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Aim: Traumatic dental injuries at the anterior region of the maxilla occur frequently in children and adults. In this case report, we aimed to describe the temporary aesthetic restoration of the upper lateral incisor with a fiber-reinforced bridge by using the original tooth crown, which had avulsed after dental trauma. Methodology: Case 1: A 14-year-old girl with an avulsion in tooth #11 due to trauma visited our clinic. During the examination, it was seen that the wound had healed, and there was no luxation in teeth #21 and #12. Since the patient could not undergo prosthetic procedures, for reasons including implants, and did not want a removable prosthesis, a single crown supported by acrylic tooth fibers was constructed. Case 2: A 17-year-old male patient was referred to our clinic because of an avulsed left lateral incisor tooth, which was traumatized 15 days before visiting the clinic. His medical history revealed that his parents had found the tooth two hours after the trauma. However, the emergency clinic that he had previously visited did reimplant that tooth and repaired it with fiber-reinforced composite. Case 3: In the examination of a 12-year-old male patient who applied to our clinic due to trauma, it was observed that tooth #11 had an avulsion and tooth #12 had a crown fracture. Root canal treatment was performed. A crown was made for the patient by supporting the fiber inside the canals of tooth #11 and tooth #21. It was revised aesthetically with the support of the crown of the other tooth. Conclusion: Avulsion after anterior trauma affects patients’ appearance aesthetically; thus, patients want to be treated as soon as possible. Function, phonation, and aesthetics must be quickly provided for a loose anterior tooth. Fiber-reinforced adhesive bridge techniques may be considered as a temporary treatment for providing an aesthetically appealing appearance until the completion of permanent prosthetic treatment. How to cite this article: Şahin M, Toptancı İR. Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports. Int Dent Res 2021;11(Suppl.1):285-91. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.42 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Introduction: The aesthetic rehabilitation of endodontically treated teeth depends on the degree of destruction of the crown, the tooth in question, the bone support, the type of prosthesis and the types of forces to which these teeth will be submitted. The indirect composite resins have improved physical and mechanical properties thanks to the incorporation of inorganic components and multifunctional monomers with a greater number of bonding points, making them capable of solving the problems in which ceramic restorations would be indicated. Objective: To present a clinical case report of an aesthetic rehabilitation of anterior teeth with indirect composite resin as a viable and less expensive treatment alternative. Case Report: Upon clinical examination, extensive and deficient restorations were observed in the upper anterior teeth. The proposed treatment plan aesthetic rehabilitation of dental elements with ceromeres. Conclusions: This treatment represented a viable and less expensive option that can be used both in situations of great dental destruction and in small dental absences, in substitution for ceramic restorations. Introducción: La rehabilitación estética de los dientes tratados endodónticamente depende del grado de destrucción de la corona, el diente en cuestión, el soporte óseo, el tipo de prótesis y los tipos de fuerzas a las que estos dientes serán sometidos. Las resinas compuestas indirectas tienen propiedades físicas y mecánicas mejoradas gracias a la incorporación de componentes inorgánicos y monómeros multifuncionales con mayor número de puntos de unión, lo que las hace capaces de resolver los problemas en los que estarían indicadas las restauraciones cerámicas. Objetivo: Presentar un caso clínico de rehabilitación estética de dientes anteriores con resina compuesta indirecta como alternativa de tratamiento viable y menos costosa. Reporte de Caso: En el examen clínico, se observaron restauraciones extensas y deficientes en los dientes anteriores superiores. El plan de tratamiento propuesto para la rehabilitación estética de elementos dentales con cerómeros. Conclusiones: Este tratamiento representó una opción viable y menos costosa que se puede utilizar tanto en situaciones de gran destrucción dentaria como en pequeñas ausencias dentales, en sustitución de las restauraciones cerámicas. Introdução: A reabilitação estética de dentes tratados endodonticamente depende do grau de destruição da coroa, do dente em questão, do suporte ósseo, do tipo de prótese e dos tipos de forças a que esses dentes serão submetidos. As resinas compostas indiretas apresentam propriedades físicas e mecânicas aprimoradas graças à incorporação de componentes inorgânicos e monômeros multifuncionais com maior número de pontos de união, tornando-os capazes de solucionar os problemas em que seriam indicadas restaurações cerâmicas. Objetivo: Apresentar um relato de caso clínico de uma reabilitação estética de dentes anteriores com resina composta indireta como alternativa de tratamento viável e de menor custo. Relato de Caso: Ao exame clínico foram observadas restaurações amplas e deficientes nos dentes anteriores superiores. O plano de tratamento proposto reabilitação estética dos elementos dentários com cerômeros. Conclusões: Este tratamento representou uma opção viável e de menor custo que pode ser utilizado tanto em situações de grande destruição dentária como em pequenas ausências dentárias, em substituição às restaurações de cerâmica.

Dental fluorosis can be defined as a developmental condition that affects dental hard tissue, mainly enamel characterised with white or yellowish lesions due to excessive fluoride exposure. Fluorosis can have a major impact on the appearance, structure and shape of the tooth which posed a significant aesthetic concern to individuals having this condition. There are several treatments recommended in treating dental fluorosis depending on the severity of the disease itself ranging from tooth bleaching to prosthetic crowns in severe cases. This case report describes the use of resin infiltration technique on a patient with mild to moderate severity of dental fluorosis of the upper anterior teeth which produce an acceptable improvement of the appearance of the affected tooth. Resin infiltration technique in this case provided a conservative and inexpensive approach in treating mild to moderate dental fluorosis for the patient, improving the aesthetic without significant loss of tooth structure.

La interrelacion de las diversas especialidades de la odontologia para la resolucion de los tratamientos realizados en los pacientes que llegan a la consulta odontologica es hoy en dia fundamental, ya que la vision sesgada de algun area nos puede privar el brindar una mejor posibilidad de tratamiento. Trabajar con especialistas en diferentes areas conlleva a orientar adecuadamente los tratamientos y a optimizar resultados. En el presente caso se detalla la rehabilitacion integral de un paciente con la participacion de las especialidades endodoncia, periodoncia, rehabilitacion oral, operatoria dental. El tratamiento multidisciplinario en odontologia lleva a optimizar los resultados clinicos brindando una vision mas amplia de las posibilidades de tratamiento para los pacientes. The interrelation of the different specialties of dentistry for the resolution of the treatments performed in patients who come to the dental office is fundamental nowadays, since the biased vision of any area can deprive us of providing a better possibility of treatment. Working with specialists in different areas leads to an adequate orientation of the treatments and to optimize results. In the present case the integral rehabilitation of a patient is detailed with the participation of the specialties endodontics, periodontics, oral rehabilitation and dental surgery. Multidisciplinary treatment in dentistry leads to optimize clinical results providing a broader vision of treatment possibilities for patients.

