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Cureus Sep 2022Developmental anomaly of the maxillary lateral incisors most commonly leads to the occurrence of peg lateral. It is a variant of microdontia where the lateral incisors...
Developmental anomaly of the maxillary lateral incisors most commonly leads to the occurrence of peg lateral. It is a variant of microdontia where the lateral incisors are smaller than the normal size. This appears as unilaterally or bilaterally. This condition is characterised by the converging of the mesial and distal surfaces forming a cone shape. A variety of treatment options exist for this anomaly including orthodontic treatment, restorative technique and veneer. This case report deals with an individual presenting with peg lateral of the maxillary arch along with midline diastema. The multidisciplinary treatment protocol of orthodontic treatment involving minor tooth movement and space closure in conjunction with a restorative technique for correction was preferred.
PubMed: 36258978
DOI: 10.7759/cureus.29184 -
Journal of Oral Biology and... 2022Increased orthodontic treatment duration is associated with iatrogenic risks such as root resorption, white spot lesions etc. Recent research using pharmacological...
BACKGROUND
Increased orthodontic treatment duration is associated with iatrogenic risks such as root resorption, white spot lesions etc. Recent research using pharmacological agents to accelerate tooth movement has mostly been conducted on animals and there is no reported research conducted on humans comparing the effects of Vitamin D3 and Platelet Rich Plasma (PRP) in the same subjects using a split mouth technique.
OBJECTIVES
To determine and compare effects of local injection of PRP and Vitamin D3 on the rate of tooth movement. Also, to assess association of external apical root resorption with the use of PRP, Vitamin D3 and compare it to a control group.
MATERIALS & METHODS
11 subjects who diagnosed with Class I bi-maxillary malocclusion and who gave informed consent were recruited in the study. The patients were randomly divided using split mouth design and each quadrant served as either experimental or control group one. At the beginning of retraction phase, Vitamin D3 and PRP were injected to the randomly assigned quadrants while the contralateral side served as a control. The amount of space closure in 4 months was measured from distal surface of canine to mesial surface of 2nd premolar. Root resorption was assessed using CBCT taken at the beginning and at the closure of retraction phase.
RESULTS
Mean rate of tooth movement was higher in PRP and Vitamin D3 groups compared to their controls. In the PRP group, the increased rate of tooth movement was observed throughout the study interval, but in the Vitamin D3 group it was only seen in first two months. Also, the PRP group demonstrated a higher rate of tooth movement compared to Vitamin D3 group. Root resorption was lesser in both experimental groups. Among the teeth assessed, lateral incisor showed maximum root resorption and canine the least.
CONCLUSIONS
PRP is a more efficient pharmacological agent compared to Vitamin D3 for accelerating tooth movement.
PubMed: 36250145
DOI: 10.1016/j.jobcr.2022.09.011 -
European Journal of Dentistry Jul 2023This study compared the shaping ability of the Hyflex CM and XP-endo Shaper rotary file systems in curved mesial canals of mandibular molars using micro-computed...
OBJECTIVE
This study compared the shaping ability of the Hyflex CM and XP-endo Shaper rotary file systems in curved mesial canals of mandibular molars using micro-computed tomography.
MATERIAL AND METHODS
Seventeen mesial roots of extracted first mandibular molars with two independent mesial canals were scanned before and after root canal preparation with the tested rotatory file systems. Each mesial canal from the same specimen was prepared with one of the two systems. The parameters analyzed were canal centering (transportation) for the cervical, middle, and apical segments, as well as for the entire canal (0-10 mm from the apex); and canal volume increase, canal surface area increase, and unprepared canal walls for two segments, 0 to 4 mm and 0 to 10 mm from the apex.
RESULTS
There was no significant difference between both systems regarding canal centering (transportation), volume increase, and unprepared canal walls for the 0 to 10 mm segment (> 0.05); however, a significant difference was observed for the 0 to 4 mm segment ( <0.01), where the Hyflex CM left 28.46% of unprepared walls and XP-endo Shaper left 13.26%.
