was conducted as a cross‐sectional web survey. The questionnaire used included questions regarding respondent characteristics, awareness, knowledge and management of MIH and was distributed through the Royal Dutch Association for Dentistry (KNMT) to a random sample of 900 dentists. Variables were analysed using descriptive statistics, and differences between distinct groups of dentists were tested using the chi‐squared test. Results: Respondents consisted of 76.6% general dental practitioners, 9.1% paediatric dentists and 14.3% differentiated (specialist) dentists, with a 25.6% overall response rate. The majority knew the term MIH and its clinical characteristics, and could distinguish MIH from other enamel defects. Regarding aetiological factors, 76.6% reported a genetic component. In an asymptomatic case, 47.3% reported non‐invasive treatments. In a mild symptomatic case, treatments from non‐invasive to invasive were reported (p <.05). In a severe symptomatic case, the majority reported invasive treatments. Two‐thirds of respondents were interested in further clinical training about MIH. Conclusions: Most respondents knew the term MIH and its clinical characteristics and would like further clinical training about MIH. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this retrospective study was to compare the dento-skeletal changes observed in growing Class III patients treated with the Face Mask Protocol (FMP) with and without Bite Block (BB). Materials Thirty subjects (12 f, 18 m) who underwent FM/BB therapy were compared to a matched group (FM) of 29 patients (15 f, 14 m) treated without BB. All patients were evaluated before treatment (T0), at the end of active treatment (T1), and at a post-pubertal follow-up observation (T2). A control group (CG) of 20 subjects (10 f, 10 m) with untreated Class III disharmony was used for the comparison of post-pubertal changes. Intergroup statistical comparisons were performed with the independent samples t -test (P  < .05). Results The comparison between treated samples showed a significant improvement of SN^GoGn (FM/BB vs FM, −2.1°), Overbite (FM/BB vs FM, +1.2 mm), and vertical position of lower molars FM/BB vs FM, −3 mm). When compared with the controls, both treated groups revealed a significant improvement of SNA (FM/BB, +1.8°; FM +2.1°), ANB (FM/BB +1.6°, FM +2.4°), gonial angle (FM/BB −4.9°; FM −4°), incisor inclination (Upper, FM/BB +1.7°, FM +2.3°; Lower, FM/BB −2.5°, FM −2.7°), and Overjet (FM/BB +3.2 mm; FM +4 mm). Improvement of SN^GoGn (−2.1°), Overbite (+1.8 mm), and vertical position of lower molars (−3.8 mm) were observed when FM/BB was compared with CG. Limitations Limitations are related to the difficulty to recruit a larger contemporary long-term control group due to ethical reasons. Conclusion Both FM protocols induced favorable changes in the treatment of Class III malocclusion with a good post-pubertal stability. The BB allows a more efficient control of the vertical skeletal relationship. [ABSTRACT FROM AUTHOR]

Objective: The primary focus of this investigation was to evaluate the biomechanical effects of high trimline design aligners on the distalization of mandibular molars, employing three-dimensional finite element analysis (3D-FEA). The study concentrated on aspects such as tooth movement, stress distribution, and anchorage control. Methods: Utilizing Cone-beam computed tomography (CBCT) data, a detailed 3D geometrical model was constructed for finite element analysis. This model was used to assess four variations of aligner trimlines, alongside the employment of Class III traction. Analyses were conducted to examine stress distributions and tooth displacements in these different scenarios. Results: Aligners with a high trimline design were found to be more effective in facilitating the distal movement of mandibular molars than those with scalloped trimlines, providing improved management over tooth movement and stress distribution. In specific configurations where Class III traction was applied, a reduction in the deformation of anterior teeth was observed, which enhanced anchorage stability. Nevertheless, the anterior teeth in all configurations were subjected to compressive stresses that surpassed thresholds likely to induce external root resorption, underlining the importance of vigilant monitoring. Conclusions: The research verified the biomechanical advantages of high trimline aligners in the distal movement of mandibular molars and underscored the critical role of aligner design and traction application in optimizing orthodontic treatment outcomes. Additionally, it raised concerns regarding the potential for root resorption due to significant stress in the periodontal ligament, necessitating thorough observation of patients, particularly those fitted with high trimline aligners. Despite these insights, the study's findings are derived from the data of a single patient, suggesting a need for further investigations involving broader samples and extended clinical assessments. [ABSTRACT FROM AUTHOR]

