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Objective: This study aimed to examine and compare the efficacy of mouthwashes containing different proteins and peptide on the prevention of enamel erosion in vivo, as well as to evaluate the participants’ satisfaction with the formulations. Methods: Twelve participants were selected and underwent five cross-over mouthwash phases: Water (control); 0.1 mg/mL CaneCPI-5; 0.5 mg/mL MaquiCPI-3; 0.1 mg/mL CsinCPI-2; and 0.037 mg/mL Stn15pSpS. After prophylaxis, the participants rinsed (1 min), followed by the acquired enamel pellicle (AEP) formation (2 h). An erosive challenge was made (biopsy, citric acid 1%, 15s) on the buccal surface of the central maxillary incisors. The Relative Surface Reflection Intensity (%SRI) was assessed and analyzed by ANOVA/Tukey’s tests. The calcium release in acid was measured by the Arsenazo method and verified by Kruskal-Wallis/Dunn’s tests. The Spearman’s correlation was used between analyses. A questionnaire evaluated the satisfaction of participants. Results: For both analyses, the results showed that mouthwashes containing the proteins or peptide were significantly more effective in preventing enamel erosion compared to deionized water, with no significant differences among the active ingredients (p < 0.05). Also, there was a significant negative correlation between %SRI and calcium released (r=-0.5754). The questionnaire revealed that the volunteers were satisfied with the taste of the products. In addition, the experimental procedures were well tolerable, and no side effects were reported. Conclusion: All mouthwashes containing proteins or peptide were acceptable and effective in protecting enamel against initial dental erosion in vivo. Clinical significance: This study highlights the potential of these pioneer organic components for the development of mouthwashes designed for people with risk of erosive tooth wear. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to assess clinically and radiographically the usage of autogenous tooth bone graft (ATBG) combined with and without Simvastatin (SMV) around immediately placed dental implants in periodontally compromised sites. Methods: Thirty-nine patients required a single extraction of periodontally compromised tooth were divided into three groups (13 patients each). Group I received immediate implant placement (IIP) without grafting. Group II received IIP with ATBG filling the gap around IIP. Group III received SMV gel mixed with ATBG around IIP. Radiographic changes were reported at the baseline, 6-, and 12-months post-surgery. Results: All implants achieved the success criteria with no complications. At 6- and 12-months post-surgery, group III showed a statistically lower mean ridge width loss compared to Group I and Group II (P <.001). Group II revealed less reduction in the mean alveolar ridge width compared to group I (P <.001). Group III showed a statistically significantly less MBL loss than group I and group II (P <.001). All groups showed a statistically significant increase in BD gain compared to baseline (P <.001). Group III showed statistically significant high BD compared to group II (P <.001). Group II showed statistically significantly higher mean BD gain than that of group I (P <.001). Conclusion: SMV combined with ATBG boosts the hard tissue parameters around dental implants over ATBG alone. Clinical trial registration was on August 1, 2021 (NCT04992416). Clinical relevance: ATBG with SMV in periodontally compromised sites could improve implant osseointegration and promote favorable changes in peri-implant tissues. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study was to evaluate permanent teeth with post-traumatic transversal root fractures, for their initial healing modality, the effect of candidate predictors and their long-term prognosis. Methodology: A retrospective longitudinal clinical study was conducted to evaluate records from patients bearing transversal root fractures in permanent teeth in order to radiographically assess short-term healing and non-healing events in the fracture line, their prognostic factors and their relationship with long term outcomes. The inter-fragmentary tissues were classified as healing: hard tissue (HT), connective tissue (CT) or connective tissue and bone (CT + B) and non-healing: interposition of granulation tissue (GT). A competing risk survival analysis was conducted to estimate the hazards of healing and non-healing events in the short-term and the effect of demographic, clinical, and treatment variables was assessed using the subdistribution regression model (Fine & Gray). Results: Radiographic findings showed 61.4% of healing in the short-term being strongly influenced by the presence and type of concomitant injuries to the coronal fragment. Teeth with concomitant crown fractures (sHR 24.38, 95% CI [3.16–188.3], p = 0.0022), luxations with dislocations (sHR 10.58, 95% CI [1.37–81.9], p = 0.0240) and subluxations (HR 9.66, 95% CI [1.14–81.7], p = 0.0370) were more likely to present non-healing of root fractures in the short-term. The healing rate in the long-term was of 75.9%, most of them with interposition of bone and connective tissue. Kappa statistics demonstrated an overall agreement of 67.1% between short and long-term healing patterns, in special HT and CT + Bone modalities. Conclusion: Healing at the fracture site was the most frequent outcome, both in the short-term and in the long-term. Short-term healing modality was strongly influenced by the presence and type of concomitant injuries to the crown fragment, being the worst prognosis observed in root-fractured teeth with concomitant crown fractures, followed by concomitant luxations with dislocation. Clinical relevance: Post-traumatic transversal root fractures have a positive prognosis supporting therefore, a more conservative approach for these teeth before considering more radical treatments. [ABSTRACT FROM AUTHOR]

Objective: Since 2002, patients with statutory health insurance in Germany must undergo an assessment of orthodontic treatment need using the "Kieferorthopädische Indikationsguppen" (KIG; orthodontic indication groups) classification system. According to this system, tooth and jaw misalignment are divided into 11 subgroups and five grades. The objectives of this study were to determine the distribution of KIG classifications in patients with statutory insurance of a German orthodontic practice (North Rhine, Germany) and to analyze changes over a 20-year period. Materials and Methods: Since the introduction of the KIG index in 2002, 4940 statutorily insured patients over a 20-year period (2330 m, 2610 f, min 3.2, max 49.5 years, peak between 10 and 12 years) were classified at their first appointment. According to the valid guidelines of the statutory health insurance (GKV), the division was made into the highest possible KIG classification. Multiple entries were thus not made. In accordance with the operating cycles of the practice, the progression was divided into four 5-year periods. Results: Over a 20-year period, 24.98% of the patients were assigned to the classification "D". 86.52% of the patients were among the 6 most frequently ("D", "E", "K", "S", "P" and "M", > 10% each) and only 13.49% among the 5 least frequently recorded classifications ("U", "B", "T", "O" and "A", < 5% each). Conclusion: The distribution of the 6 most frequent and the 5 least frequent KIG classifications was constant over a 20-year-period. Among all possible tooth and jaw misalignment variants, the sagittal classifications "D" and "M" represent the most frequent malocclusions. Clinical relevance: The results and their comparison with historical data show that both frequency and severity of tooth and jaw misalignment with orthodontic treatment need appear identical for patients with statutory health insurance over a 20-year period. [ABSTRACT FROM AUTHOR]

Objectives: This retrospective study was undertaken to clinically and radiographically evaluate the long-term outcomes of regenerative endodontic procedures (REPs) for nonvital mature permanent teeth, to analyze predictors influencing treatment outcomes. Methods: Nonvital mature permanent teeth treated by REPs with a minimum follow-up period of 6 months were included from 2015 to 2017. Treatment outcomes were categorized as success and failure. The periapical status and lesion healing were assessed in terms of the periapical index (PAI) and the percentage changes in periapical radiolucency (PARL) area. The clinical and radiographic outcomes of REPs were assessed by Mann–Whitney test at different follow-up period. Kaplan–Meier curves and Univariate Cox regression analysis were conducted to assess the success and identify potential predictors affecting outcomes, respectively. Results: A total of 37 mature teeth with an average follow-up of 4.3 years satisfied the criteria, and 89.2% of the teeth had a successful outcome. Significant differences in PAI scores were found between each period with respect to the baseline (p <.05). Among different periods, there was a significant difference between intervals of 3-6 months and 7-12 months (p =.039) and no significant difference between each interval of more than 12 months (p >.05). Eighty-seven percent of teeth with preoperative PARL presented completely healed. REPs significantly decreased the PARL area at the interval of 7-12 months compared to 3-6 months (p =.025), with no significant difference between each interval of more than 12 months (p >.05). No significant predictor was found for the success of outcome (p >.05). Thirteen teeth (35.1%) regained pulp sensibility, and 40.5% of the teeth exhibited intracanal calcification. Conclusions: Within the limitations of this study, REPs provided a high long-term success rate and promoted the resolution of PARL as a biologically-based alternative treatment option for nonvital mature teeth. Clinical relevance: REPs provide a high long-term success rate and promoted healing of apical periodontitis comparable with reported outcomes for root canal therapy of mature teeth. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this in vitro study was to evaluate the effect of a 3D-printed drill sleeve (DS) on the precision and duration of coronectomy sections. Materials and methods: Thirty-six trainees and oral surgeons performed 72 coronectomy cuts in a 3D-printed, entirely symmetric mandible model. Coronectomy was performed freehand (FH) on one side and with a DS on the other side. The occurrence of "too superficial" (≥ 4 mm unprepared lingual tooth tissue) and "too deep" (drilling ≥ 1 mm deeper as tooth contour) cuts and sectioning times were registered. Results: In 7 cases, the sections were "too deep" with FH, while none with DS (OR: 18.56; 95%CI: 1.02–338.5; p = 0.048). The deviation between virtually planned and real cut depths was significantly greater in the FH group (1.91 ± 1.62 mm) than in DS group (1.21 ± 0.72 mm) (p < 0.001). A total of 18 "too superficial" buccolingual sections occurred with FH, while 8 cases with DS (OR: 3.50; 95%CI: 1.26–9.72; p = 0.016). Suboptimal sections did not correlate with experience (p = 0.983; p = 0.697). Shortest, suboptimal drillings were most frequently seen distolingually (OR: 6.76; 95% CI: 1.57–29.07; p = 0.01). In the inexperienced group, sectioning time was significantly longer with FH (158.95 ± 125.61 s vs. 106.92 ± 100.79 s; p = 0.038). Conclusions: The DS effectively reduced tooth sectioning times by less experienced colleagues. Independently from the level of experience, the use of DS obviated the need for any preparation outside the lingual tooth contour and significantly decreased the occurrence of "too superficial" cuts, leaving thinner unprepared residual tooth tissue lingually. Clinical relevance: Coronectomy sections may result in lingual hard and soft tissue injury with the possibility of damaging the lingual nerve. The precision of the buccolingual depth-control can be improved, while surgical time can be reduced when applying a drilling sleeve. [ABSTRACT FROM AUTHOR]

