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Background: The analgesia after lower third molar alveolectomy is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs) that have significant risks, and are contraindicated in the third trimester of pregnancy. Aiming to reduce NSAIDs use after this surgery, we quantified analgesic effects of ultrasound (US)-guided extraoral mandibular nerve block. Methods: Thirty-six patients were equally allocated to the experimental or control group, based on their willingness to receive experimental US-guided extraoral mandibular nerve block for postoperative analgesia. The experimental block applied prior to lower third molar alveolectomy, was followed by standard intraoral inferior alveolar nerve block. In the control group, patients received only intraoral block of inferior alveolar nerve. All patients reported pain level (visual analogue scale, VAS) right after the application of blocks. The next day, patients reported duration of pain-free time and the use of analgesic. Results: The US-guided extraoral mandibular nerve block prolonged the pain-free time to 8 h (vs. 4 in control group, P < 0.001) and reduced NSAIDs use (12 patients needed analgesic in experimental vs. 17 patients in control group, P = 0.038). The application of experimental block was less painful (VAS = 2) than the application of intraoral inferior alveolar nerve block (VAS = 4, P = 0.011). In 8/18 patients in the experimental group US-guided extraoral mandibular nerve block solely achieved adequate surgical anesthesia. Conclusion: US-guided extraoral mandibular nerve block prolonged pain-free period and reduced the use of NSAIDs after lower third molar alveolectomy, thus proving to be successful analgesia method for this dental surgery. Clinical trial registration: https://classic.clinicaltrials.gov/ct2/show/NCT06009302, identification number: NCT06009302, date of registration: 18/08/2023. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Conventional injection technique with adrenaline during removal of impacted third molar of mandible had proportionally increased pain during administration with slow onset of action and shorter duration of anesthesia. Purpose: The purpose of this study was to compare the effective nature of 8.4% and 7.5% buffered lidocaine hydrochloride during surgical removal of mandibular impacted third molar. Materials and Method: This prospective crossover study included 50 patients requiring bilateral removal of impacted mandibular third molars. Group I included 50 impacted mandibular third molars that were administered with 8.4% buffered lidocaine hydrochloride and group II included 50 impacted mandibular third molars were administered with 7.5% buffered lidocaine hydrochloride. The outcome variables were pain on injection, time of onset of anesthesia, and duration of action of anesthesia. The above parameters were recorded by the investigator and statistically analyzed through Chi-square test using SPSS software. Results: Patients in group I had mild pain (1.02) and patients in group II (5.74) had moderate pain with a statistical significance of p< 0.05 for group I respectively. The mean onset of action of anesthesia in group I was 0.08 seconds and 0.59 seconds in group II (p< 0.05). The duration of anesthesia was 342.51 minutes from group I and 122.06 minutes in group II (p< 0.05) respectively. Conclusion: Lidocaine hydrochloride buffered with 8.4 % sodium bicarbonate was found to be more effective in reduction of pain during injection, also had a faster onset of action and longer duration of the action of anesthesia when compared to 7.5% buffered lidocaine hydrochloride. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Conventional injection technique with adrenaline during removal of impacted third molar of mandible had proportionally increased pain during administration with slow onset of action and shorter duration of anesthesia. Purpose: The purpose of this study was to compare the effective nature of 8.4% and 7.5% buffered lidocaine hydrochloride during surgical removal of mandibular impacted third molar.Materials and Method: This prospective crossover study included 50 patients requiring bilateral removal of impacted mandibular third molars. Group I included 50 impacted mandibular third molars that were administered with 8.4% buffered lidocaine hydrochloride and group II included 50 impacted mandibular third molars were administered with 7.5% buffered lidocaine hydrochloride. The outcome variables were pain on injection, time of onset of anesthesia, and duration of action of anesthesia. The above parameters were recorded by the investigator and statistically analyzed through Chi-square test using SPSS software.Results: Patients in group I had mild pain (1.02) and patients in group II (5.74) had moderate pain with a statistical significance of p< 0.05 for group I respectively. The mean onset of action of anesthesia in group I was 0.08 seconds and 0.59 seconds in group II (p< 0.05). The duration of anesthesia was 342.51 minutes from group I and 122.06 minutes in group II (p< 0.05) respectively.Conclusion: Lidocaine hydrochloride buffered with 8.4 % sodium bicarbonate was found to be more effective in reduction of pain during injection, also had a faster onset of action and longer duration of the action of anesthesia when compared to 7.5% buffered lidocaine hydrochloride.

Abstract Background The analgesia after lower third molar alveolectomy is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs) that have significant risks, and are contraindicated in the third trimester of pregnancy. Aiming to reduce NSAIDs use after this surgery, we quantified analgesic effects of ultrasound (US)-guided extraoral mandibular nerve block. Methods Thirty-six patients were equally allocated to the experimental or control group, based on their willingness to receive experimental US-guided extraoral mandibular nerve block for postoperative analgesia. The experimental block applied prior to lower third molar alveolectomy, was followed by standard intraoral inferior alveolar nerve block. In the control group, patients received only intraoral block of inferior alveolar nerve. All patients reported pain level (visual analogue scale, VAS) right after the application of blocks. The next day, patients reported duration of pain-free time and the use of analgesic. Results The US-guided extraoral mandibular nerve block prolonged the pain-free time to 8 h (vs. 4 in control group, P

Background/Aim. Swelling, trismus, and pain (STP) are the most common complications that occur after the surgical extraction of impacted lower third molars (LTM). Buccal triangular and envelope flaps are the two most commonly used mucoperiosteal flaps in LTM surgery. The aim of this study was to compare the possible impact of these two types of flaps on the occurrence and intensity of postoperative STP after the surgical extraction of impacted LTMs. Methods. The study included 30 adult patients of both genders, with fully impacted LTMs in vertical position according to Winter classification and class I or II, and position A or B, according to Pell and Gregory classification. All patients were randomly divided into two groups depending on the type of the applied mucoperiosteal flap (triangular or envelope type). The degree of edema, interincisal distance (trismus), and the level of pain were evaluated preoperatively and at each follow-up (on the first, second, and seventh day postoperatively). Results. No statistically significant difference was found among the examined groups in terms of STP reduction in the postoperative period (p > 0.05). Conclusion. The choice of mucoperiosteal flap design, buccal triangular or envelope, during the surgical extraction of impacted LTMs has no impact on the intensity of postoperative STP.