Introduction: Crossbite is a discrepancy in buccolingual relationship of the upper and lower teeth. When the labial surface of the lower anterior teeth occlude labial to the labial surface of the upper anterior teeth is called as anterior cross bite. The aetiology for anterior crossbite can be vary. Crossbite of all of the incisors is usually rarely found in children who do not have class III skeletal jaw relationship. A crossbite relationship of one or two anterior teeth, however, may develop in a child who has good facial proportions. A comprehensive understanding of the problem by the practitioner is a key element for successful management.

A 27-year-old woman with a right-sided cleft lip and palate and a left sided cleft lip and congenitally missing teeth #s12 and 11. After primary treatment of the cleft during childhood and adolescence, the teeth were still missing and a large defect in the alveolar crest remained. Patient’s chief complaint was poor aesthetics in the upper anterior region. This case presentation describes how, with a multidiscipline approach by means of orthodontics, soft tissue grafting and a tooth-supported fixed partial denture the conditions were treated to achieve as good aesthetical result as possible. Keywords: Cleft Lip and palate, Ridge augmentation, Multidiscipline approach.

Purpose: This study evaluated tensile bond strength (TBS) between anterior acrylic teeth and denture bases made of high-impact heat-cured acrylic resin (HI PMMA) impregnated with zirconia nanoparticles. Materials and Methods: A total of 30 specimens (each specimen containing a set of six upper anterior teeth) were fabricated from HI PMMA denture base acrylic resin reinforced with different weight concentrations of zirconia nanoparticles: 0% (control), 1.5%, 3%, 5%, 7% and 10%. TBS was tested according to a British standard (BS EN ISO 22112: 2017). A one-way analysis of variance (ANOVA) was employed with a Tukey post-hoc test. Results: TBS values between the anterior teeth (central and lateral incisors and canine) and HI-PMMA denture base groups containing 7 wt.% (261.5 ± 66.0 N, 172.5 ± 57.4 N and 271.9 ± 86.3 N) and 10 wt.% (332.1 ± 122.9 N, 165.4 ± 48.7 N and 301.6 ± 73.2 N) zirconia were significantly lower compared to the control group (645.4 ± 84.8 N, 306.1 ± 81.6 N and 496.7 ± 179.1 N) and the other nanocomposite groups. However, TBS values for HI PMMA with 1.5 wt.% (534.4 ± 115.3 N, 304.7 ± 86.4 N, 514.0 ± 143.2 N), 3 wt.% (685.7 ± 159.6 N, 281.1 ± 78.3 N, 462.6 ± 122.1 N) and 5 wt.% (514.5 ± 134.3 N, 229.8 ± 67.3 N, 387.2 ± 99.4 N) zirconia showed slightly lower values than that of the control group but these were not significant. Failure modes between the teeth and denture base nanocomposites were predominantly cohesive fractures, which were clinically acceptable according to the Standard. Conclusion: The addition of zirconia nanoparticles to HI PMMA denture base at high concentration (7 wt.% and 10 wt. %) significantly (p< 0.05) reduced the bonding strength for all types of anterior teeth compared to the control group.

Background: The aim of this study was to investigate the association between chronological age and the pulp/tooth volume ratio (PTR) of specific teeth using cone-beam computed tomography (CBCT) enhanced with Materialise-Mimics Research software 21.0 in children and young adult population from Eastern China. Materials and methods: CBCT scans of 230 patients (119 males, 111 females), aged 8.18–19.92 years were analysed by two well-trained examiners in this retrospective study. The intraclass correlation coefficient value was calculated to test the intra- and inter-examiner agreement. The volumetric analysis of the pulp and calcified tissues was performed on the maxillary left central incisors and canines. The correlation and regression analyses were then performed. Results: The Pearson correlation analysis showed a strong coefficient of correlation (r) for maxillary left canines (–0.81 for girls and –0.88 for boys) as compared to central incisors (–0.63 for girls and –0.70 for boys). Regarding performance, the canine model was more powerful than the central incisor model. The derived regression equation from maxillary left canines had high coefficients of determination (Age = 21.979 – 105.42 × PTR, R2 = 0.69). Conclusions: Our study proved that the PTR value of canines had a negative correlation relationship with a subadult’s chronological age and volumetric analysis of CBCT scans using the software may become an efficient method to estimate the chronological age of children and young adults.

Background/purpose: A perfect sealing of root canal system is essential for preventing ingress of bacteria from the oral environment. The purpose of this study was to evaluate the apical sealing ability of bioceramic (EndoSequence BC Sealer®) and epoxy resin-based (AH Plus®) sealers at 24 h, 7 days and 4 weeks. Materials and methods: Forty two extracted human upper anterior teeth were sectioned to leave the root 15-mm long, then all the roots were instrumented using a set of ProTaper® rotary instruments. Four roots were selected randomly as controls, and the remaining 38 roots were randomly divided into 2 groups of 19 roots each: group 1: EndoSequence BC Sealer® and gutta-percha, and group 2: AH Plus® and gutta-percha using a multiple wave condensation technique. The apical sealing ability of the filled root canal was measured using the fluid filtration method with 200 mmHg (26.67 KPa) above atmospheric pressure at 24 h, 7 days and 4 weeks. Scanning electron microscopy (SEM) was used to assess the adaptation and penetration of the sealers. The apical microleakage between 2 groups was compared using Student's t-test. P