Objectives: The current research on single-nucleotide polymorphism (SNP) mutation sites at different positions of the FAM83H gene and their phenotypic changes leading to amelogenesis imperfecta (AI) is inconsistent. We identified a previously reported heterozygous nonsense mutation c.1192C>T (p.Q398*) in the FAM83H gene and conducted a comprehensive analysis of the dental ultrastructure and chemical composition changes induced by this mutation. Additionally, we predicted the protein feature affected by this mutation site. The aim was to further deepen our understanding of the diversity of AI caused by different mutation sites in the FAM83H gene. Methods: Whole-exome sequencing (WES) and Sanger sequencing were used to confirm the mutation sites. Physical features of the patient's teeth were investigated using various methods including cone beam computer tomography (CBCT), scanning electron microscopy (SEM), contact profilometry (roughness measurement), and a nanomechanical tester (nanoindentation measurement). The protein features of wild-type and mutant FAM83H were predicted using bioinformatics methods. Results: One previously discovered FAM83H heterozygous nonsense mutation c.1192C>T (p.Q398*) was detected in the patient. SEM revealed inconsistent dentinal tubules, and EDS showed that calcium and phosphorus were lower in the patient's dentin but higher in the enamel compared to the control tooth. Roughness measurements showed that AI patients' teeth had rougher occlusal surfaces than those of the control tooth. Nanoindentation measurements showed that the enamel and dentin hardness values of the AI patients' teeth were both significantly reduced compared to those of the control tooth. Compared to the wild-type FAM83H protein, the mutant FAM83H protein shows alterations in stability, hydrophobicity, secondary structure, and tertiary structure. These changes could underlie functional differences and AI phenotype variations caused by this mutation site. Conclusions: This study expands the understanding of the effects of FAM83H mutations on tooth structure. Clinical relevance: Our study enhances our understanding of the genetic basis of AI and may contribute to improved diagnostics and personalized treatment strategies for patients with FAM83H-related AI. [ABSTRACT FROM AUTHOR]

Objectives: Clinical data on retaining extensively damaged teeth using forced orthodontic extrusion followed by restorative rehabilitation are scarce, and economic evaluations are basically absent. A health economic evaluation of this method was performed based on a clinical study. Materials and methods: In a convenience sample of individuals recruited from routine care, extensively damaged teeth were orthodontically extruded prior to restoration. Patients were followed up for up to 6 years. The health outcome was tooth retention time. Direct medical, non-medical, and indirect initial and follow-up costs were estimated using the private payer's perspective in German healthcare. Association of initial direct medical treatment costs and cofounding variables was analyzed using generalized linear models. Success and survival were secondary outcomes. Results: A total of 35 teeth in 30 patients were followed over a mean ± SD of 49 ± 19 months. Five patients (14%) dropped out during that period. Median initial costs were 1941€ (range: 1284–4392€), median costs for follow-up appointments were 215€ (range: 0–5812€), and median total costs were 2284€ (range: 1453 to 7109€). Endodontic re-treatment and placement of a post had a significant impact on total costs. Three teeth had to be extracted and in three patients orthodontic relapse was observed. The survival and success rates were 91% and 83%, respectively. Conclusions: Within the limitations of this clinical study, total treatment costs for orthodontic extrusion and subsequent restoration of extensively damaged teeth were considerable. Costs were by large generated initially; endodontic and post-endodontic therapies were main drivers. Costs for retreatments due to complications were limited, as only few complications arose. Clinical relevance: The restoration of extensively damaged teeth after forced orthodontic extrusion comes with considerable initial treatment costs, but low follow-up costs. Overall and over the observational period and within German healthcare, costs are below those for tooth replacement using implant-supported crowns. Trial registration: ClinicalTrials.gov Identifier: DRK S00026697). [ABSTRACT FROM AUTHOR]

Objectives : To comparatively evaluate the in vivo outcome of MTA repair for contaminated and non-contaminated furcation perforations (FP) with or without PRF and CGF as a matrix in dogs' teeth. Methods: Ninety dog teeth were divided into five groups based on the iatrogenic FP repair approach after doing root canal treatment: negative control (without FP), positive control (FP without repair), MTA, MTA + PRF and MTA + CGF groups, where FP were repaired promptly in subdivision 1 (n = 10; non-contaminated) and after 4 weeks of oral contamination in subdivision 2 (n = 10;contaminated). After 3 months, the perforation site was assessed radiographically (vertical bone density), histologically (inflammatory cell count, epithelial proliferation, cementum and bone deposition) and immunohistochemically (OPN and TRAP antibodies localisation). Data collected were statistically analysed using SPSS software at a 0.05 significance level. Results: The MTA + PRF and MTA + CGF groups demonstrated significantly more bone formation, OPN immunolocalisation and fewer inflammatory cell counts than MTA group. MTA, MTA + PRF and MTA + CGF groups showed significantly favourable radiographic, histological and immunohistochemical healing features than the positive control, especially in non-contaminated subdivisions, that significantly showed better features than the contaminated subdivisions (P < 0.001). Conclusion: The use CGF and PRF as a matrix beneath MTA in FP repair in dog's teeth is promising as it could increase hard and soft tissue regeneration in non-contaminated and contaminated perforations. Clinical relevance: The repair of FP is challenging especially when associated with contaminated inter-radicular bone loss. Radiographic, histological and immunohistochemical comprehensive evaluation of the root and surrounding attachment apparatus response to different perforation repair protocols could give a predictable clinical outcome. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to analyze three-dimensional dental compensation in patients with different types of skeletal Class III malocclusion with mandibular asymmetry, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction measurement technology, thereby providing clinical guidance and reference for combined orthodontic and orthognathic treatment. Methods: 81 patients with skeletal Class III malocclusion with mandibular asymmetry were selected in accordance with the inclusion criteria. According to a new classification method based on the direction and amount of menton deviation relative to ramus deviation, patients were divided into three groups called Type 1, Type 2, and Type 3. In Type 1, the direction of menton deviation was consistent with that of ramus deviation and the amount of menton deviation was greater than that of ramus deviation. In Type 2, the direction of menton deviation was consistent with that of ramus deviation and the amount of menton deviation was smaller than that of ramus deviation. In Type 3, the direction of menton deviation was inconsistent with that of ramus deviation. The maxillary occlusal plane (OP), anterior occlusal plane (AOP), and posterior occlusal plane (POP) were measured on reconstructed CBCT images. The vertical, transverse, and anteroposterior distances from maxillary teeth to reference planes and the 3D angles between the long axis of these teeth and reference planes were measured. These dental variables measured from the deviated and non-deviated sides were compared within each group, as well as among each other. Results: Of the 81 patients with asymmetrical Class III malocclusion, 52 patients were categorized in Type 1, 12 patients in Type 2, and 17 patients in Type 3. There were significant differences between deviated and non-deviated sides in Type 1 and Type 3 (p < 0.05). In Type 1, the vertical distances of maxillary teeth on the deviated side were lower than those on the non-deviated side, and AOP, OP, and POP on the deviated side were larger than those on the non-deviated side (p < 0.05). In Type 3, the vertical distances of the maxillary teeth on the deviated side were lower (p < 0.05), and the AOP and OP on the deviated side were larger than those on the non-deviated side. In all three groups, the transverse distances of the maxillary teeth from the mid-sagittal plane on the deviated side were larger than those on the non-deviated side (p < 0.05), and the angles between the long axis of maxillary teeth and the mid-sagittal plane on the deviated side were larger, respectively (p < 0.05). Conclusions: The maxillary teeth on the deviated side were observed to have smaller eruption heights in Type 1 and Type 3. In Type 1, AOP, POP, and OP were greater on the deviated side, while in Type 3, only AOP and OP were greater on the deviated side. The maxillary teeth of patients in all three groups on the deviated side were buccal and buccally inclined. Larger sample observations are still needed to further verify these findings. [ABSTRACT FROM AUTHOR]

Objectives : Previous studies have shown that aligners have limited ability to control root movements. The purpose of this study was to investigate which modification geometry and foil thickness are optimal for generating the force-moment (F/M) systems required for palatal root torque of maxillary central incisors. Materials and methods: Tooth 11 was separated from a maxillary acrylic model and connected to a movement unit via a 3D F/M sensor. Different modification geometries (crescent, capsular, double-spherical) with different depths were digitally implemented in the labio-cervical region of tooth 11 to induce an increased contact force. We evaluated the F/M systems exerted by aligners with thicknesses of 0.4–1.0 mm. F/M measurements were taken with tooth 11 in the neutral position and during palatal displacement of tooth 11 (simulating its initial clinical movement). Results: The mechanical requirements of palatal root torque are a palatally directed force (− Fy) and a palatal root torquing moment (− Mx). These requirements were reliably achieved with modification depths > 0.5 mm. The modification depth and foil thickness had a significant influence on − Fy magnitudes (linear mixed-effect models, p < 0.01). With the 0.75-mm aligners combined with 1.5-mm deep modifications, the palatal root torque range (palTR) started after an initial palatal crown displacement of 0.09, 0.12, and 0.12 mm for the capsular, crescent, and double-spherical modification geometries, respectively. Conclusions: A relatively early start of the palatal torque range (after a 0.1-mm palatal crown displacement) and appropriate − Fy magnitudes were achieved with 0.75-mm-thick aligners containing 1.5-mm deep capsular or crescent pressure regions. Subsequent clinical trials are required to confirm the clinical effects of these modifications. Clinical relevance: In vitro testing indicated that modified aligners are capable of generating the F/M components required for palatal root torque of upper central incisors. [ABSTRACT FROM AUTHOR]

