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The International Journal of... May 2024It is incumbent upon our profession to reevaluate our preference for routinely replacing a missing single maxillary incisor, especially a maxillary lateral incisor, with...
It is incumbent upon our profession to reevaluate our preference for routinely replacing a missing single maxillary incisor, especially a maxillary lateral incisor, with a dental implant in a young adult. The dental literature is replete with beautiful restorative results using implants in this area, but there is minimal discussion regarding the long-term consequences of this treatment. The maxillary lateral incisor is one of the most commonly missing teeth due to agenesis, and it is also one of the most common teeth to be lost due to trauma in the developing child.1 Therefore, the decision for replacement must be made with the long-term in mind, as these restorations are commonly placed between ages 18 and 21 and must serve the patient for many decades. There are several reasons that implants can be associated with complications or even fail, including the following: (1) Continued craniofacial growth, which has a predominant anterior and vertical component and has been shown to occur in the maxilla, resulting in the apparent submersion of the implant crown as the natural teeth move incisally in relation to the implant2,3-there is no evidence that this can be predicted, let alone how far into the future it may happen; (2) peri-implantitis, which has a patient-level prevalence estimate of nearly 25% according to the findings of a recent systematic review;4 (3) thinning and recession of the peri-implant mucosa due to poor implant placement, inadequate prosthetic management, and/or poor case selection, often resulting in compromised esthetics and a predisposition for the onset and progression of peri-implant diseases; and (4) mechanical failure of the implant, abutment screw, transmucosal abutment, and/or crown. Clinicians should also keep in mind that, once an implant is placed in the anterior maxilla, it precludes the possibility for palatal expansion in the adult patient because the space created by the expansion cannot be redistributed orthodontically. Canine substitution is one traditional method for replacement of the missing maxillary lateral incisor. It is still a viable option when the canine tooth has an acceptable shape and color, and the occlusion will not be compromised by the substitution.5 Additionally, the bonded single-wing zirconia bridge has become a primary treatment option.6 Zirconia has the strength of metal and beauty of porcelain, which makes it an ideal substrate for a bonded bridge. The literature has demonstrated the long-term success of this replacement option for the missing maxillary incisor.7 There are clearly many potential long-term disadvantages associated with replacing a single missing maxillary incisor with an implant in young adults. We should be prescribing the least-invasive treatment option for the replacement of these teeth. Therefore, when treatment-planning for a missing maxillary incisor in a young adult, alternatives to implant therapy-such as the bonded single-wing zirconia bridge and canine substitution-should be the primary treatment options. The implant should only be considered as a secondary treatment when the other options are not viable or have previously failed.
Topics: Humans; Incisor; Maxilla; Dental Implants, Single-Tooth; Anodontia; Young Adult; Dental Prosthesis, Implant-Supported; Peri-Implantitis
PubMed: 38787712
DOI: 10.11607/prd.2024.3.e -
Journal of the Mechanical Behavior of... Oct 2023The periodontium is a biological structure that supports the tooth in the jaw and behave as a developmental, biological, and functional unit. Teeth may be considered to...
The periodontium is a biological structure that supports the tooth in the jaw and behave as a developmental, biological, and functional unit. Teeth may be considered to be 'suspended' in their tooth sockets which provides teeth the ability to move in response to an applied load. In terms of the protection the suspension effect of the periodontal ligament may offer dental restorations, movement in an axial direction is of interest. No device or system to measure this movement is readily available, thus a novel approach had to be developed to address the questions of this research. The device developed allowed images to be taken of the participants teeth before, during and after a participant bit down on the tooth and used to measure the displacement of the tooth in image processing software. Average maximum tooth displacement from all participants of 73.8 μm (sd = 22.5 μm) were recorded. Longer application time of bite force was associated with greater cumulative tooth displacement, for a given level of force, and female participants experienced approximately 2 μm more displacement per Newton than males. The device and methods utilised in this study has shown good potential as a measurement protocol for measurement of vertical tooth movements in vivo. The response to load the teeth in this study has shown, highlighted the visco-elastic properties of the periodontal ligament and the amount of movement recorded supports the protection that controlled tooth movement offers teeth.
Topics: Male; Humans; Female; Periodontal Ligament; Bite Force; Image Processing, Computer-Assisted; Movement; Software
PubMed: 37604099
DOI: 10.1016/j.jmbbm.2023.106059 -
Journal of Pharmacy & Bioallied Sciences Jul 2023Dental professionals play an important role in an individual's appearance which can affect the perception of others that can vary greatly depending on their educational...
INTRODUCTION
Dental professionals play an important role in an individual's appearance which can affect the perception of others that can vary greatly depending on their educational and socioeconomic background.
