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Accurately identifying periodontal landmarks via acoustic imaging is increasingly important. Here, we evaluated the accuracy of cementoenamel junction (CEJ) identification using ultrasound by comparing it to clinical methods in 153 extracted human teeth. The distance between the CEJ to a reference point was measured using two clinical methods (visual examination and tactile sensation) as well as ultrasound imaging. Statistical analyses were performed across all teeth and sub-groups, including tooth types (incisors, cuspids, and molars/premolars), and two classifications: A- vs. B- (visually detectable or undetectable CEJ, respectively); and CL-S vs. CL-D (shallow or deep cervical lesions). In A- or CL-S teeth, ultrasound measurements highly agreed with clinical measurements, showing a 1.72-mm 95% CI for A- and 1.99-mm 95% CI for CL-S compared to visual examination, and a 1.77-mm 95% CI for A- and a 2.10-mm 95% CI for CL-S compared to tactile sensation, respectively. For 80% of A- and 76% of CL-S teeth, the difference between ultrasound and visual examination was within ± 20%. For 81% of A- and 80% of CL-S teeth, the difference between ultrasound and tactile sensation was within ± 20%. The variance of ultrasound versus clinical CEJ identifications showed a significant correlation (r = 0.6607) to the cervical lesion depth. The errors between ultrasound and clinical measurements show no significant bias across different tooth types.

Purpose: To investigate the effect of full-mouth disinfection on the sizes of the periodontal wound and periodontal inflammatory burden and whether it leads to a decrease in C-reactive protein (CRP) levels. Materials and Methods: The study included 20 systemically healthy subjects (11 women and 9 men) 30 to 68 years old with localised or generalised periodontitis (stage III, grade C). The sizes of the periodontal wound and periodontal inflammatory burden were measured with the web application “Periodontalwound”, which is based on measurements of average tooth cervices, as well as probing depths and bleeding on probing assessed at six sites around each tooth present in the oral cavity. The levels of hsCRP (high-sensitivity CRP) were measured with an immunochemical method. All three parameters were measured before initial treatment and 3 months after therapy. Full-mouth disinfection included removal of plaque and calculus with ultrasonic and hand instruments in one session. Results: The results showed a statistically significant decrease in the size of the periodontal wound (p < 0.001), a statistically significant decrease in the size of periodontal inflammatory burden (p < 0.001), and a decrease in hsCRP levels 3 months after therapy. Conclusion: Full-mouth disinfection leads to a decrease in the periodontal wound and periodontal inflammatory burden size, as well as a decrease in the levels of hsCRP in patients with localised or generalised periodontitis (stage III, grade C) [ABSTRACT FROM AUTHOR]

The article "Digital Technology: A Tool for the Treatment of Implant Reintervention" in Quintessence of Dental Technology discusses a case study of nonesthetic rehabilitation of a maxillary right central incisor with an implant. The use of digital planning tools facilitated safe and efficient interdisciplinary treatment involving cosmetic surgery and prosthetic rehabilitation. The article emphasizes the importance of proper planning and the use of digital tools to ensure predictable outcomes and simplify the treatment process. [Extracted from the article]

Purpose: To evaluate the marginal leakage of three different types of bonding agents used with two posterior composites and a giomer, available commercially. Material and methods: Class II box-only cavities were prepared on 90 mandibular first molars with margins extending 1 mm beyond the cementoenamel junction. The samples were divided into nine groups based on three different bonding agents, two different composites, and a giomer. Cavities were restored per the manufacturer's description. Teeth were subjected to a thermocycling procedure (500Ã--, 5°C to 55°C) and dye penetration by immersing in a 2% methylene blue solution (Merck Specialties) for 24 hours. The marginal adaptation was evaluated as a continuous margin at the gingival level under a stereomicroscope. The results were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: The results of the groups with the total-etch technique showed no statistical difference between the nanohybrid Filtek Z250 XT (3M ESPE) and fine hybrid SwissTEC composite (Coltène\Whaledent AG). The groups with the self-etch technique showed no statistical difference when used with either of the two composites. The acid-etch technique showed better marginal adaptation than the self-etch technique. When the giomer (Beautifil II, Shofu) was used with the total-etch technique, it showed better adaptation than when used with the self-etch technique but overall showed more marginal leakage than the composites. Conclusion: The total-etch technique provided better marginal adaptation for the composites and giomer compared to the self-etch technique. Clinical significance: The demand for esthetic restorations continues to increase, and composite restorations are now considered the material of choice for Class II cavities. There are various concerns with composite restorations, one of them being good marginal adaptation to increase the life of the restoration. This study evaluated marginal leakage with the nanohybrid composite Filtek Z250 XT, fine hybrid composite SwissTEC, and a giomer when used with the total-etch technique and self-etch technique and reported satisfactory adaptation with the total-etch technique. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Plain Language Summary This study aimed to assess the relationship of maxillary alveolar bone thickness (BT) and height (BH) with gingival phenotype (GP) in smokers and nonsmokers using cone‐beam computed tomography (CBCT).This cross‐sectional study was conducted on 60 participants. The participants underwent periodontal examination, and their GP was determined by placing a periodontal probe in the gingival sulcus at the midline and observing the transparency. The participants were then assigned to four groups (n = 15) based on their smoking status and GP: thin phenotype/smoker, thick phenotype/smoker, thin phenotype/nonsmoker, and thick phenotype/nonsmoker. BT and BH of the participants were measured in the sagittal plane on CBCT scans at the bone crest and at 2, 4, and 6 mm apical to the crest at the site of maxillary central and lateral incisors. Data were analyzed by two‐way ANOVA and LSD test (alpha = 0.05).The distance between the cementoenamel junction (CEJ) of maxillary central and lateral incisors and alveolar bone crest in smokers was significantly greater than that in nonsmokers (p < 0.001). Smoking had no significant effect on alveolar BT at the crestal level or 2, 4, and 6 mm apical to the crest. BT at the crest and 2, 4, and 6 mm apical to the crest was significantly greater in thick, versus thin, GP (p < 0.001).Smoking significantly increased the distance between the CEJ and alveolar crest at the site of central and lateral incisors but had no significant effect on BT.This study found that smoking significantly increased the distance between the cementoenamel junction and the alveolar bone crest in maxillary incisors but did not affect alveolar bone thickness, which was greater in individuals with a thick gingival phenotype compared to those with a thin gingival phenotype. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: The continuous evolution in orthodontics introduces innovative materials and methods to enhance treatment efficacy. Among these advancements, orthodontic anchorage screws, particularly miniscrews, have revolutionized treatments by offering diverse nonsurgical solutions for managing space discrepancies and certain skeletal malocclusions. The success of miniscrews is influenced by various factors including patient-related factors (age, sex, skeletal pattern, and oral hygiene), miniscrew-related factors (diameter, length, shape), and treatment-related factors (technique, applied forces, and insertion site). Materials and Methods: This study used Cone Beam Computed Tomography (CBCT) to evaluate the mandibular buccal shelf area for miniscrew placement across different sagittal and vertical skeletal patterns in 63 subjects, categorized based on the ANB angle and Jarabak ratio into Class I, II, III, and horizontal, average, and vertical growth patterns, respectively. Measurements were taken at specific sites related to the mandibular first and second molars, focusing on angulation, buccal bone depth (4mm and 6mm from the cementoenamel junction), and buccal bone thickness (6mm and 11mm from the cementoenamel junction). Results: There were no significant statistical differences in any measurement between the right and left hemiarches. The values for the bone around the distal root of the mandibular second molar were significantly greater than the other values. With regard to Sagittal Skeletal Pattern, Class I cases showed greater values as compared to Class II and Class III with a significant difference in the angulation, bone depth, and thickness at 11 mm from CEJ. Although values tended to be greater in patients with horizontal growth pattern, the difference was not statistically significant. Conclusion: Mandibular buccal shelf provides an optimal bone site for miniscrew insertion with better osseous characteristics at the distal root of the mandibular second molar. Subjects with skeletal Class I and horizontal growth pattern exhibit the most favorable osseous characteristics in the MBS area. However, in terms of bone thickness at 6 mm from CEJ Class III cases showed significant difference compared to Class I and Class II. [ABSTRACT FROM AUTHOR]