Objective: We investigated the association of severely damaged endodontically infected tooth with carotid artery plaque and abnormal mean carotid intima-media thickness (CIMT) ≥ 1.0 mm. Methods: A retrospective analysis of 1502 control participants and 1552 participants with severely damaged endodontically infected tooth who received routine medical and dental checkup in Health Management Center, Xiangya Hospital was performed. Carotid plaque and CIMT were measured with B-mode tomographic ultrasound. Data were analyzed using logistic and linear regression. Results: Severely damaged endodontically infected tooth group had a significantly higher prevalence of carotid plaque (41.62%) compared to 32.22% of carotid plaque in control group. Participants with severely damaged endodontically infected tooth had a significantly higher prevalence of abnormal CIMT (16.17%) and a significantly increased level of CIMT (0.79 ± 0.16 mm) in comparison to 10.79% of abnormal CIMT and 0.77 ± 0.14 mm CIMT in control participants. Severely damaged endodontically infected tooth was significantly related with formation of carotid plaque [1.37(1.18–1.60), P < 0.001], top quartile length [1.21(1.02–1.44), P = 0.029] and top quartile thickness [1.27(1.08–1.51), P = 0.005] of carotid plaque and abnormal CIMT [1.47(1.18–1.83), P < 0.001]. Severely damaged endodontically infected tooth was significantly associated with both single [1.277(1.056–1.546), P = 0.012] and multiple carotid plaques [1.488(1.214–1.825), P < 0.001] and instable carotid plaques [1.380(1.167–1.632), P < 0.001]. Presence of severely damaged endodontically infected tooth increased 0.588 mm of carotid plaque length (P = 0.001), 0.157 mm of carotid plaque thickness (P < 0.001) and 0.015 mm of CIMT (P = 0.005). Conclusion: Severely damaged endodontically infected tooth was associated with carotid plaque and abnormal CIMT. Clinical relevance: Early treatment of endodontically infected tooth is warranted. [ABSTRACT FROM AUTHOR]

Objectives: This 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins. Materials and methods: A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the Kaplan–Meier estimator and log-rank test. In addition, Cox regression analysis was performed. Results: The cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0–46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6–48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9–25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2–47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4–66.8, p = 0.463). Conclusions: Higher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only. Clinical relevance: If endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient. [ABSTRACT FROM AUTHOR]

Objectives : To describe the current state of the art regarding technological advances in full-automatic tooth segmentation approaches from 3D cone-beam computed tomography (CBCT) images. Materials and methods: In March 2023, a search strategy without a timeline setting was carried out through a combination of MeSH terms and free text words pooled through Boolean operators ('AND', 'OR') on the following databases: PubMed, Scopus, Web of Science and IEEE Explore. Randomized and non-randomized controlled trials, cohort, case–control, cross-sectional and retrospective studies in the English language only were included. Results: The search strategy identified 541 articles, of which 23 have been selected. The most employed segmentation methods were based on deep learning approaches. One article exposed an automatic approach for tooth segmentation based on a watershed algorithm and another article used an improved level set method. Four studies presented classical machine learning and thresholding approaches. The most employed metric for evaluating segmentation performance was the Dice similarity index which ranged from 90 ± 3% to 97.9 ± 1.5%. Conclusions: Thresholding appeared not reliable for tooth segmentation from CBCT images, whereas convolutional neural networks (CNNs) have been demonstrated as the most promising approach. CNNs could help overcome tooth segmentation's main limitations from CBCT images related to root anatomy, heavy scattering, immature teeth, metal artifacts and time consumption. New studies with uniform protocols and evaluation metrics with random sampling and blinding for data analysis are encouraged to objectively compare the different deep learning architectures' reliability. Clinical relevance: Automatic tooth segmentation's best performance has been obtained through CNNs for the different ambits of digital dentistry. [ABSTRACT FROM AUTHOR]

Objectives: The aims of the present longitudinal retrospective observational case series study were to investigate the survival and success rates of primary non-surgical endodontic therapy. Materials and methods: Patients with at least one endodontically treated tooth (ETT), with 5 years of follow-up and in compliance with the recall programme of at least 1 time per year in a private practice setting, were recruited. Kaplan-Meier survival analyses were performed considering (a) tooth extraction/survival and (b) endodontic success as the outcome variables. A regression analysis was performed to evaluate prognostic factors associated with tooth survival. Results: Three hundred twelve patients and 598 teeth were included. The cumulative survival rates showed 97%, 81%, 76% and 68% after 10, 20, 30 and 37 years, respectively. The corresponding values for endodontic success were 93%, 85%, 81% and 81%, respectively. Conclusions: The study demonstrated high longevity in symptomless function as well as high success rates of ETT. The most significant prognostic factors associated with tooth extraction were the presence of deep (> 6 mm) periodontal pockets, the presence of pre-operative apical radiolucency and the lack of occlusal protection (no use of a night guard). Clinical relevance: The favourable long-term (> 30 years) prognosis of ETT must encourage clinicians to rely on primary root canal treatment when taking the decision regarding whether a tooth with pulpal and/or periapical diseases should be saved or be extracted and replaced with an implant. [ABSTRACT FROM AUTHOR]

Objective: The pulpal response to Hoffmann's Pulpine mineral (PMIN) and Pulpine NE (PNE) was compared to mineral trioxide aggregate (MTA) when used as pulpotomy materials in immature permanent teeth in dogs. Materials and methods: Immature premolars were randomly divided according to the observation period into three equal groups (n = 24) (10 days, 30 days, and 90 days) then furtherly subdivided into 3 subgroups according to the material used. Histopathological analysis regarding inflammatory cell infiltration and dentin bridge (DB) formation was done. Immunohistochemical analysis was performed using osteopontin marker. Results: The results showed that after 90 days, both MTA and PMIN subgroups had 100% complete thick DB without inflammation in 87.5% of the samples, while the PNE subgroup failed to form DB in 37.5% of the samples and 50% of samples showed thin initial DB with heavy inflammation in 62.5% of the samples. There was no significant difference between MTA and PMIN, while there was a statistically significant difference between PNE and the two other subgroups in DB formation and inflammatory cell infiltration (P > 0.05). After 90 days, MTA showed the highest mean value of osteopontin positive fraction area followed by PMIN without statistically significant differences, while the least value was recorded in PNE subgroup with statistically significant difference with the remaining subgroups (P < 0.05). Conclusion: PMIN is a promising alternative to MTA when used for pulpotomy. Clinical relevance: Vital pulp therapy in immature teeth can be done using PMIN as an alternative to MTA. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the influence of dental prophylaxis cleaning procedures and artificial aging on veneers in human teeth. The external marginal and internal tooth veneer as well as the restoration surfaces were examined. Material and methods: Thirty-two extracted premolars were restored with resin-based composite (RBC) and polymer-infiltrated ceramic network (PICN) veneers. Artificial aging by alternating thermocycling and subsequent prophylaxis procedure (glycine-based powder air polishing or ultrasonic scaling) was conducted for five consecutive cycles. The external marginal interface was examined by height profile measurements and the internal interface was investigated using micro X-ray computed tomography. In addition, the surface texture of the veneer surface was analyzed using confocal laser scanning microscopy. Results: The application of both prophylaxis procedures resulted in a deepening of the marginal interface (10 µm ± 8 µm) for materials. Furthermore, the internal interface of PICN restorations showed marginal gaps after both treatments and artificial aging (16 µm ± 3 µm). In contrast to the RBC specimens, a significant increase in surface roughness was identified for PICN veneers after ultrasonic scaling. Conclusions: The marginal and internal interface regions in veneers fabricated from PICN and RBC were affected by prophylaxis procedures. Furthermore, it may result in increased veneer surface roughness, especially in PICN and after ultrasonic scaling, which might affect bioadhesion and longevity. Clinical relevance: After dental prophylaxis procedures, examination of the marginal and the internal interface as well as the veneer surface provides a precise insight into damage mechanisms and offers an assessment of longevity. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the intra- and inter-examiner reliability in the assessment of probing depth (PD) measurements at healthy dental implant sites and periodontally healthy natural teeth. Materials and methods: Five patients exhibiting 21 dental implants were enrolled in the study. Eight experienced examiners performed duplicate PD measurements at six sites of all implants and of preselected natural teeth. Intra-examiner accuracy was estimated using intra-examiner correlation coefficients (ICCs) with 95% confidence intervals (CI). A gold standard (GS) examiner was set. Inter-examiner accuracy compared to the GS examiner was assessed using pairwise inter-examiner ICCs. Results: The intra-examiner ICC ranged from 0.759 (95% CI, 0.692–0.812) to 0.863 (95% CI, 0.826–0.892) for the measurements at teeth and from 0.712 (95% CI, 0.580–0.800) to 0.841 (95% CI, 0.774–0.888) for the PDs assessed at implants. The inter-examiner ICCs for tooth measurements varied from 0.197 (95% CI, − 0.280 to 0.511) to 0.791 (95% CI, 0.560–0.892). The corresponding values for the assessments at implants varied from 0.576 (95% CI, 0.286–0.734) to 0.794 (95% CI, 0.708–0.855). Conclusions: The intra- and inter-examiner reproducibility of repeated PD measurements assessed by experienced examiners tended to be higher for the measurements at periodontally healthy teeth compared to healthy dental implant sites. Clinical relevance: Experienced examiners demonstrated a higher degree of reliability of probing measurements around teeth compared to dental implants. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the obturation efficacy of sealers placed with different techniques using microcomputed tomography (µCT) and assess the influence of µCT testing parameters on the obturation data obtained. Materials and methods: Incisors and mesial roots of lower molars with standardized root length were scanned using µCT, and one tooth of each type was 3D printed in acrylic. Two obturation techniques (warm vertical and single cone) and 4 sealer types (AH Plus, BioRoot RCS, Totalfill BC, and Bio-C Sealers) were assessed following storage in Hank's balanced salt solution for 3 and 6 months by assessing gap and void volume percentages on both natural and replica incisor and molar roots. The storage solution was analysed to assess calcium ion leaching. The influence of temperature, tooth positioning, and moisture content of the teeth while µCT scanning was also investigated. Results: The obturation quality in the incisor group was the same using both natural teeth and replicas (p > 0.05). No changes in void volume were identified when comparing the same sealer using different obturation techniques. The premixed sealers used in single-cone obturation exhibited high void volume in the 3D printed replicas in the long term. The temperature, positioning, and moisture content of the teeth did not affect the outcome of µCT testing. Conclusions: BioRoot RCS, Totalfill BC, and Bio-C Sealers are suitable for obturation of both complex and simple root canal systems using different obturation techniques with BioRoot RCS exhibiting the highest calcium ion release. 3D printed acrylic teeth can be used to assess the obturation quality in uncomplicated root canal systems. µCT parameters had no significant effect on the µCT measurement. Clinical relevance: The single-cone obturation technique with hydraulic sealer is a simple technique that can be used for obturation of all root canal systems. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this randomized clinical trial was to compare selective removal to soft dentin (SRSD) and selective removal to firm dentin (SRFD) in permanent teeth. The primary outcome of the study was to compare the success rates of the two caries removal techniques. The secondary outcome of the study was to investigate whether or not calcium silicate-based material (CS) had an effect on the success rate of the treatment. Materials and methods: Between November 2018 and March 2020, patients with deep caries lesions were invited to participate in the study. Posterior teeth (N = 165) with primary caries lesion radiographically extending ¾ of dentin and positive response to cold test were randomly selected. A total of 134 participants meeting the inclusion criteria were randomized to SRSD and SRFD (control) groups. After the caries removal procedure, teeth with exposed pulps were assigned to the pulp exposure (PE) group, and the SRSD group was further divided into test 1 (with CS) and test 2 groups (without CS). Success was defined as a positive response to the cold test, a negative response to percussion, the absence of pain, an abscess, a fistula, and periapical alterations. Fisher–Freeman–Halton exact tests, Kaplan–Meier survival analysis, and the log-rank tests were performed for comparisons between groups. Results: No statistically significant difference was found between the success rates of test 1 (100%) and test 2 (93.5%) groups, whereas the proportion of success in control (82.4%) and PE (84%) groups were significantly lower when compared with test groups (p = 0.024; p < 0.05) at the end of 2-year follow-up. Conclusions: SRSD had a higher success rate when compared to SRFD to treat deep carious lesions after 2 years of follow-up. The use of CS material after SRSD as a liner had no effect on the treatment outcome. Clinical relevance: SRSD with good coronal sealing might be recommended without CS application for the treatment of deep caries lesions in permanent teeth. Trial registration: Clinical trial registration number NCT04052685 (08/09/2019). [ABSTRACT FROM AUTHOR]