Objectives: To explore the knowledge, attitudes, and practice (KAP) of non-medical students regarding impacted teeth and the factors associated with KAP. Materials and methods: This cross-sectional study enrolled non-medical students at two universities (Northeastern University and Shenyang Conservatory of Music) in northeastern China between December 2022 and February 2023. Scores > 70% were defined as adequate knowledge, positive attitudes, and proactive practice. Results: A total of 519 non-medical students participated in this study. Most participants were male (54.72%), ≤ 20 years of age (72.83%), and freshmen (36.03%). The mean knowledge score was 4.98 ± 3.46 (possible range: 0–10), indicating poor knowledge (49.80%). The multivariable analysis showed that having impacted teeth were independently associated with adequate knowledge (OR = 3.114, 95% CI: 1.589–6.103, P = 0.001). The mean attitude score was 24.65 ± 3.78 (possible range: 7–35), indicating favorable attitudes (70.43%). The knowledge (OR = 1.182, 95% CI: 1.116–1.251, P < 0.001), junior grade (OR = 0.541, 95% CI: 0.327–0.895, P = 0.017), senior grade and above (OR = 0.477, 95% CI: 0.274–0.829, P = 0.009), and a history of impacted tooth extraction (OR = 2.386, 95% CI: 1.048–5.436, P = 0.038) were independently associated with the good attitudes. The mean practice score was 21.45 ± 5.64 (possible range: 6–30), indicating positive practice (71.50%). The knowledge (OR = 1.074, 95% CI: 1.017–1.133, P = 0.010) and female (OR = 1.501, 95% CI: 1.052–2.141, P = 0.025) were independently associated with the proactive practices. Conclusions: Non-medical students had poor knowledge but favorable attitudes and good practice toward impacted teeth. Non-medical students require additional education and awareness about the importance of early detection and management of impacted teeth. Clinical relevance: The study highlights the need for improved education and awareness among non-medical students regarding impacted teeth. [ABSTRACT FROM AUTHOR]

Introduction: Odontogenic lesions related to impacted teeth are common findings in routine dental exams, with the potential to cause tooth pain, displacement, bone expansion, or even bone erosion. Thus, their early detection is important. This study aimed to evaluate the frequency of such lesions based on patient age, gender, and location at the Tehran University of Medical Sciences, School of Dentistry, over five years. Materials and Methods: This retrospective study evaluated records from the oral pathology department, covering a five-year period. The association of odontogenic lesions with impacted teeth was assessed. Data on lesion type, patient age and gender, involved jaw, lesion location, and affected teeth were extracted from patient records. Statistical analysis was performed using SPSS 24. Results: Out of 815 odontogenic lesions, 44.4% were associated with impacted teeth. The patient distribution was 52.48% male and 47.52% female. Lesions were most prevalent in the third decade of life (24.58%), and third molars (59.39%) were frequently involved. The posterior mandible (68.5%) and mandibular third molar (55%) were common sites. Dentigerous cysts had the highest frequency (35.4%), with odontogenic cysts (developmental) occurring more frequently (70.7%) than odontogenic tumors. Conclusion: The study underscores a significant association between odontogenic lesions and impacted or unerupted teeth. Periodic follow-ups are crucial for retaining impacted teeth based on these findings. Keywords: Tooth; Impacted; Odontogenic cysts; Odontogenic tumors; Jaw; Pathology; Oral.

In recent research, there has been a growing awareness of the role of genetic factors in the positioning and eruption of teeth in the maxilla and mandible. This study aimed to evaluate the potential of specific polymorphic markers of single nucleotide polymorphisms (SNPs) located within the PAX9, MSX1, AXIN2, and IRF6 genes to determine the predisposition to tooth impaction. The study participants were divided into two groups: the first group consisted of individuals with at least one impacted secondary tooth. In contrast, the second group (control group) had no impacted teeth in their jaws. To analyze the genes, real-time PCR (polymerase chain reaction) and TaqMan probes were utilized to detect the selected polymorphisms. The findings suggest that disruptions in the structure and function of the mentioned genetic factors such as polymorphic and haplotype variants of PAX9, MSX1, AXIN2, and IRF6 genes, which play a direct role in tooth and periodontal tissue development, might be significant factors in tooth impaction in individuals with genetic variations. Therefore, it is reasonable to hypothesize that tooth impaction may be influenced, at least in part, by the presence of specific genetic markers, including different allelic variants of the PAX9, AXIN2, and IRF6 genes, and especially MSX1. [ABSTRACT FROM AUTHOR]

The adenomatoid odontogenic tumor (AOT) is a rare benign neoplasm that is typically treated through surgical enucleation and curettage. Any impacted tooth associated with the tumor are also extracted during the procedure. We present a case of AOT encompassing an impacted left maxillary central incisor in a 13-yearold male. The patient underwent routine treatment, but the tooth was orthodontically extruded using traction. Within two years, the incisor successfully attained its functional position in the arch, without any signs of recurrence. Preserving an impacted tooth associated with AOT is not common, and only a few cases have been reported in the literature. It is important to manage AOT conservatively and to save the associated tooth for both functional and aesthetic purposes. Long-term follow-up is crucial to monitor any potential recurrence. In summary, our case highlights the successful orthodontic management and preservation of an impacted tooth in a teenager with AOT. [ABSTRACT FROM AUTHOR]

