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Aim: This case report aimed to present a novel surgical technique involving orthodontics luxation of the offended tooth using miniscrew prior to performing intentional replantation (IR) to remove an extruded separated instrument that injured the inferior alveolar nerve (IAN)., Background: Intentional replantation is a dental procedure that involves extracting a tooth, managing the root canal, and then reinserting the tooth back into its socket. This procedure is typically used as a last resort when other treatment options have failed or are not possible. Intentional replantation can be successful in preserving the tooth and preventing tooth loss, but it is important to note that there are risks involved. Maintaining the viability of the periodontal ligament (PDL) is a pivotal step to achieve a favorable outcome., Case Description: A 15-year-old female patient came to the clinic complaining of electric-like pain in the left mandibular posterior area that radiated to the left ear and sometimes caused a headache. Upon clinical and radiographic evaluation, extruded endodontic file from the mesial root of the left first molar that penetrated the IAN canal was noticed. Nonsurgical root canal retreatment was performed, which failed to retrieve the separated file. Orthodontics luxation of the offended tooth was done 2 weeks before the surgical intervention using a miniscrew to induce PDL inflammation, which increased the tooth mobility and PDL volume, facilitating the atraumatic extraction and reduced the risk of complications, such as root resorption and ankylosis. Then, IR was performed, and the extruded file was successfully retrieved. Three months follow-up showed complete recovery of the endodontics-related IAN injury symptoms. Preapical radiographic evaluation and cone-beam computed tomography scan showed complete healing of the periapical radiolucency/area of low density and complete formation of the PDL space and lamina dura around the resected roots., Conclusion: This novel approach using a miniscrew suggests a noninvasive technique that minimizes the damage to the offended tooth surrounding tissues as well as minimizing the morbidity of the adjacent teeth and the vital anatomical structures., Clinical Significance: Multidisciplinary comprehensive preplanning of complicated cases is essential to maximize treatment efficiency. The orthodontic extrusion facilitates the extraction process that helps in preserving the PDL, and ultimately increases the survivability of the teeth. How to cite this article: Alharbi MA, Alghamdi BA, Alswajy WA, et al . A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023;24(11):895-901.

Background: Sugar is the main culprit in many health dysfunctions. Excessive sugar intake can negatively affect oral health, precipitate diabetes, and lead to weight gain and obesity. Sucrose is the primary form of sugar, and is strongly correlated with dental caries. Artificial sweeteners are chemically synthesized sugar substitutes that are generally regarded as being low-calorie., Objective: This review examines the current evidence in the literature for the need for artificial sweeteners and outlines its implications for the health of children. We briefly outline its adverse effects, and concerns regarding their safety., Review Results: Artificial sweeteners are a widely used food additive. Six main artificial sweeteners are approved by the food and drug administration (FDA). The conflicting results and divergent regulatory norms of each sweetener are a constant cause of concern and debate. However, most studies have spotlighted the beneficial effects of artificial sweeteners. Dental caries diminish with the increase in sweetener intake. An increase in appetite and eventually weight gain is observed in individuals consuming artificial sweeteners., Conclusion: Artificial sweeteners are indeed a bane according to present studies, although more research on recently discovered non-nutritive artificial sweeteners is required. It also has a positive effect on overall health disorders. If one curbs the onset of dental caries, then the eventual rise is highly unlikely., Clinical Significance: Artificial sweeteners' effect on lowering dental caries will help to reduce the caries index in general. Oral hygiene is maintained, and the growth of oral bacterium is depressed. Research on novel sweeteners will help to compare their efficacy in caries prevention compared to existing ones. It is necessary to educate people on artificial sweeteners and its implication as one can use them by being aware of their properties.