Objectives: To determine and compare the effects of high-frequency mechanical vibration (HFV) with light force and optimal force on the tooth movement and root resorption in rat model. Materials and methods: Seventy-two sites in 36 male Wistar rats were randomly assigned using a split-mouth design to control (no force/no vibration) or experimental groups: HFV (125 Hz), light force (5 g), optimal force (10 g), light force with HFV, and optimal force with HFV for 14 and 21 days. The amount of tooth movement, 3D root volume, and root resorption area were assessed by micro-computed tomography and histomorphometric analysis. Results: Adjunction of HFV with light force significantly increased the amount of tooth movement by 1.8-fold (p = 0.01) and 2.0-fold (p = 0.01) at days 14 and 21 respectively. The HFV combined with optimal force significantly increased the amount of tooth movement by 2.1-fold (p = 0.01) and 2.2-fold (p = 0.01) at days 14 and 21 respectively. The root volume in control (distobuccal root (DB): 0.60 ± 0.19 mm3, distopalatal root (DPa): 0.60 ± 0.07 mm3) and HFV (DB: 0.60 ± 0.08 mm3, DPa: 0.59 ± 0.11 mm3) were not different from the other experimental group (range from 0.44 ± 0.05 to 0.60 ± 0.1 mm3) with the lowest volume in optimal force group. Conclusions: Adjunction of HFV with orthodontic force significantly increased tooth movement without causing root resorption. Clinical relevance: Using light force with HFV could help to identify alternative treatment option to reduce the risk of root resorption. [ABSTRACT FROM AUTHOR]

Background: Unsightly opaque white impaired enamel may ruin a great aesthetic orthodontic outcome. This study aims to evaluate effectiveness of Clinpro Tooth Crème (0.21% w/w NaF anti-caries dentifrice with 950 ppm fluoride and f-TCP) and MI Varnish with RECALDENT™ (CPP-ACP) for treatment of white spot lesions (WSLs). Materials and methods: This was a randomized (1:1:1), single-blind, 3-armed, active-controlled, parallel-group trial. The study comprised three groups of 35 patients randomly assigned in blocks of 3 or 6 to one of the three following arms of the study- Group I: Clinpro™ Tooth Crème 0.21% Sodium Fluoride Anti-Cavity Paste with functional–Tri Calcium Phosphate(f-TCP) group. Group II: Fluoride varnish group (MI Varnish with RECALDENT™). Group III: Home-care group (control). For the subjective assessment, a blinded panel of 4 dental experts rated the improvement in WSLs over the eight weeks using a visual analog scale (VAS). Results: In total, 240 WSLs were identified, with maxillary lateral incisors and canines showing the highest incidence. Group I achieved the highest success rate of 67.61 (%) followed by group II (60.59%). There were no significant differences between the success rates of treatment in groups I and II. A minimum decline in WSLs was found in the control group, with a success rate of only 32.43%, significantly less than the first two groups (P <.001). Conclusion: Both the test agents in consideration were comparable in their remineralization potential. Clinpro Tooth Crème provides additional protection against decalcification of enamel compared to MI Varnish with RECALDENT™ (CPP-ACP). Trial/project registration no. and date: 4857/2017 on 21 June 2017. [ABSTRACT FROM AUTHOR]

Objective: The study aims to evaluate the color adjustment potential (CAP-I, CAP-V) of different single-shade resin composites. Materials and methods: The shades of 40 human incisors were determined using a spectrophotometer, with the teeth divided into four groups of the same shade (n = 10). The following single-shade resin composites were tested: Omnichroma, Charisma Diamond One, Vittra Unique, and Essentia Universal. The specimens were prepared as "dual" and "single." Standardized cavity preparations (diameter, 7 mm; depth, 2 mm) were prepared in human incisor teeth and then restored for dual specimens. Composite duplicates of human incisors were prepared with resin composites for single specimens (n = 10). The color match of these specimens to that of unrestored human incisors was compared, and the color difference (ΔE*) was calculated. Independent observers conducted a visual evaluation of the specimens and scored them. CAP-I and CAP-V values were determined. A one-way analysis of variance test was used for statistical analysis (p < 0.05). Results: There was no statistically significant difference between the CAP-V and CAP-I values of the tested single-shade resin composites (p > 0.05). All the materials tested had acceptable color-matching potential. Conclusions: In terms of color matching, there were no significant differences between the different tooth shades of all the tested resin composites. Clinical relevance: Single-shade resin composites have acceptable CAP. The use of single-shade resin composites can reduce in-chair clinical times by minimizing the time spent on shade selection. [ABSTRACT FROM AUTHOR]

Objective: The study investigated orthodontic tooth movement by comparing various horizontal and angular measures of the teeth having different sinus–root relationship (SRR) of patients undergoing first premolar extraction treatment protocols. Materials and methods: This retrospective cross-sectional study included 45 Taiwanese adult patients, classified as the control group (n = 15) and the sinus group (n = 30) according to SRR. The control group had type I SRR (sinus floor above the level connecting the buccal and palatal root apices), whereas the sinus group included patients with type V SRR (the buccal and palatal root displayed apical protrusion into the sinus floor). Morphology was identified using pretreatment orthopantomograms. Lateral cephalometric measurements were conducted before treatment (T1) and at debonding (T2). Results: Post debonding, there were no statistically significant difference in the two groups. However, the incisors in the control group became marginally more upright than those of the sinus group, and the molars demonstrated tipping movement with minimal anchorage loss in the sinus group than in the control group. The total treatment time was not significantly different between the 2 groups. Conclusion: The study revealed that the sinus–root relationship does not affect the orthodontic tooth movement. However, a more extensive 3-D study with larger sample size is strongly recommended before coming to any conclusion. Clinical relevance: The lining of the floor of the maxillary sinus does not affect the orthodontic tooth movement. [ABSTRACT FROM AUTHOR]

Objectives: To assess the influence of estrogen deficiency on tooth eruption rate (TER) and gene expression of estrogen receptor alpha and beta (ERα and ERβ) in the odontogenic region of teeth with continuous formation in a rat model. Materials and methods: Ovariectomies (OVX; n = 25) and sham surgeries (SHAM; n = 25) were performed in female Wistar rats when animals were 25 days old. The TER of the lower incisors, both in impeded (hyperfunction condition) and unimpeded (trimmed incisal edge—hypofunction condition) conditions, was evaluated using standardized digital photographs acquired every 48–72 h for 3 weeks (35th–53rd day of life), using a camera coupled to a stereomicroscope. Quantitative real-time PCR was performed to evaluate the relative gene expression of ERα and ERβ in the odontogenic region. Results: The OVX group showed a significant reduction in TER when compared to the SHAM group, only in the impeded condition (p = 0.03). There was no statistically significant difference between the groups in ERα gene expression (p = 0.33). ERβ showed a significantly higher gene expression in the OVX group (p ≤ 0.05). Conclusions: Estrogen deficiency decreases TER in teeth under impeded condition. Estrogen deficiency also increases ERβ gene expression in the odontogenic region of teeth with continuous formation. Clinical relevance: Hormonal disturbances affecting estrogen levels can cause alterations in dental formation and teeth eruption. [ABSTRACT FROM AUTHOR]