Purpose: Prior to cone-beam computed tomography (CBCT), orthodontic competence included radiological interpretation. Nevertheless, maxillary impacted canines (MICs), because of their position and adjacent complex anatomy, have been challenging to interpret, particularly with regard to root resorption. Although CBCT crosssectional reconstructions of MICs yielded clearer insights into its diagnosis and treatment planning, the value of simultaneously using 2 different cross-sectional or multiplanar reconstructions of the CBCT datasets - orthogonal and curved/panoramic multiplanar reconstructions - has hitherto not been considered. Materials and Methods: Both orthogonal and curved/panoramic multiplanar reconstruction series of 5 screenshots were each reconstructed from the 5 cm×5 cm CBCT datasets of 15 separate MICs. Fifteen credentialled and experienced orthodontist volunteers reviewed 2 separate PowerPoints of 15 randomized series each, 1 week apart. Their review considered 6 factors that could affect treatment: the position and level of the MIC, the presence or absence of root resorption, ankylosis, cysts, and dilaceration. Results: All 15 orthodontists were statistically similar regarding overall years of experience and of CBCT use. Although either reconstruction alone allowed the orthodontists to determine whether ankylosis and, to a lesser extent, most of the other features were present or absent in the MIC, reviewing both reconstructions together was necessary to determine whether root resorption was present or absent in the adjacent tooth. Conclusion: Reviewing both orthogonal and curved/panoramic multiplanar reconstructions was necessary to evaluate the presence or absence of root resorption in the teeth adjacent to MICs and that of many other features. [ABSTRACT FROM AUTHOR]

Purpose: Odontomas represent a common clinical entity among odontogenic tumors, but are not well-addressed in the Vietnamese population. The present study aimed to determine the clinical and preclinical characteristics of odontomas and associated factors in the Vietnamese population. Materials and Methods: This retrospective study retrieved data from histopathological diagnoses from 2 central hospitals of Odonto-Stomatology in Ho Chi Minh City, Vietnam during 2004-2017. The odontomas were classified as complex (CxOD) or compound (CpOD) subtypes. The epidemiological, clinical, and radiological characteristics of the odontomas, stratified by subtype and sex, were obtained and analyzed. Results: Ninety cases, consisting of 46 CxODs and 44 CpODs, were included. The average age of patients was 32.4 (±20.2) years. The patients with CxOD were older than those with CpOD (P<0.05). Clinically, 67% of patients showed an intraoral bone expansion. Approximately 60% of patients with CxOD exhibited a painful symptom, about 3-fold more than those with CpOD (P<0.05), whereas almost all patients with CpOD exhibited perturbations of dentition, unlike those with CxOD (P<0.05). Radiologically, CxOD was characterized by a larger dimension than CpOD in both sexes (P<0.05), and CpOD induced complications in adjacent teeth more often than CxOD (P<0.05). The development of odontoma with advancing age differed significantly in odontoma subtypes related to their pathological origins, and between the sexes, resulting from different physiological states. Conclusion: The findings of this study highlight the value of clinical and radiological features of odontomas and their associated factors for the early diagnosis and adequate treatment of younger patients. [ABSTRACT FROM AUTHOR]

Introduction: Extraction of the impacted mandibular third molar is a common procedure in dentistry. Many complications may arise after this operation, the most common being pain, trismus, and swelling. Systemic medications have been used in an attempt to manage these problems, but because of their side effects, the need for non-medication treatment arises to treat these complications without side effects, such as cryotherapy, ice packs, low-level laser therapy, and ozone. Ozone is one of the most effective antimicrobials used in the dentistry field, and it also has a positive effect on soft tissue healing, activates cellular metabolism, and can react with blood components; for these reasons ozone is used to manage trismus, swelling, and pain after removal of the mandibular third molar. Aim: The purpose of the study was to assess the effects of topical ozone gel on complications from the extraction of the impacted mandibular third molar. Materials and Methods: Thirty patients were enrolled in the current study and were randomly divided into two equal groups. Preoperatively clinical examination included measurement of facial swelling measurements and maximum mouth opening. The position and configuration of the impacted lower third molar, the surrounding bone, the mandibular canal, and the neighboring tooth were all assessed using a panoramic X-ray. On days 2 and 7, after surgery, the facial swelling dimensions and maximum mouth opening were again assessed. Statistics were used to analyze results. Results: Findings indicate statistical significance for pain, but not for swelling or mouth opening. Conclusions: After lower third molar surgery, topical ozone gel helps reduce postoperative pain.

Autotransplantation is a potential treatment alternative when orthodontic traction of an impacted tooth is difficult. In this article, we describe two cases of guided autotransplantation of an impacted canine using a computer-aided designed and manufactured surgical template. The impacted canine was segmented on preoperative cone-beam computed tomography images to ensure a sufficient periodontal ligament space and placement of the donor tooth with the least pressure on it. The canine was virtually transposed using a simulation program considering the adjacent teeth. The surgical template, which was connected to the occlusal stop on adjacent teeth, was designed and 3D-printed with polymer resin. The recipient site was prepared using the surgical template, followed by immediate transplantation of the surgically extracted canine into the socket. The transplanted donor tooth was positioned in planned infra-occlusion to prevent occlusal interference. It was then splinted with the adjacent teeth for initial stabilization. During follow-up, one transplanted tooth showed pulp canal obliteration and the other had suspected pulp necrosis; endodontic treatment was performed. One year after the procedure, the periradicular condition of both teeth was favorable. [ABSTRACT FROM AUTHOR]

Background: Infraocclusion of deciduous molars is a clinical disturbance that occurs during primary and mixed dentition and has some orthodontic implications. Infraoccluded teeth are believed to be potential sites of malocclusion, with a risk of tipping neighbouring teeth and losing space. This systematic review aims to analyse the management of primary molars infraocclusion and to provide updated guidelines. Methods: A literature search was performed using PubMed, Scopus, and Web of Science databases from 1 January 2017 to 28 November 2022. The inclusion criteria were: studies only on human subjects, open access studies, case reports, randomised trials, retrospective, observational studies, and English language. Results: A total of 372 publications were identified from the databases and a final number of nine studies were included in the review for qualitative analysis. Conclusion: Management of patients suffering from infraocclusion depends on the severity, age at diagnosis, and presence of succeeded premolars. Early diagnosis of infraoccluded primary elements is fundamental and cannot be postponed. Preservation of the primary molars may be a valid option with long-term stability if there is no or moderate primary molar infraocclusion, root resorption of less than half of the root, and no decay or restoration. [ABSTRACT FROM AUTHOR]

