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The odontogenic tissue surrounding an impacted tooth is a harbinger of a wide variety of odontogenic cysts and tumors. As these hamartomatous and neoplastic aberrations can occur at any stage of odontogenesis, therefore combined features of odontogenic tumors with epithelial and mesenchymal components can develop within the odontogenic cysts. One of the odontogenic cysts is the dentigerous cyst (DC) which is not only the most common developmental odontogenic cyst arising from the pericoronal tissue but is of great clinical significance owing to its neoplastic potential and association with other rare odontogenic tumors. We herein describe an unusual case of adenomatoid odontogenic tumor which developed secondary to a DC in a 22-year-old female and created a diagnostic conundrum. The approach to such a case, differential diagnosis, and review of the literature is also presented.

The compromised tooth structure after endodontic treatment necessitates the use of post and core for structural durability. Management of the flared root canal is still a tough obstacle for the clinicians. Reinforcing the root canal space with the customised anatomic post thus regains the lost structure within the canal and aids in establishing a great strength and stability to the tooth structure. The report of this case scenario aims on clinical technique of fabricating anatomic post with glass - fibre posts and composite resin on a central and lateral incisor.

Download : Download high-res image (246KB) Download : Download full-size image This article is a 16-year posttreatment follow-up of a girl who had avulsed her maxillary right central and lateral incisors and was left without space maintenance. The lost incisors were replaced by implant restorations that became infraoccluded over time and resulted in esthetic concerns. The elongated natural central incisor which had a long clinical crown height was equilibrated and leveled with the implant restorations. Good smile esthetics and a well-maintained long-term result were achieved.

The use of fixed retainers at the end of a course of orthodontic treatment has become standard practice. The main complication that can occur with fixed retainers is the detachment of the wire from one or more teeth. A less common complication is unwanted tooth movement.This article presents a patient with extreme tooth movement associated with a mandibular fixed retainer. Ten years after orthodontic treatment, a 26-year-old male sought treatment for post-orthodontic movement of the mandibular anterior six teeth. Despite the fixed retainer still being attached to all teeth, the apex of the right canine was completed avulsed labially. Severe labial recession was also present on the left lateral incisor. The canine was extracted, and the fixed retainer was removed. Significant root resorption identified on a panoramic radiograph contraindicated any further extensive orthodontic intervention.This case highlights that clinicians and patients should be aware of this rare but serious complication.L’utilisation d’un appareil de contention fixe à la fin d’un traitement d’orthodontie est devenue une pratique courante. La principale complication qui peut survenir avec les contentions fixes est le décollement du fil sur une ou plusieurs dents. Le mouvement dentaire indésirable est une complication moins courante.Cet article est illustré par le cas d’un patient présentant un mouvement dentaire extrême associé à une contention mandibulaire fixe. Dix ans après un traitement d’orthodontie, un homme de 26 ans a demandé un traitement en raison d’un mouvement post-orthodontique des six dents antérieures mandibulaires. Bien que le dispositif de contention fixe soit toujours en place sur toutes les dents, l’apex de la canine droite a été complètement versé vestibulairement. Une récession gingivale vestibulaire sévère était également présente sur l’incisive latérale gauche. La canine a été extraite et la contention fixe a été retirée. Une résorption radiculaire importante identifiée sur une radiographie panoramique contre-indiquait toute nouvelle intervention orthodontique.Ce cas souligne que les cliniciens et les patients doivent être conscients de cette complication rare mais grave.

Introduction: Amongst the anomalies observed in human dentition, agenesis is one of the most commonly found. Maxillary lateral incisor agenesis is one such anomaly. Various treatment modalities involving orthodontic & prosthetic treatment have been advocated for the management of this anomaly. Objective: To analyze the best treatment modality for maxillary lateral incisor agenesis amongst the orthodontic space closure, prosthetic replacement & implant based upon the esthetic results. Methodology: Till October 2020 a thorough literature search in various popular data bases performed with the end result of inclusion of 11 articles. Result and Conclusion: Esthetic outcomes of all these modalities was found to be satisfactory for patients as well as for the dentists, however orthodontic space closure was considered to be the most appropriate modality for lateral incisor agenesis pertaining to esthetics.

Rationale: Bone lid surgery (BLS) is minimally invasive surgery that removes the cortical bone and returns it to original position after removing lesions. However, jawbone lesions are completely covered with cortical bone, and it can be difficult to accurately determine the lesion position from the outside. Patient Concerns: A 24-year-old Japanese woman, identified as having an impacted maxillary canine, was referred to our department. Periapical radiolucent lesion, with lateral incisor root absorption by canine compression, was confirmed. Diagnosis: The diagnosis was incisor root absorption due to an impacted canine. Treatment: As a potential solution, we performed navigation-assisted BLS. Outcomes: Using navigation, we could confirm the state of impacted tooth under the covered bone. We could establish reliable bone cutting and the removed cortical bone was successfully returned to the presurgical position. Take-away Lessons: Navigation-assisted BLS for the removal of impacted teeth may increase surgical accuracy and minimize invasion.

