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Background/Objectives: Molar Incisor Hypomineralization (MIH) is a prevalent multifactorial developmental dental defect with unclear etiology. This study aimed to identify potential risk factors for MIH among primary school children in Jeddah, Saudi Arabia. Methods: A cross-sectional study including children aged 7 to 10 years old, recruited from twelve randomly selected schools located in three regions of Jeddah city, was carried out. The children were examined for MIH and dental caries using the European Academy of Pediatric Dentistry Criteria (2003) and the DMFT/dmft WHO index. Parents were asked to provide medical and socio-demographic information on their children from their first two years of life. Results: A total of 2010 children were examined, with 888 parents responding to the survey (a 44.2% response rate). Lower maternal education was found to be significantly associated with a decreased adjusted odds ratio (AOR) of MIH (Model 1: p = 0.014, AOR = 0.646, and 95% CI = 0.456 to 0.915; Model 2: p = 0.019, AOR = 0.658, and 95% CI = 0.465 to 0.933). Being an only child, a child's birth order, type of delivery, breastfeeding, and medical conditions were not associated with MIH. Conclusions: The significant association between MIH and maternal education suggests that further research is needed to explore the underlying mechanisms and identify other potential confounding variables. [ABSTRACT FROM AUTHOR]

One of the most critical aspects of clinical dentistry is ensuring a painless post-operative period. It is not uncommon for patients to still experience discomfort even after receiving anesthesia. Additionally, the analgesics and antibiotics prescribed can cause gastric irritation for the patient. Therefore, we intended to conduct a study to compare the effectiveness of a transdermal analgesic patch with an oral analgesic in reducing pain during transalveolar extraction and to see the additive effect of intrasocket tetracycline in socket healing. During the period from June 2022 to January 2023, a comparative, singleblinded, in-vivo study was carried out in the Department of Oral and Maxillofacial Surgery. The primary objective of this study was to evaluate post-operative pain and gastritis in the context of surgical extraction of mandibular molars. A total of 34 surgical extractions of mandibular molars were scrutinized. Employing the Sequentially numbered opaque sealed envelope (SNOSE) method, the study cohort was systematically bifurcated into two distinct groups. Following extraction, both groups had tetracycline fibres meticulously inserted into the sockets. Preceding the extraction, one group received a diclofenac transdermal patch, while the control group was administered oral analgesics. Consequently, patients underwent thorough assessments on day one, three and five postoperatively, encompassing parameters such as intraoperative pain perception, post-operative pain, gastric irritation, and the healing process of the extraction site. The mean age of participants in both groups was 33±7.16 and 33.5±7.64, respectively. The majority of participants were male in the oral analgesics group and female in the transdermal patch group. Most of the teeth that were extracted in both groups were lower third molars. Regarding pain and gastritis, it was found that the transdermal patch was statistically superior to oral analgesics in alleviating postoperative pain and had no adverse effects like gastritis. We have determined that the transdermal patch form of diclofenac is a superior alternative to traditional oral analgesics for alleviating pain and preventing gastritis after the extraction of mandibular molars. The combined use of a transdermal patch with intrasocket tetracycline fibers completely eliminates the need for oral medications. [ABSTRACT FROM AUTHOR]

Background and Objectives: With the goal of identifying regions with bicortical bone and avoiding root contact, the present study proposes an innovative technique for the simulation of the insertion of mini orthodontic implants using automatic jaw segmentation. The simulation of mini implants takes place in 3D rendering visualization instead of Multi-Planar Reconstruction (MPR) sections. Materials and Methods: The procedure involves utilizing software that automatically segments the jaw, teeth, and implants, ensuring their visibility in 3D rendering images. These segmented files are utilized as study models to determine the optimum location for simulating orthodontic implants, in particular locations characterized by limited distances between the implant and the roots, as well as locations where the bicortical structures are present. Results: By using this method, we were able to simulate the insertion of mini implants in the maxilla by applying two cumulative requirements: the implant tip needs to be positioned in a bicortical area, and it needs to be situated more than 0.6 mm away from the neighboring teeth's roots along all of their axes. Additionally, it is possible to replicate the positioning of the mini implant in order to distalize the molars in the mandible while avoiding the mandibular canal and the path of molar migration. Conclusions: The utilization of automated segmentation and visualization techniques in 3D rendering enhances safety measures during the simulation and insertion of orthodontic mini implants, increasing the insertion precision and providing an advantage in the identification of bicortical structures, increasing their stability. [ABSTRACT FROM AUTHOR]

Aim: The main aim of the study was to evaluate tooth position in plaster models of nonorthodontic subjects that have optimal occlusion, using the American Board of Orthodontics (ABO) criteria and comparing it to ABO standards. Methods: Forty nonorthodontic subjects with optimal occlusion were evaluated for teeth positioning with ABO measurement criteria, using the ABO gauge. These measurements were compared to the ABO standards. On the panoramic radiographs of these subjects, distances between the roots of teeth were measured using the digital ruler in Quick CephR. Lateral cephalograms were scanned and digitized into Quick CephR systems to evaluate the skeletal anteroposterior and vertical relationship. Means and standard deviations were calculated for all the variables and compared to ABO standards. Correlations were obtained between attrition and overjet. Correlations were also studied between anteroposterior skeletal relation, vertical skeletal relation, and teeth positioning. In subjects that had accurate age records, the relationship between age and change in buccolingual inclination was evaluated. Results: A significant difference in the mean values for inclination of maxillary and mandibular first bicuspids, second bicuspids, first molars, and second molars as compared to the board criteria was observed. Accuracy of panoramic radiograph to measure root proximity, especially in the cuspid region, is questionable. There was a positive correlation between overjet at the cuspid region and attrition. There was a minimal correlation between age and buccolingual inclination of teeth, indicating only a trend for mandibular second bicuspid to upright with age. Conclusion: The ABO criteria and standards used to evaluate finished orthodontic cases are consistent with naturally occurring optimal dentitions, except for buccolingual inclination of posterior teeth in both maxillary and mandibular arches. [ABSTRACT FROM AUTHOR]

To evaluate and compare the shear bond strength of composite resin restorations in primary teeth, following cavity preparation with both traditional dental burs and laser irradiation. One hundred primary molars extracted from the children visiting our department were collected and randomly divided into five groups (A-E) with 20 teeth in each group. In groups A, B, C, D, and E the teeth samples were etched with phosphoric acid, Er; YAG laser followed by acid etching, Er, Cr: YSGG laser followed by acid etching, Er; YAG laser etching only and Er, Cr: YSGG laser etching only, respectively. Following, all the samples were restored with composite resin and subjected to 500 cycles of thermocycling. The shear bond strength of the resin composite was analyzed. The type of fractures was also noted. Data obtained were subjected to statistical analysis. The mean value of shear bond strength of Group A, B, C, D, and E was 17.562 ± 0.810, 15.928 ± 0.415, 14.964 ± 0.566, 11.833 ± 0.533 and 11.187 ± 0.517, respectively. Adhesive failure was most commonly seen in all the groups. The phosphoric acid etching remains a highly effective technique for pre-treating dentin in composite resin restorations. The shear strength of composite resin to the dentin of laser-prepared cavity in primary teeth can be improved by the addition of acid etching. [ABSTRACT FROM AUTHOR]