Background/Aim. A frequently reported phenomenon associated with impacted maxillary canines is root resorption (RR) of the adjacent teeth. The reported incidence of RR also depends on the radiographic imaging method used. The aim of the study was to evaluate the correlation between two radiographic methods: panoramic imaging (orthopantomogram -- OPT) and cone beam computed tomography (CBCT), in diagnosing contact between the impacted canine with the adjacent teeth and the existence of their resorption. Methods. The study included 64 subjects aged 12 to 33 years, with 80 impacted maxillary canines not orthodontically treated previously. Positions of impacted maxillary canines and possible RR of adjacent teeth were firstly estimated on the OPT and then on the CBCT. Results. The estimated prevalence of RR of permanent teeth was significantly different concerning the estimation of OPT and CBCT imaging. RR of the adjacent teeth was found in 25% of the OPT but in 66.25% of the CBCT. The lateral incisor was the tooth most commonly affected by RR. It is especially important to emphasize that premolar resorption was not detected at all using OPT. Conclusion. There was a highly significant difference between OPT and CBCT analysis concerning the relationship between the impacted canine and adjacent teeth and their possible resorptions. CBCT is a more accurate and precise examination method compared to OPT for determining the localization of impacted teeth and the possible presence of RR in the adjacent teeth. [ABSTRACT FROM AUTHOR]

Copyright of RGO: Revista Gaúcha de Odontologia is the property of RGO: Revista Gaucha de Odontologia 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.)

Maxillary permanent canines are the second most frequent cases of impacted teeth; their resolution demands a multidisciplinary evaluation to delineate a viable treatment plan based on the individual esthetic and functional outcomes required. An impacted maxillary permanent canine which was ankylosed in a horizontal position was extracted followed by a regeneration technique, filling the bone defect with biomaterial. An implant was immediately installed in the alveolus of the extracted deciduous canine, and a connective tissue graft was buccally positioned. After the osseointegration period, a modified Palacci and Nowzari surgical technique was performed to gain papilla, and the implant was loaded with an interim restoration with a proper profile to manipulate the soft-tissue contour. Finally, the definitive restauration was cemented achieving the desired outcomes. The achieved clinical outcomes remain stable during a 2-year follow-up. A successful management of this challenge esthetic case lies in the details at surgical and prosthetic phases based in biological response of the peri-implant tissues.

Introduction: Maxillary canine impaction is directly associated with changes in dentoalveolar dimensions and adjacent teeth displacement. This investigation aimed to perform skeletal and dentoalveolar measurements of unilateral palatally impacted canines and compare them with the unaffected contralateral side using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study examined unilaterally impacted canines of the maxilla in 46 CBCT scans. The lateral incisor angulations, nasal cavity width, alveolar bone height, bucco-palatal width, and arch perimeter were measured and compared on both impaction and unaffected sides. All statistical tests were two-sided and analyzed using the paired sample t test and the Kolmogorov-Smirnov test using SPSS 26.0. A P < 0.05 was deemed statistically meaningful. Results: On the impacted side, a significant decrease was observed in the width of the alveolar bone at the height of 2 mm (P = 0.001). Furthermore, at the height of 10 mm, the impacted side was significantly thicker (P = 0.001). There was a statistically significant difference between the maxillary arch width on the nonimpacted and impacted sides (P = 0.001); the distance of mid-palatine raphe to the first premolar and canine proximal bone on the non-impaction side was significantly lower (13.251 ± 1.75 mm) compared to the impacted side (14.334 ± 1.80 mm) (P = 0.01). The external angle of the lateral maxillary incisor on the impacted side (86.803 ± 8.425°) showed a significant decrease (P = 0.001) compared with the contralateral side (91.403 ± 6.791°). Conclusion: The lateral incisors’ lateral angulations, the inter-premolar width, and the alveolar bone thickness can be affected by palatally impacted canine teeth. However, the height of the alveolar bone and the width of the nasal cavity are not affected.