Objective: To compare the rate of accelerated tooth movement in canine retraction with micro-osteoperforation on one side and control on the other. Study Design: Quasi experimental study. Place and Duration of Study: Orthodontics department, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jul 2018 to Jan 2019. Methodology: A total of 30 patients were inducted. After alignment and extraction of maxillary first premolars, canine retraction was started with closed NiTi coil spring on both sides of the maxillary arch. Micro-osteoperforation was done on the right side and other side was a control side. The distance between the lateral incisor and the canine was measured on both sides before micro-osteoperforation. The same measurements were recorded after three weeks of retraction. The difference between pre and post retraction measurements was recorded. The difference in the rate of canine retraction between both modalities was compared using independent sample t-test. Results: The study included 17 males (56%) and 13 females (43%). The mean rate of tooth movement at experimental side of maxilla was 1.6 ± 0.52 mm and on control side was 0.66 ± 0.31 mm (p

Objective. This study is aimed at analyzing different points of force application during miniscrew supported en masse retraction of the anterior maxillary teeth to identify the best line of action of force in lingual orthodontic treatment. Materials and Methods. Three-dimensional (3D) finite element models were created to stimulate en masse retraction with different heights and positions of the miniscrew and lever arm to change the force application points; a 150 g retraction force was applied from the miniscrew to the lever arms, and the initial tooth displacements were analyzed. Results. Lingual crown tipping and occlusal crown extrusion were seen at all heights and positions of the miniscrew and lever arm, but when the miniscrew height was at 8 mm and the power arm was located between the lateral incisors and canines, these tipping patterns were less than those obtained with a 4.5 mm high miniscrew and a lever arm located distal to the canines. Conclusion. All miniscrew heights and lever arm positions showed initial lingual crown tipping and labial root tipping with occlusal crown extrusion. However, the 8 mm miniscrew height and the lever arm located between the lateral incisor and canine showed fewer amounts of these tipping patterns than a 4.5 mm miniscrew height and lever arm located distal to the canines. Therefore, this could be the preferred point of force application during en masse retraction in lingual treatment with additional torque control methods.

Transposition of maxillary teeth is not very uncommon nding in clinical practice and poses a challenge to the clinician. Maxillary canine is the most commonly involved tooth in transposition exchanging its place with either lateral incisor or rst premolar. This case report describes successful management of a case of transposition between maxillary canine and lateral incisor involving right side st only with an insight into etiology, treatment alternatives and treatment procedure. This case had been treated with extraction of all four 1 premolars and involved teeth were successfully moved to their clinically normal position without any signicant damage to supporting structures or roots.

الملخص: أهداف البحث: تحقيق ابتسامة طبيعية أثناء استعادة الأسنان الأمامية يمثل تحديا. ويعد اختيار البعد المناسب للأسنان أمرا مهما للحصول على ابتسامة جميلة. الهدف من هذه الدراسة هو قياس وتحليل أبعاد الأسنان الأمامية العلوية، ونسب عرضها النسبي في المجتمع السعودي. طرق البحث: ضم البحث ١٨٠ (ذكور = ١١٢؛ إناث = ٦٨) شخصا لديهم جميع الأسنان الأمامية للفك العلوي (المدى العمري = ٢٠-٣٠) سنة. تم عمل طبعات الفك العلوي باستخدام مادة (فينيل-بولي سيلوكسان) وصبها. وتم استخدام الفرجار الرقمي لحساب طول وعرض الأسنان الأمامية العلوية من قوالب الأسنان بالمليمترات (ملم) وتم تصوير القوالب رقميا لحساب نسب العرض النسبية. النتائج: متوسط عرض القاطعة المركزية كان ٨.٧٤ ملم (ذكر = ٨.٨٩ ملم، أنثى = ٨.٦٠ ملم)، والقواطع الجانبية ٦.٦٤ملم (ذكر = ٦.٧٩ ملم؛ أنثى = ٦.٤٩ ملم) وكان الناب ٧.٨٢ملم (ذكر = ٨.٠١ ملم؛ أنثى = ٧.٦٣ ملم). ومتوسط الطول المسجل لهذه الأسنان كان ٩.٨٤ ملم (ذكر = ١٠.٠٤ملم، أنثى = ٩.٦٤ملم)، ٨.٠٩ ملم (ذكر = ٨.٣٠ ملم، أنثى = ٧.٨٩ملم) و٩.٠٨ ملم (ذكر = ٩.٤٨ ملم، أنثى = ٨.٦٩ ملم)، على التوالي. وكانت القيم المتوسطة لنسبة العرض النسبي التي تم قياسها على صور قوالب الأسنان ٦٣.٦٩ للقواطع الجانبية / القاطعة المركزية و٣٥.٧٨ للقاطع الناب / الجانبي. ولم توجد فروق ذات دلالة إحصائية بين القيم المتوسطة لنسبة العرض النسبي للجانب الأيمن والأيسر وبين الذكور والإناث. الاستنتاجات: لوحظ عدم وجود تماثل بين الأسنان الأمامية اليسرى واليمنى. وكانت نسبة العرض إلى الطول للقواطع المركزية والجانبية مماثلة لكلا الجنسين مع اختلاف طفيف في الأنياب. وتتخذ الأسنان الأمامية للسكان السعوديين شكلا أقرب للمربع مع تشابه في الأبعاد مع السكان الأتراك. Abstract: Objectives: Achieving a natural smile while restoring anterior teeth is challenging. Selecting appropriate dimensions of teeth is important for aesthetics. This study aims to measure and analyse the dimensions of the maxillary anterior teeth and their relative width proportions in a Saudi subpopulation. Methods: One hundred and eighty patients (112 men and 68 women) with intact maxillary anterior teeth (age range = 20–30 years) participated in this research. Maxillary impressions (Vinyl Polysiloxane) were created and poured. A digital caliper was used to record the length and width of maxillary anterior teeth in millimetres (mm) from the dental casts, and the casts were digitally photographed to calculate relative width ratios. Results: The mean width for central incisor was 8.74 mm (men = 8.89 mm, women = 8.60 mm), lateral incisor 6.64 mm (men = 6.79 mm, women = 6.49 mm) and canine 7.82 mm (men = 8.01 mm women = 7.63 mm). The recorded mean lengths for these teeth were 9.84 mm (men = 10.04 mm, women = 9.64 mm), 8.09 mm (men = 8.30 mm, women = 7.89 mm) and 9.08 mm (men = 9.48 mm, women = 8.69 mm). The mean values of apparent width/width ratio measured on the cast photographs were 63.69 mm for the lateral incisor/central incisor and 78.35 mm for canine/lateral incisor. No statistically significant difference was found between the mean values of the apparent width/width ratio of the right and left sides and between men and women. Conclusions: This study showed a minor asymmetry between left and right side anterior teeth among the participants. The width to length ratio of the central and lateral incisors was similar for both genders, with minor differences in the canines. A squarish form of anterior teeth for the Saudi population with dimensional similarities to the Turkish population was found.