Aim: to assess the relationship between deep overbite with palatal impingement and periodontal health status in a cohort of adult Saudi dental patients. Materials and Methods:Ten patients (4 males and 6 females, aged 16 to 31 years old) with deep traumatic overbite and palatal impingement were examined. A Hawley retainer appliance with an anterior bite plate was provided for all patients.Pocket depth, bleeding index, gingival index, plaque index and mobility were recorded for four visits after using the appliance with fixed intervals in-between. Repeated measures analysis of variance (ANOVA) was used to assess the differences between visits, control /experimental teeth and surfaces (palatal /labial) for pocket depth, bleeding index, plaque index,gingival index and mobility. Results:Statistically significant differences between visits 1-4 were reported for all measurements: pocket depth, bleeding index, gingival index, and mobility (p≤0.05), except for plaque index (p=0.43). Comparison between control vs experimental teeth showed significant differences for bleeding index (p=0.026), gingival index (p=0.014), and mobility (p=0.00). Conclusion: The results of the current study showed a clear association between deep traumaticoverbite with palatal impingement and the periodontal health of the upper anterior segment which indicate that traumatic overbite is a contributing factor in the development and pathogenesis of periodontal disease.In cases of deep overbite, using Hawley retainer with anterior bite plate can eliminate the gingival trauma and improve the general condition of the periodontium

Background: Various conditions may lead to bony deficiency in the anterior maxilla. The present study evaluated esthetic (PES—pink esthetic score and WES—white esthetic score) results after augmentation of the anterior atrophic maxilla using cancellous bone-block allograft followed by implant placement and late (conventional) loading. Methods: Cohort study that included 33 patients with missing teeth in the upper anterior region characterized by extensive bone loss. Allogeneic cancellous bone-blocks were used for augmentation. Six months later, a dental implant was inserted. After a waiting time of an additional six-months, implant exposure and reconstruction were performed. The mean follow-up period was 62.93 ± 17.37 months (range 19–82 months). Results: The mean value of PES/WES was 17.8 ± 2.78. All patients had a PES/WES value above 12 (threshold value defined as clinically acceptable esthetics). The mean value of PES was 9.0 ± 1.79 and the mean value of WES was 8.8 ±1.84. Conclusions: Bone augmentation of the anterior atrophic maxilla using cancellous block-allograft and late loading supports achievement of a predictable esthetic result with long-term stability of soft and hard tissues around implant-supported reconstructions.

This article discusses about a fixed dentulous appliance that was constructed to replace the primary upper anterior teeth in a five year old boy. It constituted of a design, where the maxillary primary second molars were used to support the appliance through bands and a wire that contained spurs bearing strip crowns, anteriorly. The appliance was functionally and aesthetically compliant. Keywords: Early childhood caries, Fixed dentulous appliance, Pediatric ridge.

Purpose: The purpose of this study is to evaluate the clinical efficacy of enhancing deficient interdental papilla with hyaluronic acid gel injection. Materials and Methods: Eight patients (three males and five females) were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, photographic images were taken for each patient. After the administration of a local anesthetic, a 23G needle was used to inject

With the advancement in the implant in dentistry, improvement in the implant designs and placement protocol has enhanced the esthetics outcomes in the anterior zone. Yet the preservation of the peri-implant soft tissue and providing an appropriate emergence profile to the implant crown prosthesis, the tissue grafting procedures are necessary to overcome the ridge contour change. However through the socket-shield technique, the bone resorption process is preserved, and the contour of the buccal gingiva is maintained, thereby preventing its collapse and achieving good aesthetic results. This case report describes the placement of an implant in the upper anterior region and rehabilitation with a cement-retained crown prosthesis using the socket-shield technique and the patient being followed up for 6 months with good results.

Background: Depigmentation has become an important treatment modality among the general population due to the growing esthetic concern about the pigmentation. Previous studies have not considered parameters such as anatomical distribution of gingiva, intensity of pigmentation, and skin color in their classification systems. The purpose of this study was to assess physiologic gingival pigmentation in individuals based on certain gingival parameters and their correlation with skin color for better treatment strategies using a new classification system. Methods: The study was carried out in Ragas Dental College using a cross-sectional design. A total of 112 female dental students were examined for skin color and gingival parameters. The facial gingiva of upper anterior teeth was assessed for gingival phenotype, intensity and distribution of pigmentation. Descriptive statistics were used to describe the data and the associations between variables were done using chi-square test (P < 0.05). Results: It was found that skin color has a significant association with the intensity of pigmentation (P = 0.0001). In both dark and fair skinned individuals, Class II pigmentation (47%, 23.2%) with thick phenotype (62.5%, 35%) was most prevalent. Dark-skinned individuals were also found to have a generalized distribution of melanin pigmentation (19%) with high intensity of pigmentation (28.5%) predominantly. Fair-skinned individuals had a patchy distribution of melanin pigmentation with low intensity of pigmentation (37%). Conclusions: The association of skin color with various parameters affecting gingival pigmentation can help in determining the depigmentation treatment strategies.

espanolEl objetivo de este estudio fue evaluar la utilidad clinica de la Tomografia Computarizada Cone Beam (CBCT) en casos de mediana y alta complejidad endodontica. Se midio la relevancia del CBCT para definir conducta terapeutica a traves del cuestionario de Wittenberg y en la variacion de los planes de tratamientos posterior al analisis del examen. La muestra (n=40) se eligio por conveniencia en un periodo de 4 meses, considerando las recomendaciones actuales para solicitar este examen en Endodoncia. La recoleccion de datos se realizo por medio de una encuesta aplicada a los clinicos tratantes, despues de examinar la informacion obtenida por el CBCT. Los datos se analizaron a traves del software Stata version 13 y para el analisis inferencial se utilizo la prueba de chi cuadrado. Se utilizo un intervalo de confianza de 95%. Los grupos dentarios mas frecuentes correspondieron a posteriores y anteriores superiores (47,5% y 30,0%), los casos se distribuyeron igualitariamente segun complejidad (50% y 50%), el motivo principal para solicitar el CBCT, correspondio a anatomia del sistema de conductos de caracter complejo y/o atipico (37,5%), el CBCT aumento la confianza en el tratamiento inicial escogido por los clinicos en el 50% de los casos segun el cuestionario de Wittenberg y se obtuvo un 45% de variacion en los planes de tratamientos. No se aprecio relacion estadistica entre la complejidad con las variables estudiadas. El CBCT aporto en gran medida el manejo terapeutico de los casos independiente de su complejidad. EnglishThe aim of this study was to evaluate the clinical utility of Cone Beam Computed Tomography (CBCT) in cases of medium and high endodontic complexity. The relevance of CBCT to define treatment was evaluated through the Wittenberg questionnaire and the variation in treatment plans after CBCT exam analysis. The sample (n=40) was chosen for convenience over a period of 4 months. It considered the current recommendations to request CBCT exams before performing root canal treatments. Data collection was carried out through a survey applied to the treating clinicians, after examining the information obtained by the CBCT system. Data were analyzed with the Stata version 13 software, and the Chi-square test was used for inferential analysis. A 95% confidence interval was considered. The most frequent dental groups corresponded to upper posterior and upper anterior teeth (47.5% and 30.0%); the cases were equally distributed according to complexity (50% and 50%). The main reason for requesting CBCT exams corresponded to complex anatomy and/or atypical canal system (37.5%). The use of CBCT increased confidence in the initial treatment chosen by clinicians in 50% of cases according to the Wittenberg questionnaire, and a 45% variation in treatment plans was observed. There was no statistical relationship between complexity and the variables studied. CBCT contributed greatly to the therapeutic management of cases regardless of their complexity.

