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The usual surgical approaches for zygomaticomaxillary complex fracture are subciliary incision, transconjunctival incision, eyebrow incision, lateral canthal incision, coronal incision, preauricular incision, and superior gingivobuccal incision. In the intraoral approach, a horizontal mucoperiosteal incision is performed at the superior gingivobuccal region, and sometimes, includes the upper labial frenum. This may cause discomfort in the oral cavity because of postoperative scarring and shortening of the upper labial frenum. To avoid these complications, the authors performed a novel approach using gingival sulcus incision instead of oral mucosal incision to treat 5 zygomatic fractures. The authors evaluated the regression of the gingival interdental papillae, gingival swelling, and gingival perception at 2 weeks, 1 month, 3 months, and 6 months after the operation. The regression of the gingival papillae and gingival swelling disappeared 3 months and 1 month after the operation, respectively. No paresthesia was observed in any of the cases. The gingival sulcus approach can lead to scarless results and contribute considerably to the aesthetic appearance of the oral cavity.

Objectives: The aim of this retrospective study was to determine the frequency and localization of the overhanging restorations by observing patients’ routinely taken panoramic radiographs. Materials and Methods: The panoramic radiographs of 4,960 patients who applied to a dental clinic in University between 2015 and 2016 and had one or more previous restorations were retrospectively examined. The study group included 243 patients (133 females and 110 males) with a mean age of 39.7 ± 12.5 years. Superposed interdental areas were not evaluated. Frequency distributions and percentages were calculated for the categorical data as to the surface of the maxillary-mandibular premolar and molar teeth, also the presence or absence of root canal treatment. Chi-square tests were used to compare data relating to the localization and frequency of overhanging restorations. Results: In the radiological evaluation of 243 patients, a total of 280 overhanging restorations were detected. Root canal treatment was present in 45.4% of the teeth with an overhanging restoration. The frequency of overhanging restorations in the maxilla was significantly higher (60.4%) than that of the mandible (39.6%), (p

Introduction Dental trauma and congenital anodontia are common causes of anodontia in the anterior maxilla. The proposed restorative treatment constitutes a challenge for many dentists, particularly if it is a question of a young patient who has not yet completed skeletal and dental development. Current treatments for anterior maxillary anodontia include: fixed or removable partial dentures; orthodontic closure of interdental spaces; and dental implants. Dental implants do not move with the dento-alveolar complex during the growth period of the maxilla. Therefore, many researchers maintain that implants should be postponed until after adolescence, in order to prevent complications, such as infra-occlusion, that would require the replacement of the abutment and crown-implant restoration, or even invasive treatments, such as the removal of the implant in the future. The objective of this literature review is to investigate the aetiology of the phenomenon, and outcome. Results Continuous tooth eruption is not affected by age, so considerable changes may occur due to eruption of adjacent teeth. In addition, both women and men are affected by this phenomenon and, usually, there is no significant difference in the amount of growth between the short face and the long face. Conclusion It can be concluded that continuous facial skeletal growth and teeth eruption are evident in the second and third decades. Where possible, it is advisable to delay placement of an anterior maxillary implant in the adolescent patient.

The aim of this randomized controlled trial was to evaluate the interproximal cleaning efficacy of waist-shaped compared with straight soft interdental brushes in patients undergoing nonsurgical periodontal therapy. Ten patients diagnosed with periodontitis stage II or III were scheduled for nonsurgical periodontal therapy. Baseline plaque control record (PCR), modified approximal plaque index (API), papillary bleeding index (PBI), probing pocket depth (PPD), and bleeding on probing (BOP) were evaluated. Four interdental spaces of equal sizes were determined, and baseline plaque indices (PI) were assessed on eight surfaces of the respective adjacent teeth, resulting in 640 measuring positions. Interdental brushes with a straight or waist-shaped design were randomly allocated to the right or left side, and patients received oral hygiene instructions. Follow-up measurements including PCR, API, PBI, and site-specific PI were performed during initial nonsurgical periodontal therapy sessions and reevaluation which was undertaken 8 weeks afterwards. PCR, API, and PBI decreased significantly compared with baseline at each time point (p

The aim of this split-mouth, prospective controlled study was to compare the effects of two different interdental devices on clinical plaque elimination, gingival bleeding and patient acceptance and comfort. Thirty participants who had been diagnosed with gingivitis were included in the study. After professional oral prophylaxis and a 3-day washout period, patients were advised to use two test devices (TePe Interdental Brushes Original and TePe EasyPick™, Malmo, Sweden) according to instructions. The plaque index (Turesky modification of the Quigley and Hein Index) and bleeding index (Papillary Bleeding Index) were recorded at baseline and after 2 weeks. Patient satisfaction and comfort were assessed with a questionnaire. Both of the tested devices improved the plaque and bleeding index scores. There were no differences between the two sides in terms of time-dependent changes. The patients felt more satisfied with the cleansing capacity and more comfortable with the use of SCIP compared with IDB (p = 0.001). Pain sensation with the use of SCIP was significantly lower than with IDB (p = 0.002). The clinical efficiency of the tested interdental devices was similar in terms of removing plaque and decreasing bleeding. However, SCIP were found to be more comfortable and preferable to IDB. The silicone coated interdental picks showed similar effects on plaque removal as interdental brushes and superiority in terms of ease to use than interdental brushes.

Background Dental implant is widely used as a treatment for missing teeth. However, proximal contact loss (PCL) between implant-supported fixed dental prostheses (FDP) and adjacent teeth has been reported as one of the common and adverse complications. Purpose We aimed to evaluate the prevalence of PCL up to 18 years after implant prosthesis delivery and to analyze associated factors. Materials and methods A total of 317 patients who had received implant FDP at the posterior regions were included in this study. Nineteen factors were assessed, including degrees of proximal contact tightness, oral hygiene, periodontal conditions, and food impaction. Chi-square test, univariate generalized estimating equation (GEE), and multivariate GEE were utilized to identify factors influencing PCL. Results Proximal contacts at both the mesial and distal (if present) sides were evaluated. The mesial contact loss rate (27%) was significantly higher than that of the distal contact loss (5%). Increased PCL rates over functional time were observed at both the mesial and distal sides. Six factors, including patient age, implant functional years, frequent use of interdental brushes, splinting or single implant, plunger cusp, and food impaction, were revealed to be associated with the mesial PCL using the chi-square test and univariate GEE analysis. However, only functional years (>5 years), frequent use of interdental brushes and food impaction showed significance in the multivariate GEE. Conclusions Mesial PCL was frequent and increased over functional years. An occlusal retainer and routine follow-up may help prevent PCL. Although oral hygiene conditions contribute little to PCL, food impaction and frequent use of interdental brushes were influential factors.