Aim and Objective: The aim of this study is to evaluate the importance of panoramic radiographs in diagnosis and treatment planning for pediatric patients. The objective of this study is to examine and determine the rate of incidentally observed oral pathologies, associated lesions, dental anomalies and dentition status in pediatric patients. Materials and Method: A total of 102 panoramic radiographs obtained from Department of Oral Medicine, Saveetha Dental College. These radiographs were randomly selected from pediatric patients with mixed dentition who came for their regular dental check up. Panoramic radiographs were examined to detect the presence of any lesions, pathologies, anomalies and also their dentition status. Results obtained were tabulated and analyzed. Results: Among the 102 radiographs, the most commonly observed finding was decayed primary tooth (76.5%) with second commonest finding being eruption delay due setback in exfoliation of primary tooth or retained deciduous tooth (20.4%). Hypodontia accounted for about 15 in 102 radiographs (15.3%). Impacted tooth was found in about 6.12% of the OPG's. Pulp therapy was done in 5.1% cases and Crown placement was done without pulp therapy in 8.16% cases. Clinical Significance: A dental professional must be able to differentiate between normal and variation in normal panoramic radiographs which plays a key role in diagnosing and treatment planning of these conditions accordingly. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the effect of extraoral 940 nm low-level diode laser on pain, edema, and trismus following surgical extraction of impacted mandibular third molars. Materials and methods: This split-mouth, randomized, placebo-controlled clinical trial evaluated 25 patients with bilaterally impacted mandibular third molars. One side of the jaw was randomly assigned to the laser and the other side to the control group. The laser quadrant received 940 nm diode laser irradiation (0.5 W, 10 J/cm2, continuous-wave mode, 20 s) at three points in the master muscle in contact mode immediately after surgical extraction of third molar. The third molar in the placebo quadrant was extracted after 2 weeks by the same surgeon using the same standard approach. The pain score was measured at 2 and 7 days postoperatively using a visual analog scale (VAS). To assess trismus, the distance between the incisal edges of the upper and lower central incisors was measured in maximum opening. To assess edema, the distance between the tragus and chin point was measured before and immediately after surgery and after 2 and 7 days. Data were analyzed using t-test, ANOVA, and Bonferroni test. Results: The mean pain score in the first 7 days was significantly lower in the laser group (P < 0.05). Edema and trismus were the same in both groups (P > 0.05). Number of analgesics taken was significantly lower in the laser group (P < 0.05). Conclusion: Single-session irradiation of 940 nm diode laser can effectively decrease pain following third molar extraction surgery. Trial registration number: IRCT20141209020258N91 on 29/12/2018. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Mandibular second premolars are the third most frequent impacted. By evaluating the three-dimensional position of the impacted tooth and timely treatment, possible problems and damage to adjacent structures can be prevented. This study was designed to assess the position of Impacted Mandibular Second Premolar (MnP2) as well as the effect on adjacent structures using CBCT imaging due to the lack of adequate studies in this field. METHODS: This cross-sectional study was performed on 25 impacted mandibular second premolars. Two radiologists assessed and compared CBCT images to determine the following variables: unilateral/bilateral, position of the crown, root resorption of the adjacent permanent teeth, root dilaceration, depth of impaction, type of impaction, pathology incidence, residual primary tooth, position and distance to inferior alveolar nerve canal and the mental foramen. FINDINGS: In most cases, unilateral impaction was seen (19(76%), p=0.063). Crown position of most of MnP2 was displaced lingually (17(68%), p=0.324). Vertical and distoangular position of tooth were more common (12(48%) and 5(20%), p=0.922). Root resorption of the adjacent permanent teeth and dental pathologies did not occur in any of cases. Most of Mnp2 were categorized under the classification as mild (14(56%), p=0.270). CONCLUSION: According to the results of the present study, it is unlikely that the MnP2 of young patients analyzed in this study would adversely affect adjacent structures.

Autotransplantation is a potential treatment alternative when orthodontic traction of an impacted tooth is difficult. In this article, we describe two cases of guided autotransplantation of an impacted canine using a computer-aided designed and manufactured surgical template. The impacted canine was segmented on preoperative cone-beam computed tomography images to ensure a sufficient periodontal ligament space and placement of the donor tooth with the least pressure on it. The canine was virtually transposed using a simulation program considering the adjacent teeth. The surgical template, which was connected to the occlusal stop on adjacent teeth, was designed and 3D-printed with polymer resin. The recipient site was prepared using the surgical template, followed by immediate transplantation of the surgically extracted canine into the socket. The transplanted donor tooth was positioned in planned infra-occlusion to prevent occlusal interference. It was then splinted with the adjacent teeth for initial stabilization. During follow-up, one transplanted tooth showed pulp canal obliteration and the other had suspected pulp necrosis; endodontic treatment was performed. One year after the procedure, the periradicular condition of both teeth was favorable.

Third molar impacted teeth are a common issue with all ages, possibly causing tooth decay, root resorption, and pain. This study was aimed at developing a computer-assisted detection system based on deep convolutional neural networks for the detection of third molar impacted teeth using different architectures and to evaluate the potential usefulness and accuracy of the proposed solutions on panoramic radiographs. A total of 440 panoramic radiographs from 300 patients were randomly divided. As a two-stage technique, Faster RCNN with ResNet50, AlexNet, and VGG16 as a backbone and one-stage technique YOLOv3 were used. The Faster-RCNN, as a detector, yielded a mAP@0.5 rate of 0.91 with ResNet50 backbone while VGG16 and AlexNet showed slightly lower performances: 0.87 and 0.86, respectively. The other detector, YOLO v3, provided the highest detection efficacy with a mAP@0.5 of 0.96. Recall and precision were 0.93 and 0.88, respectively, which supported its high performance. Considering the findings from different architectures, it was seen that the proposed one-stage detector YOLOv3 had excellent performance for impacted mandibular third molar tooth detection on panoramic radiographs. Promising results showed that diagnostic tools based on state-ofthe-art deep learning models were reliable and robust for clinical decision-making. [ABSTRACT FROM AUTHOR]

Maxillary permanent canines are the second most frequent cases of impacted teeth; their resolution demands a multidisciplinary evaluation to delineate a viable treatment plan based on the individual esthetic and functional outcomes required. An impacted maxillary permanent canine which was ankylosed in a horizontal position was extracted followed by a regeneration technique, filling the bone defect with biomaterial. An implant was immediately installed in the alveolus of the extracted deciduous canine, and a connective tissue graft was buccally positioned. After the osseointegration period, a modified Palacci and Nowzari surgical technique was performed to gain papilla, and the implant was loaded with an interim restoration with a proper profile to manipulate the soft-tissue contour. Finally, the definitive restauration was cemented achieving the desired outcomes. The achieved clinical outcomes remain stable during a 2-year follow-up. A successful management of this challenge esthetic case lies in the details at surgical and prosthetic phases based in biological response of the peri-implant tissues. [ABSTRACT FROM AUTHOR]