Purpose: To comprehensively analyze the palatal thickness of soft tissues and determine optimal regions for the placement of palatal orthodontic miniscrews. Methods: Cone-beam computed tomography (CBCT) images on the coronal plane were obtained from 60 patients (30 female, 30 male; age range 19–45; mean age 32 ± 11), with 3-mm intervals in the regions of the canine (Ca), first premolar (Pr1), second premolar (Pr2), midpoint between the first and second molars (M1-M2), first molar (M1), second molar (M2) and midpalate. Results: The mucosal thickness measurements between the teeth showed significantly greater thickness in the Ca region at the 3 mm point, in the Pr1 region at the 6 mm point, and in the Pr2 region at the 9 and 12 mm points. At the 9 mm point, the Pr1 region demonstrated greater thickness than the M1-M2 whereas the Pr2 region was thicker than the M1 and M1-M2 regions. At the 12 and 15 mm points, the thickness increased from anterior to posterior: the Pr1 region was thinner than the Pr2, M1, and M2 regions and the Pr2 region was thinner than the M2 region. A schematization was devised for the optimal areas recommended for miniscrews in the palatal region. Conclusion: The mucosal thickness in the palatal region increases from anterior to posterior except the midpalatal region. Based on the results, in terms of soft tissue, the most suitable place for miniscrew placement is 6 mm from the gingival margin of the teeth and in the median portion of the palate. The findings may guide clinicians in choosing the optimal sites for palatal mini-implants. [ABSTRACT FROM AUTHOR]

Background: This investigation compared the extent of external apical root resorption (EARR) in root-filled teeth (RFT) and their contralateral vital pulp teeth (VPT) counterparts during orthodontic treatment (OT) with clear aligner (CA) treatment or fixed appliance (FA) treatment. Methods: Sixty-six patients with similar baseline American Board of Orthodontics (ABO) discrepancy index scores were divided into two groups: 37 patients (21 females, 16 males; mean age 17.45 ± 2.67 years) in the FA group, and 29 patients (18 females, 11 males; mean age 18.33 ± 1.96 years) in the CA group. Digital panoramic radiographs captured pre- and post-OT were used to measure tooth lengths and root surface measurements in mandibular molars. EARR in both RFT and contralateral VPT was evaluated pre- and post-OT. Statistical analysis employed paired t-tests, independent t-tests, and analysis of covariance (ANCOVA) (p <.05). Results: All teeth exhibited varying degrees of EARR following OT. FA treatment resulted in significantly longer treatment duration (p <.05) and greater EARR compared to CA treatment (p <.05). Moreover, statistically significant differences in EARR were observed within both groups between RFT and VPT (p <.05). Conclusions: Comparison of pre- and post-OT radiographs revealed different degrees of EARR in all teeth. CA treatment resulted in less frequent and less severe EARR compared to FA treatment. RFT demonstrated greater resistance to EARR than VPT in both treatment groups. [ABSTRACT FROM AUTHOR]

Background: To investigate the anatomic features of the root furcation of permanent mandibular first molars. Methods: A total of 50 extracted mandibular first molars (25 two-rooted and 25 three-rooted) were collected and scanned using micro-computed tomography. The digital models of teeth and root canal systems were reconstructed three-dimensionally. The tooth models were displayed in parallel projection mode from buccal and distal views. Screenshots were captured and subsequently analyzed using Image-Pro Plus 6.0 software after calibration. The furcation angle, root trunk length, maximum depth and level of distal root concaves of mesial roots, and length of enamel projections were measured, and the furcation types (classified into type V, type U and type W) were detected. Statistical analysis was performed using the Shapiro-Wilk's test, one-way analysis of variance, Student's t-test and Chi-square test. Results: The mean furcation angle between the distobuccal (DB) and distolingual (DL) roots (in distal view) was the greatest (59.2°), whereas the furcation angle between the mesial and DL roots (in buccal view) was the smallest (25.4°) among the four furcation angles (all p < 0.05). Regarding the furcation types, bucco-lingual root trunk length, maximum depth and site of the distal root concavities, and enamel projection length, no significant differences were detected between the three- and two-rooted molar groups (all p > 0.05). The frequency of type V was the highest (54.0%), followed by type U (26.0%), and type W had the lowest occurrence rate (20.0%). The mean length of distal root trunk in the three-rooted mandibular molars was significantly greater than that of the buccal/lingual one (3.7 mm vs. 3.0 mm, p < 0.01). The maximum depth of the distal concavities of the mesial roots was on average 0.66 ± 0.19 mm, and the site was located at an average of 2.8 ± 1.3 mm below furcation. The mean length of buccal enamel projections was significantly longer than that of lingual ones (3.1 mm vs. 0.7 mm, p < 0.01). Conclusions: The furcation anatomy of the mandibular first molar is complex, and the presence of the DL root may further complicate its topography. A thorough understanding of these anatomic features is essential for successful periodontal treatment. [ABSTRACT FROM AUTHOR]

Background: Dental caries is still a major disease that affect the oral health of people in China. First permanent molars (FPMs) are the most caries-susceptible teeth among school-aged children. The aim of this study was to investigate the eruption and caries status of first permanent molars in children aged 6–7 years in Shijingshan District, Beijing, China, to provide information for oral health promotion. Methods : The study was a cross-sectional survey conducted in 6-7-year-old first grade children from public elementary schools in Shijingshan District, Beijing. Participants were invited to receive a clinical oral examination. The eruption status and caries experience of FPMs were recorded. Questionnaires assessing children's sociodemographic information and oral health-related behaviors were completed by the children's parents or guardians. Results: A total of 3,176 children, including 1,644 boys (51.8%) and 1,532 girls (48.2%) were included in the oral examination and questionnaire. Eruption status of FPMs was as follows: 37.5% fully erupted, 28.3% partially erupted, 34.2% not erupted. Girls had more erupted FPMs than boys (70.1% VS 61.8%, P < 0.001). The prevalence of dental caries in FPMs was 5.5% (174/3,176) in studied children. The mean decayed missing filled teeth score of FPMs was 0.11 and the mean decayed missing filled surface score of FPMs was 0.19. Binary Logistic regression analysis demonstrated that girls had more tooth decay than boys and father's educational background also associated with the caries experience of the studied children (P < 0.05). Conclusions: Around two-thirds of FPMs were fully erupted or partially erupted among children aged 6–7 years old in Shijingshan District, Beijing. Approximately 5% of the newly erupted FPM established dental caries. Effective intervention should be applied in this age group for oral health promotion. [ABSTRACT FROM AUTHOR]

Background: Pulpotomy is a crucial method to preserve primary teeth until natural exfoliation. This study aimed to evaluate the clinical and radiographic outcomes of pulpotomy with iRoot BP Plus in primary molars and to explore the association between hemostasis time and these outcomes. Methods: Primary molars that underwent iRoot BP Plus pulpotomy and were followed for at least 12 months were selected for this study. Clinical and radiographic data were collected, and the success rate was analyzed in relation to factors such as hemostasis time, tooth type, and arch type. The tests of significance used were the chi-square test, Fisher's exact test, or Kruskal-Wallis test. Statistical significance was set at P < 0.05. Results: A total of 183 teeth in 106 patients were included in the analysis. The follow-up period fell into a range of 1–3 years, with a mean of 1.6 years. The clinical and radiographic success rates were 96.7% and 92.9%, respectively. The earliest time to observe the radiographic failures was half a year after the treatment, and the latest time was two years after the treatment. Among all the teeth, 130 were recorded with hemostasis time before the application of iRoot BP Plus. Compared to teeth with a hemostasis time of 5 min or less, teeth with a hemostasis time exceeding 5 min showed no significant differences in clinical and radiographic success (P = 1.000 and 0.879). Additionally, neither arch nor teeth type showed a relationship with the pulpotomy success rate (P > 0.05). Conclusions: Pulpotomy using iRoot BP Plus in primary molars achieved favorable results. The hemostasis time may not significantly impact the outcomes of pulpotomy using iRoot BP Plus in primary molars. [ABSTRACT FROM AUTHOR]