OBJECTIVES: The objective of the study was to evaluate the marginal and internal fit of anterior nano-ceramic composite endocrowns with different preparation designs. METHODS: 28 extracted upper anterior teeth were selected and divided into 2 groups (n=14), group A: prepared with short extension (2 mm) and group B with long extension (5 mm). The two groups were further divided into another 2 subgroups; subgroup 1: with 2 mm ferrule while subgroup 2: without ferrule. Endocrowns were fabricated using Cerec CAD/CAM system (Dentsply Sirona, Germany) and the material for endocrowns fabrication was Lava ultimate blocks (3M ESPE, Germany). The internal and marginal fit were then measured using replica technique. General Linear Model (GLM) procedure was used for testing the significance of the main effects; (ferrule effect, endocrown extension) and their interaction, on the internal and marginal fit. (ANOVA with two fixed effects). RESULTS: 1- Marginal fit: the mean marginal replica thickness ranged from (22.05 µm) for group A1 to (36.42 µm) for group A2 with no significant effect of both ferrule and extension on marginal adaptation. P>0.05. 2-internal fit: The mean replica thickness ranged from (41.52 µm) for group A1 to (75.68 µm) for group A2. With high significant effect of ferrule P0.05. CONCLUSION: the ferrule significantly improved the internal fit of CAD/CAM nano-ceramic composite anterior endocrown, but it had no significant effect on the marginal fit. The extension of endocrown did not affect neither internal nor marginal fit.

Summary The purpose of this study was to compare the effect of a 4-bracket system including Alexander, Roth, MBT (Maxillary Transverse Bioadaptation), and Gianelly on the upper anterior tooth movement in sliding mechanics with the help of a 3-Dimensional (3D) Finite Element Method. Methods Displacement, stress, strain, centre of rotation and resistance on the incise edge and apex of the maxillary central incisor were calculated when 100, 200, 300, 400 grams of retraction force were applied. Results The amount of incise edge displacement was 2.609 × 10−4 mm 2.682 × 10−4 mm 2.875 × 10−4 mm and 2.881 × 10−4 mm in Alexander, Gianelly, Roth and MBT respectively with 100gr of retraction force. The value of apex root movement was 3.485 × 10−4 mm 3.547 × 10−4 mm 3.852 × 10−4 mm and 3.864 × 10−4 mm in Alexander, Gianelly, Roth and MBT respectively with 400 g of retraction force. Conclusions The MBT system had the maximum apex root and incisal edge movement in all 100, 200, 300, 400 grams of retraction force. The Alexander system had the lowest apex and incisal edge movement in all retraction forces.

Objective: To explore the cure rate of bracketless invisible headgear orthodontic for opening deep occlusion of anterior teeth. Methods: 10 cases with deep occlusion of anterior teeth were selected. All of the patients were admitted to our hospital from January 2017 to January 2020. All selected patients received bracketless invisible headgear orthodontic treatment. We took CBCT (cone beam CT) before and after orthodontics) lateral cranial radiographs and curved tomographic radiographs to analyze the effect of orthodontic treatment in 10 patients. Results: The changes of 10 patients before and after the orthodontic treatment were not significant in U1-SN, U6-SN, MP-FH (P>0.05); the U1-PP of the patients all decreased by 3~5mm. Compared with the effect before orthodontic treatment, the difference is significance(P

AIM The aim of this retrospective study is to assess potential correlation between the width of the keratinized gingiva (KG), and the dimensions of the supracrestal gingival tissue (SGT) components. MATERIALS AND METHODS On the sample of 259 teeth of 79 patients, the following measurements were collected: width of KG, sulcus depth (SD), SGT, and biological width (BW) dimensions; separate correlations between measured elements were computed for males and females, for anterior and posterior, and for maxillary and mandibular teeth separately. RESULTS Correlations between buccal KG and BW were present only for the upper anterior teeth and were nonsignificant in the female subsample, whereas the correlation between lingual KG and SGT were present only in females. Additionally, correlations between buccal KG and SD were present in upper anterior teeth only and were absent in the male subgroup. CONCLUSION The width of the KG cannot routinely be used as an indicator for the dimensions of the SGT components. CLINICAL SIGNIFICANCE While the width of the KG can hardly be a useful indicator in upper anterior teeth, probing depth and bone sounding prior to prosthetic rehabilitation remains an essential tool to ensure tissue preservation.

During the first session with a new patient, the analysis and discussion are often focused on a particular facial feature, such as “the nasal hump,” “the crowded upper anterior teeth,” or “the periorbital wrinkles.” This is related to a common idea among patients that there is only one single major problem, which needs treatment, and many minor or “undetected” details, which are entirely acceptable. I favor this initial approach in every case, writing an itemized list of the patient’s concerns to reassure her about my understanding of her wishes.