This paper describes the orthodontic treatment of two cases that were successful in winning the British Orthodontic Society (BOS) Membership in Orthodontics (MOrth) Cases Prize in 2019. The first case describes the management of a 12-year-old girl with a Class II division 2 malocclusion complicated by moderate upper and lower arch crowding, multiple unerupted teeth, restored lower first permanent molars, pseudo-transposition of the lower left lateral incisor and canine, and diminutive upper lateral incisors. Treatment involved a combination of an upper removable appliance followed by upper and lower preadjusted edgewise fixed appliances. Anteroposterior correction and overbite reduction was achieved with triangular Class II elastics with posterior occlusal disengagement. Both upper permanent canines were exposed and aligned, and the diminutive upper incisors built up with resin-based composite. Treatment was completed over a period of 23 months. The second case describes the management of a 13-year-old boy with a Class II division 2 malocclusion complicated by severe upper and lower arch crowding with unerupted UR5, UL4, LR3, rotated LR5, an increased overbite complete to tooth, buccally displaced upper canines and hypoplastic upper first premolars. Treatment involved a first phase of functional appliance therapy, followed by the extraction of UR4, UL4, LL5, LR4 and upper and lower preadjusted edgewise fixed appliances over a 28-month period.

Objective: To compare the congenital tooth deficiencies seen in permanent dentition in individuals with unilateral cleft lip and palate (UCLP) to non-cleft individuals with Angle Class I malocclusion. Method: The study was performed on orthopantomograph films of 50 individuals with UCLP aged between 12 - 16 years and 50 individuals with Angle Class I malocclusion individuals aged between 13 - 15 years. Individuals with UCLP; 32 clefts were on the left side and 18 clefts were on the right side. Permanent third molar teeth deficiency was excluded from the study. Results: In 50 individuals with UCLP; 35 (70%) upper lateral incisors were congenitally deficient in the cleft area, while 15 (30%) missing lateral teeth were found in the non-cleft side. In control group, 12 (24%) of 50 patients had congenital lateral incisor deficiency. Congenital deficiency of upper lateral incisor in UCLP; the cleft area was higher than the non-cleft side (p < 0.01). The difference was statistically important when compared with the control group (p < 0.001). In 50 individuals with UCLP; while 27 (54%) of second premolar teeth were congenitally deficient in cleft side, 23 (46%) were missing in non-cleft side. In control group, 18 (36%) congenital second premolar deficiency was detected. However, second premolar congenital deficiency was higher in UCLP group when compared to control group (p < 0.01). Conclusion: The deficiency of the lateral incisors in the cleft side is more often congenitally deficient than upper second premolar teeth and this should be considered in the treatment planning from an early age.

Aim: The aim is to evaluate the maxillary anterior tooth proportion relationship using different calculations. Materials and Methods: Forty pleasing smile photographs were evaluated for the different calculations. Mesiodistal width of all the maxillary anterior teeth were measured and were subjected to different calculations like individual tooth width divided by the combined width of all the anterior teeth of one side and individual tooth width divided by the combined width of the remaining two teeth of one side. Calculated results were tabulated and were subjected to descriptive statistics. Results: Among the various formulas, the mesiodistal width of canine divided by the sum of mesiodistal width of central, lateral incisors, and canine showed the consistent quotient of 0.3 for all the subjects. Mesiodistal width individual teeth like central incisors when divided by the combined width of central incisor, lateral incisor and canine, also showed the constant quotient of 0.3 for all the patients. The sum of Mesiodistal width of central and lateral incisor when divided by combined width of central, lateral incisor and canine gave the constant value of 0.6. Conclusion: The consistent quotients obtained by the formulas like width of central incisors and the canine divided by the combined width of central-lateral incisors-canine and the other formulas can be used for building up of the missing teeth and the smile designing.

Background: Maxillary canines are important aesthetically and functionally, but impacted canines are more difficult and time consuming to treat. Moreover, impacted canines vary greatly in the inclination and location and can lead to resorption of neighboring incisors. Aim: To locate the impacted canine and compare resorption cases with non-resorption cases. Methods: Thirty -five 3 D CBCT scans were evaluated 17 presented with bilateral palatal impactions and 18 with unilateral impactions. Fifty –two canines were divided in two groups: group A: included impacted canines causing resorption to neighboring teeth and group B: impacted canines not causing resorption. Canine axis inclination, horizontal cusp location and distance to nearest adjacent tooth were recorded. T-tests (paired, student) determined the significance (P≤0.05) performed to evaluate the effect of resorption within and between each group. Results: Twenty–one canines caused resorption (40%) of the lateral incisor while there were 31 canines not causing resorption. Palatally impacted canines causing resorption to the adjacent teeth showed higher inclination of their axis to the midsagittal plane. Conclusions: Palatally impacted canines have high chance of causing resorption to adjacent teeth. As the canine is more medially located there is an increased chance of resorption especially when the cusp of the maxillary canine was positioned medially to the long axis of the lateral incisor. Highly significant correlation between palatally impacted canines in contact with neighboring teeth and resorption was found.