Relevance. Effective preventive programs cannot be developed without studying the issue using population epidemiological survey.Purpose. Improving efficiency of dental diseases preventionbasing on the information obtained during an epidemiological survey of Izhevsk citizens.Materials and methods. 107 residents were examined according to WHO criteria in representative age categories: n = 57 (63.3%) in the category from 35 to 44 years old; n = 50 (46.7%) - from 65 to 88 years; n = 83 (77.6%) women (54.9 ± 1.9 years); n = 24 (22.4%) men (53.7 ± 3.7 years). The study was random and voluntary, the conclusions are based on the results of statistical analysis.Results. The respondents’ menu included products with a cariogenic effect: fruits (4.27 ± 0.09 on a 6-point scale), cookies (3.66 ± 0.11), jam or honey (3.56 ± 0.13), pies (3.48 ± 0.12), coffee (3.33 ± 0.13), tea (3.25 ± 0.13), chewing gums (3.21 ± 0.13 points), sweets (3.05 ± 0.12), beverages (3.02 ± 0.14). Respondents brushed their teeth 2 times (67.3%) or 1 time daily (30.8%), some of them used flosses (14.0%). Prevalence (p < 0.001) of positiveteeth(61.7%) and gums (72.8%) conditionappraisalmust be conceived as subjective perception. Considering “satisfactory” and “unsatisfactory” as similar critical manifestation negative assessment of the respondents reliably prevails (p Conclusion. Cariogenic diet, lack of interdental hygiene and a check-upculture define Izhevsk citizensas potentialdentist patients. Forming preventive programs we have to explain the importance of interdental hygiene; dental care should be refocused from the category of forced demand to the category of preventive conscious demand in the mind of citizens. Due to the high educational levelwe can hope for the effectiveness of prevention programs among Izhevsk citizens.

Introduction Necrotizing periodontitis (NP) is an atypical and painful form of periodontal disease, it is described by a promptly progress of ulceration and destruction of periodontal tissues; the NP is commonly linked to HIV-positive patients. The aim of this report is to present a rare case of severe necrotizing ulcerative periodontitis treated non-surgically. Case presentation A 28-year-old dark skin female patient was referred to a dentistry college with the main complaint of spontaneous gingival bleeding and enlargement, oral pain during deglutition and dental hypersensitivity. Clinical and radiographic examination revealed generalized severe periodontal destruction, extensive bleeding, increased biofilm presence and spontaneous suppuration. Medical exams were requested, red and white blood cells were evaluated and among those exams an enzyme-linked immunosorbent assay for HIV-1 antibodies, the result reveled reagent to HIV-1. The diagnosis of NP was assigned based on periodontal parameters such as necrosis and ulceration of the coronal portion of interdental papillae and gingival margin. Treatment established was scaling and root planning plus antibiotics. At 3 months of treatment the clinical and periodontal condition were stable. Conclusion This case report highlights a severe and generalized form of NP, where periodontal non-surgical associated with antimicrobials resulted in elimination of the gingival enlargement, necrosis and ulceration of the coronal portion of interdental papillae and significant improvement of periodontal parameters.

Elderly patients often find it challenging to remove plaque accumulated on the attachments of implant overdentures (IODs) using conventional cleaning instruments. Further, excessive plaque accumulation can lead to peri-implant diseases and occasionally to respiratory diseases. Therefore, here, we aimed to compare the effectiveness of waist-shaped interdental brushes (WIBs) with that of straight-shaped interdental brushes (SIBs) in plaque removal from the locator attachments of IODs. Twenty participants with 2 locator attachments retaining mandibular IODs participated in this study. After the baseline cleaning, the participants refrained from oral hygiene maintenance for 3 days. A dentist cleaned 1 of the attachments using the WIB and the other attachment using the SIB. The pre- and post-cleaning modified plaque index (mPLI) scores were recorded. After another 3 days free from oral hygiene maintenance, the trained participants repeated the same cleaning procedure using the WIB and SIB. Pre- and post-cleaning mPLI scores were recorded. Regardless of the type of brush used, the post-cleaning mPLI scores were lower than the pre-cleaning scores. After the cleaning procedure, the overall mean mPLI score was lower in the WIB group than in the SIB group. The post-cleaning mPLI scores at the line angles and on the axial surfaces of the attachments were also lower in the WIB group than in the SIB group. There was no difference in the cleaning effectiveness between the dentist and participants when they used the same type of interdental brush. The WIB was significantly more efficient in plaque removal than the SIB, especially at the line-angle sites.

Dynamic occlusion is the main indicator of the harmonious functioning of the dental apparatus. At the same time, irrational reconstructive treatment can lead to its disorders and, as a result, increased tooth wear, periodontal diseases, dysfunction of masticatory muscles and temporomandibular joints. To date, the computer diagnostic methods allow studying occlusion in dynamics. The aim of the research was to study the prevalence and character of occlusal disorders in young people with intact dentitions, and those whose defects in teeth and dentitions were restored by direct and indirect restorations. 300 persons aged 25-44 years were examined, equally men and women: the first group – 100 persons with intact dentitions; the second one - 100 persons with direct composite restorations located on the occlusal surfaces of the molars; the third one - 100 persons, who had indirect restorations of the crowns of teeth and dentitions of small sizes. Intercuspidation were analyzed using methods of occlusiography, the study of diagnostic models in the articulator, and computer analysis of occlusion. According to the peculiarities of centric and eccentric occlusions, the sequence of formation of the maximum occlusal load vector, the balance of occlusion and the time of closing and opening of dentitions, occlusal disorders were diagnosed in 14.0% of the first group, 35.0% of the second one and 44.0% of the third one. In 100% of patients these disorders were compensated, asymptomatic. The presence of supracontacts in centric occlusion leads to a displacement of the mandible in a forced position in 17.7% of cases. In 83.0% of the examined persons, the occlusion balance was at the level of 50% - 50% and in 13.7% – 60% - 40%. The remaining 3.3% of patients had an occlusive imbalance in the range of 70% - 30%. In this case, significant deviations of the total trajectory vector of the occlusal load were not revealed. The most common occlusion disorders were centric contacts, which are formed as consecutive single, multiple, unilateral and bilateral overload areas, constantly being changed on sliding in dynamic occlusion. Occlusive disorders are characterized by an increase in the time of closure and opening of the dentitions, and the time to reach the maximum number of interdental contacts. The efficiency of occlusiography was only 29.7%, the efficiency of the study of diagnostic models in the articulator was 59.7%, compared to the computer method with 100% of the information value. The widespread use of direct and indirect restorations of teeth and dentitions leads to an increased prevalence of occlusal disorders in young people. Usually, small restorations are integrated into the dentition by grinding their occlusal surface, focusing on patient's comfort on closing the teeth and unhindered movements of the mandible to the sides and forwards. This simplified approach is conformative and incapable of providing optimal functional occlusion. The presence of occlusal imbalance requires appropriate measures for its diagnosis and correction.

