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Cemento-Enamel junction is an anatomical point where the enamel of the crown surface connects to the cementum of the root. It lies in a region covered with the gingivalsoft tissue, but with the increasing age and due to many pathological conditions this junction may be exposed to the external environment and sometimes mayprovide a path for bacterial infection into the tooth.Aim: To analyze different types of Cemento-Enamel Junctions in thepopulation of Himachal Pradesh.Methodology: 40 extracted teeth were obtained from various regions of Himachal Pradesh. Ground sections of the tooth were made and analyzed for the type of Cemento-Enamel Junction under a Binocular Microscope.Result: Sharp junction was most frequent type of inter-relation between the two hard tissues in our study followed by Gap junction and Overlap type junction. Though we found cementum overlapping enamel in few cases but we could not find any sample in which enamel was overlapped by cementum. Conclusion: Cemento-Enamel Junction presents different morphological patterns so a study of this region is necessary to avoid complications during various dental procedures such as sensitivity after bleaching or cervical caries after placement of crown or clamps.

Background Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest. Methods An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool and the overall meta-evidence certainty using the GRADE approach. A single means random-effects meta-analysis was performed to obtain the weighted mean for 95% confidence interval. A meta-regression of covariates and subgroup analysis was conducted. The nullity Qh test and I2 index for heterogeneity was estimated. Results 2560 potentially relevant articles were recorded from which 29 studies were selected for the qualitative analysis, including 17,321 teeth. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was ≤ 1 mm in maxillary incisors and canines (0.75–1.05 mm) and 1–2 mm in premolars. Patients over 50 years of age, females and thin gingival phenotype was associated with thinner FAB at some apico-coronal locations of maxillary incisors and canines. The geographical setting was an effect modifier that could explain up to 87% of the heterogeneity in FAB thickness, being Asian populations that showed the lowest FAB thickness values. The CEJ-bone crest distance was 2–2.5 mm in all teeth analyzed. Population over 50 years of age exhibited greater CEJ-bone crest distances, and males also showed a trend for greater distance. Evidence certainty has shown moderate quality in most analysis subsets. Conclusions Facial alveolar bone at anterior maxillary teeth is thin, heterogeneous in width along its apico-coronal dimensions, and increases in thickness in maxillary premolars. The CEJ-bone crest distance presented homogeneous and similar values in all teeth analyzed.

BackgroundUnderstanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest. MethodsAn electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool and the overall meta-evidence certainty using the GRADE approach. A single means random-effects meta-analysis was performed to obtain the weighted mean for 95% confidence interval. A meta-regression of covariates and subgroup analysis was conducted. The nullity Q(h) test and I-2 index for heterogeneity was estimated. Results2560 potentially relevant articles were recorded from which 29 studies were selected for the qualitative analysis, including 17,321 teeth. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was

(1) Background: This study aimed to evaluate the microporosity of the tooth surface structure adjacent to the cemento-enamel junction (CEJ) after the removal of composite fillings with a drill in comparison with removal by an Er:YAG laser and after cleaning with a periodontal curette, chemical EDTA and NaOCl (sodium hypochlorite) conditioning. (2) Methods: The research material consisted of 30 extracted premolars with cervical composite fillings. The teeth were divided into six groups according to the method of tooth preparation: group G1 (n = 5)—a diamond drill, group G2 (n = 5)—a diamond drill + curette, group G3 (n = 5)—a diamond drill + 24% EDTA (PrefGel, Straumann, Switzerland), group G4 (n = 5)—an Er:YAG laser (LightWalker, Fotona, Ljubljana, Slovenia) set with the following parameters: power: 1.65 W (composite removal, CR), 1.2 (tooth conditioning, TC), energy: 110 mJ (CR), 80 mJ (TC), frequency: 15 Hz, pulse duration: 50 μs, tip diameter: 1 mm, air/fluid cooling: 4, distance 1.5 mm, energy density: 14.01 J/cm2 (CR), 10.19 J/cm2 (TC), group G5 (n = 5)—an Er:YAG laser + 2% sodium hypochlorite (NaOCl), group G6 (n = 5)—an Er:YAG laser + 5.25% NaOCl. In each tooth, three cavities were made and subjected to analysis. The dentin surface was evaluated using a scanning electron microscope (SEM). (3) Results: Groups G1 and G2 exhibited mechanical damage to the tooth surface structure caused by the rotary motion of a diamond drill. The SEM image showed a smear layer that could only be removed chemically using 24% EDTA gel (group G3). The tooth surfaces prepared with the Er:YAG laser (groups G4–G6) revealed a homogeneous structure without damage along with open dentinal tubules (without smear layer) and visible denaturation of collagen fibers. The sodium hypochlorite (NaOCl) conditioning did not increase the visibility of dentinal tubules. (4) Conclusions: Dentin surfaces have open dentinal tubules after removal of the composite filling using the Er:YAG laser and therefore do not require additional NaOCl conditioning.

The following study describes the mineralized tissue distribution which composes the cement-enamel junction, in a simple of Chilean people, comparing several teeth surfaces. Cervical area was observed (M-V, D-V, M-L/P, D-L/P sites) from 136 (n=68) longitudinal sections on premolars and incisors, with orthodontic or prosthetic reasons for exodontia, which were analyzed by optical microscope in order to identify the type of cement-enamel junction. For that measurement it was Choquet's criteria, founding four types: 1) cement over enamel, 2) enamel over cement, 3) vis a vis, 4) Gap presence between enamel, cement and exposed dentin. The objective of this study was to determine the prevalence of these. As result, it was observed that there was no association between tooth surface and Choquet's classification; however that association was observed while comparing the type of tooth and the relationship with mineralized tissues at the CEJ. So, incisors were associated with class 1 and premolars with class 3 of Choquet. Class 3 prevalence is the most frequently observed in the sample size (51.9%), following class 1 (42.4%), class 4 (4.4%), and class 2 with the lower prevalence on the sample (1.5%). Because this region is fragile and highly susceptible to pathological changes and from the external environment, it must be carefully handled during clinical procedures such as teeth whitening, orthodontics, restorations, root scaling and clamp placement.