Treatment of lingual recession on the mandibular anteriors is not a regularly implemented procedure owing to its anatomical restraints, difficulty in isolation as well as lack of esthetic importance. The present case report describes the application of Mucograft® as an alternate to connective tissue graft in the treatment of mandibular lingual recession using minimally invasive tunneling technique. The surgical technique comprises preparation of full thickness tunnel to treat a narrow and deep gingival recession of 5mm midlingually with minimal attached gingiva and keratinized tissue width of 1mm in the right mandibular lateral incisor region and then placement of a mucograft within the prepared tunnel and securing it in place using sling sutures. 21 days follow up showed satisfactory results both in terms of root coverage as well as reduction of dentinal hypersensitivity. Thus, it can be concluded that lingual root coverage with a minimally invasive full thickness tunneling technique and Mucograft® successfully resolves the problems of dentinal hypersensitivity, proper plaque control along with the restoration of periodontal soft tissues. Keywords: Recession, Lingual, Mucograft.

Odontomas are one of the most common tumours of odontogenic origin. They are usually asymptomatic but may be associated with retained primary teeth or missing permanent teeth. Though the exact aetiology is unknown, the postulated causes include trauma, infection, inheritance and genetic mutation. Early diagnosis and management will result in fewer complications. Conservative surgical excision is the treatment of choice. This case report presents a treated case of compound odontoma associated with delayed eruption of the permanent central incisor in a nine-year-old boy. Keywords: Compound Odontoma. Continuous...

In this retrospective study, the frequency and severity of ectopic eruption in the children's permanent canines, changes between the impacted canine parameters on orthopantomography (OPG) taken for routine follow-up were demonstrated. Also, it was aimed to reveal the differences between OPG and cone beam computed tomography (CBCT). Ten thousand (5020 girls, 4980 boys) pediatric patient, were retrospectively investigated for the presence of impacted canine radiographically. OPG and CBCT images of 343 pediatric patients (207 girls, 136 boys) detected impacted canines (n = 432) were evaluated in four steps that the angular and linear measurement, position and status relationships with adjacent anatomical structures were investigated. The incidence of impacted canine in children was 3.43% (4.02% girls, 2.73% boys). The percentage of adjacent lateral incisor' resorption was 33%. Although the presence of resorption in lateral incisors in contact with a canine was found to be statistically significant (p = 0.02), there was no statistically significant relationship the follicle size and localization of canine in the transverse plane. When images were compared, it was found that there was a statistically significant difference between CBCT and OPG about the parameter of canine angulation to the midline and parameter of canine angulation to the lateral incisor. Pediatric dentists should prefer OPG as the first choice for radiographic imaging for the diagnosis of impacted canine at an early age. Follow-up OPGs should be carefully studied with advancing age. The CBCT should be preferred to prevent complications, to view its relationship with adjacent anatomical structures and canine localization in detail.

Background: Fixed orthodontic appliances, such as Edgewise and Straightwire techniques, can increase the amount of plaque retention containing Streptococcus mutans (S. mutans), which can lead to white spot lesions. Purpose: The aim of this study is to analyse the correlation of fixed orthodontic treatment with Edgewise and Straightwire techniques on the incidence of white spot lesions and accumulation of S. mutans. Methods: The samples consisted of three groups: control group (n=8), Edgewise technique group, and Straightwire technique group. We observed the samples at the sixth month and eighth month of the treatment, after the installation of the fixed orthodontic appliances. The observation of white spot lesions with caries detector was applied in all regions. Bacterial swabs were acquired in the lateral incisor region, then a bacterial culture procedure was carried out on selective media of S. mutans, and then a bacterial count was performed. The data was analysed using two-way ANOVA, the post-hoc least square differences test, and the Pearson’s correlation test. Results: The number of white spot lesions in the Edgewise group was higher than in the Straightwire group in the sixth and eighth month of treatment with insignificant difference (p>0.05). The number of S. mutans bacteria increased in all groups, but there were no significant differences (p>0.05). There was no significant relationship between the number of white spot lesions with the accumulation of S. mutans between groups (p>0.05). Conclusion: The Edgewise and Straightwire techniques increase the incidence of white spot lesions but accumulation of S. mutans with the incidence of white spot lesions has no relationship.

A 14 year child reported with a swelling and mobile upper right lateral incisor and was diagnosed with periapical cyst. the case report deals with the diagnosis, treatment and follow up of the case. Keywords: Radicular cyst, Cleaning and shaping.

Tooth transposition is an unusual form of positional interchange of two adjacent teeth. The maxillary canine is the most frequently involved tooth. This is a case report of a complete left maxillary canine transposition with lateral incisor and impacted right maxillary 2nd premolar. Careful planning of the orthodontic transposition correction was done, and teeth were followed meticulously to their normal positions.

Dens invaginatus (dens in dente) is a frequent malformation of the hard tissues of the tooth the maxilar permanent lateral incisors. This anomaly is often not identified by the dentist during examinations and are not correctly diagnosed in the treatment. On the basis of a clinical case of chronic periodontitis of the tooth 1.2, which was specified malformation in combination with the wrong early diagnosis, developed perspective of the phenomenon in relation to the upper second incisors. Recommended x-ray diagnostics of all lateral upper incisors, visually discovered a blind fissure. Also discusses the use of the material Biodentine as an alternative to endodontic treatment in the case of extensive destruction of dens invaginatus malformation.