Bacterial plaque is the dominant etiological factor in periodontitis, furthermore it has been convincingly demonstrated that gingivitis is most frequent and most severe in interproximal area. Tooth brushing is indispensable for maintaining oral hygiene. However tooth brushing alone is not sufficient in interproximal area. Interdental aids provide auxiliary assistance. Lack of use of these may leads to interproximal caries and periodontitis.

Introduction Loss of the interdental papilla, leading to the formation of black triangular spaces just below the contact area of adjacent teeth, is one of the most challenging periodontal conditions to treat and often requires an interdisciplinary approach by the periodontist, restorative dentist, and orthodontist. Although these "black triangles" may appear quite small from a clinician's standpoint, they can have a significant impact on oral health satisfaction for patients. This case series illustrates a novel minimally invasive approach to restore interdental papilla deficiencies. Case presentation Four interdental papilla defects were treated in three females. No patients were lost to follow-up over 6 months. The surgery consisted of a horizontal incision placed apical to the area of papillary loss in the alveolar mucosa just beyond the mucogingival junction. An interdental subperiosteal tissue space was then created by tunneling toward and under the dental papilla. Once adequate release was achieved, dermal filler was administered into and underneath the deficient papilla. The papillary margins were then sealed with cyanoacrylate and additional dermal filler was injected as needed to achieve ideal papillary fill. Six months after treatment there was an improvement in patient-satisfaction regarding papilla fill demonstrated by a mean increase in visual analogue scale (VAS) measurements of 62.46%. Mean papilla fill was 1.75 mm. Conclusion This surgical technique demonstrates the restoration of deficient interdental papillae between teeth and implants, and perhaps as importantly, a considerable improvement in patient-based outcomes quantified through VASs.

OBJECTIVE The aim of this study is to compare information provided by the 2 orientations of bitewing radiographs, horizontal (HBW) and vertical (VBW) taken in a dental school. METHODS AND MATERIALS Radiographic records were reviewed at Tufts University School of Dental Medicine (TUSDM) for patients showing posterior bone loss who had both HBW and VBW. 320 records were reviewed with 6 criteria: visibility of crestal bone from the distal of the cuspids to the distal of the most posterior tooth, visibility of horizontal or angular bone loss, the crestal density of bone, visibility of interproximal contact areas, visibility of the entire anatomical crown, and visibility of furcations. RESULTS Significantly higher number of VBW compared with HBW (P

This study aimed at determining whether oral health behavior differs between patients regularly checked by male and female dentists. The analysis was based on a cross-sectional survey of 354 Japanese community residents (median age = 54 years; 145 men and 209 women) conducted in a municipality from January to February 2017. Data on demographic characteristics and factors associated with oral health behavior were obtained through self-administered questionnaires. The association between regular dentist gender and patients' regular dental care check-up and interdental cleaning performance was examined after adjusting for potential confounders. Among respondents, 88.7% and 11.3% reported having male and female regular dentists, respectively. In a multivariate logistic regression model, patients regularly checked by female dentists had an increased likelihood of visiting their dentist for dental care check-up at least once every year (odds ratio [OR] = 2.23, 95% confidence interval [CI] = 1.09-4.55)and using an interdental cleaner (OR = 2.62, 95% CI = 1.03-6.71) compared to those regularly checked by male dentists. Patients regularly checked by female dentists tended to have more preventive oral health behaviors than those regularly checked by male dentists. These findings suggest that dentist gender has important clinical implications for patients' oral health behavior.

The purpose of this study was to investigate the relationship among the waist-to-height ratio (WHtR) and the body mass index (BMI) as obesity indicators and gingival inflammation as determined by bleeding on probing (BOP). The participants comprised employees of a milk products company based in Tokyo, Japan. A total of 159 non-diabetic men aged 40 to 59 yr and with a minimum of 28 teeth were included. Multiple logistic regression analysis controlling for age, smoking status, pocket depth, frequency of daily brushing, frequency of weekly interdental brushing, and regular dental attendance was performed to compare the relationships among the obesity indicators and BOP. Participants with good oral hygiene had significantly less BOP than those with poor oral hygiene (p

The use of immediate implantation (directly into the extracted tooth socket) in the aesthetic zone is a rather difficult task due to the specific structural features of the bone tissue of the alveolar processes and parts of the jaw. The aim of the study was to develop and evaluate the efficacy of the new method of immediate implantation during restoration of teeth in the anterior part of the jaw with bone deficiency, which allows obtaining a high aesthetic result. Materials and methods The clinical study involved patients with partially edentulous anterior maxillae, chronic apical periodontitis and dental root fractures in the absence of possibility to restore these teeth with orthopedic structures. To identify the main criteria determining smile aesthetics, the detailed analysis of changes in the bone and soft tissues of the alveolar processes was made based on tooth extraction causes and dates. These criteria included gum biotype, the height of the distal and mesial interdental papillae; the width of the keratinized attached gingival area, gingival zeniths, the alveolar ridge thickness. The condition of the facial alveolar bone wall in the planned intervention area was assessed and its thickness was measured using cone-beam CT scan of the jaw. These parameters were measured during traditional immediate implantation, immediate implantation with a free connective tissue graft, implantation performed using the method developed by the authors and during delayed implantation in the anterior part. In each patient, the obtained data were compared with the results in the respective teeth area on the opposite side before the surgery, 4, 6 months and 1 year after the surgery. Results Clinical and X-ray studies of the developed method of immediate implantation in the aesthetic zone of the jaw with bone deficiency in the facial alveolar bone wall have convincingly demonstrated its efficacy in the long term (1 year after the surgery). The proposed protocol has made it possible to reduce the length of rehabilitation time, and most importantly, to stabilize and preserve the alveolar ridge architecture. Conclusion The proposed method showed the promising outlook for dental implant-supported restoration in difficult anatomical conditions.