Edentulousness affects the mental health of most patients. Missing teeth in the anterior esthetic zones is a matter of concern, especially for young adults. Various replacement options such as fixed partial dentures, removable partial dentures, and dental implants are available to treat edentulousness. Dental implants have been a booming treatment option in modern-day dentistry as they more closely mimic the natural tooth. The most important criterion for placement of the implant in the esthetic zone is the conservation of alveolar bone, especially in the anterior region which is usually compromised due to tooth extraction or resorption of the ridge. The root membrane concept or the socket shield technique is a recently introduced concept in implant dentistry where a portion of the root acts as a shield to protect against alveolar bone resorption and maintain bone integrity, especially in the esthetic area. This case report describes the clinical management of fractured upper anterior teeth using a dental implant and the root membrane technique. Keywords: Anterior zone, Esthetics, Immediate implants, Implant, Missing teeth, Root membrane technique, Socket shield.

Aim: To systematically review the comparative differences in the performance and timeliness of conventional orthodontic treatment with that of corticotomy-assisted accelerated orthodontic treatment., Data Sources: The electronic databases PubMed and Google Scholar were searched from January 2007 to January 2018 in English, with manual searches of reference lists and gray literature. Thirty-six articles were included in the study with inclusion criteria as prospective clinical studies of patients treated with fixed conventional appliance and the intervention was the corticotomy-assisted accelerated orthodontic treatment method., Study Selection: Two reviewers assessed independently the eligibility of the included articles. One investigator abstracted study design information, intervention details, and harms data from all included studies into a standardized evidence table. The accuracy of these data was checked by the second investigator. We resolved any disagreements through discussion with other authors., Results: Different aspects of the corticotomy-assisted accelerated orthodontics treatment method were investigated including risk factors, advantages, and disadvantages as compared to that of conventional orthodontic treatment., Conclusion: There is limited available evidence about effectiveness of corticotomy-assisted accelerated orthodontics. Although the current review indicates that the corticotomy-assisted accelerated orthodontic treatment method can fasten the treatment duration by 2.2-3 folds compared to conventional orthodontic treatment, furthermore, the level of evidence needs well-conducted prospective research with big sample size to draw valid conclusions., Clinical Significance: Orthodontic treatment is a time-consuming process and due to noncompliance of patients, research has found different methods to accelerate the treatment, thus reducing the total treatment duration. Use of accelerated orthodontic techniques is expected to help clinicians in better treatment decisions for noncompliant patients.

Aim: The present study aimed to assess the efficacy of different dental varnishes in prevention of demineralization of enamel along the orthodontic brackets., Materials and Methods: A total of 60 premolars that do not have caries and were extracted for orthodontic purposes were used in this study. Transbond™ Plus was used to bond premolar brackets onto the treated surface of enamel. The teeth were then divided into three groups. Group I: Profluorid varnish, group II: CPP-ACP varnish, and group III: Duraflor™ varnish. A Vickers diamond indenter was used to assess the microhardness of the surface of enamel at baseline, fourth day, and seventh day., Results: A slightly meaner surface microhardness (SMH; 334.20 ± 2.10) was seen in group III when compared with group I (332.16 ± 3.02) and group II (330.40 ± 2.02). The mean SMH was 342.02 ± 0.82 in group I on the fourth day which was slightly higher than that of the baseline values, followed by group III (339.48 ± 0.34) and group II (336.64 ± 1.14). No statistically significant differences were noted between the groups. A higher mean microhardness of 349.84 ± 0.66 was seen in group I on the seventh day, followed by group III (342.26 ± 1.08) and group II (338.18 ± 1.08). A statistically highly significant difference was seen between the groups., Conclusion: The present study concluded Profluorid varnish to have maximum potential to reduce demineralization of enamel followed by Duraflor and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group., Clinical Significance: A most common clinical challenge encountered in orthodontic clinical practice is enamel demineralization or white spot lesion (WSL) development throughout the fixed appliance treatment. Thus, the information about several available varnishes is important to prevent demineralization in regular dental practice.