Objective The spatial position of a canine can affect the level of proximal root resorption and the success of orthodontic treatment. The aim of this study was to examine the mesiodistal and vertical position of impacted maxillary canines and to assess their relationship with the lateral incisor by using cone beam computed tomography (CBCT). Material and method One hundred and sixty-nine CBCT scans of patients presenting with maxillary impacted canines were included in the study. The buccopalatal, mesiodistal (classified as sectors I, II, III, IV from distal to mesial) and vertical (cervical, middle, apical) position of the maxillary impacted canines were determined. The positional effect on the morphology (width, length, and depth) and resorption was assessed on the roots of the maxillary lateral incisors. Obtained data were statistically analysed by using Student t-test, the Mann Whitney U and Chi-Square tests. Results Of the maxillary impacted canines, the 34.72% that had associated resorption on the adjacent lateral incisors were buccally positioned, and 65.28% were palatally positioned. While 45.58% of sector I impacted maxillary canines were buccally positioned, 68.31% of sector IV impacted maxillary canines were palatally positioned. Furthermore, there was a statistical significance between the mesiodistal position and palatal or buccal maxillary canine impaction (p < 0.05). In addition, the vertical position of the impacted maxillary canines was also related to their mesiodistal and buccopalatal positions (p < 0.05). Conclusion While all maxillary impacted canines had the potential to cause lateral incisor resorption, there was no close relationship related to the canine’s buccopalatal, mesiodistal and vertical position. Nevertheless, if an impacted maxillary canine migrated towards the midline, the buccopalatal and vertical position of the tooth changed from buccal to palatal and cervical to apical, respectively.

Endodontic treatment of fused teeth needs special care and attention due to its complex anatomy. The aim of this article is to highlight the problems encountered and the strategy in treating such cases. We report a case of unilateral fusion of the left mandibular central incisor and lateral incisor, with a single pulp chamber. The single pulp chamber separates into two root canals and a large communication exists at the apical third of the root canals. This is the first time fused teeth with a large communication is reported. CBCT analysis was effective in confirming the morphological aberrations and aided in accurate planning and treatment. Chemomechanical preparation with manual dynamic irrigation coupled with passive ultrasonic activation of the irrigant and obturation with thermoplasticised gutta percha helped in successful outcome of the case.

Классическая конфигурация боковых резцов верхней челюсти представляет собой один корень с одним каналом. Однако не являются исключением вариации анатомического и морфологического строения. Рентгенограммы, сделанные под разными углами, особенно мезиальными и дистальными, имеют решающее значение в подобных случаях нетипичного анатомического строения корневых каналов, хотя можно ожидать большую точность при использовании операционного микроскопа и конусно-лучевой компьютерной томографии. Важное значение имеют доскональное знание и тщательная диагностика конфигурации каналов, аномалий развития и тщательная оценка рентгенограмм, проводимых перед лечением. Цель исследования повышение эффективности эндодонтического лечения зубов со сложным морфологическим строением корневых каналов на примере клинического случая. Материалы и методы исследования. В анамнезе получение травмы пять месяцев назад. При клинической оценке выявлено изменение цвета коронки бокового резца. При тестировании на жизнеспособность с помощью электронного тестера пульпы как центральные, так и боковые резцы не показали реакции, что указывает на то, что зубы нежизнеспособные и требуют эндодонтического лечения. Результаты и их обсуждение. Обтурация была проведена техникой холодного бокового уплотнения с использованием гуттаперчи и Sealapex. Для восстановления после обтурации использовалась композитная смола Filtek Z350 XT и произведена контрольная рентгенограмма подтверждающая успешное лечение. Заключение. Учитывая различия в анатомической и морфологической конфигурации этих зубов, клиницист должен активно выявлять дополнительные корни и каналы., The classic configuration of the maxillary lateral incisors is a single root with a single canal. However, variations in the anatomical and morphological structure are not an exception. Radiographs taken at different angles, especially mesial and distal, are crucial in such cases of atypical root canal anatomy. Although you can expect greater accuracy when using an operating microscope and cone beam computed tomography. Thorough knowledge and careful diagnosis of canal configuration, developmental anomalies, and careful evaluation of pre-treatment radiographs are essential. The research purpose is to increase the effectiveness of endodontic treatment of teeth with a complex morphological structure of root canals on the example of a clinical case. Materials and research methods. There was an injury five months ago in the anamnesis. Clinical evaluation revealed discoloration of the crown of the lateral incisor. When tested for vitality with an electronic pulp tester, both central and lateral incisors showed no response, indicating that the teeth are not viable and require endodontic treatment. Results and its discussion. The obturation was performed with the cold lateral sealing technique using gutta-percha and Sealapex. Filtek Z350 XT composite resin was used for obturation recovery and a followup radiograph was taken confirming successful treatment. Conclusion. The clinician should actively identify additional roots and canals, taking into account differences in the anatomical and morphological configuration of these teeth.

Objective To describe oral alterations in children with congenital Zika syndrome (CZS). Methods This was a case series, whose research instrument was a structured questionnaire, associated with the use of medical record data and extra and intraoral clinical examination. Results Thirty-two children were evaluated, the majority male (18/32%-56.3%), mean age 22 months (SD = 2.71). It was also observed that the majority of the patients (19/32%-59.4%) presented a low family income. All the children had a mean head circumference of 29.43 cm (SD = 1.42). Regarding the alterations, an ogival-shaped palate was observed in 14 children (43.7%), and delayed chronology of eruption was observed in 15 children (46.9%), of whom 7 children (21.9%) did not present eruption of the upper left lateral incisor (p = .0002) and upper right lateral incisor (p = .002) until the moment of analysis. Additionally, 03 children with yellowish dental pigmentation were identified in erupted teeth after the onset of phenobarbital use. Enamel hypoplasia was identified in 9 children (28.1%) and only one child with ankyloglossia. Conclusion CZS may present delayed chronology of eruption, ankyloglossia, ogival-shaped palate, and enamel hypoplasia, requiring dental follow-up aimed at prevention, promotion, and rehabilitation of the health of these children.