The atrophy of the periodontal ligament places the tooth very close to the bone or another tooth, as occurs in unerupted teeth. The absent interdental bone and the lack of functional periodontal stimulus may lead to the fusion of the appositional layers of cement between the roots of the teeth. Concrescence almost always occurs in the region of the maxillary molars. Asymptomatic, it should always be remembered when the proper response to orthodontic movement is not obtained, and there is no apparent explanation. When surgically extracting a tooth and there is resistance, insisting will not be the best strategy. Moving the teeth with concrescence is not convenient, as it requires very intense forces. Once separated, these teeth can be considered normal for movement. It is possible to separate two teeth presenting concrescence, but it depends on the extension of the area, the surgical access and, especially, the clinical convenience. The tooth to be extracted will be repaired with new cement deposited in the sectioned area. The simple separation with the maintenance of the proximity and the lack of function of one of the teeth will cause a new concrescence. After a period of 1 to 3 months, the separated teeth are biologically prepared to be moved. The most important detail in this separation of teeth presenting concrescence is that the diagnosis should be made in advance, and not at the time of the intervention.

Aim The aim of the study was to quantify the specific spatial displacement of gingival zenith (GZ) and determine a representative value for the interdental papilla height as a percentage ratio of clinical crown length (CL), as measured from GZ in the maxillary anterior dentition. Materials and methods A total of 100 subjects and 1,200 interdental papillae were included. Eighty percent of the population presented with the gingival margin of lateral incisor (LI) teeth positioned coronally to the GZ of the ipsilateral canine (C) and central incisor (CI). Results No significant difference was found between mesial and distal papilla proportion (DPP) of maxillary incisor groups. In the C group, numerical values showed higher DPP. Conclusion The data achieved provide the ideal numerical values for prosthetic, restorative, periodontal, implant, postorthodontic, and esthetic treatment outcomes. Clinical significance The study describes the importance of quantifying the ideal numerical values for prosthetic, restorative, periodontal, implant, postorthodontic, and esthetic treatment outcomes. The readers should understand to quantify the specific spatial displacement of GZ and determine a representative value for the interdental papilla height as a percentage ratio of clinical CL, as measured from GZ in the maxillary anterior dentition.

Several verbal morphologies including the core orthography {ld} are attested in ninth- and eighth-century bce Aramaic texts from Sefire and Tell Fekheriyeh. From their similar contexts, all can be demon-strated to have the semantics ‘to remove’, but scholars are divided as to the root source and precise phonology of these verbs. The present paper demonstrates that these {ld} verbs belong to a cognate set descendant from proto-Semitic . The representation of the reflex of the interdental by {d} is a precocious development only attested broadly in later Aramaic, but its surfacing here can be ration-alized by appeal to diachronic phonology, phonotactics and linguistic typology. The consistent employment of developed orthography for this root is perhaps related to the existence of a broad and consistent early Aramaic curse tradition.

The present paper aims at revisiting the question of interdental fricatives in the so-called pre-Hilali Arabic dialects, that is the descendants of the first stage of Arabicization in North Africa. It attempts to challenge, from a diachronic and comparative approach, the view that the absence of interdental fricatives—and their merger with dental stops—is a hallmark of pre-Hilali Arabic. On the basis of neglected data, we will provide evidence suggesting that interdental phonemes occur or did occur in some of the Arabic dialects which resulted from the early Muslim conquest of North Africa.

RESUMO Este trabalho tem como objeto o angolar, língua autóctone de São Tomé e Príncipe, e pretende: (i) investigar seus aspectos fonético-fonológicos; e (ii) comparar os resultados da pesquisa com Maurer (1995) e Lorenzino (1998), as primeiras descrições. Como corpus , foram utilizados 3000 itens coletados em duas viagens de campo (em 2014 e 2018) para a comunidade de São João dos Angolares, em São Tomé. Quanto ao quadro consonantal, defende-se que o angolar possui 16 fonemas: /p, b, t, d, k, g, f, v, θ, ð, l, m, n, ɲ, j, w/. Este estudo diferencia-se das análises de Maurer (1995) e Lorenzino (1998) por considerar [t͡ʃ], [d͡ʒ] e [r] como alofones; por outro lado, os três estudos concordam quanto ao estatuto fonológico das fricativas interdentais. Com relação ao quadro vocálico, o angolar apresenta 14 vogais orais: /i, e, ɛ, a, ɔ, o, u, ii, ee, ɛɛ, aa, ɔɔ, oo, uu/, sendo possíveis foneticamente realizações nasais. Por fim, quanto à estrutura silábica, foi encontrado um número maior de moldes silábicos, incluindo uma possível realização de onset complexo. Com esse estudo, foi possível conhecer mais acerca da fonologia do angolar, lançando novas luzes sobre uma língua ainda pouco estudada e contribuindo para a área de contato. ABSTRACT This work addresses Angolar, a native language of São Tomé and Príncipe. It aims to (i) investigate its phonetic-phonological aspects, and (ii) compare the research results with Maurer (1995) and Lorenzino (1998), two of the first descriptions. The corpus is constituted by 3,000 items collected in two field trips (in 2014 and 2018) to the community of São João dos Angolares in São Tomé. Regarding the consonants, we argue that Angolar has sixteen phonemes: /p, b, t, d, k, g, f, v, θ, ð, l, m, n, ɲ, j, w/. This study differs from the analyses of Maurer (1995) and Lorenzino (1998) because it considers [t͡ʃ], [d͡ʒ] and [r] as allophones. On the other hand, all three studies agree as for the phonological status of interdental fricatives. Regarding the vowel inventory, Angolar has fourteen oral vowels: /i, e, ɛ, a, ɔ, o, u, ii, ee, ɛɛ, aa, ɔɔ, oo, uu/. Nasal realizations are possible. Finally, regarding syllable structure, there is a larger number of syllable templates, including a possibility of realization of complex onsets. With this study, it is possible to know more about Angolar phonology, to shed new light on a still little studied language, and to contribute to the area of Contact Linguistics.

Interdental space between anterior teeth is an aesthetic and a phonetic problem. While various treatment options are available, patients often have concerns regarding treatment invasiveness, duration of treatments, costs and long-term prognosis. This case report describes a step-by-step smile makeover with direct composite restorations in maxillary incisors and canines with interdental spaces, tooth size discrepancy and altered passive eruption. CPD/Clinical Relevance: Minimally invasive dentistry is an integral component of contemporary clinical practice With recent advances in innovative materials and improved clinical technique, attaining aesthetic results with a minimally invasive approach is highly achievable.