Background: The aim of this trial was to evaluate the effect of a preoperative, single dose sublingual fast-dissolving piroxicam (20 mg) compared to placebo on postoperative pain at rest (POP), on biting (POPB) and on percussion (POPer) after single-visit endodontic treatment of asymptomatic mandibular molars with non-vital pulp. Methods: Seventy patients randomly received either piroxicam or placebo 1 h before treatment (n = 35). Patients recorded their pain (POP and POPB) level 6 h, 12 h, 24 h, 48 h, 72 h and 7 days postoperatively using an 11-point numerical rating scale; POPer was assessed after 7 days. Resuce-analgesic intake (RAI) and flare-up incidence (FUI) were recorded. Data were statistically analyzed. Results: Both groups had similar baseline characteristics (P > 0.05). Piroxicam showed less POP intensity and incidence than placebo at 6, 12 and 24 h, less POPB intensity and incidence at all timepoints, less POPer intensity and incidence and less RAI (p > 0.05), but similar FUI (P > 0.05). A significant rise in pain compared to baseline occurred with placebo from 6 to 72 h for POP and to 7 days with POPB (p > 0.05); such rise was not detected with piroxicam. POPB showed higher pain intensity than POP at all time points (p < 0.05). No swelling or adverse effects occured. Conclusions: A preoperative single dose of sublingual fast-dissolving piroxicam can be effective in reducing spontaneous pain up to 24 h, stimulated pain up to 7 days, and RAI incidence in asymptomatic mandibular molars with non-vital pulp; it can prevent rise in POP and POPB postoperatively. Stimulated postoperative pain can be more severe and longer lasting than spontaneous pain. Trial registration: Clinicaltrials.gov ID: NCT03998826 (2019). [ABSTRACT FROM AUTHOR]

The use of artificial intelligence algorithms (AI) has gained importance for dental applications in recent years. Analyzing AI information from different sensor data such as images or panoramic radiographs (panoramic X-rays) can help to improve medical decisions and achieve early diagnosis of different dental pathologies. In particular, the use of deep learning (DL) techniques based on convolutional neural networks (CNNs) has obtained promising results in dental applications based on images, in which approaches based on classification, detection, and segmentation are being studied with growing interest. However, there are still several challenges to be tackled, such as the data quality and quantity, the variability among categories, and the analysis of the possible bias and variance associated with each dataset distribution. This study aims to compare the performance of three deep learning object detection models—Faster R-CNN, YOLO V2, and SSD—using different ResNet architectures (ResNet-18, ResNet-50, and ResNet-101) as feature extractors for detecting and classifying third molar angles in panoramic X-rays according to Winter's classification criterion. Each object detection architecture was trained, calibrated, validated, and tested with three different feature extraction CNNs which are ResNet-18, ResNet-50, and ResNet-101, which were the networks that best fit our dataset distribution. Based on such detection networks, we detect four different categories of angles in third molars using panoramic X-rays by using Winter's classification criterion. This criterion characterizes the third molar's position relative to the second molar's longitudinal axis. The detected categories for the third molars are distoangular, vertical, mesioangular, and horizontal. For training, we used a total of 644 panoramic X-rays. The results obtained in the testing dataset reached up to 99% mean average accuracy performance, demonstrating the YOLOV2 obtained higher effectiveness in solving the third molar angle detection problem. These results demonstrate that the use of CNNs for object detection in panoramic radiographs represents a promising solution in dental applications. [ABSTRACT FROM AUTHOR]

Minimally invasive access cavities have been proposed in the last decade to reduce tooth tissue loss during endodontic treatment and mitigate compromised fracture resistance of endodontically treated teeth. Fracture resistance of molars with different types of access cavity design may be affected by restorative materials and aging. Insufficient literature data exist on the effect of cavity design and type of restorative materials on restorative aspects such as material adaptation or photo-polymerization in restricted access cavities. This study analyses quality of polymerization, material adaptation and fracture resistance of molars with different types of access cavities restored with glass-ionomer, high-viscosity fiber-reinforced bulk-fill and nanofilled resin composite. Plastic molar teeth with truss (TREC) and traditional endodontic access cavity (TEC) were restored with nanofilled composite (Filtek Supreme), glass-ionomer Fuji IX and Filtek or fiber-reinforced everX Posterior and Filtek. Porosity was determined using microcomputer tomography and the degree of conversion of resin-based materals using micro-Raman spectroscopy. Human molars prepared and restored in the same way were used for fracture resistance testing at baseline and after thermocycling. The results demonstrate that high-viscosity fiber-reinforced composite was difficult to adapt in TREC cavity leading to greater porosity than Filtek or Fuji. TREC design did not affect composite polymerization and led to higher fracture resistance of restored molars compared to TEC but also more unrestorable fractures. [ABSTRACT FROM AUTHOR]

Background/Objectives: Many older adults living in long-term care (LTC) environments have varying numbers of retained natural teeth. The objective of this study was to assess the disease findings based on tooth type and estimate the role of tooth types in occlusion. Methods: We conducted clinical oral examinations of 276 LTC residents. The disease findings were analyzed for each tooth type and to determine their associations with dementia. Results: In total, 67.8% of the participants had molar teeth. Premolars/canines were often present as residual roots and had caries. Deepened periodontal pockets and higher plaque index (PI) values for molars had odds ratios of 2.5 (95% confidence interval [CI] of 1.59–3.91) and 1.61 (95% CI of 1.29–2.02), respectively. Participants with dementia were more likely to have incisors and premolars/canines in the form of root remnants and higher PI scores for all tooth types (p ≤ 0.01), as well as more deepened periodontal pockets in all teeth (p = 0.029), than those without dementia. The median number of remaining molars per participant was 3 out of a maximum of 12 (95% CI 3.4–4.0); thus, they often lacked occlusal contact. Conclusions: The LTC residents' molars were more prone to periodontal problems, whereas their premolars/canines often had caries or were present in the form of root remnants, especially in the participants with dementia. People's teeth should be treated in an easy-to-maintain way before they move into LTC to enable daily oral hygiene measures and maintain oral health. [ABSTRACT FROM AUTHOR]

Background: The molecular mechanisms and signaling pathways involved in tooth morphogenesis have been the research focus in the fields of tooth and bone development. However, the cell population in molars at the late bell stage and the mechanisms of hard tissue formation and mineralization remain limited knowledge. Results: Here, we used the rat mandibular first and second molars as models to perform single-cell RNA sequencing (scRNA-seq) analysis to investigate cell identity and driver genes related to dental mesenchymal cell differentiation during the late bell hard tissue formation stage. We identified seven main cell types and investigated the heterogeneity of mesenchymal cells. Subsequently, we identified novel cell marker genes, including Pclo in dental follicle cells, Wnt10a in pre-odontoblasts, Fst and Igfbp2 in periodontal ligament cells, and validated the expression of Igfbp3 in the apical pulp. The dynamic model revealed three differentiation trajectories within mesenchymal cells, originating from two types of dental follicle cells and apical pulp cells. Apical pulp cell differentiation is associated with the genes Ptn and Satb2, while dental follicle cell differentiation is associated with the genes Tnc, Vim, Slc26a7, and Fgfr1. Cluster-specific regulons were analyzed by pySCENIC. In addition, the odontogenic function of driver gene TNC was verified in the odontoblastic differentiation of human dental pulp stem cells. The expression of osteoclast differentiation factors was found to be increased in macrophages of the mandibular first molar. Conclusions: Our results revealed the cell heterogeneity of molars in the late bell stage and identified driver genes associated with dental mesenchymal cell differentiation. These findings provide potential targets for diagnosing dental hard tissue diseases and tooth regeneration. [ABSTRACT FROM AUTHOR]

Background-objective(s): This randomized, split-mouth study aimed to compare postoperative complications following the surgical extraction of impacted lower third molars using piezosurgery versus conventional rotary instruments. Materials and methods: Twenty-one patients, aged 18–35 years, with bilaterally and symmetrically impacted lower third molars, were randomly assigned to undergo extraction using piezosurgery on one side and conventional rotary instruments on the other. Results: The piezosurgery method required a longer operation time. However, it resulted in quicker resolution of postoperative swelling by the 7th day compared to the conventional method, where swelling persisted longer. Mandibular angle-tragus measurements were significantly higher with the conventional method on the 1st, 3rd, and 7th postoperative days. Although mouth opening decreased significantly after piezosurgery, it returned to preoperative levels by the 7th day, outperforming the conventional method. Postoperative pain was notably higher with the conventional method during the first four days but showed no significant difference from the 5th day onward. Alveolar bone healing was significantly better with piezosurgery at the 3rd and 6th months. Temporary paresthesia occurred in one patient from the conventional group, resolving within four weeks. Neither method resulted in alveolar osteitis. Conclusion(s): Within the study's limitations, piezosurgery demonstrated a reduction in postoperative discomfort, suggesting its advantage in enhancing patient recovery following lower third molar extractions. Clinical significance: Piezosurgery, when used appropriately, can reduce postoperative complications compared to conventional methods. Clinicians should be aware of its indications, benefits, and potential challenges. Trial registration This study was registered as a clinical trial to the ClinicalTrials.gov, and the registration ID is NCT06262841 (https://clinicaltrials.gov/study/NCT06262841). [ABSTRACT FROM AUTHOR]