Objectives: To compare changes in root length of maxillary incisors with and without dental trauma throughout orthodontic treatment. Materials and method: Patients younger than 18 years, with trauma on at least one maxillary incisor, undergoing orthodontic treatment between 2017 and 2021 were included, using the contralateral side as control without trauma when available. Periapical radiographs were taken pre-treatment and at 6 months intervals, and root/crown ratio was calculated. Linear mixed models were used to describe the evolution of root length at the different time points and to compare trauma and control values. Differences between central and lateral incisors and between treatment modalities were additionally explored. Results: A total of 1768 measurements were performed on 499 teeth (201 with trauma) in 135 patients. Incisor root length significantly decreased during orthodontic treatment in teeth with and without trauma. Lateral incisors with trauma were more susceptible to root resorption than those without trauma and central incisors. No significant decrease in root length was observed with removable appliances, which never exceeded 15 months of treatment. Treatment with fixed appliances led to gradually increasing, significant root length shortening in teeth with and without trauma. Conclusion: Treatment duration directly correlated with root length shortening both in teeth with and without trauma history. Teeth with trauma showed significantly more root resorption after treatment with fixed appliances while removable appliances had no significant influence on root length. Clinical relevance: Previous history of dental trauma is no absolute contra-indication to start orthodontic treatment, as long as treatment duration is kept as short as possible. [ABSTRACT FROM AUTHOR]

Objective: To assess the clinical performance of tooth implant–supported removable partial dentures in terms of abutment survival in relation to the attachment system used. Methods: An electronic search in MEDLINE/PubMed Web of Science and Cochrane Central Register of Controlled Trials databases was performed. The methodological quality of the studies was assessed using the Newcastle–Ottawa Scale. Survival rates after 3 years and 5 years, loss, and complication rates per 100 years were estimated by Poisson regression. Results: A total of twelve studies were included; eleven studies were used for the meta-analysis. Survival analysis for mixed attachments showed an estimated survival rate of 100% after 3 years and 5 years. For uniform attachments, the estimated survival rate was 99.3% after 3 years and 98.8% after 5 years. Tooth abutment survival analysis for mixed attachments estimated a survival rate of 95% after 3 years and 91.7% after 5 years: Uniform attachments reached a survival rate of 97.2% after 3 years and 95.4% after 5 years. The prosthetic survival rate was 100% for mixed and uniform abutments after 3 years and 5 years of function. Conclusions: Tooth implant–supported removable partial dentures can be considered as a reliable option with excellent prosthetic and implant survival rates and favorable rates for the abutments after 3-year and 5-year follow-ups. Complications may be reduced when 5 or more abutments are used. Clinical relevance: Tooth implant–supported removable partial dentures are a favorable and potential alternative to restore a partially edentulous arch by optimizing the number and distribution of abutments. [ABSTRACT FROM AUTHOR]

Objetive: To evaluate all the available evidence assessing if in hypomineralized teeth, yellow-brownish opacities are more prone to post-eruptive breakdown (PEB) compared to white-creamy opacities. Materials and methods: Observational studies that evaluated the occurrence of PEB in hypomineralized teeth were considered for inclusion. Electronic searches were performed up to January 2022 in MedLine, LILACS, BBO, Cochrane Library, Web of Science, Scopus, and EMBASE. Neither publication date nor language restrictions were imposed to the searches. Two researchers independently performed the study selection, data extraction, and quality assessment of the included studies according to the Newcastle–Ottawa Scale (NOS). Datasets from studies were grouped for narrative synthesis based on the severity of the PEB (enamel or dentin), type of tooth (molar or incisor), unit of analysis (subject or tooth or tooth surface), and follow-up period (in months). The certainty of evidence was evaluated using the GRADE approach. Results: Nine studies were included, five cohort and three cross-sectional. All studies assessed the opacities and PEB by visual examination and diagnosed MIH according to EAPD criteria. In the cohort studies, considering all follow-up periods (ranging from 6 to 36 months), dark opacities fractured more than light opacities, at both enamel and enamel/dentin levels, and molars fractured more than incisors. In two out of three cross-sectional studies, dark opacities also fractured more than light opacities, but the deep of the PEB (enamel or dentin breakdown) or the type of tooth (molar or incisor) was not considered in the analysis. Conclusion: Although it seems plausible to state that darker demarcated opacities in MIH patients broke more often than light ones, based on this systematic review of the literature, the certainty of the available evidence about this association is still very low. Clinical relevance: More reliable and valid research is still necessary to support any future recommendation that MIH children who present yellow-brownish opacities should be monitored at shorter intervals compared to those who present only white-creamy opacities. [ABSTRACT FROM AUTHOR]

Objectives: One or more missing teeth, such as hypodontia, make it difficult to obtain accurate results in age estimation methods. This paper aims to test the accuracy of the models developed by Bedek et al. that can estimate age with fewer than seven teeth for Turkish children. Materials and methods: Panoramic radiographs of 1118 children (540 girls and 578 boys) aged between 6 and 16 years were evaluated using the Willems method and Bedek models for the entire sample and for different ages and sexes. Differences between dental age (DA) and chronological age (CA) calculated for all methods for each sex and all age groups were analyzed the paired sample t-test and Wilcoxon signed rank test. The accuracy of the DA estimation methods was determined by the proximity of DA to CA by calculating mean absolute error (MAE). Results: While all Bedek models underestimated CA by 0.2 to 0.1 years, the Willems method overestimated CA by 0.3 years. DA-CA difference in the total sample and girls was statistically significant in all methods. In the total sample, the seven- and four-teeth models had the lowest MAE, while the one-tooth model had the highest MAE. Conclusions: Seven- and four-teeth models were the most suitable for age estimation, and all models except the one-tooth model were found to be more accurate than the Willems method in northwestern Turkish children. Clinical relevance: Especially in children with hypodontia, it may be possible to estimate DA with the use of Bedek models. [ABSTRACT FROM AUTHOR]

Objectives: SOPs recommend high-volume evacuation (HVE) for aerosol-generating procedures (AGPs) in dentistry. Therefore, in the exploratory study, the area of splatter contamination (SCON in %) generated by high-speed tooth preparation (HSP) and air-polishing (APD) was measured when different suction cannulas of 6 mm diameter (saliva ejector (SAE)), 11 mm (HC11), or 16 mm (HC16) were utilized versus no-suction (NS). Materials and methods: Eighty tests were performed in a closed darkened room to measure SCON (1m circular around the manikin head (3.14 m2) via plan metrically assessment through fluorescence technique. HSP (handpiece, turbine (Kavo, Germany)) or APD (LM-ProPowerTM (Finland), Airflow®-Prophylaxis-Master (Switzerland)) for 6 min plus 5 s post-treatment were performed either without suction or with low-flow (150 l/min for SAE) or high-flow rate (250 l/min/350 l/min for HC11/HC16) suction. All tests were two-tailed (p≤0.05, Bonferroni corrected for multi-testing). Results: Irrespective the AGP, SCON was higher for NS (median [25th; 75th percentiles]: 3.4% [2.6; 5.4]) versus high-flow suction (1.9% [1.5; 2.5]) (p=0.002). Low-flow suction (3.5% [2.6; 4.3]) versus NS resulted in slightly lower but not statistically significantly lower SCON (p=1.000) and was less effective than high-flow suction (p=0.003). Lowest contamination values were found with HC16 (1.9% [1.5; 2.5]; p≤0.002), whereat no significant differences were found for HC11 (2.4% [1.7; 3.1]) compared to SAE (p=0.385) or NS (p=0.316). Conclusions: Within study's limitations, the lowest splatter contamination values resulted when HC16 were utilized by a high-flow rate of ≥250 l/min. Clinical relevance: It is strongly recommended to utilize an HVE with suction cannulas of 16mm diameter for a high-flow rate during all AGPs and afterwards also to disinfect all surface of patients or operators contacted. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between orofacial clefts (OFC) and tooth abnormalities (TA). Methods: We searched PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and BBO, and in the gray literature and selected observational studies that evaluated the association between TA and OFC. The risk of bias was analyzed using the Newcastle–Ottawa Scale. A random-effects meta-analysis was performed comparing the presence and absence of OFC, cleft type—cleft palate (CP) and cleft lip with or without palate (CL/P)—and cleft laterality—unilateral and bilateral. The certainty of evidence was evaluated using the GRADE approach. Results: A total of 99 studies were included in the qualitative analysis, and 37 were included in the meta-analysis. Only four studies were classified as low risk of bias. Significant associations were observed between the presence of OFC and tooth agenesis (OR = 19.46; 95%CI = 4.99–75.96), supernumerary teeth (OR = 4.04; 95%CI = 1.26–12.99), developmental defects of enamel (OR = 3.15; 95%CI = 1.28–7.80), microdontia (OR = 15.57; 95%CI = 1.06–228.51), and taurodontism (OR = 1.74; 95%CI = 1.74–2.86). Individuals with CP had a lower frequency of supernumerary teeth (OR = 0.22; 95%CI = 0.08–0.64), peg-shaped tooth (OR = 0.31; 95%CI = 0.12–0.80), and morphological TA (OR = 0.13; 95%CI = 0.04–0.45) than individuals with CL/P. No TA was significantly associated with cleft laterality (p > 0.05). The quality of the evidence was very low in all analyses. Conclusion: Individuals with OFC had a higher frequency of TA than those without OFC. Individuals with CP had a lower frequency of TA than individuals with CL/P. No TA was associated to cleft laterality. Clinical relevance: Help to identify the treatment needs of individuals affected by OFC, improving the services provided to this population. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate post-treatment movements of lower anterior teeth during orthodontic retention in patients with fixed twistflex retainers versus those with combined fixed and removable retainers. Materials and Methods: This study was based on a retrospective data analysis of 57 adult patients during orthodontic retention. They were assigned to two groups: In group 1 (n = 30) the lower jaw was provided with twistflex retainers only and in group 2 (n = 27) with a twistflex combined with a removable retainer for night-time use. Orthodontic study models of the lower jaw were digitalized and superimposed. Tooth movements were analyzed at the retainer bonding (t0) and follow-up appointment ≥ six months later (t1). Rotational tooth movements (°) were measured around the x-axis (mesial/distal direction), the y-axis (buccal/lingual direction) and the z-axis (longitudinal direction, tooth axis). Translational tooth movements (mm) were registered along the x-axis (buccal/lingual direction), the y-axis (mesial/distal direction) and the z-axis (apical/coronal direction). Results: Canine and incisor position changes during orthodontic retention were more pronounced in group 1 compared to group 2 except for canine rotations around the z-axis. In both groups in most of the cases stable lower incisor alignment could be found, but the proportion was significant higher in group 2 (group 1: 56.7% vs. group 2: 81.5%). Severe misalignment was present in 13.3% of the participants of group 1 and only in 7.4% of group 2. The extent of canine tipping and movements along the x- and y-axis in severe misalignment cases was significantly lower in group 2 compared to 1. Conclusions: Lower incisor alignment was more stable in patients with combined fixed and removable retainers compared to fixed retainers only. Clinical Relevance: Based on the present findings, the routinely application of supplementary removable retainers can be recommended to enhance anterior tooth alignment in patients with fixed twistflex retainers. [ABSTRACT FROM AUTHOR]