This study aimed to identify the location of root resorption in relation to an impacted maxillary canine and grade its severity using cone-beam computed tomography (CBCT) in the Saudi Arabian population. Materials and Methods: CBCT scans of 169 patients with maxillary canine impaction were evaluated. The location and the severity of root resorption of the affected tooth in relation to the impacted maxillary canine were recorded for each patient. Results: a total 204 impacted maxillary canines caused root resorption in 218 adjacent teeth. Maximum root resorption was present in 63.3% of the apical one-third of the root and 37.6% of the palatal surfaces. There was mild root resorption in 55%, moderate in 10% and severe in 35%. There was no statistically significant difference between the gender, age, type of impaction, side of impaction, and the number, location, or degree of root resorption. Multiple logistic regression models showed significant association (p = 0.024) between gender, type of impaction, and root resorption. A significant correlation was found between the level and the surface of the root resorption (p = 0.018). Conclusion: In the Saudi population, apical one-third root levels and palatal surfaces were primarily involved in root resorption caused by impacted canines. The females with bilateral canine impaction were more likely affected by root resorption.

Purpose The aim of this systematic review was to evaluate and compare three commonly used proportions that include the golden proportion, golden percentage, and Recurring Esthetic Dental (RED) proportion to identify which of the mathematical formulas, if any, can be used to provide predictable and repeatable esthetic clinical outcomes. Methods A comprehensive search of electronic databases that included EBSCO, ProQuest, SCOPUS, Science Direct, Wiley, Google Scholar and PubMed was conducted using the terms: "golden proportion", "golden percentage", and "Recurring Esthetic Dental (RED) proportions" alone or in concurrence with one or both ensuing terms: "tooth proportions" and "esthetic tooth proportions". In addition, the following journals were hand searched for relevant articles: Journal of Prosthodontics, Journal of Prosthetic Dentistry and Journal of Esthetic and Restorative Dentistry. Related citations were also considered. Results Tooth proportions varied substantially in the natural dentition. No studies revealed findings that supported the use of one mathematical formula to predict esthetic success. The golden proportion is present between the central to lateral incisor in some cases, but rarely between the lateral incisor and the canine. When compared to the other proportions, the golden percentage provided better starting points for tooth shape and size, but only when values were adjusted to consider other factors such as ethnicity and/or facial proportions. Conclusion Mathematical formulas did not provide consistent results that would allow for their use as a standardized guide for esthetically pleasing smiles. Although the golden percentage may be a good starting point if the percentages are adjusted on a case-to-case basis, generalized esthetic ideals cannot be determined by a mathematical formula and are open to interpretation by both the clinician and the patient. This article is protected by copyright. All rights reserved.

OBJECTIVE To investigate laypeople and dental professionals' opinions of the aesthetic outcome from implant therapy (IT) and orthodontic space closure (SC) for missing maxillary lateral incisors. MATERIAL AND METHODS Evaluation was performed by three groups: laypeople 20-30 years of age (n = 26), laypeople 50-70 years of age (n = 26) and orthodontists (n = 25). The assessors viewed photographs of 44 different cases treated with IT or SC, and made an evaluation of the aesthetics. RESULTS The gingival color adjacent to the replaced tooth was rated as having better aesthetics in the SC cases (p = 0.000). The orthodontists preferred the aesthetics of the dentition in the SC cases (p = 0.042). The young laypeople, compared to the older laypeople and orthodontists, were more dissatisfied with the color of the tooth replacing the missing lateral incisor in SC cases (p = 0.043). CONCLUSION The color of the gingiva adjacent to the implant-supported crowns had a lower aesthetic rating than the SC group. Laypeople rated both treatments as equally good. The orthodontists had a slight preference for the aesthetics in the SC cases.

Objective: To assess the relationship of ɑ and s angles of maxillary impacted canines with maxillary lateral incisor root resorption . Material and Methods: For this, 40 patients (between 11 and 45 years) with impacted maxillary canines presenting to a private orthodontic clinic were evaluated.20% of the cases were male and 80% were female. The ɑ and s angles were measured on panoramic radiographs to determine the angulation of impacted canine. CBCT scans had been taken by ProMax 3D CBCT system were used to examine lateral root reorption. The relationship between the size of ɑ and s angles of impacted maxillary canines and root resorption in the adjacent maxillary lateral incisor was analyzed using SPSS version 22. Results: The mean size of ɑ and s angles had no significant correlation with the presence/absence, location, or severity of root resorption in the adjacent lateral incisor or the buccolingual position of impacted canine. The ɑ and s angles in impacted maxillary canines cannot be used to determine the incidence or severity of root resorption in the adjacent lateral incisor . Conclusion: No significant association between ɑ and s angles and incidence or severity of root resorption in the adjacent lateral incisor was found.

Maxillary lateral incisors are generally considered as a tooth with a single root and single canal. This is not true in all cases as case reports have advocated maxillary lateral incisors showing two roots with two or three root canals, Thorough knowledge of the internal and external dental anatomy and its variations is essential for a successful endodontic treatment. This case report deals with the periapical surgery in a two rooted maxillary lateral incisor along with the central incisor.

Dens in dente is known as a growth disorder caused by inversion of the coronary tissue into the pulp chamber prior to mineralization; it can be constrained to the crown or extent the root and influence the periapical area. The condition seen in radiographic image like a tooth within a tooth. Although it happens rarely, it is the most frequent malformation detected in human dentition. It can be specially observed in maxillary lateral and then central incisors. Because of the complexity as well as strange anatomy, the tooth has the potential to show pulp necrosis and open apex, which may bring about some challenges to manage it. An early detection of the malformation is critical for better handling and makes treatment plan more conservative like restorative procedures. We describe the management of an uncommon case of type III dens in dente diagnosed using cone-beam CT scan in a maxillary lateral incisor, having a chronic periapical lesion, buccal sinus tract as well as palatal expansion healed successfully after treating with non-surgical root canal procedure.