Aim: To investigate the root number and morphology of the maxillary second molars in the Syrian population besides bilateral symmetry, and the effect of gender. Methods: 250 Cone Beam Computed Tomography (CBCT) images (140 females, 110 males) were examined by two endodontists. The detailed analysis included the number of roots, the number of canals and their configurations, bilateral symmetry, and relation to gender. The evaluation was made according to Vertucci classification by analyzing the CBCT images at all levels (Axial, Coronal, Sagittal, Oblique, and 3D). The Chi-square statistical analysis was performed to compare the canals' morphologies and bilateral symmetry in both genders via SPSS. Result: The most common shape of the upper second molars is three roots (90.4%). There were significant differences between males and females regarding the symmetry of the number of roots (P < 0.05). The root canal configuration was mainly Vertucci type I classification in the Distobuccally (93.4%) and palatal root (99.6%). The most common type in the mesial root was type I (29.5%), showing all varieties of Vertucci classifications (except VII, and VIII) percentage of MB2 of 70.5%. The ratio of symmetry was (59.6%) with no significant statistical difference between the genders (P = 0.708). Conclusion: Most maxillary second molars in the examined Syrian population were types (II) (associated with MB2 cases with three roots and four canals). In terms of symmetry, the number of roots surpassed the canal configuration. Males had a greater symmetrical tendency in the number of roots than females. [ABSTRACT FROM AUTHOR]

Counting growth layers in dentine and/or secondary cementum is widely used for age determination in wild mammals but the underlying seasonal changes in the structure and degree of mineralisation of dental tissue have not been well characterised. We embedded first (m1) and second (m2) mandibular permanent molar teeth from a 12‐year‐old female Svalbard reindeer (Rangifer tarandus platyrhynchus) in PolyMethylMethAcrylate (PMMA), prepared cut and polished surfaces coated with evaporated carbon and used 20 kV back‐scattered electron imaging in a scanning electron microscope (BSE‐SEM) to study aspects of dental tissue structure which depend on the degree of mineralisation at the micron and sub‐micron scale. BSE‐SEM revealed differences between the mineral content of growth layers (annulations) in the secondary cementum and the primary and secondary dentine, the latter, incidentally, still forming at death in m1. Wide bands of less well mineralised tissue formed in the cementum during active appositional phases. Thin, denser bands formed by maturation‐mineralisation of existing tissue when growth slowed in winter. This maturation mimics the processes seen in lamellar bone and articular cartilage. Counter to previous suggestions, there was evidence of substantial resorption and repair of the secondary cementum and of formation of dentine throughout life. Secondary dentine is layered by mineral content like cementum. In the crown, this was mainly tubular dentine with well‐marked interglobular dentine layers. In the lower pulp chamber and root, it was largely without tubules. Substantial non‐mineralised spaces found at the cement‐dentine junction in the root apical regions in m2 represent inclusions of the Hertwig's Epithelial Root Sheath (HERS) or the Epithelial Rests of Malassez (ERM) between the two tissues, a phenomenon which has previously only been identified in Muridae. The anatomical changes which result in the formation of the incremental lines (annulations) in dental tissues of reindeer, identified here for the first time at the micrometre level, are likely to be common across most if not all long‐lived species of mammals living in seasonal environments. [ABSTRACT FROM AUTHOR]

Purpose: Children's fear of the injection of local anesthetic agents affects their cooperation in pediatric dentistry. Different techniques are available to decrease the injection pain, including the use of precooling agents or vibrators. The present study investigated the effectiveness of Buzzy (Buzzy MMJ Labs, Atlanta, GA, USA). This device transfers cold and external vibration to the injection site during the inferior alveolar nerve block (IANB) injection. Materials and Methods: The present self‐control, randomized, and double‐blind clinical trial evaluated 30 children aged 6–12, who had bilateral mandibular permanent or primary carious molar teeth. On one side, the BUZZY was applied before and during the IANB injection, and the other side was considered as control. On both sides, a topical anesthetic gel was applied before injection. The pain severity and children's anxiety were determined using Wong–Baker, face, leg, activity, cry, consolability (FLACC) scales, and the heart rate. Results: The mean age of the participants was 7.18 ± 1.5 years, with 12 girls and 18 boys. The Wong–Baker scale and FLACC scale did not show any statistically significant difference between BUZZY and control (p value = 0.9 and 0.15, respectively). In addition, BUZZY tool did not significantly decrease pain and anxiety during injection, assessed through the heart rate difference (p = 0.38). Conclusion: Under the limitations of the present study, a combination of precooling and vibration using the BUZZY device did not decrease pain and anxiety in children during the IANB injection. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Key Points Plain Language Summary This study evaluates the long‐term stability and clinical outcomes of the reverse palatal pedicle graft (RPPG) technique in treating maxillary molar palatal recessions over a 3 to 4‐year follow‐up period.Three patients with palatal recession defects on maxillary molars were treated using the RPPG technique. Clinical parameters including recession depth, probing depth, and clinical attachment levels (CALs) were recorded at baseline, 2 months, and 3–4 years postoperatively. Healing outcomes, tissue perfusion, and soft tissue thickness were assessed through clinical examination, cone beam computed tomography (CBCT), and ultrasonography.All patients demonstrated significant CAL gain and partial root coverage. The RPPG technique resulted in significant improvements in attachment gain (41%–67%) and root coverage (44%–83%). In addition, a CBCT scan of one grafted site at a 4‐year follow‐up (Case 1) demonstrates a gain in soft tissue thickness and partial root coverage. Ultrasound imaging of another grafted site at a 4‐year follow‐up (Case 2) demonstrates a gain in soft tissue thickness and adequate graft perfusion. The outcomes suggest stable graft sites with some evidence of creeping attachment.The RPPG technique provides a viable option for treating maxillary molar palatal recessions, demonstrating promising long‐term stability and clinical improvements. Further studies with larger sample sizes and frequent follow‐ups are needed to better understand the dynamics of creeping attachment and refine clinical guidelines for palatal grafting. The reverse palatal pedicle graft (RPPG) is a surgical technique providing a viable solution for the treatment of maxillary molar palatal root coverage for a single recession site with 3–4 years of follow‐up demonstrating a degree of predictability. Clinical indications for the application of the RPPG technique include severe palatal recession with little to no interproximal attachment loss (RT1 or RT2), palatal root sensitivity, and a sufficient amount of keratinized tissue on the palatal aspect of adjacent teeth. The main limitations of the application of the RPPG technique include its ability to treat only one isolated recession site, the inability for coronal advancement of the flap, and the quality and thickness of the autogenous graft being patient‐dependent. The reverse palatal pedicle graft (RPPG) is a surgical technique providing a viable solution for the treatment of maxillary molar palatal root coverage for a single recession site with 3–4 years of follow‐up demonstrating a degree of predictability.Clinical indications for the application of the RPPG technique include severe palatal recession with little to no interproximal attachment loss (RT1 or RT2), palatal root sensitivity, and a sufficient amount of keratinized tissue on the palatal aspect of adjacent teeth.The main limitations of the application of the RPPG technique include its ability to treat only one isolated recession site, the inability for coronal advancement of the flap, and the quality and thickness of the autogenous graft being patient‐dependent.This study explores the reverse palatal pedicle graft (RPPG) technique, a method used to treat gum recession in the palate around the upper posterior teeth. The research followed three patients over a period of 3–4 years after they underwent the RPPG procedure. This technique involves using a piece of tissue from the roof of the mouth and repositioning it to cover the receded gum area. All patients showed significant improvement in gum attachment and coverage of the exposed roots. The grafts remained stable, and there was continued growth of the gum tissue, further covering the exposed roots over time. These promising results suggest that RPPG could be a reliable and effective option for treating severe gum recession on the roof of the mouth. However, further studies with larger patient groups are needed to confirm these findings and refine the technique. [ABSTRACT FROM AUTHOR]