CONCLUSIONS
The shaping ability of the two tested rotatory file systems in mesial roots of first mandibular molars was similar for all parameters in all the segments evaluated, except for the 0 to 4 mm segment, where XP-endo Shaper left a smaller area of unprepared canal walls than Hyflex CM.
PubMed: 36220114
DOI: 10.1055/s-0042-1750694 -
American Journal of Orthodontics and... Oct 2022Orthodontists, surgeons, and patients have taken an interest in using clear aligners in combination with orthognathic surgery. This study aimed to evaluate the accuracy...
INTRODUCTION
Orthodontists, surgeons, and patients have taken an interest in using clear aligners in combination with orthognathic surgery. This study aimed to evaluate the accuracy of tooth movements with clear aligners during presurgical orthodontics using novel 3-dimensional superimposition techniques.
METHODS
The study sample consisted of 20 patients who have completed presurgical orthodontics using Invisalign clear aligners. Initial (pretreatment) digital dental models, presurgical digital dental models, and ClinCheck prediction models were obtained. Presurgical models were superimposed onto initial ones using stable anatomic landmarks; ClinCheck models were superimposed onto presurgical models using surface best-fit superimposition. Five hundred forty-five teeth were measured for 3 angular movements (buccolingual torque, mesiodistal tip, and rotation) and 4 linear movements (buccolingual, mesiodistal, vertical, and total scalar displacement). The predicted tooth movement was compared with the achieved amount for each movement and tooth, using both percentage accuracy and numerical difference.
RESULTS
Average percentage accuracy (63.4% ± 11.5%) was higher than in previously reported literature. The most accurate tooth movements were buccal torque and mesial displacement compared with lingual torque and distal displacement, particularly for mandibular posterior teeth. Clinically significant inaccuracies were found for the buccal displacement of maxillary second molars, lingual displacement of all molars, intrusion of mandibular second molars, the distal tip of molars, second premolars, and mandibular first premolars, buccal torque of maxillary central and lateral incisors, and lingual torque of premolars and molars.
CONCLUSIONS
Superimposition techniques used in this study lay the groundwork for future studies to analyze advanced clear aligner patients. Invisalign is a treatment modality that can be considered for presurgical orthodontics-tooth movements involved in arch leveling and decompensation are highly accurate when comparing the simulated and the clinically achieved movements.
Topics: Bicuspid; Humans; Incisor; Maxilla; Orthodontic Appliances, Removable; Tooth Movement Techniques
PubMed: 36182208
DOI: 10.1016/j.ajodo.2021.12.019 -
Dental Research Journal 2022When immediate molar implants first were proposed, submerged initial healing and delayed loading were the norm. It is now recognized that some early loading of a...
When immediate molar implants first were proposed, submerged initial healing and delayed loading were the norm. It is now recognized that some early loading of a nonocclusal nature can stimulate faster osseointegration, although full occlusal loading is still delayed for 3 or more months. Here, we test the hypothesis that earlier occlusal loading of mandibular premolar and molar immediate implants may be possible. In this retrospective case series study, 18 mandibular molar and nine mandibular premolar teeth were atraumatically extracted and immediate implants placed 1-2 mm apical to buccal and lingual crestal bone. Periimplant gaps received particular allograft covered with acellular dermal matrix barrier. Healing abutments were placed through puncture points in the membranes to help in stabilizing the latter and to permit nonsubmerged site healing. At 6-8 weeks, each implant was evaluated for stability using the Periotest® device and restored if the Periotest® (PTV) value seen was negative. Data were analyzed by t test and MannWhitney U at a significance level of < 0.05. Retrospective assessment of all 27 implants after 5 years' period of follow up showed all implants to have survived. Overall mean crestal bone loss was determined to be-0.25 ± 0.54 mm. Individual mean bone levels for mesial and distal surfaces were-0.24 ± 0.77 mm and-0.26 ± 0.72 mm, respectively ( = 0.78). A statistically significant difference in bone loss between genders was detected. Overall mean probing depth was 2.09 ± 0.57 mm. Based on the widely used Albrektsson criteria, the overall survival and success rate was 100%. Immediate implants placed into mandibular premolar and molar extraction sockets and allowed nonsubmerged healing may be ready for restoration at earlier times than previously thought possible.