Aim: The present study aims to correlate between gender and width-length ratio of maxillary anterior teeth in a sample of Egyptian population and to obtain an optimal esthetical accepted ratio of teeth dimensions to gingival display. Materials and Method: Stone casts were poured from irreversible hydrocolloid impressions of 100 adult Egyptian participants. These casts were used to measure the maximum mesiodistal width, maximum crown length and the width/length ratio for each maxillary anterior tooth. In addition, two frontal photographs were taken for each participant and the visible anterior teeth width, length and width/length ratio were measured. Finally, a sample with gummy smile was selected and the gingival display of the original image was digitally manipulated to create a series of five images with different gingival displays, then these images were subjected to assessment by 50 dentists and 50 laypersons using a numerical rating scale. Results: There was statistically significant difference between female and male group for all teeth width values and W/L ratio of lateral incisor and canine. There was no significant difference between dentists and laypersons perception except for the smile with -4 mm gingival display. Conclusion: Gender affects actual teeth width values as well as actual and apparent W/L ratios of lateral incisor and canine. Laypersons considered 0mm and -2mm gingival display the most attractive situation, on the other hand dentists considered 0 mm gingival display the most attractive one, while all participants agreed that 4mm gingival display is the least attractive one.

Objective: To evaluate the craniofacial morphology of Japanese patients with unilateral cleft lip and palate and to evaluate the multiple congenital factors that affects craniofacial morphology in unilateral cleft lip and palate patients. Material and Methods: Lateral cephalograms of 140 subjects with unilateral cleft lip and palate were taken before any orthodontic treatment and alveolar bone graft. Subjects mean age was 6.85 ±1.56 years. Primary surgeries performed by surgeons from Hokkaido University Hospital. The craniofacial morphology of the 140 subjects was assessed by angular and linear cephalometric measurements. Gender, side of cleft, complete/incomplete type of cleft, presence/absence of lateral incisor in the affected side, family history of cleft and family history of skeletal Class III was chosen as congenital factors. To compare the assessments using congenital factors affecting craniofacial morphology in the unilateral cleft lip and palate subjects, angular and linear cephalometric measured values from each individual subject (control group) were converted into Z scores in relation to the means and standard deviation of the two parameters. Results: Twelve out of 13 craniofacial morphology outcomes were insignificant in 5 out of 6 dependent variables. Only 1 dependent variable showed 3/13 significant differences. Conclusion: Current study revealed the evidence that there were almost no significant differences in the craniofacial morphology outcome among various congenital factors. This will provide base line information and help determine the effectiveness of such factors.

A beautiful smile is often considered to have an important role on people’s lives, since it contributes to self-confidence and social relationships. Therefore, dental discrepancies such as conoid teeth could affect negatively one’s life and, as long as the patient desires, intervention should take place. Conoid teeth have significant alterations of basic anatomy, size and shape, which lead to a non-proportional smile. This case report regards to a reshape of a conoid lateral incisor, using direct composites, in order to help the orthodontic work. The chosen technique to provide this reshape was developed by the Styleitaliano® group, in order to simplify the restorative steps, using only three composite shades (one for dentin, one for enamel and one for optical effect). This case report emphasizes that different dentistry areas, such as Cosmetic Dentistry and Orthodontics must perform together in order to achieve good results, especially in cases that require shape changes.

The objective of this study was to revisit the topic of compensatory interactions between maxillary anterior teeth during development advanced by Sofaer et al. (1971). We addressed the hypotheses listed by Sofaer and colleagues using data derived from our Australian twin sample to investigate whether final tooth size in permanent maxillary central incisors and canines showed evidence of developmental compensation for adjacent missing or microdont lateral incisors. Such compensation is one factor interacting in the complex system of dental development.A 2D image analysis system was used to measure crown height from the labial view, labiopalatal crown width from the incisal view, and mesiodistal crown width from both the labial (MDl) and incisal (MDi) views of the permanent maxillary central incisors and canines on the dental study model of twins enrolled in a longitudinal study of dental development.Developmental variations of maxillary lateral incisors influence the morphogenesis of the adjacent teeth. For example, individuals with one missing lateral incisor and one lateral incisor of average dimensions, had significantly larger central incisors than the control group for the MDl and MDi dimensions (p 0.05). Of the 7 monozygotic twin pairs, 6 were discordant in maxillary anterior hypodontia and microdontia, and 13 out of 14 dizygotic twin pairs were discordant.This study provides further evidence of developmental interactions in the maxillary anterior region, partially supporting Sofaer and colleagues' hypotheses. These interactions are part of a complex adaptive system involving genetic, epigenetic and environmental factors.