Introduction: Maxillary canine impaction is directly associated with changes in dentoalveolar dimensions and adjacent teeth displacement. This investigation aimed to perform skeletal and dentoalveolar measurements of unilateral palatally impacted canines and compare them with the unaffected contralateral side using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study examined unilaterally impacted canines of the maxilla in 46 CBCT scans. The lateral incisor angulations, nasal cavity width, alveolar bone height, bucco-palatal width, and arch perimeter were measured and compared on both impaction and unaffected sides. All statistical tests were two-sided and analyzed using the paired sample t test and the Kolmogorov-Smirnov test using SPSS 26.0. A P < 0.05 was deemed statistically meaningful. Results: On the impacted side, a significant decrease was observed in the width of the alveolar bone at the height of 2 mm (P = 0.001). Furthermore, at the height of 10 mm, the impacted side was significantly thicker (P = 0.001). There was a statistically significant difference between the maxillary arch width on the nonimpacted and impacted sides (P = 0.001); the distance of mid-palatine raphe to the first premolar and canine proximal bone on the non-impaction side was significantly lower (13.251 ± 1.75 mm) compared to the impacted side (14.334 ± 1.80 mm) (P = 0.01). The external angle of the lateral maxillary incisor on the impacted side (86.803 ± 8.425°) showed a significant decrease (P = 0.001) compared with the contralateral side (91.403 ± 6.791°). Conclusion: The lateral incisors' lateral angulations, the inter-premolar width, and the alveolar bone thickness can be affected by palatally impacted canine teeth. However, the height of the alveolar bone and the width of the nasal cavity are not affected. [ABSTRACT FROM AUTHOR]

This retrospective observational study aimed to evaluate the diagnostic accuracy of two-dimensional radiographs on canine-induced root resorption (CIRR) in lateral incisors and identify predictors of CIRR in patients with impacted maxillary canines (IMC). Ninety-nine patients aged 9–17 years, with 156 IMCs, were included in the study. All had CBCT-volumes and two-dimensional radiographs consisting of at least one panoramic radiograph. Two radiologists jointly viewed all cases twice. First, radiographic features related to the IMC and possible CIRR were recorded from two-dimensional radiographs. Then, CIRR was determined from CBCT and according to position and extension classified as mild, moderate and severe. CIRRs was detected in 80% of lateral incisors (mild: 45%; moderate: 44%; severe: 11%). The sensitivity was generally low at mild and moderate cut-offs (29 and 29%), and somewhat higher for severe (50%). Corresponding specificities were 48%, 63% and 68%. Canine cusp-tip superimposing the lateral incisor's middle third and root/crown ratio >1 was positively associated with mild CIRR, with an odds ratio (OR) of 3.8 and 6.7, respectively. In addition, the root development stage was positively associated with moderate/severe CIRR when the canine root was nearly or fully developed (OR = 3.1). The diagnostic accuracy of two-dimensional radiographs was inadequate for detecting CIRR amongst patients referred for CBCT examinations. Based on our results, none of the suggested two-dimensional radiographic features could predict moderate/severe CIRR except for root development stage. IMC in a later stage of root development seems to be associated with a higher risk of moderate/severe CIRR. [ABSTRACT FROM AUTHOR]

Copyright of Clinical Orthodontics is the property of Dental Press International 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: The calcifying odontogenic cyst (COC) is a rare cystic lesion, mainly affecting the anterior aspect of the jaws. It is usually discovered in unexpected settings and can be clinically observed as a painless and well-defined lesion. The COC may be associated with other odontogenic tumors, such as odontomas. Nearly 50% of COCs are associated with an unerupted tooth, most often a canine. The most unique features of this pathology are histopathological features, including a cystic lining with characteristic ghost epithelial cells with a tendency for calcification. Radiological examinations often reveal a radiolucent and unilocular lesion, sometimes associated with radiopaque lesions. Pathological assessments are required for the final diagnosis. Management is through complete excision with annual radiographic monitoring for five years. Case Presentation: Here, we report a classic case of COC in the left mandibular region associated with an extremely displaced impacted canine in a 16-year-old girl. Conclusion: Although uncommon, COCs are frequently associated with impacted teeth. The radiolucencies associated with impacted teeth have different effects on the surrounding structures and require different treatment plans, depending on the type of the lesion.

Objective: Treatment of impacted maxillary canines is essential, both aesthetically and functionally. This study aims to define the radiographic features of maxillary impacted canines, evaluate treatment options, and to detect related pathologies.Materials and Methods: In this retrospective study, orthopantomographs, treatment options, and demographic features of the patients were analyzed. Impacted maxillary canines were classified according to the study of Yamamoto et al. According to this classification, maxillary canines are evaluated under seven types according to the occlusal plane and their relative location to adjacent teeth. Moreover, the pathologies around impacted canines were detected via panoramic radiographies.Results: 323 impacted maxillary canines of 270 patients were analyzed. Two hundred fifteen of these teeth (66.6%) belonged to females, while the rest 108 (33.4%) belonged to males. It was observed that impacted maxillary canines were bilateral in 53 patients and unilateral in 217 patients. In the classification based on direction and position of impacted maxillary canines, the highest rates was Type 2 (55.42%) which was followed by Type 4 (26.93%), Type 1 (12.38%), Type 7 (2.79%), Type 3 (1.86%) and Type 5 (0.62%), respectively. Twenty-eight patients with cystic lesion related to impacted maxillary canines were detected. Impacted maxillary canines concomitant with odontoma was detected in 4 patients. In 52 of the patients, it was detected that maxilla was edentulous except for the impacted canines, and the extractions of impacted canine teeth were due to prosthetic reasons. Thirty impacted maxillary canines of 24 patients (n=30, 9.28%) were placed buttons for orthodontic maintenance, while surgical tooth extraction was preferred as a treatment option in other patients.Conclusions: Orthodontic, surgical treatments or combinations may be preferred depending on the impact level of the canine. Early diagnosis and correct orientation of the patient is essential for the success of the treatment.

Introduction: Impacted canine is a frequently encountered clinical problem during orthodontic practice with different prevalence in each region. Treatment usually requires an interdisciplinary approach which is difficult and time consuming. Surgical exposure of the impacted tooth and the complex orthodontic mechanisms are used to align the tooth into the arch. This study was designed to find out the prevalence of impacted canine in orthodontic patients. Methods: A descriptive cross-sectional study was done with hospital records of patients from 15 to 38 years of age visited department of Orthodontics at a tertiary care hospital from August 2020 to March 2021 after obtaining ethical clearance from the institutional review committee. Convenience sampling method was used. Patients Orthopantomogram and clinical notes were thoroughly evaluated. To locate position of impacted canine cone-beam computed tomography images were used. The data was collected and entered in Microsoft Excel. Point estimate at 99% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 1008 patients, 44 (4.37%) (2.71-6.03 at 99% Confidence Interval) patients had impacted canines. Among them, maxillary canine impaction was seen in 38 (3.77%) and mandibular canine impaction in 6 (0.60%). Conclusions: The overall prevalence of impacted canines was found lower than previous studies done in similar settings. Large number of patients had buccal impaction compared to palatal impaction.