Background: Obtaining a perfect color match with resin composite presents a significant challenge. The chameleon effect has enabled resin composite to mimic the color of the adjacent tooth structure in vitro. This double-blind, split-mouth and equivalent randomized clinical trial evaluated the color matching of one-shade resin composite with chameleon effect versus multi-shade resin composite in non-carious cervical lesion restorations (NCCLs). Methods: One hundred twenty restorations were performed on NCCLs with two restorative materials (n = 60). After prophylaxis, the teeth were isolated with rubber dam and one universal adhesive was applied in the selective enamel etching strategy. For both groups, the restorations were inserted incrementally. The values of ΔEab and ΔE00 in the cervical and middle third were evaluated using a digital spectrophotometer before vs. after the restorations. The restorations were evaluated at baseline and after 7 days, 6-, 12- and 18-month of clinical performance according to the FDI criteria (Word Federation Criteria). Statistical analysis was performed using Chi-square test for all parameters. Color change was analyzed by two one-sided t-tests for paired samples (α = 0.05). Results: Regarding the color measurement no significant difference was observed when Vittra APS (FGM Dental Products, Joinville, SC, Brazil) was compared to Vittra Unique (FGM Dental Products, Joinville, SC, Brazil) for any of the comparisons performed (p > 0.05). However, the ΔEab and ΔE00 values for the cervical third, both before and after the restorations, were higher compared to the ΔEab and ΔE00 values observed when comparing the cervical and middle thirds after the restorations. After 18 months, five restorations exhibited minimal discrepancies in terms of marginal adaptation or marginal discoloration (p > 0.05). In all other criteria, including retention rate, no changes were detected at the 18-month recall. Conclusions: The one-shade resin composite used achieve the same color match when compared to a multi-shade resin composite after a period of 7 days in NCCLs. Overall, the restorations scored clinically very good (FDI) at baseline and after 18 months for all outcomes. Clinical Significance: The use of a one-shade resin composite in NCCLs can be recommended because it has the ability to simplify the restoration procedure and maintaining an excellent clinical performance. Registration of clinical trials: RBR-8txr4fw: 26/05/2022. [ABSTRACT FROM AUTHOR]

Background: Crown lengthening (CL) in esthetic areas has become a versatile procedure with applications in many clinical situations. Knowledge concerning different periodontal phenotypes, and the supracrestal tissue attachment (STA)—former biological width—has allowed for a better understanding of surgical management, allowing for the individualization of surgical therapy. This review presented an individualized surgical approach to CL in esthetic areas based on evaluating the phenotype and current considerations about the STA, correlating them to suggestive surgical techniques. Methods: For an individualized surgical approach, it is primarily necessary to understand STA, including the relationship and distance between the cementoenamel junction (CEJ) and the bone crest (BC) and the position of the free gingival margin (FGM); secondarily, it is necessary to verify the periodontal phenotype to prepare surgical planning (gingivectomy or osseous resection/contouring). Three periodontal phenotypes are recognized, presenting different biological behaviors due to specific characteristics implicitly correlated to soft tissue management. Results: Then, after assessing the distance from the CEJ to the BC, the position of the FGM, and the periodontal phenotype, it is possible to individualize the treatment according to the phenotype. In cases of a thin and scalloped periodontium with delicate gingiva, there might be the presence of bone dehiscence, fenestration, and instability in the healing of the gingival margin, bringing extra attention to tissue manipulation and suggesting a minimally invasive technique (no flap). A partial-thickness flap is recommended for a thick and scalloped periodontium, keeping the periosteum adhered to the bone. For periodontium B (fibrous and dense gingiva and tissue resistant to injuries), the surgical approach recommended is an open full-thickness flap with osteotomy for horizontal and vertical bone volume removal. Then, observing first the specific parameters, such as the STA, CEJ, BC, FGM, and KTW, and then the characteristics of periodontal phenotypes, it is possible to determine the individualized surgical strategy and a reasonable surgical approach to tissue manipulation in clinical CL surgeries. Conclusions: The surgical approach must be defined according to individualized planning since several variables can influence the dynamics of the periodontal tissues. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Dentin bonding with etch-and-rinse adhesives involves demineralizing the 5-8µm of the surface dentin to create micro space for resin infiltration. The presence of continuous fluid movement in dentin tubules and positive pulpal pressure prevents complete water replacement by resin monomers. This results in areas of demineralized dentin, which contain collagen fibers without resin infiltration. The exposed collage fibers are subjected to enzymatic degradation leading to less durable hybrid layer. Purpose: The aim of this study was to evaluate the remineralizing effect of the nanoparticles on the resin dentin bonding interface. Materials and Method: The three experimental remineralizing nanoparticles were characterized for their morphology, size, and composition. A total of 48 extracted non-carious human third molar teeth were sectioned at 2 mm below the cemento enamel junction. Class I cavity was prepared and the tooth samples were placed in an intra pulpal pressure simulation device. After etching of the prepared cavity, the samples were randomly divided into four groups (n=10) as follows: (1) control group(c) (n=10) (2) Nano-hydroxyapatite (nHAP) (n=10) (3) Chitosan-nanohydroxyapatite (Chi-nHAP) (n=10) (4) Mesoporous silica-hydroxyapatite (MS-nHAP) (n=10). After 30 days remineralization period, the samples were evaluated for micro tensile bond strength, hybrid layer morphology, and mineral composition of the hybrid layer. The results were analyzed statistically by one-way ANOVA and Tukey's multiple post hoc tests. Results: Scanning electron microscopic observation of nanoparticles revealed irregular particle shapes with calcium phosphate ratio of 1.60. The zeta analyzer showed a mean diameter of 161.0 nm, 323.0nm, 185.0nm for nHAP, Chi-nHAP, and MS-nHAP respectively. Post hoc Bonferroni test revealed significantly higher bond strength for nHAP, Chi-nHAP, and MS-nHAP when compared to control group. MS-nHAP resulted in the uniform deposition of apatite crystal on the surface without any evidence of dentinal tubules openings and had higher mineral to matrix ratio compared to other groups. Conclusion: MS-nHAP nanoparticles can be considered as a reliable source of calcium and phosphate for biomimetic remineralization of hybrid layer. Application of nanoparticle remineralization precursors before application of dentin bonding agents results in remeralization of exposed collagen fibers thereby improving the clinical longevity of hybrid layer. [ABSTRACT FROM AUTHOR]

Background: Immediate implant placement (IIP) has shown predictable outcomes when specific requirements are met. The aim of the present study was to radiographically evaluate the dimensions of mandibular incisors and the alveolar bone to further determine the feasibility of IIP in this area. Materials and methods: A total of 404 intact mandibular incisor CBCT images from 101 patients (42 males, 59 females; mean age 49 ± 16.84 years) were analyzed. The mesiodistal tooth width and the distance between the incisal edge (IE), cementoenamel junction (CEJ), facial bone crest (bo, root apex (RA), and fenestration point (F) were registered, together with the alveolar bone width at 1 and 3 mm below BC. Finally, the angular discrepancy between the dental and the alveolar bone long axis (BLA) was recorded as the tooth torque (TT). Results: The CEJ to BC distance was 3.23 ± 1.67 mm. The RA to F mean distance was 15.02 ± 3.97 mm. The mean alveolar bone buccolingual widths at 1 and 3 mm below the facial BC were 7.12 ± 0.82 and 6.32 ± 0.71 mm in the lateral and central incisors, respectively (P < 0.001). The buccolingual width was less than 6 mm in more than 33% of the central incisors, but only in 3% of the lateral incisors, displaying increased alveolar width. The average was 165.66 ± 7.47 degrees. Conclusions: The results presented in this study point toward the need for careful consideration of the requirements for anterior mandibular IIP for success and predictability purposes. [ABSTRACT FROM AUTHOR]