This study assessed the effect of triweekly interdental brushing for a period of 6 months using the bleeding on full-mouth interdental brushing (BOFIB) index. All participants answered questionnaires and were instructed to clean all interdental areas using an interdental brush at least every second day. A dentist assessed the BOFIB index of 28 participants at baseline and at 3- and 6-month follow-up visits. We stratified the participants into three groups: IB-NN, those who used the interdental brush less than three times per week both before and after this program, IB-NY, those who used the interdental brush less than three times per week before the program but at least three times per week after the program, and IB-YY, those who used it at least three times per week both before and after the program. Owing to the weekly number of interdental brushings, the IB-YY and the other two groups showed a significant difference at baseline. At the 6-month follow-up, the weekly number of interdental brushings led to a significant difference between the IB-NN and the other two groups. The BOFIB index was lower among the compliant participants than among the noncompliant participants after 3 and 6 months of triweekly interdental brushing.

Background and Objective: This study identifies the prevalence and severity of periodontal diseases in a given population of Sulaimani using the Community Periodontal Index of Treatment Needs (CPITN) and attempts to find the relation of CPITN with age, sex, location, visit to dentist, tooth brushing, use of mouth wash and interdental aids, systemic disease, smoking status and missing teeth. Methods: Periodontal examinations were performed using CPITN, plaque index (PI) and bleeding index (BI). Other data including location, visit to dentist, tooth brushing, use of mouth wash and interdental aids, presence of systemic diseases, smoking status and missing teeth were also collected. The data were subjected to logistic regression to find a relation between periodontal status and other variables. Results: Among the 1354 subjects examined, 43.6% were male and the majority of these (80.9%) were from urban areas. The mean PI and BI were 0.64±24 and 0.39±0.28, respectively. Calculus was the most prevalent highest score amongst examined subjects (62.2%), followed by shallow pocket (22.2%) and bleeding (9%). Among the sextants, lower central sextants were found to have the highest percentage of calculus. The highest percentages of shallow and deep pockets were found at upper left (14%, 2.5%, respectively) and upper right (11.4%, 3.2%, respectively) sextants. Logistic regression analysis showed that age, sex, frequency of brushing and smoking significantly correlated with CPITN scores. Conclusion: Prevalence and severity of periodontal diseases are high in the examined population and age, sex, brushing and smoking were shown to have an impact on periodontal condition.

Maxillary midline diastema (MMD) is a relatively common dental malocclusion characterized by a space between the maxillary central incisors, with functional and esthetic consequences. A diastema between the maxillary central incisors is a relatively common finding in the primary, mixed as well as permanent dentitions. In the primary dentition, interdental spaces help to settle down the superceding permanent teeth. Majority of these close spontaneously by the time the maxillary canines appear, but a few may persist in the permanent dentition. Various treatment modalities are implemented to bring about closure of the diastema. This paper presents a series of 10 cases treated for the closure of diastema with a M shaped spring fabricated chairside. Keywords: Midline diastema, M spring, Central incisors.

Background: Trauma and injury to teeth and their supporting tissues often occur in cases of oromaxillofacial trauma. Oromaxillofacial trauma is found in 15% of all emergencies, with dentoalveolar trauma involvement in 2% of these cases. Objective: Management of dentoalveolar fractures with minor head injuries. Case: A 53-year-old man, traumatized by a single motorcycle accident and hit by a wooden board with his face hit first. The patient was unconscious shortly after the accident, then complained of pain in the lower lip and gums, teeth 11, 21 avulsed, 12, 22, 31, 21, 41, 42 mobile, and headache. Management: The inspection and handling of the airway was not carried out because it had been previously handled at Puskesmas. The patient was consulted on the Neurosurgery Department for a history of loss of consciousness, then under general anesthesia, definitive care was performed by attaching the eyelet splint to fix the anterior maxillary teeth, and fixation with Erich arch bar for the lower anterior teeth. Conclusion: Interdental wiring is an intraoperative fixation technique for dentoalveolar trauma, accompanied by eyelet splint and Erich arch bar. Patients with head trauma should be consulted to a neurosurgeon before definitive measures are taken.

Cheek teeth diastemata are the most common cause of quidding in the horse. They most commonly affect the most distal mandibular interdental spaces (09/10s and 10/11s) and they begin with impaction of food material, which may progress to gingivitis and periodontitis. They are diagnosed during a thorough oral examination, given under sedation. The initial assessment should include removal of the food from the diastema, which is also therapeutic. Many cases may be resolved by removing the impacted food and with good quality routine dentistry. Other proposed treatments include packing or stenting of diastemata, removing teeth from occlusion, diastema widening and extraction of cheek teeth.

Pemphigus vulgaris (PV) is an autoimmune mucocutaneous disease characterized by epithelial blistering affecting the mucosal/cutaneous surfaces. This case report demonstrates the oral manifestations of PV in the uncommon locations such as the attached, marginal, and interdental gingiva with no involvement of oral mucosa, tongue, palate, or buccal mucosa.

Currently, more and more often at the dental reception there are various types of combined anomalies and deformities. The relationship manifestations of common somatic diseases are often correlated with manifestations in the oral cavity. Not an exception is acromegaly. In this paper, the features of the structure of the oral cavity in persons with acromegaly at the dental reception were studied. In patients with this disease, the mass of soft tissues is increased, the shape of the dentition and the timbre of the voice are changed. An objective examination revealed macroglossia, hypoplastic gingiva, macrocheilitis, increased interdental spaces. The prevalence of this deformation makes it necessary and relevant knowledge of this pathology by dentists.

Background/aims Fracture of the alveolar process is a common injury, but the traditional splinting fixation may not be possible in some cases. The aim of this study was to describe the osteosynthesis performed in segmental alveolar fractures by internal fixation and evaluate the prognosis of the fractures and teeth involved. Materials and methods Twenty-two patients who were identified as having segmental alveolar fractures treated with osteosynthesis by internal fixation at the authors' department from January 2007 to December 2016 were included with 90 traumatized teeth. The prognosis of the fractures and teeth involved in the fractures was evaluated by the post-operative computed tomography combined with a follow-up study. Results All patients achieved healing and consolidation of the alveolar fractures. Furthermore, the occlusion was restored and the wounds healed. During the surgical procedures, no observed iatrogenic dental damage caused by the interdental drilling was found. Eventually, only 15.6% of the teeth had pulp necrosis, whereas the other healing complications were rare or not observed in the study. Conclusions Osteosynthesis by internal fixation is an effective and safe treatment for some segmental alveolar fractures. The teeth involved in these fractures also have good prognosis.