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association 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.)

Objective: This study sought to assess the frequency and severity of second molar external root resorption (ERR) due to the adjacent third molar and its correlation with the position of third molar and other related factors using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study evaluated 320 second molars and their adjacent impacted third molars on CBCT scans of patients over 16 years, retrieved from the archives of Azad University Radiology Department. Presence/absence of second molar ERR, its location and severity (if present), and position of adjacent third molar were determined on CBCT scans, and recorded in a checklist. Data were analyzed using a logistic regression model. Results: The frequency of second molar ERR was 33.4% in the mandible and 14% in the maxilla. The severity of ERR was significantly correlated with the involved jaw (P=0.001) but had no correlation with age, gender, or depth of impaction of adjacent third molar (P>0.05). The mesioangular and horizontal positions of impacted third molars had a significant correlation with the frequency of second molar ERR (P

Impaction of the anterior teeth, which is less frequent in central incisors, can cause serious esthetic and subsequent psychological problems for patients during the mixed dentition period. Traumatic injury to deciduous teeth is the most common etiologic factor. Thus, treatment of maxillary incisor impaction is highly important. Nowadays, application of laser has been suggested in orthodontics and pediatric dentistry for different treatments, such as surgical exposure of impacted teeth and application of low-level laser therapy (LLLT) for acceleration of orthodontic tooth movement. In this paper, the authors present treatment of an impacted and dilacerated maxillary central incisor with laser application for its surgical exposure and LLLT for acceleration of its orthodontic traction and eruption.

With the exception of the third molar, maxillary canine impaction is considered to be the most common form of tooth impaction. The position of the permanent maxillary canine at the angle of the mouth is strategically important in preserving the harmony and symmetry of the dental arches. The incidence of maxillary canine impaction in the maxilla is more than twice higher compared to the mandible. Approximately one-thirds of the cases are labially located, and two-thirds are palatally located. Bilateral impaction has been reported in 8% of the patients with canine impaction. The treatment procedure is time-consuming and imposes a significant financial burden on the patient. Impacted maxillary canines could be erupted and guided to an appropriate location in the dental arch with early detection, timely interception, and proper surgical management in order to perform orthodontic treatment. Various surgical and orthodontic techniques could be used to guide impacted canines into the arch. Accurate selection of surgical and orthodontic techniques is essential to the successful alignment of impacted teeth. Management of impacted tooth often requires an interdisciplinary approach. In addition, proper cooperation of the orthodontist, oral surgeon, and periodontist seems crucial in this process. The present study aimed to review the clinical and practical aspects required for the management of maxillary canine impaction based on the location and age of the impaction.

Abstract Background Even though periodontal health was suggested to be not related to the traction technique, some other variables might influence the esthetic outcome of palatally displaced canines (PDC) when aligned, such as the initial position and impaction rate of the canine before treatment. The purpose of the present study was therefore to evaluate the existing correlations between periodontal health outcome of PDC after their exposure and alignment and their initial position identified according to the different rates of impaction severity. Materials and methods The final sample enrolled 293 PDC which satisfied inclusion and exclusion criteria. All the canines were exposed using CT by the same oral surgeon and orthodontic traction was applied using the easy cuspid device followed by fixed appliance treatment. Image analysis and periodontal status evaluation were performed for all PDCs. Results α-Angle and d-distance showed no significant differences in the periodontal outcome of PDCs after treatment. The only tested variable showing significant differences was S, since canines with CEJ visible at the end of the treatment presented sectors with a mean score of 1.67, which was significantly different (P

Background: Association of cuspid impaction with adjacent lateral incisor anomalies is under controversy. The aim of this study was to investigate the correlation between maxillary cuspid impaction with dental anomalies. Material and Methods: In this in vitro experimental study, the material consisted of pretreatment dental records of 102 patients with at least one palatally or buccally displaced impacted permanent cuspid (palatal and buccal impaction groups). They were matched with a comparison control group of 102 patients having normally erupted maxillary cuspids. Available space, mesiodistal dimensions of teeth, and morphologic parameters of lateral incisors were measured using the digital caliper. Comparison of mean values of lateral incisors anomalies and severity of crowding between different groups were performed using the one-way ANOVA test, and the analysis of associations between position of the impaction and anomaly of the lateral incisors and severity of crowding was performed using the Chi-square test. P < 0.05 was considered statistically significant. Results: There was no statistically significant difference in the arch length--tooth size discrepancy between the cuspid impaction groups and control group. The impaction group (buccal or palatal) presented statistically significant differences in terms of anomalies of maxillary lateral incisor compared to the control group. Peg-shaped lateral incisor was related to buccal cuspid impaction and microdontia had relationship with palatal cuspid impaction. Conclusion: There is the relationship between cuspid impaction and adjacent lateral incisor abnormality, but no difference was observed between buccal and palatal cuspid impactions. Crowding revealed no relationship with cuspid impaction (buccal or palatal) in this study. [ABSTRACT FROM AUTHOR]

Exodontics is one of the techniques most used by dentists in dental clinics. In any surgery, it is essential that the operator request the complementary radiographic examination. For the same, it indicates structures not visible present in the operative field. In cases of third molar extractions, it is essential to check the orthopantomography. Since, if there is proximity to the roots, with the inferior alveolar nerve, it can originate a state of temporary or permanent paresthesia in the patient. Therefore, this study aims to demonstrate several techniques to prevent future nerve injuries, such as coronectomy, piezosurgery and split mandibular sagittal osteotomy. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas 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.)