Objective: To assess the radiographic outcomes and prognostic factors in nonvital immature permanent teeth after apexification with modified calcium hydroxide paste. Materials and methods: Clinical and radiographic data were collected from 115 necrotic immature permanent teeth (71 caused by trauma and 44 caused by dens evaginatus) treated with apexification using a modified calcium hydroxide. Postoperative root morphology and changes in radiographic root area (RRA) on periapical radiographs were determined and statistically evaluated. Regression analysis was performed to identify factors associated with the outcomes of apexification. Results: The average time for a calcified barrier formation was 10.66 ± 6.37 months. The root morphology after apexification with calcium hydroxide + iodoform paste was similar to that previously described after calcium hydroxide apexification. Compared with the trauma cases, the dens evaginatus cases revealed more type I (40.91% vs 16.9%) and less type II morphology (45.45% vs 67.61%). Although the changes in RRA were limited, the dens evaginatus cases showed greater increment of RRA than the trauma cases (4.12% ± 5.58% vs 0.70% ± 5.21%, P < 0.001). A significant association was found between the preoperative stage of root development and postoperative percentage change in RRA (P < 0.001). Conclusions: Teeth caused by dens evaginatus had better outcomes after apexification than teeth caused by trauma. Early stages of root development were associated with superior radiographic outcomes. Clinical relevance: Apexification provided reliable outcomes in the treatment of immature teeth with pulp necrosis and apical periodontitis, even though the root development is limited. Treatment decision should be made with comprehensive evaluation of prognostic factors. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to systematically review the literature to compare the risk of failure of repaired and replaced defective direct resin composite and amalgam restorations performed in permanent teeth. Materials and methods: The PubMed/MEDLINE, Scopus, Lilacs, BBO, Web of Science, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL) databases, and gray literature were searched to identify longitudinal clinical studies related to the research question. No publication year or language restriction was considered. Two authors independently selected the studies, extracted the data, and assessed the risk of bias and certainty of evidence. A meta-analysis was performed using a fixed effects model at a 5% significance level. Results: From 1224 potentially eligible studies, thirteen were selected for full-text analysis, and three were included in the systematic review and meta-analysis. There was no difference in the risk of failure of repaired and replaced defective direct restorations (RR: 1.21, 95% CI: 0.51–2.83), either for resin composite (p = 0.97) or amalgam (p = 0.51) restorations. The risk of bias was high and the certainty of evidence was very low. Conclusion: Based on the very low certainty of evidence, the repair of direct restorations does not present a significant difference in the risk of failure when compared to replacements in permanent teeth. Clinical relevance: Restoration repair is a procedure that is included in the minimal intervention principle for improvement of tooth longevity in that the risk of failure of repaired partially defective restorations in permanent teeth seems similar to that of replacement. Further studies are required before definitive conclusions can be drawn. [ABSTRACT FROM AUTHOR]

Objective: Posterior teeth intrusion is one of the best treatment options for treatment of skeletal open bite in adults; the surrounding anatomical landmarks are one of the restraining factors. This study aimed to assess the vertical relationship between the maxillary posterior teeth (MPT) and the maxillary sinus floor (MSF) in different facial growth patterns in the Chinese adult population. Materials and methods: Cone beam computed tomography images of 298 patients, 145 males and 153 females aged between 20 and 45 years, were analyzed. Based on Jarabak ratio and the mandibular plane inclination, the sample was categorized into 94 hyperdivergent, 102 hypodivergent, and 102 normodivergent facial patterns subjects. The vertical relationship between the root-apex distances were classified as favorable, indicating no contact (type 1), or unfavorable, indicating roots in contact (type 2) for the posterior teeth intrusion. The relationship in the unfavorable group was subdivided into three subgroups (T2C, T2LC, and T2P). Comparative statistical tests were done related to age, gender, tooth side, and type of multiplanar view (sagittal and coronal). The significant level was set to be P < 0.05. Results: There was a statistically significant difference in the mean distance between both genders in the hyperdivergent group (P < 0.001). The measured distance increased with age in all tooth roots (P < 0.001). In both sagittal and coronal views, the most frequent root scores were type 1 and type 2p (54.2%, 27.5%) and (55.1%, 21.4%), respectively. The hyperdivergent group demonstrated a higher prevalence of type 2P (31.6% and 25.5%), whereas the hypodivergent group showed a lower prevalence (25.1% and 19.2%); furthermore, the second molar's mesiobuccal root in hyperdivergent patients showed the closest distance to the maxillary sinus in sagittal and coronal views, 0.3 ± 3.7 and 0.4 ± 3.1 mm, respectively. Conclusions: Maxillary molars of hyperdivergent patients have the highest possible risk of root resorption due to the possible risk of cortical bone encroachment, while hypodivergent patients have the least possible risk. Clinical relevance: Analysis of apex-sinus distances can be of great help for safe posterior teeth intrusion and providing correct and adequate treatment. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the microhardness of caries-affected dentin and color stability of teeth restored after treatments with silver diamine fluoride (SDF) associated to potassium iodide (KI) and Biosilicate. Material and methods: Different samples from bovine teeth were obtained. For color readings, 80 cavities (6 mm × 6 mm × 2 mm) were prepared, and for microhardness, teeth were flattened into dentine to obtain 40 samples. All samples were submitted to cariogenic challenge and separated in 4 groups, according to the treatment used: 12% SDF + KI; 38% SDF; Biosilicate and control (no treatment). Cavities were restored with resin-modified glass-ionomer cement (RMGIC, Vitremer, 3 M ESPE) or composite resin (CR, Z350, 3 M ESPE). After restoration, the samples were submitted to thermo-mechanical cycling (TMC) for 1,200,000 cycles. Color readings (EasyShade, Vita) were performed after restorations, after TMC, and 30 days after TMC. Knoop microhardness was evaluated on the planned samples before and after cariogenic challenge, after treatments, and after 30 days. Scanning electron microscopy (SEM) evaluated the dentine surface after treatments. Data were analyzed (ANOVA, Bonferroni, p <.05). Results: The results showed a higher color alteration for RMGIC than CR. The time of analysis was significant (p <.05) for the 12% SDF + KI and control group. There was no difference (p <.05) in microhardness between groups. However, there was evidence of dentin remineralization after treatments. Conclusions: It was concluded that the samples treated with Biosilicate resulted in a color alteration similar to control. The treatments presented dentin remineralizing potential for microhardness, below the demineralization level, caused by the cariogenic challenge. Clinical relevance: Considering the remineralizing potential presented by Biosilicate, this agent is a promising alternative that overcomes the SDF adverse effects such as tooth staining. [ABSTRACT FROM AUTHOR]

Objectives: To compare the effectiveness and side effects of miniscrew-assisted rapid maxillary expansion (MARME) with conventional rapid maxillary expansion (RME) in the treatment of transverse maxillary deficiency. Materials and methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched in the MEDLINE, Embase, and Cochrane Central databases. The quality of included RCTs was evaluated using the Cochrane risk-of-bias tool. The primary outcome was the extent of dentoskeletal expansion achieved. Secondary outcomes were the dental and periodontal side effects. We calculated summary weighted mean differences (MD) with 95% confidence intervals (CI) using random-effects meta-analysis. Results: Six RCTs involving 287 participants met the inclusion criteria. Compared to conventional RME, MARME was associated with a greater palatal suture opening (mm) measured at the anterior nasal spine (MD = 1.21, 95% CI 0.75 to 1.66), first premolars (MD = 1.13, 95% CI 0.72 to 1.55), first molars (MD = 1.18, 95% CI 0.28 to 2.09), and posterior nasal spine (MD = 1.14, 95% CI 0.30 to 1.98), increased palatal width (mm) at the first molars (MD = 0.75, 95% CI 0.30 to 1.20), and reduced buccal inclination (degrees) of the first premolars (MD = − 6.06, 95% CI − 10.36 to − 1.76) and first molars (MD = − 3.17, 95% CI − 5.35 to − 0.99). Conclusions: MARME is associated with the following advantages over traditional tooth-borne RME: increased palatal suture opening, increased palatal width, and reduced buccal tooth inclination. Registration: This study is registered with PROSPERO, CRD42021256750. Clinical relevance: MARME may be preferred over conventional RME in cases with fused mid-palatal sutures or where further buccal tooth inclination is undesirable. [ABSTRACT FROM AUTHOR]