The importance of correct diagnosis, planning and treatment of dental spots is extremely important during aesthetic rehabilitation. Aesthetic requirements have become increasingly common in current society, and direct composite resin restorations are indicated due to the great advancement and increasing improvements of adhesive systems and composite resins. This work presents the clinical case of an oral aesthetic rehabilitation involving direct composite resin veneers associated with dental bleaching. The patient CSM, female, 21 years old, without systemic diseases, attended the dental clinic of the Morgana Potrich Eirelli College (FAMP) complaining of the unsatisfactory aesthetic appearance of her teeth. After careful anamnesis and detailed intraoral and extraoral examination, we identified the presence of a white spot on the upper anterior teeth. The spot was smooth and shiny, did not have soft tissue, and was well delimited and located in the cervical region. These characteristics led to the diagnosis of inactive carious lesions in the facial surface of the upper anterior teeth. After the treatment planning and its approval by the patient, the treatment started. The composite resin veneers associated with dental bleaching were indicated for better aesthetic results. The results achieved were satisfactory and met the patient’s aesthetic requirements by means of a correct diagnosis, study, and adequate planning for the case. RESUMO A importância do correto diagnóstico, planejamento e tratamento das manchas dentárias é de suma importância durante uma reabilitação estética. As exigências estéticas têm se tornado cada vez mais recorrentes na sociedade atual e as restaurações diretas de resina composta são indicadas graças aos grandes avanços e crescente melhoramento dos sistemas adesivos e das resinas compostas. O objetivo deste trabalho é relatar um caso clínico, onde foi realizado uma reabilitação oral estética envolvendo facetas diretas de resina composta associada ao clareamento dental. Paciente C. S. M do sexo feminino, 21 anos de idade, sem doenças sistêmicas, compareceu a clínica odontológica da Faculdade Morgana Potrich Eirelli (FAMP) queixando-se de estética insatisfatória nos dentes, após anamnese criteriosa, exame clínico intra e extra oral detalhados foi observado a presença de mancha branca nos dentes anteriores superiores, lisa, brilhante, sem a presença de tecido amolecido, bem delimitada e localizada na região cervical. Através dessas características e de uma anamenese criteriosa chegou-se ao diagnóstico de lesões de cárie inativa na vestibular dos dentes anteriores superiores. Após o planejamento e a aprovação da paciente, o tratamento iniciou-se, sendo indicado a confecção de facetas de resina composta associada ao clareamento dental para melhores resultados estético. Os resultados alcançados foram satisfatórios, atendendo as exigências estéticas e a satisfação da paciente, através de um correto diagnóstico, estudo e planejamento adequado para o caso.

Background: Patients with autism spectrum disorder (ASD) or other mental or physical limitations experience an imbalance in the frequency of dental treatment as compared with the general patient population, in part, due to inadequate pre-graduate training of future dentists. Case presentation: This case report describes a successful anterior tooth restoration, in awake state, in a 15-year-old boy with early childhood autism. The procedure was carried out independently by students of dentistry within the scope of their integrated clinical training semesters. Desensitization sessions were used as a preparatory measure and elements of behavioral facilitation (tell-show-feel-feel-do) were applied during the treatment. Conclusions: To avoid discrimination of this group of patients in the provision and quality of dental care, a structured approach to the transfer of theoretical and practical knowledge in the field of special care dentistry is indispensable. To this end, treatment strategies for special care patients should be taught to pre-graduate dental students as a fundamental part of their university curriculum.

Introduction: Pain is experienced by patients during various fixed orthodontic procedures such as placement of separators, insertion of arch wire and its activations, orthopedic appliances such as headgear, and debonding of the appliance. This study was formulated with the background that the level of pain sensation differs between conventional metal and ceramic brackets, arch wire being the same. Materials and Methods: The sample comprised 40 patients. The patients were separated into two groups: Group A (metal brackets) and Group B (ceramic brackets). In Group A, the brackets were bonded with 0.022” conventional stainless steel brackets (Unitek Gemini, 3M, Monrovia, California). In Group B, the brackets were bonded with ceramic brackets (Unitek Gemini Clear Brackets, 3M, Monrovia, California). The bonding of the brackets was carried out according to the conventional etching, priming, and curing technique. A 0.016” NiTi (nickel titanium) arch wire was used as the first arch wire. The intensity of pain was documented in a figure containing two 100-mm visual analog scales (VASs). Results: The level of pain reduced in intensity in due course. During 1 month, VAS scores increased at the end of day 1 (24 h) for the metal and ceramic group. The pain then decreased for up to 5 days. The average pain intensity reached 4.44 in the ceramic group, whereas it was 2.7 in the metal group for the upper anterior region. It decreased up to 1 in the ceramic and 0.22 in the metal group. Conclusion: Patients bonded with ceramic brackets experienced a higher and more severe pain of longer duration than individuals treated with conventional brackets.

Primary adenoid cystic carcinoma (ACC) of the upper anterior mediastinum mimicking a thyroid tumor has rarely been seen in clinical practice and lacks a standard of care therapy. Here, we report a 47-year old female patient with an ACC originated from the upper anterior mediastinum presenting as a thyroid gland tumor. The patient received gross surgical resection of the tumor and underwent post-surgical chemotherapy and radiotherapy. The patient was free from local recurrence 3-years following initial treatment, but developed multiple lung metastases. She remains under clinical observation without discomfort and is still followed as an outpatient. Here, we also summarized recent reports of similar cases with hope to provide some experience for future clinical practice.

An accurate estimation of both facial growth and the dentoalveolar dimension is key to successful treatment. The aim of this study was to analyze the relation between the Condylion&ndash, Gonion&ndash, Menton angle (CoGoMe^) and dentoalveolar heights in a population of patients from southern Italy. This retrospective study analyzed 270 cephalograms of 115 males (42.1%, mean age 15.5 &plusmn, 5.2 years) and 155 females (57.9%, mean age 15.6 &plusmn, 5.9 years). The facial divergency was evaluated with the Sella&ndash, Nasion and Gonion&ndash, Gnation angle (SN^GoGn), mandibular structure with the CoGoMe^, and dentoalveolar heights were assessed in four measurements: upper anterior (UADH), lower anterior (LADH), upper posterior (UPDH), and lower posterior (LPDH). Data were analyzed by means of Pearson&rsquo, s correlation and linear regression model (p &lt, 0.05). All the dentoalveolar heights were strongly correlated among them (p &lt, 0.001). The UADH was correlated with the SN^GoGn (r = 0.145, p = 0.017), while the LPDH was correlated with the CoGoMe^ (r = &minus, 0.183, p = 0.003). Moreover, there was a positive association between the UADH and the SN^GoGn (B = 0.08, 95% CI: 0.014&ndash, 0.144, p = 0.017), and a negative association between the CoGoMe^ and the LPDH (B = &minus, 0.098, 95% CI: &minus, 0.161&ndash, 0.035, p = 0.003). Facial divergency and mandibular structure are associated with dentoalveolar heights.