Background: This study aimed to analyze the effects of maxillary molar distalization using clear aligners with different intramaxillary and intermaxillary traction via the three-dimensional (3D) finite element method. Methods: A 3D finite element model consisting of the maxilla, mandible, dentitions, periodontal ligaments (PDLs), attachments, and clear aligners was constructed. Five groups were established based on different traction modalities: group 1 (control group); group 2 (orthodontic mini-implants (OMIs) were implanted between the maxillary first molars and the second premolars on the buccal side); group 3 (OMIs were implanted in the infrazygomatic crest area between the maxillary first and second molars on the buccal side); group 4 (OMIs were implanted between the maxillary first molars and the second premolars on the palatal side); and group 5 (class II elastics were utilized between the maxillary canines and the mandibular first molars). OMIs were implanted 4 mm away from the alveolar crest in each experimental group. A force of 1.5 N was applied to each experimental group. The 3D displacement of the target teeth and stress distribution around the PDLs were analyzed. Results: Group 4 exhibited the least amount of torque change in the upper anterior teeth and the highest displacement of the maxillary second molars. Group 3 showed smaller changes in anterior teeth torque and higher molar distalization efficiency compared to group 2. Group 5 showed adverse effects such as anterior teeth extrusion and mandibular anchorage loss. Conclusion: OMIs implanted on the palatal side have advantages in preserving anterior teeth anchorage and improving the efficiency of molar distalization compared to those positioned on the buccal side. OMIs implanted in the infrazygomatic crest area between the first and second molars on the buccal side demonstrate benefits in the aforementioned aspects when compared to OMIs implanted between the first molars and the second premolars on the buccal side. [ABSTRACT FROM AUTHOR]

• For anterior open bite (AOB) patients with severe incisor exposure, intrusion of the entire maxillary dentition is necessary. • An anteroposterior lingual retractor (APLR) is a useful lingual retractor for the retraction of the maxillary anterior teeth and the intrusion of the entire maxillary dentition. • When applying APLR, the length of the lever arm, the vertical position of the TADs, angulation of the posterior tube, posterior splint method, use of transpalatal arch (TPA), depth of the palatal vault, and compensatory extrusion of the mandibular molars must be taken into consideration. • Due to the total intrusion of the maxillary dentition, the mandible is rotated counterclockwise, improving AOB with severe incisor exposure. Anterior open bite (AOB) is considered one of the most difficult malocclusions to correct and achieve successful and stable results. Various treatment approaches have been proposed for the treatment of AOB in adults. Intrusion of the entire maxillary dentition is necessary for AOB patients with severe incisor exposure. In previous reports, a labial appliance with temporary anchorage devices (TADs) implanted in various positions has been used to achieve total intrusion of the maxillary dentition. This article describes the design and biomechanics of an anteroposterior lingual retractor (APLR) to attempt retraction of anterior teeth and total intrusion of maxillary dentition after premolar extraction in patients with both lip protrusion and AOB and the functions of each component of APLR is considered. When force is applied between the anterior lever arm of the APLR and a TAD in the midpalatal area, the anterior teeth are intruded and retracted with torque control. Because the direction of the APLR force and the guide bar are not parallel, intrusive force is generated in the posterior teeth. Due to this total intrusion of the maxillary dentition, the mandible is rotated counterclockwise, improving AOB with severe incisor exposure. Various cases are presented in which APLR was applied to AOB patients, and the clinical considerations behind the treatment are explained in detail. [ABSTRACT FROM AUTHOR]

Objective: To assess the tooth movement trends during the three stages of maxillary dentition distalization with clear aligners (CA) and to compare the efficacy of different mini‐screw anchorage systems. Materials and Methods: Three‐dimensional (3D) finite element models of three anchorage systems (A, control group; B, buccal mini‐screw anchorage group; C, palatal mini‐screw anchorage group) were established. Three stages of simulating maxillary dentition distalization with CA included maxillary molar distalization (stage 1), maxillary premolar distalization (stage 2) and maxillary anterior teeth retraction (stage 3). Therefore, a total of nine models were constructed to analyse the 3D displacement of maxillary teeth during the distalization process. Results: The displacement pattern of maxillary dentition during distalization was similar across the three groups, but with varying magnitudes. During stage 1, groups B and C exhibited greater amounts of molar distalization compared to group A. Group C also demonstrated the least amount of labial movement of the maxillary central incisor compared to the other two groups. During stage 2, the mesial displacement of the maxillary first molar was less significant in groups B and C than in group A. In the final stage, group C exhibited a greater amount of maxillary anterior retraction compared to groups A and B. Conclusion: The palatal mini‐screw anchorage system was effective in reducing anchorage loss and improving the efficacy of maxillary dentition distalization with CA. [ABSTRACT FROM AUTHOR]

Successful apical surgery relies on effective magnification and illumination. In the field of endodontics, the microscope has emerged as the predominant tool for meeting these requirements. The rigid endoscope is also a valuable instrument in apical surgery. This study introduces three cases demonstrating the application of endoscope technology in endodontic apical surgery. The first case employs a soft endoscope for treating an anterior tooth with apical periodontitis, the second integrates an endoscope with new attachments for a premolar, and the third combines an endoscope, attachments and navigation for the lower first molar surgery. It revealed that endoscopes offer certain advantages that are not achievable with microscope‐assisted surgery, these cases had a great outcome. In the future, a broader application of endoscopic technology in various procedures is anticipated. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine trends in primary and early permanent dentition treatment patterns and the relationships between them. Methods: A secondary data analysis was performed using Medicaid claims from 2011 to 2022 for North Carolina children ages zero to 12 years. Trends and expenditures of two primary dental treatment patterns were analyzed: early childhood caries (ECC), defined as treatment to primary maxillary incisors and/or primary first molars in zero-to five-year-olds; and late childhood caries (LCC), which comprised treatment to the proximal surfaces of primary molars in six to 12-year-olds. Trends in four early permanent dentition restorative treatment patterns were analyzed: (1) mesial surfaces of the permanent first molars; (2) pits and fissures of the permanent first molars; (3) maxillary anterior teeth; and (4) maxillary anterior and permanent first molars. The likelihood of children who had the listed restorative treatment to their early permanent dentition also having ECC and/or LCC treatment was investigated. Data analysis relied on descriptive statistics. Results: The proportion of children with LCC treatment and the yearly treatment expenditure were consistently two times more than that associated with ECC treatment throughout the 12-year period. Children who had early permanent dentition restorative treatment were, on average, two times as likely to have had LCC treament than ECC treatment. Conclusion: Future prevention and education strategies should target late childhood caries. [ABSTRACT FROM AUTHOR]