Objective: The present study evaluated the efficacy of three different supplementary cleaning protocols on the removal of bioceramic-based root canal filling materials from oval-shaped canals. Materials and methods: A total of 36 human mandibular premolars were instrumented and obturated with gutta-percha and iRoot SP using the single-cone technique. Retreatment was performed with ProTaper Universal retreatment files. The samples were randomly divided into the following supplementary cleaning protocols: conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and XP-endo Finisher R (XPR). The samples underwent micro-CT scanning to quantify the amount of residual filling materials after retreatment and after performing the cleaning protocols. The volume of filling material removal was analyzed by one-way analysis of variance and post hoc Bonferroni and Games–Howell tests (P < 0.05). Results: There were significant differences in the amount of root canal filling material removal in every comparison group (P < 0.05). The XPR removed significantly more residual filling materials (P < 0.01) followed by PUI and CSI (P < 0.05). Similar efficacy was found in the total root canal and all root thirds. Conclusions: The additional use of XP-endo Finisher R and passive ultrasonic irrigation effectively removed the bioceramic-obturated root filling materials from the oval-shaped canals. However, none of the techniques completely removed the filling materials. Clinical relevance: The XP-endo Finisher R and passive ultrasonic irrigation exhibited greater efficacy compared with syringe irrigation in the reduction of residual filling materials after retreatment in root-filled teeth with a bioceramic sealer. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to examine the occlusion of anterior teeth in individuals with shortened dental arch (SDA). Material and methods: In a case–control clinical study, 41 individuals with SDA and 41 individuals with complete dental arch (CDA) participated. The CDA control group was matched for age and gender. Testing for occlusal contacts of anterior maxillary teeth was conducted by biting on foil strips (8 µm) with subjectively normal bite force (NBF) and maximal bite force (MBF). The data was analyzed on individual and tooth levels. Results: The median rates of anterior maxillary teeth with occlusal contacts were 0.67 (NBF) and 0.83 (MBF) in the SDA group and 0.50 (NBF) and 0.83 (MBF) in the CDA group. Within both groups, the contact rates were significantly higher in MBF. The group difference with NBF was significant. A generalized linear model showed that the odds of an anterior maxillary tooth to have an occlusal contact were greater in the SDA both for NBF with an odds ratio (OR) 2.277 and MBF with an OR 1.691. Conclusions: The findings suggest effective compensatory mechanisms relative to the occlusal function in individuals with SDA. Clinical relevance: The study delivers further evidence regarding the SDA concept as a viable option in the management of posterior tooth loss. [ABSTRACT FROM AUTHOR]

Objectives: A systematic review was performed to analyze the clinical performance of class I and II restorations in posterior teeth placed with the incremental or the bulk-filling techniques. The primary outcome was retention/fracture rate, and the secondary outcomes evaluated were anatomical form, surface texture, color match, marginal adaption, marginal discoloration, caries, and postoperative sensitivity. Methods: Electronic and manual searches were performed for randomized clinical trials comparing the clinical performance of composite resin restorations in posterior teeth placed with the incremental or the bulk-filling techniques. The Cochrane Collaboration risk of bias tool was used to assess the quality of the studies and the GRADE tool was used to access the quality of the evidence. Results: Fourteen studies were included in this systematic review and most of them had unclear risk of bias. The risk difference (RD) for retention/fracture was 0.00 (95%CI = − 0.01, 0.01; p = 0.86) for 1–1.5 years of follow-up; 0.00 (95%CI = − 0.02, 0.02; p = 0.88) for 2–3 years of follow-up; 0.05 (95%CI = − 0.08, 0.18; p = 0.46) for 5 or more years of follow-up. The RD for postoperative sensitivity was 0.04 (95%CI = − 0.02, 0.10; p = 0.18) for up to 30 days; 0.00 (95%CI = − 0.01, 0.02; p = 0.63) for 1–1.5 years of follow-up; and 0.00 (95%CI = − 0.01, 0.02; p = 0.71) for 2–3 years of follow-up. For the other secondary outcomes, no significant differences were observed (p > 0.05) between the restorative techniques. The certainty of evidence was graded as moderate. Conclusions: The clinical performance of class I and II restorations in posterior teeth is similar when placed with the incremental and bulk-filling techniques. Clinical relevance: Based on the results of this study, posterior restorations placed with bulk-filling technique present satisfactory clinical performance, which is similar to direct restorations placed with the conventional incremental technique, considering various follow-up periods evaluated. Trial registration: CRD42018108450. [ABSTRACT FROM AUTHOR]

Objective: The concept of minimally invasive endodontics recommends less-invasive vital pulp therapy (VPT) modalities over more aggressive traditional endodontic approaches in mature permanent teeth with carious pulp exposure, including irreversible pulpitis (IP) cases. Consequently, VPT needs to be compared with root canal therapy (RCT) in terms of treatment outcomes. This randomized clinical trial compares the results of full pulpotomy using two calcium-silicate cements, i.e., mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement, with RCT in mature permanent teeth. Materials and methods: A total of 157 carious pulp exposure cases in two academic centers with/without established IP were selected/included/randomly appointed to three study arms; (i) RCT (n = 51) as the reference treatment, (ii) pulpotomy with ProRoot MTA (PMTA; n = 55), and (iii) pulpotomy with CEM cement (PCEM; n = 51) as two alternative VPT treatments. Two-year clinical/radiographic results were the outcomes of interest. Data were statistically analyzed through the analysis of variance, chi-square, Fisher exact test, and Kruskal–Wallis. Results: At 2-year recall, 147 teeth were examined (6.4% dropout). All molars, except for one, were clinically functional/symptom-free, and there was no statistical difference between the three study arms (p = 0.653). The radiographic success rates in RCT, PMTA, and PCEM arms were 98%, 100%, and 97.9%, respectively, without statistically significant differences (p = 0.544). Conclusion: In the management of mature permanent teeth with/without established IP, all experimental groups exhibited equivalent/comparable results. Clinical relevance: Simple VPT using MTA/CEM can be suggested/recommended as a viable advantageous alternative to RCT for the management of carious pulp exposures with/without sign/symptoms of IP. [ABSTRACT FROM AUTHOR]

Objectives: To three-dimensionally evaluate deviations of full-arch intraoral (IO) scans from reference desktop scans in terms of translations and rotations of individual teeth and different types of (mal)occlusion. Materials and methods: Three resin model pairs reflecting different tooth (mal)positions were mounted in the phantom head of a dental simulation unit and scanned by three dentists and three non-graduate investigators using a confocal laser IO scanner (Trios 3®). The tooth-crown surfaces of the IO scans and reference scans were superimposed by means of best-fit alignment. A novel method comprising the measurement of individual tooth positions was used to determine the deviations of each tooth in the six degrees of freedom, i.e., in terms of 3D translation and rotation. Deviations between IO and reference scans, among tooth-(mal)position models, and between dentists and non-graduate investigators were analyzed using linear mixed-effects models. Results: The overall translational deviations of individual teeth on the IO scans were 76, 32, and 58 µm in the lingual, mesial, and intrusive directions, respectively, resulting in a total displacement of 114 µm. Corresponding rotational deviations were 0.58° buccal tipping, 0.04° mesial tipping, and 0.14° distorotation leading to a combined rotation of 0.78°. These deviations were the smallest for the dental arches with anterior crowding, followed by those with spacing and those with good alignment (p < 0.05). Results were independent of the operator's level of education. Conclusions: Compared to reference desktop scans, individual teeth on full-arch IO scans showed high trueness with total translational and rotational deviations < 115 µm and < 0.80°, respectively. Clinical relevance: Available confocal laser IO scanners appear sufficiently accurate for diagnostic and therapeutic orthodontic applications. Results indicate that full-arch IO scanning can be delegated to non-graduate dental staff members. [ABSTRACT FROM AUTHOR]

Objectives : To investigate tooth wear in young adults, intraoral scanning was used for digital monitoring of the mandibular first molar over 12 months. A possible influence of aetiological factors obtained by a questionnaire on tooth wear was investigated. Materials and methods: A total of 109 participants (mean age at the start of the study: 21.0 ± 2.2 years) were included in this clinical study. At baseline (T0), an intraoral scan (Trios 3, 3Shape) of the study tooth (FDI # 36 or #46) was conducted. After a mean observation period of 373 ± 19 days, a second intraoral scan (T1, n = 94) of the same tooth as at T0 was performed and standard tessellation language datasets were superimposed with 3D analysis software (GOM Inspect). The occlusal surface of the study tooth was divided into 7 areas (5 cusps, 2 ridges) and maximum vertical substance loss was measured between T0 and T1 (n = 91). Three types of tooth wear were defined: cupping (C), facet (F) and combined cupping-facet (CF). Furthermore, a questionnaire on aetiological factors, such as dietary behaviour, was filled out at T0. Data were analysed with non-parametric tests (p < 0.05). Results: Only one study tooth exhibited no tooth wear at T0, whereas 3 teeth showed C, 47 teeth F and 40 teeth CF. A progression of vertical substance loss for all three types was shown. Most affected were the mesiobuccal cusps (43, 38/47 µm; median, 95%CI) followed by distobuccal (36, 33/39 µm), mesiolingual (35, 26/40 µm), distolingual (34, 27/36 µm) and distal (31, 25/34 µm). On mesial and distal ridges, only F was detected with the lowest vertical substance loss of all areas (mesial ridge: 0, 0/0 µm; distal ridge: 0, 0/0 µm). An association between aetiological factors and loss values could not be shown. Conclusions: All study teeth showed clear signs of wear, and after only 1 year, further substance loss was detectable. This result is of significance for young adults. Clinical relevance: Since data of young adults regarding tooth wear are scarce, the results give a first idea of the amount of vertical loss per year and its relation to aetiological factors such as dietary behaviour. Therefore, further studies over a longer observation period are highly recommended. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the effect of micro-osteoperforations (MOPs) on the gene expression profile of the periodontal ligament (PDL) of orthodontically moved teeth. Materials and methods: Fifteen participants were randomly assigned into two groups: tooth movement only (Tr1, n = 7) and tooth movement supplemented with MOPs (Tr2, n = 8). In each subject, orthodontic tooth movement (OTM) was performed on premolar in one side, while no force was applied on contralateral premolar (Unt, n = 15). Seven days after loading, premolars were extracted for orthodontic reasons. RNA extraction from PDL and subsequent RNA-sequencing were performed. False discovery rates (Padj < 0.05) and log2 fold change (+ / − 1.5) thresholds were used to identify sets of differentially expressed genes (DEGs) among the groups. DEGs were analyzed with gene ontology enrichment, KEGG, and network analysis. Results: Three hundred thirty-one DEGs were found between Tr1 and Unt, and 356 between Tr2 and Unt. Although, there were no significantly DEGs between Tr2 and Tr1, DEGs identified exclusively in Tr1 vs. Unt were different from those identified exclusively in Tr2 vs. Unt. In Tr1, genes were related to bone metabolism processes, such as osteoclast and osteoblast differentiation. In Tr2, genes were associated to inflammation processes, like inflammatory and immune responses, and cellular response to tumor necrosis factor. Conclusions: MOPs do not significantly alter the PDL gene expression profile of orthodontically moved human teeth. This study provides for the first time evidence on the whole PDL gene expression profiles associated to OTM in humans. Novel biomarkers for OTM are suggested for additional research. Clinical relevance The identified biomarkers provide new insights into the molecular mechanisms that would occur when OTM is supplemented with MOPs. These markers are expected to be useful in the near future for the application of personalized strategies related to the OTM. [ABSTRACT FROM AUTHOR]