Recently, effects of rapidly developing technology have been seen in the dentistry. Advances in materials enable minimally invasive treatments in which dental tissue is preserved in order to provide esthetics.. Porcelain laminate veneer technique, one of the minimally invasive treatments, is the most popular treatment today. Porcelain laminate veneers stand out with having translusity close to tooth and high biocompatibility properties. In this case report, stages of porcelain laminate veneer technique are described in detail.

Objective: To assess the prevalence of dental erosion among basketball players who report consumption of carbonated beverages. Materials and methods : a cross-sectional study is proposed in a population of 60 basketball players aged 8 to 18 years, who perform physical activity more than 3 times a week and who consume energy drinks more than 3 times a week, without syndromes or systemic disease neither physical or intellectual disability. The participants were examined clinically by a single examiner regarding their upper anterior teeth through BEWE tooth erosion index and also by a questionnaire on knowledge and consumption of acidic beverages. Results : a high prevalence of dental erosion was observed (56.6%) in the evaluated population; 41.67% of participants preferred to consume hydrating drinks after the training day, with a high percen tage of carbonated beverages per day; where 71.67% know the negative effects of the consumption of these drinks. Conclusion : The presence of alterations in dental structure in the evaluated population is high.

Loss of periodontal attachment in adults usually manifests as pathological migration, traumatic deep bite and irregular dental spacing, which lead to compromised aesthetics and function. This article describes the interdisciplinary management of an adult patient presenting with severe periodontitis accompanied by marginal bone loss and pathological migration of the upper right anterior teeth. The combination of a modified intrusion procedure of the upper anterior teeth and periodontal therapy led to significant improvement in function and aesthetics. CPD/Clinical Relevance: The modified intrusion technique described in the present case can be a useful alternative to improve the periodontal condition as well as the aesthetics in periodontally compromised adult patients.

Objective: To evaluate the radiographic technical quality of root canal fillings performed by senior dental students at Alfarabi colleges for dentistry, Kingdom of Saudi Arabia. Methods: Radiographic assessment was conducted for 246 teeth (390 root canals) endodontically treated by senior dental students to evaluate the quality of root canal fillings. Three criteria were evaluated to assess the technical quality of root canal fillings: length, density, and taper. The root canal filling was considered acceptable if it had an adequate length with no voids and consistent taper from the orifice to the apex. Statistical analysis was conducted using Kruskal–Wallis, Mann–Whitney, and chi-square tests (P=0.05). Results: Acceptable root canal fillings were detected in 127 (32.6%) patients. The frequency of an acceptable root canal filling was the highest for the upper anterior teeth (40%). There were significant differences in the length and density among the types of teeth (P0.05). Conclusion: The quality of root canal fillings performed by senior undergraduate dental students at AlFarabi colleges for dentistry was acceptable in 32.6% of patients. This outcome enhanced the poor performance of undergraduate dental students in the area of endodontics.

Background: This clinical trial investigated the effectiveness of two remineralizing creams on regression of white spot lesions (WSLs) after orthodontic therapy. Materials and Methods: The study included patients with WSLs on their upper anterior teeth who recently completed orthodontic treatment at the Department of Orthodontics of Mashhad Dental School and two private offices. The participants were randomly assigned into three groups by treatment: (1) a 12-week regimen of a cream containing casein phosphopeptide-amorphous calcium phosphate and fluoride (MI Paste Plus); (2) a 12-week regimen of a cream containing hydroxyapatite and fluoride (Remin Pro); and (3) usual home care (control). Thirty-nine patients participated and three withdrew. The main outcomes including area, mineral content, and color of WSLs were measured at enrolment and 4, 8, and 12 weeks later, respectively. Blinding was applied for outcome assessment only. The data were analyzed by analysis of variance and repeated measures analysis at the statistical significance of P < 0.05. Results: Over a 3-month period, the application of both MI Paste Plus and Remin Pro caused significantly greater reduction in area and significantly higher increase in mineral content of WSLs compared to the control group (P < 0.05). The appearance of WSLs improved significantly in both experimental groups (P < 0.05), but not in the control group. No side effect was observed throughout the experiment. Conclusion: The application of either MI Paste Plus or Remin Pro was effective in reducing the area, increasing the mineral content and improving the appearance of demineralized enamel, indicating that these products could be recommended for managing postorthodontic WSLs.

Background: The collapse of the alveolar ridge in an edentulous area in patients who will undergo oral rehabilitation impedes the harmonic relationship between pontic and ridge. To correct this type of defect there are several surgical techniques that aim to achieve soft tissue augmentation, allowing the conformation of an ideal profile with the use of a pontic. The aim was to demonstrate how the technique of tissue modification in an area with a class b defect of Allen allows the correction of aesthetics in the anterior dental sector. Case presentation: A 41-year-old Mexican woman. Extra and intraoral examination was performed, the dental treatment included connective tissue graft and rehabilitation with Zirconia. Conclusion: Surgery of residual alveolar ridge augmentation with connective tissue graft gives the patient favorable aesthetic results in the anterior area when it will be rehabilitated.

Atualmente as pessoas vêm cada vez mais tentando se enquadrar em um padrão de beleza e a busca pelo sorriso perfeito pode trazer danos e frustrações ao paciente, caso o profissional não siga os critérios necessários para realizar intervenções estéticas, como é o caso das facetas em resina composta. O objetivo deste trabalho é descrever um caso clínico onde foi realizada a troca de facetas em resina composta nos elementos dentários anteriores superiores por novas facetas de resina em busca de adequação estética e anatômica e discutir acerca desse tratamento. O paciente procurou atendimento no consultório odontológico queixando-se de suas antigas facetas, onde o mesmo achava a coloração desagradável, afirmando também que ao fazer sua higiene oral havia sangramento. Tendo em vista tais situações do paciente e análise clínica, foi proposto clareamento dental imediato da arcada inferior, remoção das 10 facetas pré-existentes e nova execução de 10 facetas em resina seguindo os princípios estéticos e funcionais. Para a realização de múltiplas restaurações estéticas é essencial que o Cirurgião-Dentista esteja atento às indicações, possíveis limitações e conhecimento da anatomia dental do paciente, respeitando também tecidos e estruturas periodontais. Sendo assim, um planejamento devidamente qualificado para executar tal procedimento é essencial para que o paciente não venha a ter qualquer tipo de desconforto, garantindo o sucesso do tratamento.