Aim: The review is to highlight the use of antibiotics in periodontal infections and prevent indiscriminate use of antibiotics., Background: Periodontitis is the most common disease of the periodontal attachment apparatus, and its etiological factor can be related to the existence of virulent microorganisms in the dental plaque biofilm which harbors millions of microorganisms. In addition, the pathogenesis of this disease is greatly influenced by the host immune response that leads to the cyclic destruction and healing pattern., Review Results: Periodontitis is mostly treated through mechanical debridement using surgical and nonsurgical therapy. However, many times, this treatment does not render desired results due to poor patient compliance, altered immune response, or other host-related factors. This leads to the administration of antibiotics as an adjunct to mechanical debridement. Antibiotics are useful in eliminating periodontopathic microbes, but these agents should be cautiously used and prescribed only if indicated., Conclusion: Indiscriminate use of antibiotics can lead to unforeseen adverse effects as well as the development of resistant strains of microorganisms., Clinical Significance: Hence, it is crucial for the dentists to know the indications, contraindications, undesirable effects, correct choice, and dosage of the antimicrobial agent before prescribing it to their patients thereby ensuring the success of periodontal therapy. Thus, the clinician should keep in mind that the antibiotics are merely adjuncts to mechanical therapy and not its replacement.

Aim: The aim of this study is to assess the impact of dental visits on oral health awareness among the Saudi population., Materials and Methods: A cross-sectional survey was conducted in Saudi Arabia. An online self-administered questionnaire was distributed from January 2011 to June 2013. The questionnaire consisted of 21 multiple choice questions which was categorized into four: demographic data, dental care status, oral hygiene behavior, and oral health knowledge (OHK). Responses to the questions in the OHK category were grouped and scored according to their percentage of correct answers: 1 = very poor (0 to <25% correct), 2 = poor (25% to <50% correct), 3 = acceptable (50 to <75% correct), and 4 = good (75-100% correct). The sample was divided based on dental visit behavior into poor, average, and good dental visitors. Descriptive statistics, group comparisons, correlations, and linear regressions were conducted using SPSS (V16.0). A significance was set at p < 0.05., Results: A total of 845 participants were included: 73.4% were females, 85.1% were older than 19 years, 76.9% had a college-level education, and 75.3% were from western Saudi Arabia. A total of 14.1% were poor dental visitors, 67.5% were average dental visitors, and 18.5% were good dental visitors. The good dental visitor group showed significantly better results than the other two groups in terms of dental services received, brushing habits, interdental cleansing habits, use of miswak, and OHK ( p < 0.05). The best predictors with significant but weak effects on dental visit habits were brushing habits, interdental cleansing habits, use of miswak, and OHK ( F (8,836) = 7.212, R 2 = 0.065, p < 0.0001)., Conclusion: Dental visits were significantly correlated with OHK. However, the impact of dental visits on oral health awareness was found to be weak., Clinical Significance: Well-designed preventive and educational dental visit programs need to be widely implemented as part of the governmental oral health plans.

Aim: The lateral cephalometric radiograph is a standard component of clinical records taken for orthodontic diagnosis and treatment planning. The present study was conducted to assess the utility of cephalometric radiography and analysis in modern orthodontic diagnosis and treatment planning., Materials and Methods: A research survey was conducted at Jacksonville University School of Orthodontics. Thirty-one residents and faculty were the participants. The survey sample was collected from the university patients' pool. A survey was given to participants at two time points. At the first time point (T1), the participants were given full records without lateral cephalogram. At the second time point (T2), they were given full records with lateral cephalogram. Two measures were analyzed: (1) a change in orthodontic treatment decision and (2) a change in the orthodontic treatment plan. A traditional McNemar's test was used on paired binary data. We used the conditional logistic regression model with robust variance at a participant level to adjust for a participant-level clustering effect to test the difference in treatment decision before and after. A statistical significance was determined at p = 0.05., Results: It was found that 93.6% of the treatment decisions and 70% of the extraction decisions were consistent after the introduction of lateral cephalograms. There was no statistically significant association observed between two outcome measures and the use of cephalograms ( p = 0.80)., Conclusion: Sufficient evidence does not exist to warrant lateral cephalometric radiographs be taken as a part of standard diagnostic records on every individual seeking orthodontic treatment., Clinical Significance: Evidenced-based selection criteria for prescribing lateral cephalometric radiographs should be developed to reduce the amount of radiation exposure to the general public.