Objective: The impact of the deep margin elevation (DME) technique and its associated materials on the stress distribution in ceramic endocrowns remains to be fully understood. This finite element analysis (FEA) aimed to assess the effects of flowable composite and resin‐modified glass ionomer (RMGI) as DME materials on the maximum Von Mises stress (VMS) values and overall stress distribution within ceramic endocrowns and the surrounding tooth structure. Materials and Methods: A mandibular molar featuring a class II mesio occlusal (MO) cavity with the gingival margin of the mesial cavity positioned 2 mm below the cementoenamel junction (CEJ) was prepared and scanned using a Medit i500 scanner. The digital file was then transferred to computer‐aided design (CAD) software to create the models. The study generated four scenarios: an intact tooth model (model of intact tooth (MIT)), a prepared tooth model without a DME layer (model without DME (MWD)), a model with a 2 mm DME layer using composite material (model with DME of composite (MDC)), and a model employing RMGI (model with DME of RMGI (MDR)). Stress distribution under axial loads was evaluated based on the Von Mises criterion. Results: The MIT model demonstrated the highest stress concentration at the CEJ region yet exhibited lower stress levels than others. The MWD model showed the highest stress levels. No significant differences in stress distribution patterns were observed between the MDR and MDC models. All models displayed similar stress distributions in the bone. Conclusion: Regardless of the material used, incorporating a DME layer in cavities extending below the CEJ is advisable to achieve uniform stress distribution. Minimizing tooth preparation and preserving tooth structure are recommended. Clinical Significance: Employing a DME layer in cavities with margins below the CEJ is beneficial for reducing stress, irrespective of the material choice. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusions Clinical Significance To investigate the surface roughness on cementoenamel junction after application of various rubber‐dam retraction clamps for different durations.Fifty‐four extracted human molar teeth were used. Various retraction clamps were placed on the cementoenamel junction. There are three main examination groups in the study. Group 1 (n = 6) included a polymer clamp (SoftClamp, Kerr Hawe, Switzerland), Group 2 (n = 6) included a metal clamp with a flat edge (Black Line RDCM7X, Hu‐Friedy Group, USA), and Group 3 (n = 6) included a metal clamp with a serrated edge (Fiesta Color Coded, Coltene, USA). All clamps were applied for 30 min, 1, and 2 h. Surface roughness measurements were performed using a profilometer before and after the clamp application and surface morphology was assessed through the SEM images. One‐way ANOVA was used to compare three or more groups. Percentage changes were evaluated using the Kruskal–Wallis test, followed by Dunn's test for post hoc analyses. The deemed significance was set at p < 0.05.Between the initial and the final roughness measurements, after 30 min of clamp application, only Group 3 showed significant increases in roughness (p = 0.001). After 1 and 2 h of clamp application, there were significant increases in roughness for all groups. No significant differences in percentage changes for all groups in 30 min and 2 h of application (p = 0.220 and p = 0.091, respectively). However, Group 1 presented significantly lower surface roughness in percentage after the 1 h of application (p = 0.040). No significant differences in the percentage changes in roughness were observed within the groups for 30 min, 1, and 2 h applications (p = 0.220, p = 0.884, and p = 0.755 for Groups 1, 2, and 3, respectively). In SEM analysis, deep point microstructure defects were seen as the clamp application time increased.Rubber‐dam clamp application may cause damage to the cementoenamel junction area. However, the level of damage is clamp‐type‐dependent. Slight scratch‐type damages were observed on teeth with plastic clamps, while metal clamps generally caused cracks. The increase in the duration of the same rubber‐dam clamp application was not considered an effective factor regarding the damage.During rubber‐dam isolation, clamp type and duration of the application may cause damage to the tooth surface or progress an existing defect. Examining the teeth before selecting the clamp might be beneficial for minimizing dental tissue damage. [ABSTRACT FROM AUTHOR]

Background/Objectives: The presence of enamel on the tooth surface is crucial for the long-term success of minimally invasive adhesive restorations such as dental veneers. Our study aims to evaluate the enamel thickness in the incisal, middle, and cervical portions of the labial surface of the upper central incisors using cone beam computed tomography (CBCT). This imaging method provides detailed and accurate three-dimensional images with a low radiation dose, allowing an accurate assessment of enamel thickness. The analysis aims to identify variations in enamel thickness depending on the age and different levels of the labial tooth surface. Methods: 800 CBCT scans performed for diagnostic or therapeutic purposes on patients aged 18–60 years were analyzed. The data were gathered from the imaging archives of private practitioners from Targu Mures and the "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures. Enamel thickness measurements were conducted using the OnDemand3D Communicator CBCT evaluation program, with subsequent statistical analysis performed using GraphPad Instat Prism software. Results: Results showed significant variation in enamel thickness between the incisal, middle, and cervical segments of the labial surface of the upper central incisors. A decrease in enamel thickness with age has been observed. In patients aged 18–40, mean values of enamel thickness 1 mm and 3 mm above the cementoenamel junction (CEJ) were 0.48 ± 0.092, respectively, 0.819 ± 0.158. In patients over 40, the mean values were 0.454 ± 0.116 and 0.751 ± 0.067 at 1 mm, respectively, 3 mm above the CEJ. Statistically significant differences were found between the two age groups at 1 mm and 3 mm above the CEJ, with p < 0.0001 and p = 0.0214. Conclusions: A statistically significant decrease can be observed in enamel thickness in almost the entire labial surface of the upper central incisors with aging. The varied thickness of the enamel at different tooth levels requires individualized planning for each patient to maximize the long-term aesthetic and functional results. [ABSTRACT FROM AUTHOR]

Objective: Mandibular full-arch distalization (MFD) is a popular approach, particularly in non-extraction cases. However, we still cannot confirm whether facial patterns affect the amount of limits. This study aimed to determine the anatomical MFD limits in patients with different facial patterns. Study design: Using computed tomography (CT), the shortest distances from the mandibular second molar to the inner cortex of the mandibular lingual surface and from the lower central incisor to the inner cortex of the lingual mandibular symphysis were measured in 60 samples (30 patients). The available distalization space in both regions was compared between groups with different facial patterns. Results: The available space in symphysis was more critical than that in retromolar area: the shortest distances to the inner cortex of the lingual mandibular symphysis at root levels 8 mm apical to the cementoenamel junction of the incisor were 1.28, 1.60, and 3.48 mm in the high-, normal-, and low-angle groups, respectively. Conclusions: Facial patterns affected the MFD capacity, and the thickness of the lingual mandibular symphysis was the most critical anatomic limit encountered. Practitioners should always pay attention to the possible impacts from facial patterns, especially in the treatment of high-angle cases. [ABSTRACT FROM AUTHOR]

Introduction: Non Carious Cervical Lesions (NCCLs) represent a prevalent dental condition characterised by the erosion of tooth structure at the cementoenamel junction without the involvement of dental caries. These lesions pose significant challenges due to their aesthetic impact, potential for dentinal hypersensitivity, plaque accumulation, pulpal complications and compromised structural integrity of the teeth. Tooth preparation traditionally uses diamond abrasive points and tungsten carbide burs for micromechanical adhesion. Newer methods, like ultrasonic tips, offer a more conservative approach, but limited research has compared their effects on bond strength, particularly in cervical cavity restorations with nanohybrid composites. Aim: To compare the surface roughness of cervical cavity preparations utilising diamond abrasive points and ultrasonic tips, and to evaluate the shear bond strength of restorations with composite resin. Materials and Methods: The present in-vitro comparative study was conducted in the Department of Conservative Dentistry and Endodontics, Guru Nanak Institute of Dental Sciences and Research, Panihati, Kolkata, West Bengal, India, from October 2023 to December 2023. The study included 52 freshly extracted maxillary 1st premolar teeth extracted for orthodontic reasons. These teeth were divided into two groups: Group-I (n=26) underwent surface preparation using a diamond abrasive point (No. 835-012, Piranha, SS White, USA), while Group-II (n=26) was prepared using an ultrasonic tip (Woodpecker G 20, Guilin Woodpecker, China). Teeth were cleaned, disinfected and stored in 0.1% thymol solution before being prepared with diamond abrasive points or ultrasonic tips, following which the specimens were restored using nanohybrid composite material (Solare X, GC Corporation, Japan). Surface roughness was assessed using a digital profilometer before the restoration, and the shear bond strength of repaired specimens was measured with a Universal Testing Machine. Statistical analysis was performed using GraphPad Prism, with independent samples t-tests applied to compare results between groups, and a significance level set at 5%. Results: Group-I exhibited greater surface roughness (6.33±2.18 μm) compared to Group-II (4.91±1.57 μm). Group-I also showed higher shear bond strength (62±13 MPa) than Group-II (59.3±19.9 MPa), though this variation was not statistically significant (p-value=0.56). Conclusion: Within the present study's limitations, diamond abrasive points created significantly greater surface roughness compared to ultrasonic tips. However, no statistically significant variations have been observed in shear bond strength among the two methods, suggesting that ultrasonic tips may be considered as an alternative to diamond abrasive points in clinical settings, avoiding their drawbacks while achieving adequate restoration retention. [ABSTRACT FROM AUTHOR]