Background: Children with dental caries are treated with stainless steel metal crowns (SSC), but the aesthetics and precision still need to be improved. Currently, both 3D‐printed resin crowns (PRC) and computer‐aided design/computer‐aided manufacture (CAD/CAM) resin crowns (CRC) meet the clinical requirements for crown applications in terms of strength, production time, cost, and aesthetics. Aim: This study replaced SSC with customized resin crowns by 3D printing and CAD/CAM. Design: In this study, PRC, CRC, and SSC were used for incisor and molar restorations, and 60 crowns were made with 10 for each group. The fabrication efficiency, surface characteristics, marginal fit, and stability of the two different crowns were evaluated. Results: PRC and CRC show superior color and surface characteristics, though production times are longer (5.3–12.4 times and 3.3–9.1 times, respectively) than for SSC (p <.05). They, however, can be completed within 80 min. Edge gaps for PRC and CRC are significantly lower (13.0–19.2 times and 13.0–13.7 times) than for SSC (p <.05). All materials exhibit good stability. Conclusion: The 3D‐PRCs and CAD/CAM resin crowns may replace SSCs as a potential choice for clinical child caries. [ABSTRACT FROM AUTHOR]

Copyright of Kieferorthopädie: die Zeitschrift für die Praxis is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Kieferorthopädie: die Zeitschrift für die Praxis is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: According to the literature, hypomineralization of molars and incisors is a multifactorial condition that depends on both genetic and environmental factors. This study aims to diagnose Molar Incisor Hypomineralization (MIH) cases with a new index that better defines the defect and to contribute to the literature by identifying possible etiological factors. Methods: This research was conducted with children aged 8–11 years old and their parents from Konya province and surrounding provinces. While children who were diagnosed with MIH as a result of the examination constituted the study group, children with no findings of MIH during intraoral examination were included in the control group. Between February and October 2020, 104 patients for the study group and 104 patients for the control group were reached, and a survey was administered to a total of 208 parents. Results: Asthma, pneumonia, lower respiratory tract infections, diarrhea, a fever, and febrile convulsions between the ages of 0–4 have been found to be related to MIH (p < 0.05). Conclusions: The association between medical diseases in children and enamel defect formation draws attention to the importance of pediatricians in the early diagnosis of MIH cases. Pediatricians can be very helpful in informing parents of children with health problems about possible dental defects and referring them to a pediatric dentist. [ABSTRACT FROM AUTHOR]

The palatal anchorage device (PAD) is commonly used in fixed appliance for anchorage, but the biomechanics of PAD in patients treated with clear aligners(CAs)remains poorly understood, especially in its elastic mode and force magnitude. This study aimed to assess the biomechanical effects of using PAD for retraction during clear aligner treatment (CAT) with the extraction of two maxillary first premolars. Four finite element models were created: (1) Incisors retraction (IR) with active contraction of the clear aligner only; (2) IR with PAD using different forces (50,75,100 g) or not; (3) PAD without IR (forces of 50,75,100 g), and (4) Different elastic directions (D1, D2, D3) from aligner to PAD without IR. IR caused lingual tipping and extrusion of the central incisors, as well as mesial and buccal tipping of the first molar. PAD during IR provided strong anchorage for the first molar, with elastics slightly increasing the lingual tipping and extrusion of the central incisors. Elastics applied to the U-shaped arch led to central incisor intrusion and reduced lingual retraction. The highest stress was observed on the mesial attachment of the canine. PAD effectively reinforced posterior anchorage in CAT, while anterior positioning facilitated anterior teeth intrusion. The biomechanical importance of the canine's mesial attachments in maxillary teeth treatment planning was highlighted. [ABSTRACT FROM AUTHOR]