Background: The aim of this case report was to present a translational approach to tooth autotransplantation using jiggling forces to enlarge the periodontal ligament (PDL) space before autotransplantation, with the goal of improving treatment success and long‐term survival. Methods: A 23‐year‐old patient, undergoing orthodontic therapy and with an unrestorable maxillary first molar, was proposed to have a healthy and fully‐erupted maxillary third molar transplanted in the socket of the first molar. Jiggling forces were applied to the third molar to enlarge the PDL space and facilitate the preservation of PDL fibers on the root surfaces during the extraction. Results: Jiggling forces induced hypermobility and widened PDL space of the third molar. The autotransplantation was successful and the patient was followed regularly over a 27‐year period. At the 27‐year visit, the patient showed optimal chewing function, oral plaque control, and absence of gingivitis. The transplanted molar exhibited periodontal health and absence of mobility. Probing depth of 5 mm and radiographic external root resorption was noted on a localized area of the transplanted tooth which had experienced traumatic and unintentional removal of PDL fibers during the extraction. Conclusions: A translational approach was proposed by integrating knowledge from the fields of orthodontics, trauma from occlusion, and replantation. It validated the crucial importance of maintaining healthy PDL fibers on the root surface and demonstrated clinically the successful autotransplantation of a fully formed third molar into the socket of a first molar with a retention of 27 years. Key points: Why is this case new information?This case provided evidence of successful autotransplantation of a molar with complete root formation. It reported the longest‐term follow‐up (27 years) present in the literature. Most importantly, it used a translational medicine approach to apply concepts from the fields of orthodontics and traumatic occlusion to improve the success of the autotransplantation procedure. What are the keys to the successful management of this case?Jiggling forces induced tooth hypermobility and increased the PDL space of the tooth planned for autotransplantation. In turn, they facilitated the atraumatic extraction and preservation of the PDL fibers on the transplanted tooth, improving the success of the reattachment of periodontal fibers. What are the primary limitations to success in this case?Traumatic extraction resulting in the unintended removal of PDL fibers from the tooth planned for autotransplantation, or intentional removal of PDL fibers with root planing are expected to decrease the success rate of the autotransplantation procedure. This is due to the lack of viable PDL cells necessary for reattachment. [ABSTRACT FROM AUTHOR]

Objective: To compare the pain response and efficacy of caries removal using tungsten carbide burs with that of using Brix Gel as a chemomechanical caries removal agent. Study Design: Randomized Controlled Trial. Setting: Department of Operative Dentistry, PIMS, Islamabad. Period: November 2023 to April 2024. Methods: Conducted on 40 participants were selected using a non-probability technique. Participants aged 12 to 65 years with open occlusal carious lesions involving dentin were included. Patients with symptoms of pulpitis, caries affecting maxillary or mandibular anterior teeth, severe systemic illnesses, allergies, sensitivities, or pregnancy/lactation were excluded. Caries removal methods were randomly assigned. Pain levels were assessed using a Visual Analog Scale (VAS), and caries removal efficacy was evaluated. Statistical analysis was done using chi-square and independent samples t test. Results: Among the 40 participants, 47.50% were female, and the mean age was 36.30±15.57 years. Mandibular molars were the most commonly affected teeth (n=24, 60%). No significant difference in age or gender distribution was observed between the two groups. The chemomechanical method resulted in significantly lower pain scores compared to carbide bur (2.59 ± 1.34 vs. 4.44 ± 1.61, p < 0.001). Pain severity also differed significantly between groups, with more mild pain reported in the chemomechanical group (80.00% vs. 5.00%, p < 0.001). However, caries removal efficacy did not significantly differ between the two methods (p = 0.48). Conclusion: Chemomechanical caries removal using Brix Gel demonstrated superior pain management compared to carbide bur. While both methods showed similar efficacy in caries removal, the chemomechanical approach may offer better patient comfort during the procedure. [ABSTRACT FROM AUTHOR]

Background: Determining the correct apical limit for root canal treatment is essential for its success. This study evaluates the accuracy of three electronic apex locators (EALs) in locating the apical constriction (AC) in molar canals. Methods: Forty extracted human mandibular molars were scanned using micro-CT, and endodontic access cavities were created. Teeth were mounted in alginate, and three EALs—Root ZX-mini, Root ZX-II, and Sirona integrated apex locator—were used to measure the canal working length in dry canals and with EDTA gel. Micro-CT scans were performed with files in place, and the distance from the AC was calculated. Measurements within 0.1–0.5 mm were categorized as 'close'. Those extending beyond towards the major foramen were categorized as 'beyond', otherwise they were classified as 'far'. Data analysis was conducted with a level of significance set at 5%. Results: Most readings for all EALs were in the 'close' category, with significant differences between devices (p < 0.0001). Root ZX-mini and Root ZX-II had 74.4% and 72.5% 'close' readings, respectively, versus 51% for Sirona integrated. Accuracy did not differ significantly between dry and EDTA-treated canals (p = 0.306). All EALs demonstrated excellent operator reliability (ICC 0.996–1.00). Conclusions: All EALs accurately determined AC, unaffected by lubricants. However, Root ZX-mini and Root ZX-II outperformed Sirona integrated. All EALs showed consistent reliability. [ABSTRACT FROM AUTHOR]

Objectives: To explore the effect of protein arginine methyltransferase 5 (PRMT5) on tooth extraction sockets healing, we established an extraction sockets model in osteoblast‐conditional Prmt5 knockout mice. The results provided clues for promoting extraction sockets healing in clinical settings. Materials and Methods: Maxillary first molars were extracted from 6 to 8‐week‐old mice to establish an extraction fossa model. Microcomputed tomography (Micro‐CT), histology, and immunostaining assays were performed on samples harvested at 3‐, 7‐, and 14‐day post‐extraction. Prmt5‐silenced cell lines were employed to explore the regulatory mechanisms underlying the osteigenic differentiation. Results: PRMT5 expression was higher in the early stage of socket healing. Micro‐CT analysis showed that the percentage of new bone in the extraction sockets was lower in OC‐Cre; Prmt5fl/fl mice than in the control group, consistent with Masson staining. We found that, Prmt5 deficiency delayed the osteogenesis during extraction socket healing, which might be achieved through the decrease of H4R3me2s in the Sp7 promoter region. Conclusion: PRMT5 in osteoblasts may promote the differentiation of osteoblasts by regulating the Sp7 promoter H4R3me2s and participate in the healing of tooth extraction sockets. [ABSTRACT FROM AUTHOR]