The "Journal of Veterinary Dentistry" contains abstracts from various studies related to veterinary dentistry. Studies include topics such as the use of videoscopes in periodontal surgery, the effects of stannous fluoride dentifrice on oral health, the relationship between periodontitis and systemic diseases, and the use of stem cells in regenerative endodontics. Other studies explore the properties of bioactive ceramic cements, the mobility of the mandibular symphysis in cats, and the anatomy of pulp cavities in feline teeth. Additionally, studies examine the outcomes of root canal treatments in fractured teeth, the prevalence of dentigerous cysts in dogs, and the impact of communication strategies on dog owners' adherence to dental care recommendations. [Extracted from the article]

Background: Silver diamine fluoride (SDF) has gained popularity for its caries-arresting properties, yet its tendency to cause esthetic concerns due to black-staining limits its widespread acceptance. Aim: The aim of the study was to evaluate and compare the shear bond strength of Activa BioActive and Giomer restorative material with different protocols of SDF pretreatment on carious dentin. Materials and Methods: Ninety-two extracted teeth were decoronated at the cementoenamel junction, sectioned 1 mm into dentin, mounted in acrylic resin and randomly divided into four (n = 8) control and six (n = 10) experimental groups. Seventy-six samples underwent demineralization process for a period of 14 days for artificial carious dentin (ACD) formation. The samples categorized based on the dentin substrate (sound or ACD) were subjected to various SDF pretreatment protocols, i.e., only SDF, SDF with potassium iodide (KI), and SDF with glutathione (GSH). Further, bioactive restorative materials, i.e., Activa BioActive and Giomer (Beautifil II), were placed on it, and the samples were subjected to shear bond strength testing. Statistical Analysis: Independent t -test was run to analyze the values obtained. Results: Giomer exhibited better mean bond strength with SDF, SDF + KI, and SDF + GSH (6.56, 4.67, and 3.34 mega-pascals [MPa], respectively) compared to Activa BioActive (3.42, 3.27, and 2.96 MPa, respectively). Conclusion: This study contributes to understanding the interplay between SDF application protocols, esthetic concerns, and the adhesive properties of bioactive restorative materials. Giomer exhibited enhanced bond strength after SDF application, unlike Activa BioActive. In addition, incorporation of KI or GSH adversely affected the bond strength of both the restorative materials, underscoring the critical need for cautious clinical application. Clinical Relevance: This study highlights the importance of selecting appropriate dentin pretreatment agents to maximize the bond strength of bioactive restorative materials with carious dentin. SDF application significantly enhanced the bond strength of Giomer with carious dentin compared to Activa BioActive, thus, making it a good choice for restoring nonesthetic areas. In addition, the application of KI or GSH to mitigate discoloration of carious dentin negatively affected the bond strength of both, Activa BioActive and Giomer. Thus, the clinicians should weigh the benefits of SDF against potential bond strength reductions when using KI or GSH, especially for esthetic restorations. [ABSTRACT FROM AUTHOR]

Aim: This study aims to compare and evaluate the fracture resistance of endodontically treated maxillary anterior teeth restored using new postplacement techniques. Methodology: Forty-five single-rooted maxillary anterior teeth (n = 15) were selected and decoronated at the cementoenamel junction. The working length was determined using a 15K file. Biomechanical preparation was done up to size 70 and the teeth were obturated. After 1 week, the root-filling material, gutta-percha, was removed, and postspace was prepared using a size 3 and 4 peeso reamer. The samples were divided into three groups (n = 15). Group I: Coltene Tenax fiber Post-reinforced with composite (anatomical post). Group II: Coltene Tenax fiber postreinforced with a leno-woven polyethylene; Ribbond fibers. Group III: Coltene Tenax fiber Post-luted with a dual cure cement. After postcementation, core buildup was done. Fracture resistance was measured using a universal testing machine. Results: Statistical analysis was done using one-way analysis of variance and Tukey's post hoc tests. A statistically significant difference was seen in the mean maximum load (N) between the groups. Group I showed the highest mean maximum load (N), followed by Group II and Group III. A significant P value (P = 0.025) was noted. Conclusion: Coltene Tenax fiber postreinforced with composite (anatomical post) showed the highest fracture resistance in endodontically treated maxillary anteriors. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the fracture strength of endodontically treated molars filled with different composite resins with vs without fiber reinforcement. Materials and Methods: A total of 60 intact mandibular molars were selected and endodontically treated. A standardized mesio-occlusal-distal cavity was prepared with cervical margins 1 mm above the cementoenamel junction and oral and buccal walls with 1.5-mm thickness. Universal adhesive was used in all specimens in etch-and-rinse mode. Specimens were divided into four groups (n = 15 each) according to restoration technique: group CSM = adhesive overlay with hybrid ceramic; group EXP = direct restoration with short fiber-reinforced composite; group ESU = direct restoration with nanohybrid composite; and group EST = direct restoration with nanohybrid composite reinforced with horizontal bidirectional glass fibers placed over the pulpal chamber floor. After 7 days of storage in water, samples were loaded until fracture using a universal testing machine. The maximum breaking loads were recorded in Newtons, and statistical analysis was then conducted with two-way ANOVA and post hoc Tukey test. Fragments were analyzed using scanning electron microscopy. Results: Mean fracture resistance values were: CSM = 1,428.91 ± 316.90 N; EXP = 1,874.57 ± 299.47 N; ESU = 1,557.44 ± 355.65 N; and EST = 1,870.27 ± 145.11 N. The CSM and EXP groups showed the highest strength values when compared to the other groups. The variable fiber insertion did not significantly alter the fracture resistance. The origin of the fracture was always located on the occlusal surface, mainly in the major contact loading area. Conclusion: The use of fiber-reinforced composite showed great improvement in fracture resistance, similar to a cuspal coverage restoration. However, only short fiber-reinforced composites showed a favorable fracture pattern. [ABSTRACT FROM AUTHOR]

Gingival recessions with noncarious cervical lesions (NCCLs), also called combined defects, are common problems, and patients often seek treatment due to esthetic concerns or dentin hypersensitivity. This case series evaluates the effectiveness of the non-coronally advanced flap (CAF) technique combined with restorative treatment for Miller Class III gingival recessions with NCCLs. A total of 16 combined defects were included. The combined defect height (CDH), recession depth (RD), pocket depth (PD), keratinized tissue width (KTW), and presence of dentin hypersensitivity were recorded at baseline and 6 months postsurgery. The mean root coverage (mRC) was 83%, and 50% of defects presented complete root coverage (CRC). In the group with an initial KTW = 2 mm, mRC and CRC were significantly higher. Further randomized controlled studies with larger sample sizes are needed to verify the prognostic factor of combined non-CAF techniques and restorative treatment for gingival recessions with NCCLs. [ABSTRACT FROM AUTHOR]

This study compared root trunk measurement methods--measuring parallel to the tooth axis (TA) vs parallel to the root surface (RS)--to assess the implications for decision-making regarding crown lengthening surgery. A total of 672 root trunks were measured by CBCT in both TA and RS planes. The possibility of performing crown lengthening in each clinical situation, based on the distance from the cementoenamel junction (CEJ) to the crestal bone (CB) after ostectomy (CEJ--CB), was judged and compared between groups. The proportions of cases with CEJ--CB values of 4, 5, and 6 mm in which crown lengthening was judged possible were 83.63%, 59.08%, and 39.18%, respectively, when RS was used as a reference point. When TA was used as a reference point, those proportions decreased 3.87% to 7.29%. The lingual root trunk of the mandibular first molar (LFL) with a CEJ--CB of 4 to 5 mm emerged as the most problematic area where the decision (based on each plane) shows a high rate of inconsistency, with differences between TA and RS measurements occurring in every 1 out of 5 to 6 teeth (16.67% to 18.75%). Within the limits of this study, utilizing TA for treatment-planning of surgical crown lengthening may not be ideal, as it may lead to extraction of many teeth that could otherwise be saved. [ABSTRACT FROM AUTHOR]

To evaluate changes in the periodontium of teeth restored with ultrathin (0.2 to 0.39 mm) ceramic laminate veneers (CLVs) placed subgingivally without a finish line compared to the same teeth before restorative treatment and to nonrestored antagonist teeth in healthy periodontium patients. Materials and Methods: A total of 73 CLVs were bonded onto the enamel surface of teeth without a finish line and with the cervical margin placed about 0.5 mm subgingivally. The gingival crevicular fluid was collected before bonding (baseline) and at 7, 180, and 365 days after bonding to quantify S mitis, P intermedia, and P gingivalis by quantitative polymerase chain reaction analysis. Visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR), and marginal adaptation were evaluated from baseline to 365 days in both groups. Results: No statistically significant differences were observed in VPI, PD, or BOP at any time point in the intragroup or intergroup comparisons (P > .05). All restorations obtained the alpha concept for marginal adaptation (ie, the restoration margin remained ideal at all time points). There was a statistically significant difference for S mitis between 180 and 365 days (P = .03). No statistically significant difference was observed for P gingivalis at any time point (P > .05). Conclusion: The periodontium in the restored group showed a clinical behavior similar to baseline. Overcontouring of the ultrathin (up to 0.39 mm) CLV, similar to the cementoenamel junction convexity, did not contribute to plaque accumulation or changes in the oral microbiota of patients with a healthy periodontium and proper oral hygiene instruction. [ABSTRACT FROM AUTHOR]