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm2, power density per second 1.59 W/cm2, dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0–10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95–4.25), 5.25 (3.37) (95% CI, 3.52–6.98), and 5.75 (2.40) (95% CI, 4.69–6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Background. According to the statistics, the incidence of dentoalveolar anomalies, as well as the frequency of orthodontic visits, is constantly growing. Objective. To analyze the efficiency of orthodontic treatment in children during the period of mixed dentition. Methods. We have performed a study on the incidence and severity of dentoalveolar anomalies of the dental status in 7-9-year-old patients vs. 15-17-year-old adolescents after the completion of occlusion. The adolescents were divided into two groups those who underwent orthodontic treatment during the mixed dentition period and those who did not. The evaluation of the childrens dental status was performed using a specialized WHO Map (2013), supplemented by the Dental Maxillofacial Anomalies section. We determined the following indices: DMF (Decayed-Missing-Filled Index), DMF-df, OHI-S, CPI, PAR, DAI, as well as the Littles irregularity index. The need in the different types of dental and orthodontic treatment was estimated, including that per one examined person in a group. Results. In the group of 7-9-year-old we have revealed a high incidence of premature teeth loss (17.0% of patients), dentoalveolar anomalies (73.9%) and their combinations (60.8%). Discussion. Orthodontic treatment during the period of mixed dentition reduces the incidence of the teeth positioning anomalies (crowding and tooth displacement) and dental arch ratio anomalies (completely eliminating the cross-bite). At the same time, early orthodontic treatment does not have a significant influence on the tooth rotation, interdental spaces, deep, open, distal, mesial occlusions and the displacement of dental arches. The severity of dentoalveolar anomalies is reduced in this case. Conclusion. Orthodontic treatment of children during the period of mixed dentition is indicated in the presence of teeth crowding and displacement, as well as in the presence of a cross-bite; concerning other types of dentoalveolar anomalies, early orthodontic treatment is justified only when the patients psychological and functional indices are reduced.

This paper investigated factors influencing students’ pronunciation. Pronunciation is one of the important aspects of the learning of English. When mastering English pronunciation, many non-native English speakers have difficulty pronouncing certain words that contain the phonemes not used in their native languages. This paper also reported several aspects that might influence pronunciation. The pronunciation aspect investigated in this research paper was the English interdental consonants [θ] and [ð], which are not available in the Indonesian language sound system. This qualitative research used interviews as a method for collecting primary data. The researchers interviewed twenty participants from the English Language Education Study Program (ELESP) of Sanata Dharma University, Yogyakarta, Indonesia, related to the pronunciation of the two interdental consonant sounds. The findings showed that the mother tongue, age, and teacher instruction on target language exposures affected the ELESP students’ (mis)pronunciation. Pedagogical implications of the findings are English teachers can assist their students in overcoming pronunciation challenges involving the two interdental consonants and pronunciation textbook writers should provide more pronunciation practices focusing on [θ] and [ð] sounds.

To identify and map existing evidence on the effectiveness of interdental cleaning devices in preventing dental caries and periodontal diseases, a scoping review was carried out by electronically searching PubMed, Scopus and Embase. Studies on interdental cleaning devices, written in English, and published from January 2008 up to April 2019 were included inthe review. Of 1860 studies identified, six systematic reviews (SR) were included in the review. One SR each was on flossing, interdental brushes, wood sticks and oral irrigation. Of two SR on multitude of interdental cleaning devices,one assessed comparative efficacy while the other both the individual and comparative efficacy. All reviews had assessed the heterogeneity and the methodological quality of studies included, and performed data extraction and meta-analysis where appropriate. Evidence ranged from weak to moderate with very low- to low-certainty for the adjunctive benefit of these devices to control plaque and gingivitis. It warrants long-term studies with sufficient power and those assessing the impact of interdental cleaning on interproximal caries to corroborate such evidence. Available evidence on the efficacy of interdental cleaning devices suggests that dental practitioners recommend patient-specific interdental cleaning devicesthat enable patients to achieve a safe and high standard of interdental cleaning. Refereed/Peer-reviewed

Background Prospective studies investigating the influence of adjuvants to oral hygiene procedures on the recurrence of periodontitis (RP) during periodontal maintenance therapy (PMT) programs have not been previously reported. The aim of this study was to compare the effect of oral irrigator devices or interdental brushes as adjuncts to toothbrushing associated with dental flossing to improving periodontal condition and reducing RP among individuals under PMT. Methods From a 6-year prospective PMT cohort study (n = 268), 142 individuals who attended at least one PMT visit within 12 months were determined to be eligible. According to oral hygiene adjuvants use, they were categorized into three groups: 1) manual brushing/dental flossing + interdental brushes (BDF + Ib; n = 44); 2) manual brushing/dental flossing + oral irrigator (BDF + Oi; n = 36); and 3) only manual brushing/dental flossing (BDF; n = 62). Full-mouth periodontal examination and oral hygiene habits were evaluated at two time points: T1 (after active periodontal therapy) and T2 (6 years). Results RP was significantly higher among BDF when compared with BDF + Ib and BDF + Oi. The final logistic model in T2 for RP included the following items: manual brushing/dental flossing alone (odds ratio [OR] = 1.94); age > 50 years (OR = 1.98), smoking (OR = 3.51), bleeding on probing >30% sites (OR = 4.10), and the interaction between manual brushing/dental flossing alone and smoking (OR = 6.1). A protective effect on RP was observed in BDF + Oi individuals (OR = 0.52). Conclusions BDF + Ib and BDF + Oi individuals presented lower rates of RP and better periodontal condition when compared to BDF individuals. Including these adjuvants to conventional oral hygiene have shown to improve biofilm control during PMT leading to a better periodontal status maintenance.