Aim: To describe the management of the palato‐mesiobuccal (PMB) canal in maxillary second molars with fused roots using conventional techniques. Summary: Root canal treatment success hinges upon effectively addressing the intricate and variable anatomy of molar teeth. Failure to do so can lead to persistent infections and treatment failure. Recent advancements in imaging technologies have provided unparalleled insights into dental anatomy, especially in molars. Among these discoveries is the PMB canal, a unique anatomical variant recently reported for the first time in Endodontic literature. This canal, found in maxillary second molars with fused roots and originating from the coronal third of the palatal canal while traversing towards the mesiobuccal root presents challenges in clinical management due to its location. This article is the first to showcase the management of the PMB canal using conventional techniques. In the first case, a 38‐year‐old male patient presented with asymptomatic irreversible pulpitis in the maxillary second right molar. Following thorough instrumentation and irrigation, the presence of the PMB canal was discovered during root canal preparation. The canal was managed using rotary instruments and obturated successfully, resulting in a symptom‐free tooth at an 8‐year follow‐up. The second case illustrates a similar scenario in a 23‐year‐old female patient presenting with symptomatic irreversible pulpitis in tooth 17. The PMB canal was identified during treatment and managed using rotary nickel‐titanium instruments, leading to a favourable outcome at a 9‐year follow‐up. Key learning points: In fused roots of maxillary second molars, a PMB canal might be expected.Exploration of the buccal wall of the palatal canal under magnification after shaping procedures can reveal the PMB canal orifice in fused roots.Small tapers are suggested for the enlargement of the PMB canal.Continuous bleeding spots in the palatal canal might indicate a possible PMB canal orifice in vital cases.The use of an apex locator is suggested for the differential diagnosis of the PMB canal orifice from a perforation site. [ABSTRACT FROM AUTHOR]

Objectives: Grotta‐Riparo di Uluzzo C (Apulia, southern Italy) is a pivotal site for investigating the evolution of the Middle Paleolithic and the earliest phases of the Upper Paleolithic in southern Italy, as the extensive stratigraphic record of this site includes a thick Mousterian sequence followed by the Uluzzian. Here, we investigate the taxonomic affinity of seven unpublished deciduous human teeth retrieved from the site of Uluzzo C in 1960. Materials and Methods: The teeth are represented by seven plaster dental casts, which are housed at the Museo Civico di Paleontologia e Paletnologia in Maglie (Lecce, Apulia). The location of the original specimens remains unknown, rendering these casts the only human remains evidence yielded by Uluzzo C to date. Based on occlusal‐view photographs and digital models of the casts, we examined the external morphology and morphometry of the teeth, comparing them to Homo sapiens and H. neanderthalensis samples. Through geometric morphometric methods and statistical analyses, we analyzed the crown outline of the deciduous molars. Results: The teeth show morphological and morphometric features that are variably found in H. neanderthalensis, H. sapiens, or both. Specifically, crown outline analysis shows that all molars fall within H. neanderthalensis variability, except for Uluzzo 853 (lower right deciduous first molar), which falls within H. sapiens variability. Discussion: This study provides the first taxonomic assessment of the hominin teeth from Uluzzo C. The results contribute additional insights into the Paleolithic peopling of southern Italy during a crucial period marked by the persistence of post‐Tyrrhenian Neanderthal techno‐complexes and the arrival of H. sapiens. [ABSTRACT FROM AUTHOR]

Objectives: This study tests whether (1) premolar topography of extant "prosimians" (strepsirrhines and tarsiers) successfully predicts diet and (2) whether the combination of molar and premolar topography yields higher classification accuracy than using either tooth position in isolation. Materials and Methods: Dental topographic metrics (ariaDNE, relief index, and orientation patch count rotated) were calculated for 118 individual matched‐pairs of mandibular fourth premolars (P4) and second molars (M2). The sample represents 7 families and 22 genera. Tooth variables were analyzed in isolation (P4 only; M2 only), together (P4 and M2), and combined (PC1 scores of bivariate principal component analyses of P4 and M2 for each metric). Discriminant function analyses were conducted with and without a measure of size (two‐dimensional surface area). Results: When using topography only, "prosimian" P4 shape predicts diet with a success rate that is slightly higher than that of M2 shape. When absolute size is included, premolars and molars perform comparably well. Including both premolar and molar topography (separately or combined) improves classification accuracy for every analysis beyond considering either in isolation. Classification accuracy is highest when premolar and molar topography and size are included. Discussion: Our findings indicate that molar teeth incompletely summarize the functional requirements of oral food breakdown for a given diet, and that the mechanism selecting for premolar form is more varied than what is expressed by molar teeth. Finally, our findings suggest that fossil P4s (in isolation or with the M2) can be used for meaningful dietary reconstruction of extinct primates. Research Highlights: "Prosimian" premolar shape predicts diet with similar accuracy to molarsCombining premolar and molar variables improves dietary classificationPremolar shape reflects functional demands that may contrast with those on molars shape [ABSTRACT FROM AUTHOR]

This article explores the challenges of diagnosing rickets and scurvy in human skeletal remains. The authors suggest a temporary pause on using microscopic mineralization defects to diagnose rickets, as more data is needed for certainty. They propose using terms like "highly consistent/typical" and "consistent with" instead. The article also discusses the potential use of machine learning and artificial intelligence in evaluating mineralization defects in bones and teeth. It emphasizes the prevalence of rickets and vitamin D deficiency globally and highlights the need for further research and collaboration between paleopathologists and clinicians. The article concludes by emphasizing the importance of interdisciplinary research in addressing global health issues. [Extracted from the article]

Objectives: Maintaining effective and efficient occlusal morphology presents adaptive challenges for mammals, particularly because mastication produces interactions with foods and other materials that alters the geometry of occlusal surfaces through macrowear and/or catastrophic failure (i.e. "chipping"). Altered occlusal morphologies are often less effective for masticating materials of given diet—but not always—some species exhibit dental sculpting, meaning their dentitions are set up to harness macrowear to hone their occlusal surfaces into more effective morphologies (i.e. secondary morphologies). Here we show that dental sculpting is present in the folivorous Presbytis rubicunda of Borneo. Methods: Thirty‐one undamaged lower second molars of P. rubicunda exhibiting various stages of macroscopic wear were micro‐CT scanned and processed into digital surfaces. The surfaces were measured for convex Dirichlet normal energy (vDNE, a measure of surface sharpness), and degree of surface wear. Regression analyses compared surface sharpness with several measures of wear to test for the presence and magnitude of dental sculpting. Results: Positive correlations between the wear proxies and vDNE reveal that P. rubicunda wear in such a way as to become sharper, and therefore more effective chewing surfaces by exposing enamel‐dentine junctions on their occlusal surfaces and then honing these junctions into sharpened edges. Compared to another primate folivore in which increasing surface sharpness with macrowear has been demonstrated (i.e., Alouatta palliata), the worn surfaces are similarly sharp, but the dental sculpting process appears to be different. Discussion: The results presented here suggest that not only do some primates exhibit dental sculpting and the attendant secondary morphology, but that there appear to be multiple different morphological configurations that can achieve this result. P. rubicunda has thicker enamel and a more stereotyped wear pattern than A. palliata, although both show positive correlations of occlusal surface sharpness (vDNE) with various wear proxies. These findings shed light on the varied approaches for the maintenance of effective and efficient occlusal surfaces in primates. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the stress induced by clamps made of different materials on mandibular first molar teeth using finite element analysis. The tooth model to be used in the study was created using micro-CT scanner and the rubber dam clamp model was created in three dimensions (3D) using Solidworks and applied to a finite element tooth model of an intact mandibular first molar. The size of the clamp opening and the force to be applied were calculated according to the buccolingual distances of the tooth. The contact areas of the clamps on the tooth were determined and subjected to force. The stress distribution patterns and maximum von Mises stresses were calculated and compared against these forces. The most stress against these forces occurred in the enamel tissue on the distal side where the clamp was in contact with the tooth. The stress value in the stainless steel clamp (191.63 MPa) was approximately 85% higher than the clamp made of polyethylene ketone (103.85 MPa). The stress in the dentin and pulp tissue of the tooth was negligible. Clinicians should examine the enamel tissue below the equatorial line of the tooth in detail before clamp application. The forces exerted by stainless steel clamps can cause damage to the enamel tissue of the tooth or progression of an existing enamel crack. [ABSTRACT FROM AUTHOR]