Aim: To prepare experimental adhesive (EA) with 1% and without chitosan nanoparticles on dentin conditioned with a conventional technique phosphoric acid (PA) compared with two different contemporary techniques: photodynamic therapy (PDT) and femtosecond laser (FSL). Method: The methodology consisted of synthesis of EA and 1% chitosan-modified adhesive (CMA). Scanning electron microscopy, dentin adhesive interface assessment, energy-dispersive spectroscopy, shear bond strength (SBS), degree of conversion (DC), and bond failure were assessed. Teeth were selected, disinfected, and mounted in acrylic up to the cementoenamel junction. Occlusal enamel was removed and teeth were randomly allocated into groups and conditioned. These included Group 1: samples treated with PA; Group 2: specimens conditioned with methylene blue photosensitizer (MBP) activated by PDT; and Group 3: samples conditioned with FSL. Following different conditioning regimes, specimens were bonded using 1% CMA and EA. The composite buildup was followed by SBS testing and a bond failure assessment. DC was assessed for both EA and CMA. Analysis of variance and Tukey's post hoc test were used to compare the mean and standard deviation of SBS and DC in different experimental groups, with a significance level of p < 0.05. d Results: Dentin pretreated with etch and rinse demonstrated the highest bond strength with 1% CMA. Dentin conditioned with MBP activated by PDT and bonded to EA showed the lowest bond scores. Overall SBS values of 1% CMA were better than EA irrespective of the conditioning regime of dentin. The DC was higher in EA adhesive. This was followed by DC in 1% CMA. DC in EA was found to be comparable with 1% CMA. Conclusions: PA remains the gold standard for dentin conditioning. The incorporation of 1% chitosan in adhesive improves SBS and results in no change in DC. The use of FSL in dentin conditioning can be used as an alternative approach as it results in SBS within acceptable limits. The study was approved by the ethical board of King Saud University. [ABSTRACT FROM AUTHOR]

Aim: The present study aims to evaluate the irrigant penetration in extracted single-rooted teeth using various irrigant activation systems in different tapered preparations. Methods: One hundred and twenty-four single-rooted teeth were selected for the present study. They were standardized at the level of cementoenamel junction and shaped to 30 size using 4% and 6% taper rotary instruments under a standard irrigation regimen. Once the complete root canal preparations were done based on activation protocols, they were divided into four groups as Group 1: Four percent preparation sonic activation (n = 31), Group 2: Six percent preparation sonic activation (n = 31), Group 3: Four percent preparation ultrasonic activation (n = 31), and Group 4: Six percent preparation ultrasonic activation (n = 31). A radiopaque solution in conjunction with radiography was utilized to evaluate the penetration of irrigants into the canal. Radiographs were taken after dye injection to measure the length of irrigant penetration in each technique. Results were statistically analyzed using SPSS software. One-way ANOVA and Post hoc Tukey tests were performed. Results: The results of the study revealed that ultrasonic activation after 6% taper instrumentation was better followed by ultrasonic activation after 4% taper instrumentation (P < 0.05). The results revealed a statistically significant difference (P < 0.05) between the irrigation techniques. Conclusion: Ultrasonic irrigant activation proved to be a better and an effective technique for cleaning the root canal. [ABSTRACT FROM AUTHOR]

Aim: The adhesion ability of filling materials to the root canal wall can be affected by the intracanal medicaments. The present study investigated the effect of pretreatment with nano-calcium hydroxide and calcium hydroxide on the bond strength of Endoseal mineral trioxide aggregate (MTA) to root canal dentin. Methods: Fifty maxillary incisor teeth were randomly divided into two experimental groups (n = 20) and a control group (n = 10) after decoronation near the cementoenamel junction and root canal instrumentation according to the type of intracanal medicament (calcium hydroxide and nano-calcium hydroxide). Each experimental group was divided into two subgroups based on manual and ultrasonic drug removal methods. After removing intracanal medicaments and irrigating them, all the groups were obturated with gutta-percha and Endoseal MTA sealer. Then, the samples were sectioned into cross-sections with a thickness of 2 mm using a diamond disc, and the push-out bond strength test was performed on them. Results: The results showed no significant difference in the mean Endoseal MTA bond strength in terms of the type of intracanal medicament and the method used to remove it from the canal (P > 0.05). Conclusion: Using the ultrasonic method compared to the manual method in removing intracanal medicament resulted in no significant difference in the strength of the Endoseal MTA bond. Furthermore, the effect of nanoparticle calcium hydroxide on Endoseal MTA bond strength was not different compared to the conventional type of this medication. [ABSTRACT FROM AUTHOR]

Aim: This in vitro study was designed to compare the effect of blood contamination on the push-out bond strength of mineral trioxide aggregate (MTA), Biodentine, and bone cement. Methods: Seventy-eight human mandibular molars with furcation were selected and decoronated at the cementoenamel junction. The samples were mounted 3 mm below the furcation area into the acrylic resin. A perforation in the center of the furcation was made using a round carbide bur size 3 with a diameter of 1.2 mm. Then, the perforation was enlarged up to a standardized diameter of 1.3 mm using a size 5 Gates-Glidden drill. The samples were randomly divided into three groups. Based on blood contamination status, each group (n = 26) was further subdivided into two subgroups (n = 13). Whole fresh human blood was obtained from the principal investigator of the research group. A 27-gauge syringe was used to inject blood into the perforated furcal area. A piece of gelatin was packed under the furcal area using a condenser. MTA, Biodentine, and bone cement were mixed according to the manufacturer's recommendations and compacted into the perforation. A universal testing machine was used to evaluate the push-out bond strength. The results were analyzed using one-way analysis of variance followed by Tukey's post hoc test (P < 0.05). Results: In the experimental groups with blood contamination, Group 2A exhibited statistically significant push-out bond strength values compared with Group 1A and Group 3A. In the groups without blood contamination, Group 2B showed statistically significant push-out bond strength values compared with Group 1B and Group 3B. Irrespective of the blood contamination status, Group 3 exhibited higher push-out bond strength values than Group 1, with no statistically significant difference between the groups. No significant difference was observed within the groups. Conclusion: Biodentine showed promising results as a better perforation repair material irrespective of the status of blood contamination. Bone cement can be a viable alternative material for furcation perforation repair compared with MTA. [ABSTRACT FROM AUTHOR]

The Chinese Journal of Dental Research article delves into the intricate processes of tooth root development and homeostasis during tooth movement. It emphasizes the collaborative interactions between different cell types and regulatory mechanisms that govern proper tooth alignment and function. The research provides valuable insights into potential mechanisms of tooth overeruption and offers implications for disease treatment and prevention in dental health. By focusing on cellular interactions and molecular mechanisms in mice models, the study sheds light on the impact of mechanical loading on periodontal tissues and underscores the importance of understanding these processes for clinical interventions in dental medicine. [Extracted from the article]