Third molar impacted teeth are a common issue with all ages, possibly causing tooth decay, root resorption, and pain. This study was aimed at developing a computer-assisted detection system based on deep convolutional neural networks for the detection of third molar impacted teeth using different architectures and to evaluate the potential usefulness and accuracy of the proposed solutions on panoramic radiographs. A total of 440 panoramic radiographs from 300 patients were randomly divided. As a two-stage technique, Faster RCNN with ResNet50, AlexNet, and VGG16 as a backbone and one-stage technique YOLOv3 were used. The Faster-RCNN, as a detector, yielded a mAP@0.5 rate of 0.91 with ResNet50 backbone while VGG16 and AlexNet showed slightly lower performances: 0.87 and 0.86, respectively. The other detector, YOLO v3, provided the highest detection efficacy with a mAP@0.5 of 0.96. Recall and precision were 0.93 and 0.88, respectively, which supported its high performance. Considering the findings from different architectures, it was seen that the proposed one-stage detector YOLOv3 had excellent performance for impacted mandibular third molar tooth detection on panoramic radiographs. Promising results showed that diagnostic tools based on state-ofthe-art deep learning models were reliable and robust for clinical decision-making.

BACKGROUND AND OBJECTIVE: Mandibular second premolars are the third most frequent impacted. By evaluating the three-dimensional position of the impacted tooth and timely treatment, possible problems and damage to adjacent structures can be prevented. This study was designed to assess the position of Impacted Mandibular Second Premolar (MnP2) as well as the effect on adjacent structures using CBCT imaging due to the lack of adequate studies in this field. METHODS: This cross-sectional study was performed on 25 impacted mandibular second premolars. Two radiologists assessed and compared CBCT images to determine the following variables: unilateral/bilateral, position of the crown, root resorption of the adjacent permanent teeth, root dilaceration, depth of impaction, type of impaction, pathology incidence, residual primary tooth, position and distance to inferior alveolar nerve canal and the mental foramen. FINDINGS: In most cases, unilateral impaction was seen (19(76%), p=0.063). Crown position of most of MnP2 was displaced lingually (17(68%), p=0.324). Vertical and distoangular position of tooth were more common (12(48%) and 5(20%), p=0.922). Root resorption of the adjacent permanent teeth and dental pathologies did not occur in any of cases. Most of Mnp2 were categorized under the classification as mild (14(56%), p=0.270). CONCLUSION: According to the results of the present study, it is unlikely that the MnP2 of young patients analyzed in this study would adversely affect adjacent structures. [ABSTRACT FROM AUTHOR]

Objective: To assess the relationship of and ß angles of maxillary impacted canines with maxillary lateral incisor root resorption. Material and Methods: For this, 40 patients (between 11 and 45 years) with impacted maxillary canines presenting to a private orthodontic clinic were evaluated.20% of the cases were male and 80% were female. The and ß angles were measured on panoramic radiographs to determine the angulation of impacted canine. CBCT scans had been taken by ProMax 3D CBCT system were used to examine lateral root reorption. The relationship between the size of and ß angles of impacted maxillary canines and root resorption in the adjacent maxillary lateral incisor was analyzed using SPSS version 22. Results: The mean size of and ß angles had no significant correlation with the presence/absence, location, or severity of root resorption in the adjacent lateral incisor or the buccolingual position of impacted canine. The and ß angles in impacted maxillary canines cannot be used to determine the incidence or severity of root resorption in the adjacent lateral incisor. Conclusion: No significant association between and ß angles and incidence or severity of root resorption in the adjacent lateral incisor was found. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with =25 years was approximately 2 times greater than age with =25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals. [ABSTRACT FROM AUTHOR]

Introduction: The primary aim of our study was to identify the problems caused by impacted teeth and to discuss treatment alternatives in older adults. The secondary aim of the study was to investigate the presence, frequency, and position of impacted teeth in older adults and to investigate the reasons for impaction. Materials and Methods: The study included 79,733 patients who were admitted to the Aydın Adnan Menderes University, Faculty of Dentistry since December 2013. From these patients, 8,670 panoramic radiographs of patients aged 60 years and older were evaluated retrospectively. Results: The most common impacted teeth were the third molar (453, 77.3%), canine (109, 18.6%), and premolar (13, 2.2%). There was a statistically significant difference between the presence of an impacted tooth and the outcome of treatment (p<0.001). Of the (216, 51.8%) patients for whom surgical tooth extraction was prescribed, (159, 38.1%) underwent extraction, while (57, 13.7%) patients refused treatment. Conclusions: Routine follow-up should be recommended for asymptomatic teeth that do not cause significant problems in the adjacent teeth and surrounding tissues instead of prophylactic extraction in all age groups, especially in older adults. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the impacted teeth due to DC (dentigerous cyst) after marsupialization and to identify which factors are related with the spontoneus eruption of those teeth among children. Materials and Methods: The records of 63 children who received marsupialization due to an impacted tooth associated with DC, were evaluated in the terms of factors that may affect the spontaneous eruption. Patients were divided into two groups depending on the situation of eruption of the tooth. The data from these patients were collected. The eruption of the tooth, along with related factors such as age, gender, tooth depth, angulation, root formation, interval to eruption, cyst size and use of obturator/space maintainer, were analyzed. Results: The mean value of tooth depth was 11.1±3.2 mm in the non erupted group and 8.1±3.9 mm in erupted group; additionally the mean values of angulation in nonerupted group was 41.5±22.6 and 27.9±21.3 degrees in erupted group. These two factors were associated with non-eruption of impacted tooth in logistic regression analysis. Conclusion: The depth and angle of the tooth can be considered as important factors in predicting whether the impacted tooth will erupt after marsupialization. In addition, if DC is detected in the presence of permanent teeth with delayed eruption, it may be advisable to start the treatment before the physiological eruption time of the impacted tooth, not to make a an obturator or a space maintainer if there is not a long time between the normal eruption time and the age to start treatment. [ABSTRACT FROM AUTHOR]