As one of today’s major oral health issues, periodontal disease affects populations worldwide. Here, methods used to record its past prevalence are reviewed, including the problems associated with the use of measurements to record bone loss. Clinical and bioarchaeological research offers strong support for the Kerr method that records interdental septum morphological changes as a means of identifying gingivitis and periodontal disease. Using Kerr’s approach, four assemblages from Sudan dating to the Neolithic, Kerma and Medieval periods are examined to track the progression of the disease through time. Results show a significantly lower prevalence of periodontal disease and a limited distribution across the mouth in the Neolithic period. Significant differences were found between the sexes at the Medieval sites, which were not present at the Neolithic and Kerma sites. With no patient history and the cumulative effects of a dynamic and episodic disease - only a snapshot of which is captured at death - the concept of ‘oral health’ may be hard to apply in archaeological remains. As suggested by Kerr, it at best provides an insight into the periodontal status at death. Here, this ‘snapshot’ reveals differences across the mouth, over time and between sexes.

The purpose of this study was to evaluate volumetric and dentoskeletal changes in 21 patients with active unilateral condylar hyperplasia (AUCH) after proportional condylectomy. A split-mouth design was used: control group healthy joints (HS, healthy side) and test group affected joints (AS, affected side) (21 per group). Cone beam tomography scans were obtained at T0 (preoperative), T1 (10days after the intervention), and T2 (approximately 12 months post-surgery). The condylar unit volume (CUV), articular cavity volume (ACV), and dentoalveolar units (DAUs) were measured. CUV showed a difference of 1.12cm3 between T0 and T1, increasing 0.4cm3 between T1 and T2 on AS. There was no difference between T0 and T2 on HS. ACV increased 0.65cm3 between T0 and T1 on AS, after which it decreased by 0.36cm3 at T2 (0.30cm3 larger than the initial articular cavity at T0). ACV showed no post-surgery differences on HS. Midline DAU showed extrusion of 0.20mm for maxilla and 0.52mm for mandible, while in the lateral area, maxilla was extruded by 0.3mm on HS and was intruded 0.12mm on AS. For the mandible, both sides showed extrusion (0.4-0.6mm). In the distal to canine and molar areas, intrusion of 0.2mm and 0.9mm, respectively, was observed on AS; there was extrusion of 0.6mm distal to the canine on HS. At the mandibular level, AS distal to the canine showed extrusion of 1mm, while intrusion of 0.2mm was observed in the molars. For HS, only extrusion at the molar level (0.2mm) was observed. In conclusion, after proportional condylectomy, a neocondyle forms within 12 months to equal the healthy contralateral side. The articular cavity, which is reduced in the initial stage, increases in size after surgery and the volume gradually approaches that of the healthy side. Dentoalveolar changes occur at the anterior and posterior levels, causing intrusion and extrusion of the interdental crests. An early proportional condylectomy as the sole surgical treatment for patients with AUCH allows normalization of the maxillomandibular relationship.

Maxillary midline (major) diastemas are common aesthetic problems for the patients. Recently, it is easier to get rid of those unwilling spaces aesthetically with the help of newly developed restorative materials. Major diastema may frequently occur due to high frenulum junctions thus causing unaesthetic outlook for some patients. In this case report a maxillary major diastema due to high frenulum was closed non-invasively with direct, prepless composite resin restorations. In this case frenectomy, office bleaching and direct prepless restorations was respectively planned. Six weeks were waited for periodontal tissue healing after frenectomy operation and then bleaching procedure was done using 40% hydrogen peroxide gel ( Opalescence Xtra Boost, Ultradent, USA ). Following vital bleaching; after 2 weeks, universal adhesive agent (Universal bond, Kuraray Noritake, Japan) was applied to the etched enamel surfaces (36% phosphoric acid etching with DeTrey Conditioner 36, Dentsply, Germany). Direct composite resin restorations was done using “A1B” and “NE” shades ( Estelite Asteria, Tokuyama Dental, Japan ). Polishing discs (SofLex, 3M ESPE, USA), interdental strips (Epitex, GC, Japan) and two spiral polishing twists (Twist Dia, Kuraray, Japan) was used during the finishing and polishing stages. The success of the final restorations were assessed in 3 month, 9 month and 18 month follow ups.

Rapid endothelial cell proliferation of blood vessels is microscopic feature of hemangiomas. These lesions usually occur during first month of life and become apparent as the age increases. Hemangiomas are non-neoplastic and developmental in origin. Although they are found on head and neck region they may involve skin, lips, and masticatory and perioral mucosa of oral cavity and rarely may be found on interdental and attached gingiva. They are more commonly seen three times in female as compared to males. These lesions have frequent tendency to bleed and are of utmost importance to dental professional hence it requires proper diagnosis and treatment. Hence, we are presenting a rare case report of female diagnosed with capillary hemangioma of interdental gingiva.

OBJECTIVE The aim of the present study was to compare the self-reported oral health knowledge, habits and attitudes of adults in Portugal, Romania and Sweden, each benefitting from a different oral health system. METHODS A cross-sectional study was conducted on 1081 adults in the three countries, using an adapted version of the WHO oral health questionnaire. This survey took place between November 2015 and June 2016. RESULTS The mean age of the respondents was 46.85 with 95% CI (45.84, 47.86). Over 85% of the Portuguese and the Swedish, but only 55% of the Romanians, reported having 20 or more teeth left (P

Lateral approximant speech sounds are notoriously difficult to measure and describe due to their complex articulation and acoustics. This has prevented researchers from reaching a unifying description of the articulatory and acoustic characteristics of laterals. This paper examines articulatory and acoustic properties of Brazilian Portuguese alveolar and palatal lateral approximants (/l/ and /ʎ/) produced by six native speakers. The methodology for obtaining vocal tract area functions was based on three-dimensional/four-dimensional (3D/4D) ultrasound recordings and 3D digitized palatal impressions with simultaneously recorded audio signals. Area functions were used to calculate transfer function spectra, and predicted formant and anti-resonance frequencies were compared with the acoustic recordings. Mean absolute error in formant frequency prediction was 4% with a Pearson correlation of r = 0.987. Findings suggest anti-resonances from the interdental channels are less important than a prominent anti-resonance from the supralingual cavity but can become important in asymmetrical articulations. The use of 3D/4D ultrasound to study articulatory-acoustic relations is promising, but significant limitations remain and future work is needed to make better use of 3D/4D ultrasound data, e.g., by combining it with magnetic resonance imaging.