Background Methods Results Conclusions Key points Plain language summary Non‐carious cervical lesions (NCCLs) refer to the loss of dental hard tissue in the cervical region due to physical and/or chemical factors, often associated with the disappearance of the cemento‐enamel junction (CEJ), posing challenges in both diagnosis and treatment of gingival recessions (GR). This case study introduces two protocols for multidisciplinary CEJ reconstruction prior to the root coverage therapy (RCT).Two patients with GR and NCCLs were treated using two CEJ reconstruction techniques: both, analogically and digitally guided. For each case, the position of the therapeutic CEJ was predetermined using a combination of the methods described by Zucchelli and Cairo. Then, an analog or digital diagnostic wax‐up was performed accordingly. In the analogically guided technique, a transparent silicone guide matrix was used to transfer information from the dental wax‐up. In contrast, the digitally guided technique employed a rigid, translucent resin prosthetic guide matrix that was designed and printed. Restorations were fabricated using direct composite resin and RCT was performed 1 week later in both techniques.At 6 months, both cases demonstrated complete root coverage and effective healing of the soft tissues surrounding the restorations.Dimensional changes in materials and precise guide adjustment in the analog technique are operator‐dependent and can affect the outcomes. Digital procedures, though effective, are costly and may limit their use. The usage of these two CEJ reconstruction techniques enhances communication within the multidisciplinary team and ensures optimal aesthetic outcomes and precise placement of the gingival margin. There are no established clinical protocols described in the literature for reconstructing the cemento‐enamel junction (CEJ) once the position of a therapeutic CEJ has been predetermined and prior root coverage therapy (RCT). Performing a diagnostic wax‐up (analogically or digitally) to reconstruct the therapeutic CEJ is crucial and facilitates the creation of a prosthetic guide that accurately reproduces the defined CEJ position. The reconstruction of the CEJ may improve the prognosis of RCT. This study looked at a dental issue called non‐carious cervical lesions, which happens when the hard tissue near the gum line of a tooth wears away, making it harder to treat gum recession. Two different approaches were tested to rebuild the lost tissue in the gum area before performing a procedure to cover the exposed roots. One approach used traditional methods with physical guides to help place the new tissue, while the other used advanced digital techniques to create a precise guide using 3D printing. After 6 months, both methods successfully covered the exposed roots and helped the gums heal properly. However, the traditional method's results can vary depending on the dentist's skill, while the digital method, although more accurate, can be expensive. Using these methods can improve teamwork among dental specialists and lead to better‐looking results by ensuring the gum line is placed exactly where it should be. [ABSTRACT FROM AUTHOR]

Background: Connective tissue graft substitutes have been used widely to overcome autogenous graft limitations. Nevertheless, they do not provide comparable results in the treatment of periodontal and peri‐implant soft tissue defects. Based on the principles of tissue‐engineered materials, injectable platelet‐rich fibrin (i‐PRF) has been combined with collagen matrices (CMs) to enhance their clinical efficacy. To the best of our knowledge, this is the first case series demonstrating the use of i‐PRF for the biofunctionalization of a volume‐stable collagen matrix (VCMX) as an adjunct to coronally advanced flap (CAF) to treat single gingival recession (GR) defects. Methods & Results: The study included 10 patients. Bleeding on probing, probing depth, GR height, clinical attachment level, esthetics, and dentin hypersensitivity were evaluated. After 6 months, a significant GR reduction (RecRed: 2.15 ± 0.7 mm; p = 0.005) and percentage of root coverage (% RC) of 81.13% were observed. Additionally, 40% of the sites showed complete root coverage. Gingival thickness increased 0.64 mm. Patient‐centered evaluations demonstrated dentin hypersensitivity and esthetics improvements by the end of follow‐up. Conclusion: VCMX biofunctionalized with i‐PRF associated with CAF technique showed promising clinical outcomes in the treatment of single RT1 GR defects. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify the risk factors for gingival invagination during orthodontic treatment after premolar extraction. Materials and Methods: The medical records of 135 patients who had undergone interdental space closure after premolar extraction were collected, and cone beam computed tomography was performed to determine the presence of gingival invagination. The risk factors were examined using mixed‐effects models and generalized propensity score weighting (GPSW) to develop a predictive model. Results: Univariate analysis revealed that the extraction site, buccal bone thickness 4 mm apical to the cemento‐enamel junction (MB1), mid‐root buccal bone thickness (MB2) and vertical skeletal relationships were related to gingival invagination (p <.05). Furthermore, a subsequent multivariable mixed‐effects model analysis indicated a significantly increased risk of gingival invagination at MB1 < 1 mm (p <.001; odds ratio [ORMB1≤0.5mm] = 29.304; 95% confidence interval [CI]: 8.986–93.807; OR0.5

Objectives: Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case–control study was to explore the risk factors for NCCLs. Methods: Cone‐beam computed tomography was used to determine whether a wedge‐shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing‐related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self‐administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs. Results: Significant variables in the univariate analysis (i.e., p <.2) included frequency of carbonated beverage consumption, sella‐nasion‐point B angle (SNB) and Frankfort‐mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039–9.532), FMA (OR = 1.100; 95% CI, 1.004–1.204) and SNB (OR = 0.896; 95% CI, 0.813–0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607–0.792; p <.001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612–0.796; p <.001). Conclusions: The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to present optimized device‐specific low‐dose cone‐beam computed tomography (CBCT) protocols with sufficient image quality for pre‐surgical diagnostics and three‐dimensional (3D) modelling of cleft defects. Methods: Six paediatric skulls were acquired, and an artificial bony cleft was created. A high‐resolution CBCT scan acted as a reference standard (Accuitomo 170, Morita, Kyoto, Japan) for comparing eight low‐dose protocols of Newtom VGi‐evo (QR Verona, Cefla, Verona, Italy), which included Eco and Regular protocols with different field of views (FOVs). Delineation of lamina dura, cementoenamel junction (CEJ), trabecular bone and bony bridge were assessed. A 3D model of the defect was also evaluated. Result: The dose area product of low‐dose protocols ranged from 31 to 254 mGy*cm2. Despite the dose difference of up to eight times between applied protocols, trabecular bone and CEJ exhibited appropriate image quality in all scans. However, Regular small FOV protocols (5 × 5 and 8 × 5 cm2), for both lamina dura and bony bridge, demonstrated a significant improvement in image quality compared to Eco FOV counterparts. Based on 3D defect analysis, no significant difference existed between low‐dose protocols and the reference standard. Conclusion: The findings highlight the possibility of achieving a considerable reduction (up to eight times) in the radiation dose using low‐dose CBCT protocols while maintaining sufficient image quality for assessing anatomical structures and 3D modelling in cleft cases. [ABSTRACT FROM AUTHOR]

Introduction: Clinical practice demands understanding the complexity of the root canal system to achieve desired treatment goals. The statistically detailed morphology of the tooth and root canal morphology is very important to know. Therefore, the present study aims to investigate the statistical analysis of root canal morphology and morphological variations of maxillary and mandibular incisor teeth using cone‑beam computed tomography (CBCT) in Saudi patients attending King Saud University Dental Hospital. Materials and Methods: CBCT images of 480 patients were selected. Number of roots and root canal configuration were identified and categorized according to Vertucci’s classification. Tooth length, distance from cementoenamel junction (CEJ) to the area of canal division, and width of the canal at the area of division were also evaluated. Bilateral symmetry and association between gender and age with the different variables were investigated. Data were analyzed using Chi‑square, multiple linear regression, and McNemar’s tests. Results: A total of 3412 teeth were evaluated. All maxillary teeth had one root with Type I canal configuration. For mandibular teeth, all exhibited one root with the majority having Type I canal configuration in central (71.2%) and lateral (75%) incisor teeth. There was a statistically significant association between number of canals and age in mandibular incisor teeth observed only in females (P < 0.001), while no association was observed between canal configuration and gender (P = 0.900 and P = 0.721, respectively). Multiple regression analyses showed that age and gender significantly explain the difference of the variance in tooth length (P < 0.001). Moreover, bilateral symmetry was observed in 98.1% of mandibular central and 97.6% of lateral incisor teeth with no statistically significant association (P = 1 and P = 0.058, respectively). Conclusion: All maxillary and most mandibular incisor teeth present with one root and Type I canal configuration. In general, males have longer teeth than females, with a significant decrease in length with each year increase in age. Mandibular lateral incisor teeth exhibited the highest mean distance from CEJ to point of canal separation and highest mean width in the area of canal division. [ABSTRACT FROM AUTHOR]

Context: Effective endodontic treatment relies heavily on proper instrumentation, thorough disinfection, and precise three-dimensional obturation of the root canal system. Aims: This study aims to evaluate and compare continuous chelation (etidronic acid and sodium hypochlorite [NaOCl]) and sequential chelation (citric acid and NaOCl) on the dentinal tubule penetration of bioceramic-based sealer (Bio-C)-A confocal laser scanning microscopic study. Settings and Design: In vitro experimental study. Subjects and Methods: Sixty extracted permanent single-rooted teeth were selected and decoronated below cementoenamel junction to get a standardized length of 12 mm across all samples followed by enlargement of root canals till rotary ProTaper F3. The samples were randomly divided into three groups: Group I (control): Canals were irrigated with 3 mL 17% ethylenediaminetetraacetic acid/3 mL 3% NaOCl; Group II: Canals were irrigated with 10 mL etidronic acid + NaOCl solution; and Group III: Canals were irrigated with 3 mL 10% citric acid followed by 3 mL 3% NaOCl. 0.1% rhodamine B dye was mixed with Bio-C sealer followed by obturation. All the samples were subjected to confocal laser scanning microscopy evaluation. Statistical Analysis Used: One-way analysis of variance with the Bonferroni post hoc test was used for the statistical analysis. The level of significance was set at P < 0.05. Results: The pairwise comparison of depth of penetration showed statistically significant results in all the coronal, middle, and apical thirds. Group II showed better depth of penetration than Groups I and III. Conclusions: Continuous chelation protocol using etidronic acid and NaOCl showed greater and statistically significant sealer penetration depth when compared to the sequential chelation protocol, i.e., citric acid at all three levels. [ABSTRACT FROM AUTHOR]