PubMed: 36159059
DOI: No ID Found -
Polymers Sep 2022Impression materials are used to record and reproduce the exact morphology of the patient's oral cavity. The dimensional stability of a material is its ability to...
Impression materials are used to record and reproduce the exact morphology of the patient's oral cavity. The dimensional stability of a material is its ability to maintain the accuracy of recording the details of the oral cavity for a longer period of time, including the time during imprinting and immediately after. The aim of this study was to evaluate the accuracy of three different impression materials commonly used in the dental practice with the aid of an extra-oral three-dimensional (3D) scanner using an in vitro analysis. A typodont tooth model of the maxillary dental arch and mandibular dental arch, containing 16 permanent teeth, was used for evaluation. With the aid of three different impression materials, this model was imprinted fifteen times, resulting in fifteen different plaster models. A capsule extra-oral scanner device was used to digitalize the models and the same device was later used to align, compare, and measure scanned model surfaces. After performing the Kruskal-Wallis test for each measurement category (model), only two out of the fifteen measurements showed statistically significant differences between the material groups: vestibular-oral and mesial-distal width. Post hoc analysis showed that the alginate model (mean range = 29.13) had significantly higher bias scores than the addition silicone model (mean range = 16.75) (z = 2.501, = 0.037). The difference between the average values of the model bias made from condensation-based silicone and addition-based silicone was initially significant, but after applying the Bonferroni correction for further comparisons, this relationship did not remain significant (z = 2.197, = 0.084). Addition-based silicone models had the highest accuracy in terms of fidelity, followed by condensation-based silicones, and then by alginate models. Silicone-based impression materials improved over time, being highly used in all areas of dentistry. Alginate impressions had the lowest pattern of accuracy among those studied.
PubMed: 36080753
DOI: 10.3390/polym14173678 -
Journal of Clinical Medicine Aug 2022Intentional replantation (IR) may offer a solution for persistent periapical lesions associated with endodontically treated teeth. A 35-year-old male patient presented...
Intentional replantation (IR) may offer a solution for persistent periapical lesions associated with endodontically treated teeth. A 35-year-old male patient presented with pain associated with the left mandibular second molar and hypoesthesia. Upon clinical examination, increased probing pocket depth in the mid-buccal surface was detected. Cone beam computed tomography revealed a previous non-surgical root canal treatment, with root canal filling material extrusion adjacent to the inferior alveolar nerve, a fractured instrument in the mesial root, and a large periapical radiolucency involving both teeth 37 and 36. A diagnosis of symptomatic post-treatment apical periodontitis was established. After discussing treatment options with the patient, an IR of tooth 37 was performed. Extra-oral procedures were completed in 17 min. At 9 months, hypoesthesia resolution was reported, and apical healing was radiographically observed. After 2.5 years, the replanted tooth showed extensive root resorption. An extraction with alveolar ridge preservation, using leukocyte-platelet rich fibrin (L-PRF), was performed. Six months after tooth extraction and regeneration, implant placement surgery was carried out. IR presents a valid treatment modality for the management of post-treatment apical periodontitis. When orthograde retreatment or apical microsurgery prove to be unfeasible, IR is a unique procedure with the potential to promote tooth preservation in properly selected cases. Although unsuccessful after 2.5 years, the IR of tooth 37 allowed for bone regeneration, the maintenance of tooth 36 vitality, and hypoesthesia resolution.
PubMed: 36079036
DOI: 10.3390/jcm11175111 -
Cureus Jul 2022External cervical resorption (ECR) is a dynamic pathological process characterized by its cervical position on the root and arises below the epithelial attachment and...