Background/Aim. Many authors find that impacted maxillary canines is associated with missing and peg-shaped lateral incisor. The aim of this study was to examine the prevalence of peg-shaped and missing lateral incisor in subjects with impacted maxillary canines, and compare the size of maxillary lateral incisor on the side with palatally impacted canines and on the opposite side of the jaw where there is no impaction. Methods. The study included 64 patients with 80 impacted maxillary canines (23 males and 41 females, mean age 16.3). For each maxillary unerupted canine, precisely correct localization and classification into groups was done. We analyzed the morphology of the lateral incisor (normal, atypical) and frequency of missing of lateral maxillary incisors with canine impaction. Then, from the mentioned examinees sample with the maxillary canine teeth, a subgroup was formed. The criteria for selection were those with unilateral palatally impacted canines (33 subjects, 22 females and 11 males, mean age 17.8 years). The linear variables of the maxillary lateral incisor were measured by using digital measurements tools. The t-test was used to test the differences between the groups. Results. Normal morphology of the lateral incisors was found in 72% of the subjects with the impacted canines, 11.2% of the subjects had the peg-shaped lateral incisors, 6% had a bilateral and 4% had unilateral deficiency of lateral incisors. In the subgroup of the patients with unilateral palatal impaction, the middle value of the length of the lateral incisors was 1.9 mm shorter and the middle value of the width of the lateral incisors was smaller by 0.9 mm when comparing to the control group. Conclusion. The frequency of the deficiency of lateral incisors was statistically significantly higher in the group with palatal canine impaction. The maxillary lateral incisors on the side with palatally impacted canines were smaller than those on the side where there was no impaction.

Tooth transposition is a rare developmental disorder in which a normal tooth erupts in an inappropriate position. The change in position occurs between two adjacent teeth within the same quadrant. In this article, two cases of tooth transposition involving mandibular molars are described. Patient 1 presented with bilateral transposition between first and second mandibular molars. In addition, giroversion of the first molars was observed. Patient 2 presented with unilateral transposition between the mandibular left molars. Because this tooth disorder does not affect quality of life, both patients declined to seek dental treatment. Out of the 120 cases of tooth transposition found in the literature, 92,5% occurred in the maxilla and 15% were bilateral, 65,8% percent of these cases involved the canine and first premolar; 26.6% involved the canine and lateral incisor; 2,5% involved the canine and central incisor; and only 0.85% involved the first and second molar. The majority of tooth transposition cases occurred in women (66,6%). In literature, tooth transposition is a poorly-documented condition. Consequently, this report seeks to contribute to the existing information in the literature on this disorder.

Although dental trauma is poorly managed by general dental practices, it is important to follow appropriate steps to achieve optimal results. This case report outlines the management of non-vital immature teeth with calcium hydroxide and reverse Gutta Percha (GP) cone cold lateral compaction to achieving endodontic success. Even though it is a disputed technique, if proper conditions are provided, the root development continues to preserve a functionally fit and sound tooth on the arch of a young adolescence, avoiding extensive surgical and prosthetic procedures to replace a potentially compromised tooth. This case report highlights the beneficial effects of both calcium hydroxide and Chlorhexidine-dygluconate (CHX), which are far to be obsolete in the field of apexification or even regenerative dentistry as a whole.The 11 years old male presents post-traumatic necrosis in the upper left lateral incisor (tooth 2.2) which is dressed with calcium hydroxide, achieving the disinfection of the root canal, remission of the apical periodontitis and complete root formation 1 year later. The importance of the use of biocompatible materials as calcium hydroxide and CHX are emphasized in this case in which, although, no modern regenerative procedures and materials were used, the results are more than satisfactory. This report will look into the management of a non-vital immature lateral incisor with a reverse GP cone lateral compaction to achieving a successful apical and canal seal radiographically.

Background The maxillary anterior teeth play a crucial role in smile aesthetics. Previous studies regarding the importance of maxillary lateral incisors for smile aesthetics concentrated on their size, incisor edge level, and inclination, etc. However, the aesthetic effect of lateral incisor movement in the spatial position has not been studied yet. Therefore, the purpose of this study was to explore the influence of the labiolingual position of maxillary lateral incisors on the aesthetic perception of smiles by orthodontists and laypersons, as well as analyze differences in this perception between male and female raters. Methods A three-dimensional (3D) dental model was generated from the photograph of a man’s smile using iOrtho7.0 software (Time Angel, Wuxi, China). Based on this model, seven images were generated with different labiolingual positions of the maxillary lateral incisors in 0.5 mm increments (+ indicating labial translation, and—indicating lingual translation). The images were evaluated by 86 orthodontists and 161 laypersons using a visual analog scale, with lower scores indicating less attractiveness. Data were analyzed using Student’s t test and one-way analysis of variance with post hoc test. Results There was no significant difference in smile ratings by males and females. Orthodontists assigned lower scores to all images than laypersons. The smile at + 1.5 mm was considered the least attractive by orthodontists, while smiles at + 1.5 mm and − 1.5 mm were regarded as the least attractive by laypersons. The smile at 0 mm was evaluated as the most attractive by all raters. Laypersons gave different scores to smiles at 0 or − 0.5 mm, but orthodontists did not. Conclusions The labiolingual position of maxillary lateral incisors does affect the perception of smile aesthetics. Orthodontists may rate smile aesthetics more critically than laypersons. Therefore, communication and discussion between orthodontists and patients is needed to achieve better therapeutic and aesthetic outcomes.

Permanent lateral incisors have been considered as major missing teeth in the mouth. The main aim ofthe present study is to conduct a comparative study of maxillary and mandibular arch widths, overjet andoverbite for a sample with missing lateral incisors and normal class I occlusion.The sample of the study comprises sixty pairs of study models of both genders, which were separated intotwo groups. The first group consisted of thirty casts of bilateral congenital missing lateral incisors, while thesecond group consisted of thirty casts of the class I occlusion. The intercanine width, interpremolar width,intermolar width, overjet and overbite were measured for the sixty samples.The results of this study demonstrate a significant reduction in maxillary and mandibular arch widthin bilateral missing lateral Incisors as compared with normal class I group. The results also revealed asignificant reduction in overjet and overbite in bilateral missing lateral incisors as compared with normalclass I group. A significant difference was also reported between the two groups based on gender differencein the maxillary arch width. Conversely, non-significant difference was found in the mandibular arch width.The present study also shows non-significant difference based on gender difference in overjet and overbitein the two groups.