Objective: To determine the influence of the presence/absence of third molars and intact/loss of cortical plate of the maxillary tuberosity on the amount of distal movement of the maxillary first permanent molar during distal movement of the maxillary dentition with mini-implants. Materials and methods: Thirty six maxillary tuberosity sites were evaluated in eighteen young adult patients. The distal movement of the entire maxillary dentition was performed with mini-implants with 200 g of distalising force applied from the mini-implant placed in the maxillary posterior buccal region to attachments placed on the arch wire between the maxillary lateral incisor and canine bilaterally. The distal movement of the maxillary first permanent molars was measured on lateral cephalograms. The maxillary tuberosity sites with intact cortical plate due to congenitally missing third molars or atraumatic extraction of third molars (G1), partial loss of cortical plate due to surgical removal of third molars (G2), fully erupted third molars (G4), third molars located at (G3), and below the cementoenamel junction (G5) were evaluated with cone beam computed tomography. One way Anova and Fisher LSD test was done. Results: The order of greater to lesser amount of distal movement of the maxillary first permanent molar depending on the integrity of maxillary of tuberosity was partial loss of cortical plate, third molars at the cementoenamel junction, third molars below the cementoenamel junction, intact cortical plate and fully erupted third molars. Conclusion: The integrity of the cortical plate and the relative position of the maxillary third molar to the second molar influence the amount of distal movement of the maxillary first permanent molar during distal movement of the maxillary teeth with TADS. Clinical relevance: The amount of distal movement of the maxillary dentition appears to depend on the presence or absence of the third molars and the condition of the cortical plate in the region of the maxillary tuberosity and thereby greatly influence the outcome of treatment. [ABSTRACT FROM AUTHOR]

Background: The determining effect of facial hard tissues on soft tissue morphology in orthodontic patients has yet to be explained. The aim of this study was to clarify the hard-soft tissue relationships of the lower 1/3 of the face in skeletal Class II-hyperdivergent patients compared with those in Class I-normodivergent patients using network analysis. Methods: Fifty-two adult patients (42 females, 10 males; age, 26.58 ± 5.80 years) were divided into two groups: Group 1, 25 subjects, skeletal Class I normodivergent pattern with straight profile; Group 2, 27 subjects, skeletal Class II hyperdivergent pattern with convex profile. Pretreatment cone-beam computed tomography and three-dimensional facial scans were taken and superimposed, on which landmarks were identified manually, and their coordinate values were used for network analysis. Results: (1) In sagittal direction, Group 2 correlations were generally weaker than Group 1. In both the vertical and sagittal directions of Group 1, the most influential hard tissue landmarks to soft tissues were located between the level of cemento-enamel junction of upper teeth and root apex of lower teeth. In Group 2, the hard tissue landmarks with the greatest influence in vertical direction were distributed more forward and downward than in Group 1. (2) In Group 1, all the correlations for vertical-hard tissue to sagittal-soft tissue position and sagittal-hard tissue to vertical-soft tissue position were positive. However, Group 2 correlations between vertical-hard tissue and sagittal-soft tissue positions were mostly negative. Between sagittal-hard tissue and vertical-soft tissue positions, Group 2 correlations were negative for mandible, and were positive for maxilla and teeth. Conclusion: Compared with Class I normodivergent patients with straight profile, Class II hyperdivergent patients with convex profile had more variations in soft tissue morphology in sagittal direction. In vertical direction, the most relevant hard tissue landmarks on which soft tissue predictions should be based were distributed more forward and downward in Class II hyperdivergent patients with convex profile. Class II hyperdivergent pattern with convex profile was an imbalanced phenotype concerning sagittal and vertical positions of maxillofacial hard and soft tissues. [ABSTRACT FROM AUTHOR]

Objectives: The abutments produced with circular symmetry failed to accurately replicate the natural teeth's cervical shapes. The purpose of this study was to measure cervical cross‐sections of maxillary anterior teeth using cone beam computed tomography (CBCT) images to design anatomic healing abutments. Materials and Methods: CBCT data of 61 patients were analyzed using Ez3D Plus software. Measurements were taken at the cemento‐enamel junction (CEJ) and 1 mm coronal to CEJ for maxillary central incisors, lateral incisors, and canines. Various parameters, including area, perimeter, and eight line segments in the distal (a), disto‐palatal (b), palatal (c), mesio‐palatal (d), mesial (e), mesio‐labial (f), labial (g), and disto‐labial (h) directions, were used to describe dental neck contours. The ratios (f/b and h/d) were analyzed, and differences based on sex and dental arch morphology were explored. Results: Significant differences were found in area and perimeter between males and females, but not in f/b and h/d ratios. Differences in the f/b ratio were observed among dental arch morphologies for maxillary central incisors, lateral incisors, and canines. Conclusions: CBCT measurements of cervical cross‐sections provide more accurate data for designing anatomic healing abutments. The fabrication of anatomical healing abutments needs to consider the influence of gender on cervical size and to explore the potential effect of arch shape on cervical morphology. Clinical Significance: The novel method provides detailed measurements for the description of dental cervical contours for patients with bilateral homonymous teeth missing. The measurements of this study could be utilized to design more accurate anatomic healing abutments to create desired morphology of peri‐implant soft tissue. [ABSTRACT FROM AUTHOR]

Background: The placement of ligatures in the cervical area of rat molars is considered as a predictable model to induce periodontitis. Objectives: The present explorative study aimed to compare the efficacy of metal wires (MWs), without or with sandblasting, versus silk ligatures (SLs) in inducing periodontal bone loss in rats. Materials and Methods: Twenty‐four Wistar rats were randomly divided into three groups of eight rats that received three different types of ligatures (MW, sandblasted wire [SMW], and SL) around their first right mandibular molar, while the contralateral tooth was left without the ligature and served as a control. Bone loss was assessed by measuring the distance from the cementoenamel junction (CEJ) to the bone crest at the distal aspect of the first molar on central mesiodistal sections generated from micro‐CT scans taken 24 and 35 days after ligature placement. Results: In the SL group, only in two rats the ligatures were retained until the end of the 24‐day period; in all other animals, the ligatures were lost at some time point. In the SMW, the ligatures were retained only for the 24‐day period. In the MW group, no ligatures were lost. Irrespective of the group or experimental period, the difference in the crestal bone level between ligated and control teeth was in most cases z < 0.20 mm, that is, in 19 out of 25 pairs of teeth. In a few cases, the bone crest was more apically located at the control teeth compared to the ligated ones (four cases each, during both 24‐ and 35‐day experimental periods). Conclusions: Bone loss was minimal during the experimental period, with no significant differences between the test and control teeth, or among the three types of ligatures. MWs, not even roughened, do not seem to be a better alternative to SLs for inducing bone loss in the experimental periodontitis model in the rat. This assumption, however, has to be confirmed in a larger, well‐powered study. [ABSTRACT FROM AUTHOR]

Objective: The present study investigated bone remodelling in the upper and lower incisor regions depending on the inclination pattern during the alignment phase of orthodontic treatment (OT). Materials and Methods: This prospective clinical study included 71 patients undergoing OT without premolar extraction. Cone beam computed tomography scans were taken before and after the alignment phase and the changes in the inclination, alveolar bone height (ABH) and bone thickness (BT) at levels 2, 3, 4, 6, 8 and 9 mm starting from the cementoenamel junction (CEJ) were determined. Results: Teeth were divided into 'Retroinclination' (lingual crown inclination <0°), 'Proclination‐low' (buccal crown inclination between 0° and 5°), or 'Proclination‐high' (buccal crown inclination >5°). The alignment phase of OT resulted in ABH loss. The highest ABH loss in the maxilla was observed on the buccal side in the 'Proclination‐high' and was 0.71 mm. ABH loss by 1.1 mm was observed in the mandible on the lingual side in the 'Retroinclination' group. The most significant changes in BT by up to 2 mm were observed at levels 6, 8 and 9 mm and these changes exhibited a moderate to strong correlation with the alterations in the inclination of individual incisors. At levels 2, 3 and 4 mm, the highest decrease in BT by up to 0.83 mm was observed on the palatal side of upper incisors in the 'Proclination‐high' group. Conclusion: The direction and amount of tooth inclination partially determine changes in the bone parameters during the alignment phase. [ABSTRACT FROM AUTHOR]