Background: Molar–incisor hypomineralization (MIH) is a qualitative enamel defect that is highly prevalent in children. It has been reported that patients with MIH have higher caries occurrence with an increased need and frequency of dental treatment compared to patients without MIH. The objective of this study was to analyze the association between MIH and a series of factors related to maternal health status during pregnancy and children´s medical history in early childhood. Methods: A retrospective study of cases (patients with MIH) and controls (patients without MIH) was designed between 2023 and 2024. A total of 280 children (cases = 140; controls = 140) aged 6 to 14 years (138 boys and 142 girls) were examined according to the European Academy of Pediatric Dentistry (EAPD) criteria for MIH. A survey was carried out with mothers regarding the potential exposure of their children to etiological factors of MIH. Possible prenatal and postnatal etiological factors were obtained through a personal interview with the patients' mothers. The statistical analysis was carried out with the contrast test and the chi-square test. Results: During pregnancy, folic acid consumption, alcohol intake, systemic viral and/or bacterial infections, and gestational diabetes were statistically significantly related to MIH, as were breastfeeding, asthma, and corticosteroid consumption during childhood. Conclusions: Although there are different factors that may have statistically significant relationships with MIH, they cannot be predicted. Therefore, longitudinal studies, with a large sample size, are needed to determine the influence of prenatal and postnatal factors on the prevalence and severity of MIH in children. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Methods and Methodology Result Conclusion Traumatic dental injuries related to sports are a significant concern, as they can have severe physical and psychological impacts on children. Using mouthguards is essential, particularly in sports like skating, where high‐impact forces are common.The study aimed to evaluate how stress is distributed on the teeth and surrounding bone in children with proclined anterior teeth when a force of 614.12 N was applied to two different regions of the jaws. The evaluation was conducted using finite element analysis (FEA), both with and without the use of a mouthguard.A 3‐dimensional finite element analysis (FEA) model was constructed using a cone beam computed tomography (CBCT) scan of a 12‐year‐old male patient. An average standardized force of 614.12 N was calculated, based on the average weight of children aged 11 to 13 years and the average speed of 13.4 m/s with which the children skate. The force was applied in two different directions and areas of the jaws: a lateral blow, perpendicular to the crown and root with the maxillary and mandibular teeth in occlusion (between the first molar and second premolar), and a blow obliquely at the pogonion point on the chin. Static simulations were then performed for four realistic scenarios—two with mouthguards and two without mouthguards.The Von Mises stresses were evaluated under all conditions. When the applied force was directed laterally, the stress values observed were 126.76 MPa with a mouthguard and 140 MPa without a mouthguard. When the force was applied to the chin region, the stress values were 37.997 MPa with a mouthguard and 40.67 MPa without a mouthguard.The use of a mouthguard in children is beneficial for protecting teeth and surrounding structures, especially in cases of proclined anterior teeth, as it helps dampen the generated stresses. [ABSTRACT FROM AUTHOR]

Atypical tooth or root anatomy should be identified as a variation when it is observed frequently in a particular community or ethnic group. The root canal morphology depends on demographic factors such as age, gender, and ethnicity. There are differences in the morphology of the root canal that are inherent to different racial and ethnic groups. Knowing this helps clinicians understand root canal anatomy leading to better endodontic treatment outcomes. The studies reviewed had reported predominantly Vertucci type I in upper and lower anterior teeth. Considering the upper back region of the jaw, first and second premolars often had single-rooted type IV canals, followed by Vertucci type I and type III configurations. Mandibular premolars mainly featured type I canals. Maxillary molars typically had three roots, with the mesiobuccal (MB) root primarily classified as type I. Compared to second molars, first molars were more likely to have second MB canal. There are two roots found in mandibular molars; the first molar's root that is distal was type I, and the proximal root was classified as type II. Accessory canals, including the middle mesial canal, were more prevalent compared to other populations, whereas C-shaped canals were relatively infrequent, varying from 7.53% to 13.12%. These results demonstrate the variety of root canal shapes, which can impact dental treatment approaches. [ABSTRACT FROM AUTHOR]