External cervical resorption (ECR) is a dynamic pathological process characterized by its cervical position on the root and arises below the epithelial attachment and the coronal part of the bone. This report will highlight a case of ECR in an asymptomatic patient. A radiolucent area was noted during a routine dental follow-up examination on the bitewings at the mesial surface of the upper right second premolar. Persistently, the radiolucency had multiple radiographic views indicating a true form of a lesion that could be diagnosed as external cervical resorption. The patient did not report any complaints since dental treatment was completed in 2016. After a series of radiographs and conducting further diagnostic measures, a diagnosis of ECR was confirmed. The best treatment of choice for this case was extraction and restoring the missing tooth with an implant-supported crown. The size and the extent of such a defect could affect the strategy for implant placement. This paper aimed to report that ECR can be asymptomatic for a long time with advanced cervical root resorption in some cases.
PubMed: 36043004
DOI: 10.7759/cureus.27334 -
Journal of Clinical Medicine Aug 2022The aim of this study was to compare the shaping ability of a modified ProTaper Next technique (PTNm) with that of TruNatomy (TN) in lower molars mesial curved canals...
The aim of this study was to compare the shaping ability of a modified ProTaper Next technique (PTNm) with that of TruNatomy (TN) in lower molars mesial curved canals using micro-computed tomography (Micro-CT). Sixty mesial canals of first mandibular molars were randomly assigned between two groups (n = 30). After canal scouting with K-File #10, glide path and shaping were carried out with TN or PTNm systems. The PTNm sequence consists of ProGlider, followed by ProTaper Next X1 and apical finishing with NiTiFlex #25 up to working length (WL) to ensure adequate apical cleaning. Samples were scanned using micro-CT and pre- and post-shaping volumes were matched to analyse geometric parameters: the volume of removed dentin; the difference of canal surface; centroid shift, minimum and maximum root canal diameters; cross-sectional areas; the ratio of diameter ratios (RDR) and the ratio of cross-sectional areas (RA). Measurements were assessed 2 mm from the apex and in relation to the middle and coronal root canal thirds. Data were analysed using ANOVA (p < 0.05). No statistically significant differences were found between the groups for any parameter at each level of analysis, except for RA at the coronal level (p = 0.037). The PTNm system showed the tendency to enlarge more in the coronal portion with a lower centroid shift at apical level compared with TN sequence (p > 0.05). Both PTNm and TN sequences demonstrated similar maintenance of original anatomy during the shaping of lower molar mesial curved canals.
PubMed: 35956222
DOI: 10.3390/jcm11154607 -
Journal of Dental Research, Dental... 2022Primary dentition takes the most important role in the development of permanent dentition. Primary second molars determine the eruption and position of permanent first...
The prevalence of different types of occlusal relationships based on the type of terminal plane in primary dentition: a study among 3- to 6-year old children in Tbilisi, Georgia.
Primary dentition takes the most important role in the development of permanent dentition. Primary second molars determine the eruption and position of permanent first molars. Early diagnosis and treatment could prevent the establishment of occlusal anomalies and deformities, therefore this study aimed to collect data about the prevalence of malocclusions based on the deciduous second molar terminal planes among the Tbilisi preschoolers. A total of 396 children aged 3-6 years, with an equal number of male and female subjects, were examined in kindergartens drawn from ten districts of Tbilisi, using the PPS (probability proportional to size) method. The relationship between distal surfaces of primary second molars was evaluated and recorded according to Baume's classification. The significance level is 0.05 for all statistical tests. Out of investigated preschoolers, 52.7% showed the flush terminal plane, followed by the distal step in 21.2% and mesial step in 26.1% of cases. There were no significant differences in genders. The most prevalent relationship between deciduous second molars was the flush terminal plane, with equal distribution in all age groups. The frequency of distal step decreased with age, more frequently recorded in the 3 to 4 year age group. The mesial step was mostly recorded in 3-4 and 5-6 year groups. The flush terminal plane is the most frequent molar relationship, followed by mesial and distal step. Prevalence of distal mesial step significantly decreased with age, while mesial step relationship showed the tendency to increase. The flush terminal plane showed little change with age.
PubMed: 35936940
DOI: 10.34172/joddd.2022.004