Purpose The purpose of the present study was to present a three-dimensional method for evaluating changes in lip morphology and to apply the method to the therapy evaluation following the correction of functional anterior crossbite. Materials and methods Twenty-five Japanese patients (age: 6 years and 10 months to 10 years and 9 months) with anterior crossbite and premature contact of at least one central incisor were included. Anterior crossbite was treated with labial movement of the upper anterior teeth using a fixed or removable appliance. Treatment was completed within 6 months. The 3D morphology of the facial soft tissue was recorded using a 3D surface imaging device before and immediately after correction of anterior crossbite. The differences in lip morphology variables were statistically analyzed. Results At post-treatment, the upper lip was positioned anteriorly and was proclined on the mid-sagittal plane, and anteriorly and superiorly on the plane apart from the midline. The lower lip was positioned posteriorly not only on the mid-sagittal plane but also on the plane apart from the midline. The lower lip was retroclined on the mid-sagittal plane. The submental region was positioned posteriorly and inferiorly. Conclusions Post-treatment imaging showed forward movement of the upper lip, backward movement of the lower lip, and backward rotation of the soft tissue in the submental region. The three-dimensional method described in the present study improves the evaluation of facial morphology and provides insight into the changes in the lip morphology of preadolescent patients.

Introduction Knowledge of tooth dimensions and relationships and ethnic variations in these parameters are important in the planning and provision of aesthetic dentistry.Aim The aim of the present study was to investigate the dimensions and relationships of the upper anterior teeth in young adults of Indian origin, living in an urban location in the UK, and to compare the data obtained with data pertaining to other ethnic groups.Materials and methods This was a qualitative, non-experimental, cross sectional descriptive study with ethical approval. The dependent variables were tooth dimensions and relationships. The independent variable was gender. Fifty male and 50 female young adult Indians were recruited to the study, according to predetermined criteria. Upper and lower, full arch impressions were obtained for each of the 100 participants. Stone cast were obtained from these impressions. The width and length of each upper anterior tooth included in the casts were measured using precision callipers. Anterior arch length was determined using a flexible measuring tape. All measurements were repeated at least three times to obtain consistent values. The error of the method was investigated by means of repeat measurements. The data obtained was analysed, and compared with existing data on tooth dimensions and used to investigate the presence of Golden Proportion relationships.Results The measurements obtained had a normal distribution. Statistical analysis revealed significant differences in the overall data for left and right canine width and length (P

Purpose: To evaluate the effect of anodization surface treatment on the stability of minimplants ( MIs ) during en-masse retraction. Materials and Methods: The sample of this split mouth; clinical trial, consisted of 27 patients with an allocation ratio of 1:1. Forty five MIs (1.8 mm diameter and 8 mm length) were divided into: 27 MIs with surface treatment by anodization technique while the other 27 were with smooth surface (group B). Finishing, leveling and alignment, the surface treated MIs and the smooth ones were randomly inserted between the roots of maxillary 2nd bicuspid and 1st molar at the mucogingival junction on both sides of each patient. After two weeks healing period, bilateral extraction of maxillary 1st bicuspids were done. Closed coil spring was extended from the MI head to along hock secured onto the main arch wire between the maxillary lateral incisor and canine on both sides, delivering 200 g force per side to en-masse retract the upper anterior teeth. The average observation period lasted 9–12 months. Results: In total, 40 of 54 minimplants were able to achieve the treatment goals. In group A, 22 (81.5%) mini-screw implants presented long-term stability, while in group B, only 18 (66%) minimplants were stable throughout the treatment. This difference was statistically significant (P =.0311). The total success rate for all inserted miniscrew implants was 74%. Conclusion: Anodized surface treated orthodontic mini-screw implants are more stable than smooth surface one during en-mass retraction.

Introduction: Knowledge about the size and proportion of upper anterior teeth allows dental rehabilitation taking into consideration the local parameters of a population. The aim of this research is to determine the width, length and the relationship between width and length of central incisor, lateral incisor and canine teeth in both sexes in young Chilean population. Methodology: A cross-sectional study was performed. Study subjects included 187 dentistry students from two Chilean cities (mean age 21.35±2.7 years, 52.9% men). The teeth width and height were measured and the width/height ratio was calculated. Differences in measurements according to sex was analyzed (p

Aim: The aim of this observational study was to assess the different esthetic smile criteria of adults in Saudi Arabia. Further goals were to find the predominant dental shades and assess subjects’ esthetic perception in a sample of Saudi community.Materials and Methods: Thirty subjects were recruited from King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. Subjects were between 18-50 years of age with intact upper anterior teeth and healthy gingiva. All participants were photographed and the following smile parameters were recorded: tooth geometry, shade, midlines, smile arc, and upper lip position. Parameters were plugged in a dedicated smile analysis software and the golden proportion values were obtained. Data were analyzed using Chi Square and Student’s t-tests according to variables tested at 0.05 significance level.Results: Regardless of age and sex, 70% of the sample has an average lip position, and consonant smile arc was the prevalent form among 73.3% of the sample. The most common shade was A2 regardless of tooth type or position. Almost half of the participants were satisfied with their overall appearance and only 6 subjects were not satisfied with the size of their teeth. Overall, the golden proportion was not present in the tested sample. Conclusion: Despite the absence of golden proportion, the majority of the sample tested was satisfied with their smile parameters. The prevalent shade was A2 in both genders.

Transthoracic ultrasound (TUS) is a validated imaging method for the assessment of the chest wall, the upper anterior mediastinum, and about 70% of the pleural surface. Therefore, pulmonary alterations are visible only when they are adherent to the pleural surface, that is, when no aerated lung, concomitant subcutaneous emphysema, or pneumothorax are interposed in between.