Objective: To investigate the vertical changes in incisors and molars that occur following molar distalisation with clear aligners. Methods: A total of 30 patients receiving clear aligner treatment (Invisalign, Align Technology, San Jose, CA, USA) were included in the study. Patients' digital models were exported from the ClinCheck software (Align Technology) and measured using Geomagic Studio 2014 (Raindrop Geomagic, Research Triangle Park, NC, USA). Various indices regarding characteristics of vertical changes following molar distalisation with clear aligners were measured and compared, including the predicted and achieved molar distalisation, intrusion and change in vertical overlap. A simple linear regression was conducted to examine the impact of distalisation on molar intrusion. Results: The characteristics of spatial changes in molar distalisation with clear aligners were measured, particularly in the vertical dimension. The actual vertical overlap deepened after clear aligner treatment (central incisors 0.43 ± 2.14 mm, lateral incisors 0.79 ± 1.91 mm). Molar intrusion occured (first molar 0.51 ± 0.77 mm, second molar 0.97 ± 0.87 mm), and the difference between the actual and expected molar intrusion was statistically significant. A significant positive correlation was identified between molar distalisation and molar intrusion (P < 0.05). In addition, by comparing the different positions of the dental arch, the intrusive effect of molar distalisation was found to be progressively greater from the anterior to the posterior teeth (P < 0.05). With the use of temporary anchorage devices, the deepening of vertical overlap and the effects of posterior open bite effects were significantly greater (P < 0.05). Conclusions: Molar intrusion is a common occurrence during molar distalisation with clear aligners. It may result in open bite in the molar region and increased vertical overlap in the incisors. The intrusive effect of molar distalisation increases gradually from the anterior to the posterior teeth. Temporary anchorage device-assisted molar distalisation with clear aligners exacerbates open bite in the molar region. Aligner overtreatment of incisor intrusion is recommended if the vertical dimension should be reduced, whereas additional molar extrusion is implemented if the vertical dimension should be maintained or increased for molar distalisation with clear aligners. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to analyze the agreement between researchers with different levels of experience in assessing periapical and panoramic radiographs for determining periapical status using the periapical index, by applying two different statistical methods. Methods: This retrospective study included 180 adult patients (mean age±SD 30.89±6.84 years) who had digital panoramic and periapical radiographs taken for various reasons and treatment procedures. Two observers scored the periapical index of the teeth with periapical lesions on panoramic radiographs. One month later, the periapical radiograph of the evaluated tooth was examined. Observer agreement for the scores due to the panoramic and periapical radiographs was assessed using kappa analysis and ICC. Results: The highest level of interobserver agreement on panoramic radiographs was found in the mandibular molar region (substantial agreement; Ƙ=0.676; p=0.001) in kappa analysis and in the maxillary incisor region (almost perfect agreement; ICC=0.925; p=0.001) in ICC analysis. The highest level of interobserver agreement on periapical radiographs was observed in the mandibular molar region (substantial agreement; Ƙ=0.749; p=0.001) in kappa analysis and in the maxillary incisor region (almost perfect agreement; ICC=0.941; p=0.001) in ICC analysis. The lowest interobserver agreement on panoramic radiographs was found in the maxillary molar region in both kappa analysis (fair agreement Ƙ=0.291, p=0.005) and ICC analysis (substantial agreement ICC=0.793, p=0.001). On periapical radiographs, the lowest interobserver agreement was found in the maxillary molar region in kappa analysis (fair agreement Ƙ=0.268, p=0.013) and in the maxillary premolar region in ICC analysis (substantial agreement ICC=0.795, p=0.001). Intraobserver agreement for panoramic and periapical radiographic assessments was found to be almost perfect agreement (ICC>0.90) for both observers in ICC analysis. Conclusion: In the observer agreement of periapical lesions scored using the periapical index on panoramic and periapical radiographs, the kappa and ICC analysis results differ. It is considered that the location of the lesions and anatomical superpositions on the radiographs have an impact on radiographic evaluation. [ABSTRACT FROM AUTHOR]

Objective: To compare the pain response and efficacy of caries removal using tungsten carbide burs with that of using Brix Gel as a chemomechanical caries removal agent. Study Design: Randomized Controlled Trial. Setting: Department of Operative Dentistry, PIMS, Islamabad. Period: November 2023 to April 2024. Methods: Conducted on 40 participants were selected using a non-probability technique. Participants aged 12 to 65 years with open occlusal carious lesions involving dentin were included. Patients with symptoms of pulpitis, caries affecting maxillary or mandibular anterior teeth, severe systemic illnesses, allergies, sensitivities, or pregnancy/lactation were excluded. Caries removal methods were randomly assigned. Pain levels were assessed using a Visual Analog Scale (VAS), and caries removal efficacy was evaluated. Statistical analysis was done using chi-square and independent samples t test. Results: Among the 40 participants, 47.50% were female, and the mean age was 36.30±15.57 years. Mandibular molars were the most commonly affected teeth (n=24, 60%). No significant difference in age or gender distribution was observed between the two groups. The chemomechanical method resulted in significantly lower pain scores compared to carbide bur (2.59 ± 1.34 vs. 4.44 ± 1.61, p < 0.001). Pain severity also differed significantly between groups, with more mild pain reported in the chemomechanical group (80.00% vs. 5.00%, p < 0.001). However, caries removal efficacy did not significantly differ between the two methods (p = 0.48). Conclusion: Chemomechanical caries removal using Brix Gel demonstrated superior pain management compared to carbide bur. While both methods showed similar efficacy in caries removal, the chemomechanical approach may offer better patient comfort during the procedure. [ABSTRACT FROM AUTHOR]

Objective: To evaluate tooth displacement and periodontal stress generated by the dual action vertical intra-arch technique (DAVIT) for open-bite correction using three-dimensional finite element analysis. Methods: A three-dimensional model of the maxilla was created by modeling the cortical bone, cancellous bone, periodontal ligament, and teeth from the second molar to the central incisor of a hemiarch. All orthodontic devices were designed using specific software to reproduce their morpho-dimensional characteristics, and their physical properties were determined using Young's modulus and Poisson's coefficient of each material. A linear static simulation was performed to analyze the tooth displacements (mm) and maximum stresses (Mpa) induced in the periodontal ligament by the posterior intrusion and anterior extrusion forces generated by the DAVIT. Results: The first and second molars showed the greatest intrusion, whereas the canines and lateral incisors showed the greatest extrusion displacement. A neutral zone of displacement corresponding to the fulcrum of occlusal plane rotation was observed in the premolar region. Buccal tipping of the molars and lingual tipping of the anterior teeth occurred with intrusion and extrusion, respectively. Posterior intrusion generated compressive stress at the apex of the buccal roots and furcation of the molars, while anterior extrusion generated tensile stress at the apex and apical third of the palatal root surface of the incisors and canines. Conclusions: DAVIT mechanics produced a set of beneficial effects for open-bite correction, including molar intrusion, extrusion and palatal tipping of the anterior teeth, and occlusal plane rotation with posterior teeth uprighting. [ABSTRACT FROM AUTHOR]