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Data on the age of apical closure in felines is limited. Moreover, differences in age of apical closure between male and female cats have not been studied. The aim of this study was to determine the timing of apical closure in cats and determine if sex or position in the dental arch affected closure. In this retrospective descriptive study, intraoral radiographs were obtained at monthly or multiple-monthly intervals for 18 cats. Nine were intact females and 9 were neutered males, ranging from 6 to 9.4 months of age at the start of the study which ranged over an 8-month period. Radiographs were evaluated to establish age of apical closure for all canine teeth as well as the mandibular premolar and molar teeth. Mandibular canine tooth apices closed between 10 and 12 months of age and maxillary canine tooth apices closed between 12 and 14 months of age. The mesial and distal root apices of both the mandibular third and fourth premolar teeth closed between 8 and 9 months. The mandibular first molar tooth mesial and distal root apices closed between 8 and 8.5 months. Root apices of canine teeth closed earlier in female cats than in male cats with mandibular canine tooth root apices closing significantly earlier than maxillary canine tooth roots in both sexes. These findings suggest that there are notable differences in age of apical closure between male and female cats and discernible trends in timing of apical closure among teeth in the dental arcade. [ABSTRACT FROM AUTHOR]

Objective: To evaluate tooth displacement and periodontal stress generated by the dual action vertical intra-arch technique (DAVIT) for open-bite correction using three-dimensional finite element analysis. Methods: A three-dimensional model of the maxilla was created by modeling the cortical bone, cancellous bone, periodontal ligament, and teeth from the second molar to the central incisor of a hemiarch. All orthodontic devices were designed using specific software to reproduce their morpho-dimensional characteristics, and their physical properties were determined using Young's modulus and Poisson's coefficient of each material. A linear static simulation was performed to analyze the tooth displacements (mm) and maximum stresses (Mpa) induced in the periodontal ligament by the posterior intrusion and anterior extrusion forces generated by the DAVIT. Results: The first and second molars showed the greatest intrusion, whereas the canines and lateral incisors showed the greatest extrusion displacement. A neutral zone of displacement corresponding to the fulcrum of occlusal plane rotation was observed in the premolar region. Buccal tipping of the molars and lingual tipping of the anterior teeth occurred with intrusion and extrusion, respectively. Posterior intrusion generated compressive stress at the apex of the buccal roots and furcation of the molars, while anterior extrusion generated tensile stress at the apex and apical third of the palatal root surface of the incisors and canines. Conclusions: DAVIT mechanics produced a set of beneficial effects for open-bite correction, including molar intrusion, extrusion and palatal tipping of the anterior teeth, and occlusal plane rotation with posterior teeth uprighting. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the dynamic cyclic fatigue resistance of Reciproc Blue files subjected to brushing motion. Twenty Reciproc Blue files (R25, VDW, Munich, Germany) were employed for chemical-mechanical preparation in root canals of 3D printed replicas of mandibular molars. The instruments were divided into two groups (n = 10): Group brushing motion, instrumentation with brushing motions; Group without brushing motion , instrumentation without brushing motions. Subsequently, the same instruments underwent cyclic fatigue testing using artificial canals consisting of a stainless-steel plate and an apical segment with a 45° curvature. Data regarding the time to fracture, number of cycles to fracture, and length of the fractured fragment were collected and subjected to statistical analysis using the t-test or Mann-Whitney test, with a significance level of 5%. Additionally, the fractured fragments were examined under a scanning electron microscope. No statistical differences were observed between the groups in terms of time to fracture (P <.05), number of cycles to fracture (P <.05) and length of the fractured fragment (P <.05). The brushing motion did not affect the dynamic cyclic fatigue resistance of Reciproc Blue files. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes. Researchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%. The prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P <.05) and higher percentages of four-rooted configurations (P >.05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P >.05). The proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate changes in geometry following root canal preparation using R-Motion instruments with different apical sizes and tapers. Fifty-four mesial canals of mandibular molars with single curvature of angles ranging between 20° and 30° were stratified into 3 groups according to their internal anatomy (R-Motion 25/.06, 30/.04, Reciproc Blue) (n = 18 per group). Micro-computed tomography was used to standardize the samples before instrumentation and, after instrumentation, to assess canal transportation, changes in canal volume and centering ability. Canals were irrigated with 17% EDTA and sodium hypochlorite, and the final rinse included subsonic agitation of these solutions. Measurements were analyzed automatically using the Dragonfly software (Come, Montreal, Canada) and were confirmed by a technician and an endodontist, based on a previously validated methodology. The results were analyzed using the Kruskal-Wallis's and Mann-Whitney's tests. The level of statistical significance was set at 5%. Significant differences were found in the coronal third for canal transportation, with Reciproc Blue R25 having greater values compared with both R-Motion instruments (P <.05) and greater changes in volume when compared with R-Motion 30/.04 (P <.05). R-Motion of apical size and taper 25/.06 and 30/.04 were associated with similar changes in geometry following root canal preparation in curved mesial canals of mandibular molars, whereas Reciproc Blue was associated with greater canal transportation in the coronal root third. [ABSTRACT FROM AUTHOR]

Curved mesial roots can be challenging for different stages of endodontic treatment. Preparation aims to enlarge, clean, and shape the root canal system, and hundreds of systems are available to carry it out. Aiming to maintain pericervical dentin, minimally invasive preparation was proposed, and with it, instruments with lower tapers emerged. This study aimed to evaluate the increase in canal volume, the centering ability of the instruments, and root canal transportation of two different rotary systems with lower tapers. Eighteen curved mesial roots of extracted mandibular molars were scanned by micro-CT at 3 moments: initial and after the 2 stages of endodontic preparation. The canals were prepared using TruNatomy (TN) and ProDesign Logic 2 (PDL2) instruments up to sizes 25.04 and 26.04, respectively, and after 36.03 and 35.05, respectively. The data were analyzed using parametric and nonparametric tests with a significance level of 5%. TN and PDL2 systems showed no difference regarding the increase in the volume of the canals with the first instruments, but after preparation with a diameter size of 35 or 36, there was a difference (P <.01) between the systems in the cervical and middle thirds. Both systems shaped the mesial canals of mandibular molars while keeping low transportation and good centering ability in enlargements up to diameter size 35 or 36 with tapers of 3 or 5%. [ABSTRACT FROM AUTHOR]

The presence of facial jewelry and medical devices within a radiographic field of view may promote the formation of artifacts that challenge diagnostic interpretation. The objective of this article is to describe a previously unreported radiographic anomaly produced by an oral piercing site below the lower lip. This unusual artifact masqueraded as a severe resorptive defect, dental caries, or cervical abfraction and occurred following removal of an extremely large labret below the lower lip and subsequent acquisition of a radiographic image. The radiolucency was ultimately attributed to an extensive aperture below the lower lip created by a series of sequentially larger soft tissue expanders. Clinicians should seek correlation of atypical radiographic presentations with soft tissue defects secondary to injury or intentional oral piercing. [ABSTRACT FROM AUTHOR]

This case report describes the use of the modified laterally positioned flap (LPF) technique associated with a subepithelial connective tissue graft (SCTG) for root coverage of homologous mandibular molars with deep gingival recession (GR). A 25-year-old woman with deep GR affecting the mandibular right and left second molars (teeth 31 and 18, respectively) reported bilateral dentinal hypersensitivity. The defect in tooth 31 was 5 mm deep and 4 mm wide. In tooth 18, the defect was 6 mm deep and 5 mm wide. There was 1 mm of keratinized tissue at tooth 31, and no keratinized tissue was present at tooth 18. The modified LPF-SCTG technique with mesial to distal positioning of the flap was selected to treat the defects. The flap was modified by a submarginal incision in the tooth farthest from the GR to preserve the integrity of the donor site. One year postsurgery, tooth 31 had 80.0% coverage, a 66.6% gain in clinical attachment, and a 5-mm increase in keratinized tissue width. Tooth 18 had 83.3% root coverage, a 71.4% gain in clinical attachment, and a 5-mm increase in keratinized tissue width. The patient's complaints of hypersensitivity were resolved, and the tissue gain provided better access and more comfort during cleaning of the teeth. The flap donor sites demonstrated no clinical signs of GR. Based on the 1-year follow-up assessments, the modified LPF-SCTG technique was effective for the treatment of deep single-tooth GR in mandibular molars without causing adverse affects on the flap donor sites. [ABSTRACT FROM AUTHOR]