AIM AND OBJECTIVE
The purpose of this study was to determine an insight of recognizing ability of dental professionals and laypersons toward facial aesthetics with different types of orthodontic malocclusion.
MATERIALS AND METHODS
A questionnaire-based study was conducted on 90 dental professionals and 90 laypersons. The perceptions differences between groups were assessed using visual analogue scale on 11 photographs. Kolmolgorov-Smirnov was used for normality test.
RESULTS
The perceptions of facial aesthetics showing various malocclusions were significantly different between dental professionals and laypersons.
CONCLUSION
The dental professionals and layperson perceptions regarding the facial particularly in central Indian population are significantly different for most of the malocclusion types.
PubMed: 37694049
DOI: 10.4103/jpbs.jpbs_286_23 -
ACS Nano Sep 2023Malocclusion is a prevalent dental health problem plaguing over 56% worldwide. Mechanical orthodontic aligners render directional teeth movement extensively used for...
Malocclusion is a prevalent dental health problem plaguing over 56% worldwide. Mechanical orthodontic aligners render directional teeth movement extensively used for malocclusion treatment in the clinic, while mechanical regulation inefficiency prolongs the treatment course and induces adverse complications. As a noninvasive physiotherapy, an appropriate electric field plays a vital role in tissue metabolism engineering. Here, we propose an occlusion-activated electromechanical synergistic dental aligner that converts occlusal energy into a piezo-excited alternating electric field for accelerating orthodontic tooth movement. Within an 18-day intervention, significantly facilitated orthodontic results were obtained from young and aged Sprague-Dawley rats, increasing by 34% and 164% in orthodontic efficiency, respectively. The different efficiencies were attributed to age-distributed periodontal tissue status. Mechanistically, the electromechanical synergistic intervention modulated the microenvironment, enhanced osteoblast and osteoclast activity, promoted alveolar bone metabolism, and ultimately accelerated tooth movement. This work holds excellent potential for personalized and effective treatment for malocclusions, which would vastly reduce the suffering of the long orthodontic course.
Topics: Rats; Animals; Rats, Sprague-Dawley; Tooth Movement Techniques; Electricity; Engineering; Malocclusion
PubMed: 37590490
DOI: 10.1021/acsnano.3c03385 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Oct 2023Orthognathic surgery changes the jaw position and occlusion, and also affects the original structure and function of the temporomandibular joint (TMJ). With the...
Orthognathic surgery changes the jaw position and occlusion, and also affects the original structure and function of the temporomandibular joint (TMJ). With the widespread development of orthognathic surgery, the impact of orthognathic surgery on the structure and function of the TMJ is increasingly valued, and the importance of the TMJ in orthognathic surgery is gradually recognized. Proper understanding the relationship between orthognathic surgery and TMJ not only helps to elucidate how the orthognathic surgery affects the condyle and causes temporomandibular disorders (TMD), but also has significant clinical significance in preventing and treating TMD in patients underwent orthognathic surgery.
Topics: Humans; Orthognathic Surgery; Orthognathic Surgical Procedures; Temporomandibular Joint; Temporomandibular Joint Disorders; Dental Occlusion
PubMed: 37818533
DOI: 10.3760/cma.j.cn112144-20230807-00059 -
Cureus Jan 2024Background and objective The occipital spur (OS) can be described as an abnormal elongation of the external occipital protuberance (EOP); its etiology is...
Background and objective The occipital spur (OS) can be described as an abnormal elongation of the external occipital protuberance (EOP); its etiology is multifactorial and may involve biomechanical, immunological, and/or genetic factors. This study aimed to determine the frequency and characteristics of elongated EOP or OS as well as the relationship of OS with occlusion in a group of Turkish dental patients. Materials and methods Lateral cephalometric radiographs of 1925 patients taken in 2022 were retrospectively analyzed. The frequency, types, and dimensions of OS were determined based on gender and age groups. Molar occlusion and incisal bite were also evaluated. Results Of the 1925 patients, 679 were males and 1246 were females. The mean age of the cohort was 18.17 ±5.03 years (range: 4-61). OS was detected in 483 (25.1%) patients and was more common in males (p<0.001); 133 (27.5%) of the OSs were flat, 247 (51.1%) crest, and 103 (21.3%) spin type. The incidence of OS increased depending on age groups (p<0.001). There was no statistically significant association between OS presence and molar occlusion (p>0.05). However, a statistically significant association was observed between anterior incisal bite (p=0.001) and OS presence. There was a statistically significant difference in terms of OS sizes in males and females; the sizes of OS were larger in males than in females (length: p<0.05, base and thickness: p<0.001). Conclusions The frequency of OS was quite high in our cohort; it was more common and of larger size in males and older age groups. The most common type was the crest type. While there was no statistically significant association between OS frequency and molar occlusion, there was a significant relationship with incisal bite. The frequency of OS was highest in people with anterior crossbite.