The presence of facial jewelry and medical devices within a radiographic field of view may promote the formation of artifacts that challenge diagnostic interpretation. The objective of this article is to describe a previously unreported radiographic anomaly produced by an oral piercing site below the lower lip. This unusual artifact masqueraded as a severe resorptive defect, dental caries, or cervical abfraction and occurred following removal of an extremely large labret below the lower lip and subsequent acquisition of a radiographic image. The radiolucency was ultimately attributed to an extensive aperture below the lower lip created by a series of sequentially larger soft tissue expanders. Clinicians should seek correlation of atypical radiographic presentations with soft tissue defects secondary to injury or intentional oral piercing. [ABSTRACT FROM AUTHOR]

Purpose: The primary aim of this study was twofold: first, to assess the prevalence of molar incisor hypomineralization (MIH) within a cohort of Egyptian children and, second, to investigate the potential correlation between MIH and various factors, including age, sex, birth complications, and endogamous marriage. Materials and Methods: This cross-sectional investigation took place in Egypt's Delta region, with approximately 3000 children aged between eight and twelve years being recruited for participation. The European Academy of Pediatric Dentistry (EAPD; 2003) criteria served as the diagnostic tool for identifying MIH cases. Upon detection of clinical signs or symptoms indicative of MIH, parents were queried regarding any potential birth complications or endogamous marriages. Lesion severity levels were diagnosed using Mathu-Muju and Wright criteria. Results: The prevalence rate for MIH was found to be 7.2%. Molars exhibited higher susceptibility rates than incisors (64.8% vs 35.2%), with approximately 37% of participants displaying severe scores, followed by mild (33.8%) and moderate (29.2%). Male subjects had significantly more occurrences than females, with positive correlations identified between MIH incidence rates alongside each gender category as well as both birth complications and endogamous marriages. Conclusion: Children born from complicated pregnancies or whose parents are related should receive frequent check-ups from pediatric dentists during their first permanent molar eruption period. so that early detection of MIH can be facilitated allowing timely intervention. [ABSTRACT FROM AUTHOR]

Copyright of Aydin Dental Journal is the property of Aydin Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this case, surgically assisted rapid maxillary expansion (SARME) was successfully adopted to treat a skeletal maxillary protrusion with large overjet and severe crowding. The female patient, aged 25 years and 11 months, was diagnosed with skeletal maxillary protrusion with severe crowding and excessive overjet associated with labially inclined maxillary central incisors. After achieving sufficient space for surgical incision between bilateral maxillary central incisors, the SARME was performed. A total of 8.0 mm lateral expansion of the maxilla was completed. At 48 days after surgery, the Hyrax appliance was replaced with an Anchor-Lock system used as an external surgical stent and skeletal anchorage for maxillary group distalization, and the distal movement of the maxillary molars was initiated without waiting for bone healing of the separated midpalatal suture by SARME. Twenty-five months' treatment, including surgical preparation, achieved an acceptable and stable occlusion with adequate interincisal relationship. The occlusion was much more stable with a little relapse through more than 4 years' retention period. In conclusion, SARME followed by the Anchor-Lock system might lead to favorable occlusal outcome in the long term without any relapses. [ABSTRACT FROM AUTHOR]

Background: This retrospective clinical study was undertaken to comparatively evaluate the number of restorative treatments, endodontic treatments, and tooth extractions performed for patients under general anesthesia due to dental anxiety or special needs between 2015 and 2022 and to examine the pain, bleeding, nausea, and vomiting data of those patients. Methods: In total, 1165 patients underwent dental treatment under general anesthesia in the faculty hospital. Those under the age of 15 and with no endodontic procedure planned (n = 918) were excluded, followed by those with incomplete data (n = 25) and those without endodontic treatment (n = 25). Patients who underwent at least one endodontic treatment were finally included in the study (n = 184). Patients were divided into two groups: healthy and with special needs. Dental treatments were recorded as endodontic, restorative, and teeth extractions. Endodontic treatments were classified according to the tooth type (premolar, molar, and incisors). The composite restorations were classified as anterior, occlusal (O), occluso-distal (OD) or occluso-mesial (OM), and mesio-occluso-distal (MOD) restorations and patients' post-treatment pain, nausea, vomiting, and bleeding were recorded. The data were analyzed statistically. Results: Among the 184 patients included in the study, 70 (38%) were healthy, and 114 (62%) had special needs. Postoperative bleeding was observed more in patients with special needs (χ2 = 4.189, p < 0.05), whereas pain was observed more in healthy patients (U = 2922.00, p < 0.05). While the number of anterior, O, and MOD restorations was higher in patients with special needs, the number of OD or OM restorations was higher in healthy patients (χ2 = 74.877, p < 0.05). Conclusions: Patients with special needs undergo a greater number of restorative treatments compared to control patients, which may be associated with the inadequate oral hygiene care of such patients. However, restorative treatment is mostly indicated for such patients in our faculty hospital, which may indicate that a conservative approach is taken. Additionally, the finding that postoperative bleeding was more severe in this group of patients compared to the control group in this study may emphasize the need to consider more possible complications after general anesthesia in these patients. [ABSTRACT FROM AUTHOR]