The aim of this prospective study was to evaluate the efficacy of a cross-linked xenogeneic volume-stable collagen matrix (CCM) in treating gingival recessions (GRs) at teeth presenting with cervical restorations or noncarious cervical lesions (NCCLs). Fifteen patients with esthetic concerns for multiple sites with GRs and cervical restorations were consecutively enrolled. The sites were treated with a coronally advanced flap (CAF) design in combination with a CCM. When present, the previous restoration was removed, and the cementoenamel junction was reconstructed with a composite material. The CCM was stabilized on the root surface(s) previously occupied by the restoration. The CAF was sutured to completely cover the graft. Clinical measurements and intraoral digital and ultrasonographic scans were collected at baseline and at 3 and 6 months postsurgery. Limited postoperative discomfort was reported by patients during the healing. The mean root coverage at 6 months was 74.81%. Average increases in gingival thickness of 0.43 mm and 0.52 mm were observed when measured with ultrasonography 1.5 mm and 3 mm apical to the gingival margin, respectively (P < .05). Relatively high patient-reported satisfaction and esthetics were associated with the treatment outcomes. The treatment resulted in a significant reduction in dental hypersensitivity (mean: 33 VAS points). The present study demonstrated that CAF + CCM is an effective approach for treating GRs at sites with cervical restorations or NCCLs. [ABSTRACT FROM AUTHOR]

This study evaluated the use of a xenogeneic acellular dermal matrix (XADM) combined with a modified coronally advanced flap (MCAF) and partial resin composite filling (anatomic crown plus 1 mm of the root surface) to treat multiple Type 1 gingival recessions associated with B+ noncarious cervical lesions (NCCLs). The study included 24 recessions in 10 patients. Bleeding on probing, probing depth, combined defect height, relative gingival recession, clinical attachment level, esthetics, and dentin hypersensitivity were recorded. After 6 months, the treatment provided statistically significant outcomes: It reduced the combined defect height by 2.02 ± 0.65 mm, increased clinical attachment level by 1.96 ± 0.83 mm, and increased keratinized tissue thickness by 0.46 ± 0.47 mm, and shallow probing depths were seen. Significant dentin hypersensitivity reduction and esthetic improvements were observed. Therefore, XADM associated with MCAF and partial restoration might be a promising alternative to autogenous grafts used to treat multiple gingival recessions associated with B+ NCCLs. [ABSTRACT FROM AUTHOR]

Maxillary canines are the second most commonly impacted teeth. Two thirds of these impacted canines are palatal, and one third are labially impacted. Maxillary labial impactions comprise approximately 0.33% to 0.75% of the general population. Like palatal impactions, preventive and interceptive methods can be employed to help the impacted tooth erupt and avoid surgical uncovering. Early extraction of appropriate primary teeth and palatal expansion has helped some of these impactions erupt spontaneously. Most labially impacted canines are positioned "in the slot," in a midalveolar location between the lateral incisor and first premolar. If they do not erupt after preventive or interceptive means, they can be managed with simple closed-eruption uncovering techniques. The most difficult labial impactions are ectopically positioned. These are usually horizontally positioned, mesial to the lateral incisor. They can be very apically positioned, near the base of the nose and near the midline. The rarest labial impaction occurs between the central and lateral incisors or between the premolars. These are extremely rare and require special orthodontic and uncovering techniques. All of these ectopic impactions require a technique that leaves the impacted tooth uncovered so the orthodontist can employ the proper mechanics to move these teeth without damage to adjacent structures. This article elucidates the surgical uncovering techniques and the orthodontic mechanics to successfully move these teeth and minimize root resorption, bone loss, and recession. [ABSTRACT FROM AUTHOR]

Purpose: To assess the thickness of the palatal bone wall of maxillary anterior teeth in relation to age, sex, and tooth type. Materials and Methods: A total of 100 CBCT images of patients ≥ 18 years of age were used. The thickness of the palatal bone at the maxillary canines and incisors was assessed perpendicular to the long axis of the teeth at three locations: 4 mm apical to the cementoenamel junction (CEJ; MP1), halfway between the CEJ and the root apex (MP2), and at the root apex (MP3). Results: At the MP1 site, 96% of the maxillary anterior teeth had a palatal bone thickness of < 1 mm, with a mean thickness of 0.5 mm. At the MP2 and MP3 sites, 86% and 100% of the teeth had ≥ 1 mm bone thickness, and the means were 2 and 5 mm, respectively. There were no significant differences among the age or gender groups. Maxillary canines showed significantly greater bone thickness than maxillary incisors, particularly at MP2 and MP3 sites. Conclusion: Most of the examined teeth had thin palatal bone at the MP1 measurement site, and maxillary canines showed significantly thicker palatal bone than maxillary incisors. This finding should be considered when treatment planning for immediate implants in the maxillary anterior segment. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the distance between the maxillary central incisor root and the incisive canal based on skeletal malocclusion classification and to analyze the morphology of the incisive canal using cone-beam computed tomography (CBCT). Skeletal malocclusion was categorized into Class I, II, and III using lateral cephalometric analysis. Measurements of the distance between the maxillary central incisor root and the incisive canal were taken at two levels: 2 mm (L1) and 4 mm (L2) superior to the labial cementoenamel junction of the maxillary central incisor. At L1, the distance was found to be closer in the Class II group compared to the Class I or Class III groups. Similarly, at L2, the Class II group exhibited a closer distance than the Class III group. Interestingly, females showed a closer distance compared to males at both L1 and L2. Further analysis revealed a significant gender difference in the Class I and III groups, but not in the Class II group. These findings emphasize the significance of evaluating the distance between the maxillary central incisor root and the incisive canal in patients with skeletal Class II malocclusion, regardless of gender. [ABSTRACT FROM AUTHOR]

This article presents a case study of a 17-year-old female with a swelling in the upper front tooth region. The patient had a history of trauma to the area and clinical examination revealed a well-defined swelling with missing teeth and fractures. The patient underwent imaging and biopsy, leading to a diagnosis of Adenomatoid Odontogenic Tumor arising from a Dentigerous Cyst. The article discusses the characteristics and origins of this tumor and emphasizes the importance of thorough investigation for accurate diagnosis. [Extracted from the article]

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Context: Endodontic success hinges on a multifactorial interplay, with meticulous canal shaping, proper disinfection, and three-dimensional obturation being paramount. Among these factors, the amount of dentin remaining after instrumentation directly influences the biomechanical resilience and longevity of the tooth. Aims: This study aims to evaluate the impact of various rotary instrumentation systems, including single-file, two-file, and multiple-file configurations, on the remaining dentin thickness (RDT) following canal preparation. Settings and Design: This was an in vitro study, original research article. Materials and Methods: Sixty mandibular premolar human extracted teeth were decoronated at the cementoenamel junction with a diamond disc. Samples were randomly assigned to three groups using a simple random sampling technique (n = 60). Group I - Single-file system (One Curve, MicroMega) (n = 20), Group II - Two-file systems (2Shape, MicroMega) (n = 20), and Group III - Multiple-file system (Hero Gold, MicroMega) (n = 20). Preoperative cone-beam computed tomography (CBCT) scans were obtained after the sample was mounted on a modeling wax sheet. The biomechanical preparation of canals followed the manufacturer's protocols for every system. Postoperative CBCT scans were obtained. Pre- and postoperative scans were compared at standardized depths (4 mm, 7 mm, and 11 mm) within the canals (coronal, middle, and apical thirds), allowing for a comprehensive assessment of RDT throughout the canal. Statistical Analysis and Results: According to one-way ANOVA, the highest mean was seen in Group I, followed by Group II and Group III. Hence, a statistically significant difference was found between all the groups. Post hoc Tukey's test was done for intergroup comparison. Conclusions: A single-file system preserved more dentin with less aggressive cutting compared to two-file and multiple-file systems. [ABSTRACT FROM AUTHOR]