Objectives: To make an in vitro assessment of fracture resistance of weakened and non-weakened teeth receiving intraradicular reinforcement using Rebilda bundled glass fiber–reinforced composite posts (GT), Rebilda conventional glass fiber posts (RP), or both systems combined (GT + RP). Materials and methods: Eighty sound bovine incisors were prepared and divided randomly into eight groups as follows: (a) nWnR: without simulating weakness, and without intraradicular reinforcement; (b) WnR: simulating weakness, but without intraradicular reinforcement; (c) nWGT: without simulating weakness, but with GT; (d) WGT: simulating weakness, and with GT; (e) nWRP: without simulating weakness, but with RP; (f) WRP: simulating weakness, and with RP; (g) nWGTRP: without simulating weakness, but with GT + RP; (h) WGTRP: simulating weakness, and with GT + RP. The specimens were subjected to the load-to-fracture test using the DL-2000MF universal testing machine. The finite element method assessed the mechanical behavior and stress distribution in endodontically treated teeth. Results: The groups nWGTRP and WGTRP presented the best results in the load-to-fracture test, with the former being better than the latter, but with no statistically significant difference (P > 0.05). However, there was a significant difference between these and the other groups (P < 0.05), except for nWRP. Stress distribution inside the canal wall was different among the groups, with promising mechanical behavior for nWGTRP and nWRP. Conclusions: The Rebilda conventional fiber post (RP), combined with the Rebilda bundled glass fiber–reinforced composite post (GT) improves the resistance and stress distribution of immature teeth. Clinical relevance: Longitudinal fracture is less frequent in teeth restored with GT and RP posts. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate techniques for approaching fractured instruments in the root canal and to present possible outcomes in relation to dentin thickness, fracture resistance, technique success, and clinical time. Materials and methods: The bibliographic research was carried out in PubMed, Cochrane, Lilacs, Web of Science, Scopus, grey literature, and manual search. Following the inclusion and exclusion criteria, the titles and abstracts of 506 articles were read. Of these, 60 articles were selected and read in full. Fourteen articles were included in this systematic review. Results: The most studied technique was the ultrasonic technique and obtained good general results. The more apically the instrument is located, the more difficult it is to remove, the more dentin is removed, and the lower the fracture resistance of the tooth. When removal is not possible, the bypass technique can be performed (bypassing), and on weakened teeth or with little dental remnants, the GentleWave System technique can be used. Conclusion: This systematic review shows the evidence from laboratory studies that the curvature and the root third in which the fracture of instruments occurred is relevant to fracture resistance and success. The ultrasonic technique got the best results. Well-conducted clinical studies should be performed for clinical practice. Clinical relevance. The approach of fractured instruments in the root canal is efficient with the use of ultrasound, bypass technique, and Gentle Wave System. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate long-term survival and success rates of conventionally cemented partial-coverage crowns (PCCs) manufactured from high noble metal alloys (hn). Material and methods: Restoration-, periodontal- and tooth-related criteria on patients, restored with a single or multiple conventionally cemented hnPCCs in a private dental office were collected from existing patient records. With regard to semi-annual follow-ups, data of the most recent clinical evaluations were considered. Kaplan–Meier and log-rank tests were used for statistical analyses. Level of significance was set at p ≤.05. Results: Between 09/1983 and 09/2009, 1325 hnPCCs were conventionally cemented on 1325 teeth in 266 patients (mean age: 44.5 ± 10.7 years). Due to various reasons, 81 hnPCCs showed complications, documenting a success rate of 93.9% after a mean observation period of 18.8 ± 5.7 years. Of these, additional 14 restorations were counted as survival, resulting in a survival rate of 94.9%. Most frequent complications were periodontal issues (n = 29, 35.8%). Significantly higher success rates were documented for hnPCCs of patients aged between 37 and 51 years (p =.012). Conclusion: Partial-coverage crowns from high noble metal alloys showed excellent survival and success rates after a mean observation period of 18.8 ± 5.7 years. Higher patient age was one of the risk factors. Clinical Relevance: According to the results of this study, hnPCCs still represent an excellent therapeutic option—even in modern dentistry. [ABSTRACT FROM AUTHOR]

Objectives: This in vitro study analysed potential of early proximal caries detection using 3D range data of teeth consisting of near-infrared reflection images at 850 nm (NIRR). Materials and methods: Two hundred fifty healthy and carious permanent human teeth were arranged pairwise, examined with bitewing radiography (BWR) and NIRR and validated with micro-computed tomography. NIRR findings were evaluated from buccal, lingual and occlusal (trilateral) views according to yes/no decisions about presence of caries. Reliability assessments included kappa statistics and revealed high agreement for both methods. Statistical analysis included cross tabulation and calculation of sensitivity, specificity and AUC. Results: Underestimation of caries was 24.8% for NIRR and 26.4% for BWR. Overestimation was 10.4% for occlusal NIRR and 0% for BWR. Trilateral NIRR had overall accuracy of 64.8%, overestimation of 15.6% and underestimation of 19.6%. NIRR and BWR showed high specificity and low sensitivity for proximal caries detection. Conclusions: NIRR achieved diagnostic results comparable to BWR. Trilateral NIRR assessments overestimated presence of proximal caries, revealing stronger sensitivity for initial caries detection than BWR. Clinical relevance: NIRR provided valid complement to BWR as diagnostic instrument. Investigation from multiple angles did not substantially improve proximal caries detection with NIRR. [ABSTRACT FROM AUTHOR]

Objectives: The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a difference in the survival rate of partial adhesive restorations performed on non-vital teeth compared to vital teeth. Materials and methods: This systematic review was conducted following the PRISMA guidelines. The considered clinical studies investigated the outcomes of adhesive inlays, onlays, and overlays conducted over the past 40 years, focusing on Kaplan–Meier survival curves to calculate the hazard ratio (primary objective) and the survival rate (secondary objective) between vital and non-vital teeth. The risk of bias was assessed using the Newcastle–Ottawa Scale. Studies included in the review were identified through bibliographic research on electronic databases ("PubMed," "Scopus," "Cochrane Central Register of Controlled Trial," and "Embase"). The K agreement between the two screening reviewers was evaluated. Results: A total of 55,793 records were identified on PubMed, Scopus, and other bibliographic sources, and after the application of the eligibility and inclusion criteria, eight articles were included for qualitative analysis and six for quantitative analysis. The meta-analysis of the primary and secondary outcomes demonstrated that hazard ratios (HR = 8.41, 95% CI: [4.50, 15.72]) and survival rates (OR = 3.24, 95% CI: [1.76, 5.82]) seemed more favorable for indirect partial adhesive restorations on vital teeth than for those on endodontically treated teeth. Conclusions: Within the limits of this study, these findings suggest that the risk of failure of indirect partial adhesive restorations on endodontically treated teeth is higher than on vital teeth. Clinical relevance: The use of partial adhesive restorations on vital and endodontically treated teeth showed different long-term clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: This systematic review aimed to assess the effectiveness of anesthetic methods for mandibular posterior teeth with symptomatic irreversible pulpitis, comparing to the inferior alveolar nerve block (IANB) by meta-analysis. Materials and methods: Studies were identified from Cochrane Library, Embase, Lilacs, PubMed, Scopus, and Web of Science databases up to May 2021. Randomized clinical trials comparing the anesthetic success rate of IANB and any other alternative anesthetic method were included. The quality of the selected studies was assessed by the Cochrane Risk of Bias 2.0 tool. Meta-analyses using Mantel–Haenszel method and random-effect models were performed to find the pooled estimates of risk ratio (RR) with 95% confidence interval (CI). The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Results: Twenty-two studies were selected, which included fourteen anesthetic methods. Two studies were classified as high risk of bias, five as uncertain risk and fifteen as low risk. Vazirani-Akinosi nerve block (VANB) [RR = 1.27; p = 0.007; 95% CI, 1.07–1.52; I2 = 0%] and intraosseous injection (IOI) [RR = 1.48; p = 0.04; 95% CI, 1.02–2.15; I2 = 46%] had superior effectiveness compared to IANB, with low certainty of evidence, as well as buccal infiltrations associated with IANB (BI + IANB) [RR = 1.84; p = 0.004; 95% CI, 1.22–2.79; I2 = 52%], with very low certainty. Conclusion: Evidence suggests that buccal infiltrations associated with IANB, VANB, and IOI are more effective than IANB at anesthetizing posterior mandibular teeth with symptomatic irreversible pulpitis. Clinical significance: Alternative primary methods of anesthesia might be indicated for mandibular posterior teeth presenting symptomatic irreversible pulpitis. [ABSTRACT FROM AUTHOR]