Background: The band and loop space maintainer is used to maintain the missing space of deciduous molars which are lost early. When the second deciduous molar is lost prematurely, the stress on the first permanent molar during different degrees of development may vary when it is the abutment. The design and use of the space maintainer may also lead to damage of the loop. The purpose of this article is to use the finite element method to study the stress on the first permanent molar and the loop with or without occlusal contact, with the first permanent molar of four different degrees of development serving as the abutment. We aimed to guide the clinical design and use of the space maintainer. Methods: We developed finite element models of the mandibular first permanent molar and the band and loop space maintainer, and simulated alveolar bone, periodontal ligament (PDL), enamel and dentin. The four developmental stages were 1/2 (I), 2/3 (II), 3/4 (III) and full development (IV). Ansys Workbench was used to analyze the effects of root development and occlusal contact between the loop and the opposite jaw on abutment teeth and the loop. Abutment teeth were statically loaded vertically and obliquely with a force of 70 N. The loop was statically loaded vertically with a force of 14 N. The stress on all structures and the displacement trends of the loop were calculated. Results: The stress on enamel, dentin, PDL and alveolar bone were similar, and the concentration was consistent. But if there was occlusal contact, the loop produced maximum displacement at the near middle edge of contact with the anterior teeth. When the loop was in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group I > group IV > group III > group II, and the maximum principal stress peak change was: group I > group III > group II > group IV. The change of the equivalent stress peak value of the loop under oblique load was: group I > group III > group IV > group II, and the maximum principal stress peak change was: group III > group I > group II > group IV. When the loop was not in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group IV > group I > group II > group III, and the maximum principal stress peak change was: group IV > group I > group II > group III. The change of the equivalent stress peak value of the space maintainer under oblique load was: group I > group IV > group II > group III, and the maximum principal stress peak change was: group I > group IV > group II > group III. Conclusions: Our results suggested that whenever possible, choosing the teeth with nearly complete root development as the abutment of the space maintainer is advisable. The design and use of the band and loop space maintainer should avoid occlusal contact with the occlusal teeth to prevent deformation of the loop. [ABSTRACT FROM AUTHOR]

Background: Molar–incisor hypomineralization (MIH) is a developmental enamel defect characterized by opacities from white to brownish color. A suspected multifactorial etiology has been suggested, whereas psychological factors during pregnancy have only been limitedly analyzed. Aim: We assessed the association between stress, depression, and anxiety in pregnancy and the presence of MIH in children at a later age. Design: Using a cross‐sectional Web‐based questionnaire, we included 384 mothers who had children aged 6 and 12 years from Pasto, Colombia. Data were collected between October 2021 and March 2022. Sociodemographic variables; maternal and child factors related to prenatal, natal, or postnatal problems; and psychological factors such as stress and symptoms of anxiety and depression in pregnancy were inquired. Utilizing photographs depicting MIH lesions, mothers assessed their child's MIH status. A directed acyclic graph (DAG) analysis was performed to create causal assumptions, and logistic regression models were estimated to evaluate these assumptions. p‐value was set at p <.05. Results: The prevalence of MIH was 33.3%; 12.8% of the participants exhibited hypomineralization in both molars and incisors. DAG analysis and logistic regression models determined that MIH (present or not) was associated with symptoms of maternal depression (ORadj = 3.26, 95% CI: 1.92–5.52, p <.001), and MIH (both molars and incisors) was associated with symptoms of maternal anxiety (ORadj = 3.49, 95% CI: 1.80–6.76, p <.001). Conclusion: Psychological factors, among others, were significantly associated with the presence of MIH. [ABSTRACT FROM AUTHOR]