PubMed: 38327918
DOI: 10.7759/cureus.51827 -
Journal of Dentistry Feb 2024This study compared the tooth morphology, internal fit, occlusion, and proximal contacts of dental crowns automatically generated via two deep learning (DL)-based dental...
OBJECTIVES
This study compared the tooth morphology, internal fit, occlusion, and proximal contacts of dental crowns automatically generated via two deep learning (DL)-based dental software systems with those manually designed by an experienced dental technician using conventional software.
METHODS
Thirty partial arch scans of prepared posterior teeth were used. The crowns were designed using two DL-based methods (AA and AD) and a technician-based method (NC). The crown design outcomes were three-dimensionally compared, focusing on tooth morphology, internal fit, occlusion, and proximal contacts, by calculating the geometric relationship. Statistical analysis utilized the independent t-test, Mann-Whitney test, one-way ANOVA, and Kruskal-Wallis test with post hoc pairwise comparisons (α = 0.05).
RESULTS
The AA and AD groups, with the NC group as a reference, exhibited no significant tooth morphology discrepancies across entire external or occlusal surfaces. The AD group exhibited higher root mean square and positive average values on the axial surface (P < .05). The AD and NC groups exhibited a better internal fit than the AA group (P < .001). The cusp angles were similar across all groups (P = .065). The NC group yielded more occlusal contact points than the AD group (P = .006). Occlusal and proximal contact intensities varied among the groups (both P < .001).
CONCLUSIONS
Crowns designed by using both DL-based software programs exhibited similar morphologies on the occlusal and axial surfaces; however, they differed in internal fit, occlusion, and proximal contacts. Their overall performance was clinically comparable to that of the technician-based method in terms of the internal fit and number of occlusal contact points.
CLINICAL SIGNIFICANCE
DL-based dental software for crown design can streamline the digital workflow in restorative dentistry, ensuring clinically-acceptable outcomes on tooth morphology, internal fit, occlusion, and proximal contacts. It can minimize the necessity of additional design optimization by dental technician.
Topics: Dental Porcelain; Ceramics; Crowns; Deep Learning; Computer-Aided Design; Dental Prosthesis Design; Dental Marginal Adaptation; Software
PubMed: 38163455
DOI: 10.1016/j.jdent.2023.104830 -
British Dental Journal Apr 2024Some dentists choose to ignore the subject of occlusion, while others propose a set of doctrinal rules. It is of little wonder therefore that it can become a source of...
Some dentists choose to ignore the subject of occlusion, while others propose a set of doctrinal rules. It is of little wonder therefore that it can become a source of confusion and even controversy. This series of two papers aims, firstly, to answer the very simple question of 'what is occlusion?'. It will put occlusion into the context of the articulatory system because that is the bio-mechanical environment where the majority of dentists do their work. The concept of jaw relation will also be discussed but within the context of this locomotive system. Ideal occlusion will be described but only after answering the question: for whom or what might an occlusion be considered ideal? Although, in the book of which this is the first chapter, he presents what has worked for him during many years as a general dental practitioner, university lecturer and specialist in restorative dentistry, he has tried not to be didactic because he feels that, in a profession, there are no right answers, only the right questions.
Topics: Humans; Male; Dentists; Professional Role; Dental Occlusion; Dentistry; Emotions
PubMed: 38609611
DOI: 10.1038/s41415-024-7192-3 -
British Dental Journal Mar 2024Some dentists choose to ignore the subject of occlusion, while others propose a set of doctrinal rules. It is of little wonder therefore that it can become a source of...
Some dentists choose to ignore the subject of occlusion, while others propose a set of doctrinal rules. It is of little wonder therefore that it can become a source of confusion and even controversy. This series of two papers aims, firstly, to answer the very simple question of 'what is occlusion?'. It will put occlusion into the context of the articulatory system because that is the bio-mechanical environment where the majority of dentists do their work. The concept of jaw relation will also be discussed but within the context of this locomotive system. Ideal occlusion will be described but only after answering the question: for whom or what might an occlusion be considered ideal? Although, in the book of which this is the first chapter, he presents what has worked for him during many years as a general dental practitioner, university lecturer and specialist in restorative dentistry, he has tried not to be didactic because he feels that, in a profession, there are no right answers, only the right questions.
Topics: Humans; Dentists; Professional Role; Dental Occlusion; Dentistry
PubMed: 38519673
DOI: 10.1038/s41415-024-7173-6