Purpose The aim of this study was to evaluate the dimensional properties of bone in the anterior maxilla in patients with different vertical skeletal patterns in order to ensure safe placement of temporary anchorage devices. Materials and methods Fifty-one CBCT images were divided into three equal groups according to vertical skeletal pattern, based on palatal plane to mandibular plane angle. Cortical bone thickness, alveolar bone thickness and interdental root distance were measured between the teeth in the anterior maxilla at 6 mm and 8 mm apical to the interdental cementoenamel junction. Results Cortical bone thickness was significantly different among vertical groups at some sites. Hyper-divergent subjects had thinner cortical bone than hypo-divergent and normo-divergent subjects. All three groups, in the anterior maxilla, cortical bone thickness tended to increase from between central incisors (U1–U1) to between lateral incisor and canine (U2–U3). Alveolar bone thickness was greatest between central and lateral incisors (U1–U2), and the thinnest alveolar bone was at U1–U1 area. Average interdental root distance ranged from 1.33 ± 0.48 mm to 3.43 ± 1.25 mm. The largest and smallest interdental root distances were at U1–U1 and U1–U2 sites, respectively. Conclusion Placement of TADs in hyper-divergent subjects should be performed with caution. The suitable site for TADs in the anterior maxilla was between the lateral incisor and canine in all vertical skeletal patterns.

Correctly managing interdental papillae is a key step in producing satisfactory, interproximal, direct composite restorations. This article discusses techniques to facilitate the restoration of sub-gingival cavities and suggests a decision-making workflow that can be applied in this challenging situation.

OBJECTIVES To compare the removal of simulated biofilm at two different implant-supported restoration designs with various interproximal oral hygiene aids. METHODS Mandibular models with a missing first molar were fabricated and provided with single implant analogues (centrally or distally placed) and two different crown designs (conventional [CCD] and alternative crown design [ACD]). Occlusion spray was applied to the crowns to simulate artificial biofilm. Thirty participants (dentists, dental hygienists, and laypersons) were equally divided and asked to clean the interproximal areas with five different cleaning devices to further evaluate if there were differences in their cleaning ability. The outcome was measured via standardized photos and the cleaning ratio, representing the cleaned surfaces in relation to the respective crown surface. Statistical analysis was performed by linear mixed-effects model with fixed effects for cleaning tools, surfaces, crown design and type of participant, and random effects for crowns. RESULTS The mean cleaning ratio for the investigated tools and crown designs were (in%): Super floss: 76 ± 13/ACD and 57 ± 14/CCD (highest cleaning efficiency), followed by dental floss: 66 ± 13/ACD and 56 ± 15/CCD, interdental brush: 55 ± 10/ACD and 45 ± 9/CCD, electric interspace brush: 31 ± 10/ACD and 30 ± 1/CCD, microdroplet floss: 8 ± 9/ACD and 9 ± 8/CCD. There was evidence of an overall effect of each factor "cleaning tool," "surface," "crown design," and "participant" (p

Strong mandibular angles and a heavy chin are perceived as masculine features, so surgical feminization of female or transgender faces may warrant mandibular base narrowing (borders and angles) and a reduction in chin width and height. With this in mind, we have devised an interdental midline osteotomy (triangular in shape and with a caudal base) to accompany a box-shaped impaction osteotomy of the chin symphysis and horizontal triangular resection of the lateral mandibular border. The reduction of the intergonial width and of the mandibular border and chin widths takes place upon closure of the midline defect. Between November 2016 and August 2017, five patients agreed to the mandibular feminization osteotomy and were followed up thereafter for 6-13 months. All expressed satisfaction with the results; no dental, periodontal, or temporomandibular joint-related complications were encountered. This technique is a viable alternative to buccal decortication, chin reduction osteotomy, and masseter reduction surgery.

In this case report, the treatment of segmental fracture by interdental loop wiring technique on the left side of the rostral region of the mandible in a 2-year-old male, Terrier breed dog was described. Mandibular fracture occurred due to the attack of another dog. In the clinical examination, there were no pathological symptoms related to neurological findings, respiratory system or the general condition. However, it was determined that the mouth of the animal could not close completely. Gingival laceration was evident. In the preoperative radiographic evaluation, a fracture line was observed between the left mandibular first premolar and the first incisor teeth. The roots of the left canine and the left first premolar teeth were also fractured. Mandibular fracture was reduced via interdental loop wiring after these two teeth were extracted. On the 24th postoperative day, clinical and radiographic evaluations were performed which revealed that this non-invasive fixation method achieved a complete fracture healing without complications. Interdental loop wiring may be used successfully in segmental mandibular fractures in dogs.

Introduction. The prognosis for a successful treatment of gingival recessions (GRs) is one of the main criteria for deciding whether or not and how to perform root coverage surgery. The defect-related factors are the most important to predict root coverage outcomes. Thus, severe GR could make the root coverage (RC) challenging especially in cases with advanced interdental clinical attachment loss (ICAL). Case Presentation. This case report demonstrates a challenging management of a deep localized Miller Class III GR with root apex exposure associated with ICAL. After initial therapy, the treatment had consisted of a multidisciplinary approach involving endodontic treatment, periodontal plastic surgery including a laterally positioned flap, and orthodontic treatment. The 6-year follow-up showed improvement in clinical outcomes (recession reduction (RR) and keratinized tissue (KT) augmentation) and a higher patient satisfaction. Conclusions. This case report demonstrates the role of the multidisciplinary approach in the management of deep GRs associated with ICAL. A rational choice of the RC technique was critical to achieve good clinical outcomes.

Introduction: This study aimed at testing the effect of the socket shield technique on the maintenance of the labial plate of bone and the change in position of its surrounding gingival soft tissues upon the immediate placement of 3 different dental implants systems, with a bone graft material filling the defects around the implants, followed by clinical and radiographic evaluation using the cone beam computed tomography after 4 and 12 months of loading.Materials and Methods: Three groups, 6 male patients each, having a failing central or lateral maxillary incisor, had their failing tooth partially extracted, with the remaining tooth half reduced to be the socket shield, then the 3 groups received 3 different dental implants systems, the Tapered Internal implant RBT Laser-Lock for group I, the Touareg-S implant for group II, and group III received the Nobel Active implant. Then, the Novabone putty bone graft was dispensed in the space between the implant and the shield and covered with a customized healing abutment. After 4 months of healing, the patients were provided with definitive restorations, and followed after 4 and 12 months for gingival recession, papillae filling the interdental spaces, and CBCT evaluation of the labial plate of bone width and vertical resorption. Each result was then statistically analyzed.Results: For all the cases in the study, no implant failed, no gingival recession was recorded, and the interdental papillae filled their spaces in most of the cases. also, no significant changes were recorded for the labial plate of bone width or height.Conclusions: The socket shield technique was able to maintain the labial plate of bone and the position of the overlying free gingival margin, with the neighboring interdental papillae showing least dimensional changes.