Aim: The aim of this study is to investigate the caries situation in a group of Swedish adolescents, who were scheduled for orthodontic treatment with fixed appliances., Materials and Methods: An age- and gender-matched control group was selected from the same city (Malmö, Sweden). Caries and fillings on smooth surfaces and fillings on occlusal surfaces were diagnosed clinically and caries and fillings on approximal surfaces by bitewings. Numbers of mutans streptococci (MS) and lactobacilli (LB) were analyzed in saliva., Results: There were no significant differences regarding manifest caries lesions and fillings on smooth surfaces. Numbers of occlusal-filled surfaces (FS) and approximal decayed and filled surfaces were around 10%, but did not differ between the groups. However, 53% had approximal enamel caries lesions in the test group and 46% in the control group. The prevalence of approximal decayed surfaces (DS) and FS was low in both groups, 0.57 ± 1.41 in the test group and 0.65 ± 1.38 in the control group ( p > 0.05), i.e., somewhat more DS in the control group ( p < 0.05). Most individuals had low/medium counts of cariogenic bacteria in their saliva and less than 10% high counts in both groups., Conclusion: Most Swedish adolescents who have been scheduled for treatment with fixed appliances appear to have a low-to-medium caries risk nowadays. However, around 10% of all approximal tooth surfaces of premolars/molars had enamel caries and one-third of the individuals had medium/high counts of cariogenic bacteria in their saliva, which may be risk factors for future caries during orthodontic treatment., Clinical Significance: Bitewing radiographs are important before starting orthodontic treatment and approximal caries and many cariogenic bacteria may be risk factors for orthodontic treatment.

Aim: This study was aimed to explore the effect of pretreatment severity of malocclusion on the duration of the treatment using The American Board of Orthodontics discrepancy index (ABO-DI)., Materials and Methods: This clinical retrospective study consisted of orthodontics records of 37 patients who were treated with comprehensive fixed orthodontic appliance from 2011 to 2013. The sample of the study was collected so as to exclude, to the maximum possible, the patient cooperation variability by reviewing all patient chart entries. The DI measurements were used to gather the information of the pretreatment and relate it to the time duration of the treatment. Statistical analyses were performed using the chi-square test and Pearson correlation coefficient., Results: The average treatment time was 24.5 months. The DI scores mean for class I and II was 14.30 and 20.15 respectively. Age and sex did not significantly influence the treatment duration (p > 0.05)., Conclusion: The results of this study showed that the ABO-DI could be a useful tool to predict orthodontic treatment time., Clinical Significance: The ABO-DI can significantly aid in orthodontic treatment time planning.

Aim: The purpose of this study was to assess the arch width, transverse discrepancy, and transverse interarch ratio for class I malocclusion sample, with and without crossbite, in permanent dentition stage., Materials and Methods: Records of class I malocclusion patients with minimal crowding and spacing with and without posterior crossbite were selected. Each group consisted of 40 pairs of dental casts (20 males and 20 females). Arch widths were measured for the canine, first, and second premolars, and first permanent molars using the buccal approach. Means and standard deviations (SDs) of dental arch widths were measured for the maxillary and mandibular arches, and the interarch width ratio was calculated., Results: There was a highly significant difference between the noncrossbite and crossbite groups regarding the maxillary width, p < 0.001. However, no differences were found between groups for the mandibular widths, p > 0.01. There were also significant differences between both groups for the intercanine, first and second premolars, and first molar ratios, p < 0.001., Conclusion: This new simple method showed that a transverse maxillary-mandibular ratio of 1:1.1 is ideal. A ratio less than 1:0.9 will indicate the presence of crossbite., Clinical Significance: The interarch ratio significantly aids in orthodontic treatment planning in patients requiring maxillary expansion and/or surgical cases.