ABSTRACT: Aim and Objective: This study aimed to compare the amount of maxillary incisor intrusion and root resorption using three methods: mini-implants, utility arches, and Connecticut intrusion arches. Materials and Methods: Eighteen patients aged 15 to 25 years with deep bite were divided into three groups: 10 patients each for mini-implant, utility arch, and Connecticut intrusion arch groups. Bilateral mini-implants were used in Group 1, while utility and Connecticut arches were used in Groups 2 and 3, respectively. Intrusion was performed over four months. Lateral cephalograms and orthopantomograms were taken at the start (T1) and after four months (T2). Results: The mean incisor intrusion measured by U1-PP was 2.08 mm in Group 1, 1.55 mm in Group 2, and 1.75 mm in Group 3 (P < 0.05). CR-PP measurements showed 1.91 mm in Group 1, 1.56 mm in Group 2, and 1.66 mm in Group 3 (P < 0.05). Incisors in Group 1 showed minimal protrusion compared to significant protrusion in Groups 2 and 3 (P < 0.05). Maxillary molars showed no significant changes in Group 1 but distal tipping in Groups 2 and 3 (P < 0.05). No root resorption was observed in any group. Conclusion: Mini-screws demonstrated the most effective maxillary incisor intrusion with minimal side effects compared to utility and Connecticut intrusion arches. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of alveolar ridge preservation on bone regeneration and tissue healing has been thoroughly documented in the literature. This study aimed to evaluate the peri-implant soft and hard tissue changes after alveolar ridge preservation using either platelet-rich fibrin (PRF) or freeze-dried bone allograft (FDBA) over a 12-month period following the prosthetic loading of implants. Methods: In this randomized clinical trial, 40 individuals were recruited for alveolar ridge preservation using (1) FDBA or (2) PRF in incisal/premolar areas. At two follow-up sessions (six- and 12-months post-implant insertion), radiographic imaging and clinical examinations assessed marginal bone loss and soft tissue factors, including gingival recession and bleeding on probing. The differences between study groups were analyzed using Generalized estimating Equations, the Binary logistic regression model, and Cochran's Q test. Results: There was a statistically significant difference regarding gingival recession at both follow-up evaluations; values in the PRF group were considerably lower compared to the FDBA group (p < 0.05). The mean values for vertical marginal bone loss and bleeding on probing showed no significant differences between the two study groups (p > 0.05). Conclusions: Except for gingival recession, applying PRF yielded comparable clinical results to FDBA after one year of implant loading and could be recommended as a potential biomaterial for alveolar ridge preservation following tooth extractions. Clinical trial registration: The research protocol was registered in the Protocol Registration and Results System on 13/08/2021, available at https://clinicaltrials.gov/ (NCT05005377). [ABSTRACT FROM AUTHOR]

Understanding how epigenetic factors impact dental phenotypes can help refine the use of teeth for elucidating biological relationships among human populations. We explored relationships among crown size, principal cusp spacing, and accessory cusp expression in maxillary dental casts of nutritionally supplemented (n = 34) and non-supplemented (n = 39) individuals from Tezonteopan, Mexico. We hypothesized that the non-supplemented group would exhibit smaller molar crowns and reduced intercusp spacing. Since intercusp spacing is thought to be more sensitive to epigenetic influences than crown size, we predicted that the supplemented and non-supplemented groups would differ more in the former than the latter. Previous work suggests that molar accessory cusp expression may be elevated under conditions of stress. We therefore expected evidence of greater Carabelli and Cusp 5 trait expression in the non-supplemented group. We further hypothesized that anterior teeth would be affected by nutritional stress during development, with the non-supplemented group having smaller anterior tooth crowns and therefore limited space to form the tuberculum dentale. Finally, we tested whether the presence of molar accessory traits followed predictions of the Patterning Cascade Model of tooth morphogenesis in the entire sample. Our results supported the expectation that cusp spacing would differ more than molar crown size between the two groups. Carabelli trait showed little evidence of frequency differences between groups, but some evidence of greater trait scores in the non-supplemented group. The non-supplemented group also showed evidence of greater Cusp 5 frequency and expression. In the central incisors and canines, there was strong evidence for smaller crown sizes and reduced tuberculum dentale frequency in the non-supplemented group. With both groups pooled together, there was strong evidence of closer mesiodistal distances among principal cusps in molars with accessory cusps, a finding that is consistent with the PCM. Overall, our findings suggest that nutritional stress may affect accessory cusp expression. [ABSTRACT FROM AUTHOR]

This document discusses the use of T-Loop springs in orthodontic treatment to retract buccally ectopic canines and close spaces in the lower arch. Two case reports are presented, demonstrating the effectiveness of T-Loop springs in achieving controlled space closure and aligning the canines. The treatment resulted in successful canine retraction and preservation of the Class I molar relationship. The document highlights the importance of monitoring the patient's progress and making adjustments as needed during treatment. [Extracted from the article]

Introduction: Odontogenic infections (Ols) can present with a variable clinical picture to hospital emergency departments (ED). Some require inpatient surgical management due to the risk of airway compromise or systemic signs of infection. Other Ols are minor and can be managed in the primary care setting. This study aimed to evaluate the differences in Ols requiring inpatient surgical treatment at the Geelong University Hospital compared to those who can be discharged to their local dental practitioner. Methods: This study analysed the in - hospital assessment of patients with Ols presenting to ED, and factors which led to surgical admission and inter-hospital transfers. Results: 228 patients were included in the study, with 59 % admitted for surgery and the remainder discharged to primary care. Smokers, patients treated with antibiotics prior to hospital, mandibular molar teeth, trismus and moderate to severe space involvement were associated with the need for inpatient surgical treatment. Anterior maxillary teeth, vestibular space infections, and low risk infections were likely to be discharged to primary care. Conclusion: There are key features of Ols which are associated with the requirement for inpatient surgical management. Minor odontogenic infections are often triaged to community dental clinics, and the dental workforce should be prepared to appropriately evaluate and manage these patients. [ABSTRACT FROM AUTHOR]