The digital smile design (DSD) has been used as a tool for esthetic dentistry that improves predictability of rehabilitation procedures such as direct restorative techniques, which are an effective alternative with low cost to obtain dental esthetics in a short clinical time. This case report aimed to present an integrated planning related to functional, esthetic and emotional requirements from the patient based on digital design parameters. A 23-years-old male patient presented yellowed lateral incisors and canines, with diastema among anterior teeth, and dento-gingival disharmony. The facial harmony, dento-gingival parameters and teeth dimensions were analyzed using DSD. The following clinical procedures were performed: gingivoplasty surgery around the upper right and left lateral incisors (teeth 12 and 22), dental bleaching with 35% hydrogen peroxide combined with 15% carbamide peroxide, and upper anterior direct restorations using resin composite, which resulted in natural aspect and the harmony of the smile.

La fluorosis dental es una patología de la que se tiene poca información en cuanto a su prevalencia en el estado de Coahuila, México. La finalidad de este estudio descriptivo con temporalidad transversal es identificar la prevalencia y severidad de fluorosis dental en adolescentes de 12 y 15 años. Se aplicó un cuestionario e inspección del sextante anterior superior en 1205 adolescentes mediante el índice de Dean modificado y el índice comunitario de fluorosis. La prevalencia de fluorosis calculada fue de 53%. Según el grado de severidad, el código más prevalente fue muy leve. El índice comunitario de fluorosis fue de 0.602, valor que indica cercanía a un problema de salud pública. Se sugiere realizar una investigación en los pozos de agua en las comunidadesinvolucradas para evitar un problema de salud pública.

Objective To perform a systematic review of the literature focused to evaluate in vitro function of prefabricated fiber posts with and without customization by additional auxillary fiber posts and composite resin on the fracture strength of wide or enlarged canals and the failure pattern. Methods Six databases were used as primary search sources (PubMed, Scopus, LILACS, SciELO, Science Direct, and Web of Science) and three databases (Open Grey, Open Thesis, and OATD) were used to partially capture the “grey literature”. The research included laboratory studies that used human upper anterior teeth aiming to assess the fracture strength and failure pattern of different glass fiber post customizations by additional auxiliary fiber posts or composite resin. The search had no restriction of year, language, and publication status. The risk of bias of the studies was assessed from the criteria established in systematic reviews of laboratory studies. Standardized mean differences were calculated by comparing the mean fracture strengths of customized and non-customized posts. Pooled estimates were calculated by Glass' delta method using the random-effects model. Subtotal estimates were presented according to each type of relining procedure and an overall estimate was described considering all studies combined. Results The search provided 2291 results, from which six met the eligibility criteria and were included in the qualitative assessment of the review. Only three studies presented a moderate risk of bias. The meta-analysis results showed that the use of auxiliary posts produced higher mean fracture strengths than non-customized posts (SMD = 2.21; 95%CI: 0.74; 3.68), and it was more effective than the use of composite resin to reline the posts. Conclusion Based on laboratories studies, even though has not been observed any difference to a statistically significant level on fracture strength and failure pattern of the customized and non-customized post, future studies should follow a standardized approach to implementation and reporting of data.

Objective: The objective of this study was to assess the pattern of tooth discoloration and care-seeking behavior among adolescents in a Nigerian community. Materials and Methods: A cross-sectional study using a questionnaire was carried out among 384 adolescents in Idere, Southwestern Nigeria. The questionnaire comprised questions on sociodemographic data, presence of tooth discoloration, and care-seeking behavior. Two calibrated examiners examined the labial and buccal surfaces of the teeth for the presence of tooth discoloration. Frequencies and bar charts were generated, and Chi-square test was used to test the association between categorical variables at P < 0.05. Results: The mean age of the study participants was 14.7 ± 2.3 years, comprising 222 (57.8%) and 162 (42.2%) in junior and senior secondary schools, respectively. Intraoral examination revealed 167 (43.9%) had discolored teeth while 127 (33.1%) perceived that they had discolored teeth. Extrinsic stains were the major cause of tooth discoloration in both anterior and posterior teeth (18%-84%) except in upper anterior teeth where enamel hypoplasia was the major cause (20%-30%). Among participants who perceived that they had tooth discoloration, 81.9% mentioned that they did not know that the discoloration can be treated. Older participants had more discolored teeth than their counterparts (P = 0.01). Age group, sex, and class of participants were associated with frequency of tooth brushing (P < 0.05). Participants who had anterior or intrinsic tooth discoloration sought care more often than those with posterior or extrinsic tooth discoloration (P < 0.05). Conclusions: Extrinsic staining was the major cause of tooth discoloration. Many adolescents did not know that the discoloration can be treated.

The purpose of this study was to investigate the relationship between interdental spacing in the upper incisors and other associated factors with colonization by Streptococcus mutans in children. A total of 47 children aged between 24 and 36 months with no decayed cavities were enrolled in the study. Models were obtained to evaluate interdental spacing in the upper anterior region. The relationships between S. mutans colonization and number of erupted teeth, interdental spacing, diet, and oral hygiene behavior were investigated. S. mutans was detected in the saliva of 14 children (29.8%). No sociodemographic variable was associated with colonization by S. mutans. Neither number of erupted teeth nor children's age showed an influence on colonization by S. mutans. However, children with interdental spacing in the upper incisors were less likely to show colonization by S. mutans (15.8%) than those without (39.3%). Furthermore, children who ceased breast-and/or bottle-feeding by 15 months of age were less likely to show colonization by S. mutans (22.7%) than those who continued feeding until 19 months of age or more (46.2%).

We describe the treatment of a young girl age, 24 years, with class II division 1 malocclusion and spacing of upper anterior segment. Treatment consisted mainly of space closing, arch contraction, leveling and alignment with Edgewise fixed appliances by multiloop technique. Due to patient good cooperation, treatment time reduced (10 months). The treatment resulted in proper alignment of upper & lower anterior segment, an ideal overjet, overbite and incisor angulations. Ban J Orthod & Dentofac Orthop, April 2016; Vol-6 (1-2), P.42-47