Purpose: The primary aim of this study was twofold: first, to assess the prevalence of molar incisor hypomineralization (MIH) within a cohort of Egyptian children and, second, to investigate the potential correlation between MIH and various factors, including age, sex, birth complications, and endogamous marriage. Materials and Methods: This cross-sectional investigation took place in Egypt's Delta region, with approximately 3000 children aged between eight and twelve years being recruited for participation. The European Academy of Pediatric Dentistry (EAPD; 2003) criteria served as the diagnostic tool for identifying MIH cases. Upon detection of clinical signs or symptoms indicative of MIH, parents were queried regarding any potential birth complications or endogamous marriages. Lesion severity levels were diagnosed using Mathu-Muju and Wright criteria. Results: The prevalence rate for MIH was found to be 7.2%. Molars exhibited higher susceptibility rates than incisors (64.8% vs 35.2%), with approximately 37% of participants displaying severe scores, followed by mild (33.8%) and moderate (29.2%). Male subjects had significantly more occurrences than females, with positive correlations identified between MIH incidence rates alongside each gender category as well as both birth complications and endogamous marriages. Conclusion: Children born from complicated pregnancies or whose parents are related should receive frequent check-ups from pediatric dentists during their first permanent molar eruption period. so that early detection of MIH can be facilitated allowing timely intervention. [ABSTRACT FROM AUTHOR]

Background: Local anesthesia (LA) during routine dental treatment in children fails in 5%–35% of first attempts. No data, however, are available on the success rates of subsequent attempts. Aim: To evaluate the effectiveness of primary, secondary, and tertiary LA attempts (P‐LA, S‐LA, and T‐LA, respectively) for anesthetizing molars during routine dental treatments in children. Design: We retrospectively analyzed dental records of all children (2–18 years) who had been administered LA for the treatment of primary or permanent molars by a single paediatric dentist, between 2011 and 2022. All LAs were delivered using a computer‐controlled local anesthetic delivery (CCLAD) system. Results: The failure rate of P‐LA in 1312 molars was 13% and correlated with age (p <.001), type of tooth (p <.001), type of treatment (p <.001), and treated arch (p <.001). The effectiveness of S‐LA for buccal infiltration, intrasulcular, inferior alveolar nerve block, greater palatine nerve block (GPNB), posterior superior alveolar nerve block (PSANB), or a combination of the last two was 50%, 87.2%, 66.7%, 63.6%, 33.3%, and 100%, respectively, and was not significantly associated with age or the type of tooth, treatment, or P‐LA. Conclusion: The optimal choice of S‐LA for anesthetizing maxillary molars was a combination of PSANB and GPNB, whereas for mandibular molars, it was IS‐CCLAD system. [ABSTRACT FROM AUTHOR]

Background: Finding the best treatment approach and suitable capping materials in primary molars with deep carious lesions remains unresolved. Aim: To compare the success rates of partial pulpotomy in deep caries lesions in primary molars treated with mineral trioxide aggregate (MTA), biodentine, or acemannan for 6–24 months. Design: A parallel‐design, non‐inferiority randomized controlled clinical trial was performed. Ninety mandibular primary molars from 65 children meeting the criteria, aged 3–8 years, were included. After inflamed pulp tissue removal and hemostasis, each tooth was randomly allocated into the MTA control group, or the biodentine or acemannan experimental group (N = 30 per group). All teeth were restored with a stainless steel crown. The outcomes were evaluated for 6–24 months. A generalized estimating equation model was used to compare the overall success rate in each group. Results: After 24 months, 58 children (83 teeth) were available for evaluation. The results indicated that the success rate in the MTA, biodentine, and acemannan groups was 83.3%, 76.9%, and 74.1%, respectively. No significant difference in success rates among groups, however, was observed at the 6‐ to 24‐month follow‐ups (at 24th month, p =.30). Conclusion: There was no statistically significant difference between MTA, biodentine, or acemannan in the partial pulpotomy success after 24 months. [ABSTRACT FROM AUTHOR]

Background: No consensus exists on how molar incisor hypomineralisation (MIH) should be covered by the undergraduate dental curricula. Aim: To assess the current teaching and assessment of MIH in the UK. Design: A piloted questionnaire regarding the teaching and assessment of MIH was disseminated to paediatric, restorative and orthodontic teaching leads in each UK dental school (n = 16). Data were analysed using descriptive statistics, chi‐squared and Kruskal–Wallis tests. Results: Response rates from paediatric, restorative and orthodontic teams were 75% (n = 12), 44% (n = 7) and 54% (n = 8), respectively. Prevention of caries, preformed metal crowns, anterior resin composites and vital bleaching were taught significantly more by paediatric teams (p =.006). Quality of life and resin infiltration were absent from restorative teaching. Orthodontic teaching focussed on the timing of first permanent molar extractions. Paediatric teams were mainly responsible for assessment. Risk factors, differential diagnoses for MIH and defining clinical features were more likely to be assessed by paediatric teams than by others (p =.006). All specialities reported that students were prepared to manage MIH. Conclusion: Molar incisor hypomineralisation is primarily taught and assessed by paediatric teams. No evidence of multidisciplinary or transitional teaching/assessment existed between specialities. Developing robust guidance regarding MIH learning in the UK undergraduate curricula may help improve consistency. [ABSTRACT FROM AUTHOR]

Background: Molar incisor hypomineralisation (MIH) is a developmental enamel defect in the first permanent molars and frequently in the incisors. It poses a unique challenge to the dental practitioner because of its nature, clinical presentations and treatment strategies. Aim: This study assessed the perception of Libyan dentists in Benghazi regarding MIH and its management. Design: Paper‐based, self‐administered questionnaires were distributed to dentists in Benghazi, Libya. The questionnaires investigated the awareness of MIH, knowledge of MIH aetiology, clinical challenges of MIH treatment and choices of restorative management. Descriptive statistics, chi‐squared test and binary logistic regression analysis were performed at a significance level of ≤.05. Results: A total of 389 questionnaires were completed and analysed, giving an overall response rate of 76% (389/511). Most participants were female (85%, 332), with an average of 6.05 (SD = 6.24) years of experience. The majority of participants (67%) recognised MIH in their practice. Statistically significant differences in the awareness of MIH and its prevalence were observed according to the type of practice (p ≤.001) and experience of dentists (p ≤.001). Dentists working in public dental practice were less familiar with MIH and less likely to report it. Likewise, novice dentists were less aware of MIH than more experienced colleagues. The most reported aetiological factor in MIH was genetics by 60.2% of respondents, followed by environmental contamination (47.6%) and fluorides (42.9%). Most participants (92.3%) considered MIH a clinical problem. Aesthetics and diagnosis were the most reported challenging aspects (59.4% and 44.2%, respectively). The most commonly selected restorative options were high‐fluoride glass ionomer cement (43.2%) and preformed metal crowns (41.6%). Conclusion: The majority of participants reported awareness of the existence of MIH condition. Nevertheless, variations in estimating MIH prevalence and its proper treatment, as well as factors influencing its treatment and diagnosis, were recorded. It is recommended that the current dental curriculum is reviewed, and scientific evidence providing dental practitioners with updated information on the diagnosis and clinical management of MIH should be circulated. [ABSTRACT FROM AUTHOR]

Background: This study compared the marginal gaps of CAD/CAM lithium disilicate (LDS) crowns constructed using a contemporary and older scanner/milling unit combination at three different cement spaces. Methods: Twenty‐four undergraduate students prepared a Columbia model lower left first molar for an LDS crown in a simulated environment. From each crown preparation, one LDS crown was constructed using an E4D scanner/E4D milling unit (E4DS/E4DM) and TRIOS 3 scanner/Sirona inLab MC X5 milling unit (TRIO/MCX5) at cement space settings of 50, 100 and 200 μm. Each LDS crown was positioned onto the original crown preparation, and then a stereomicroscope was used to make three vertical marginal gap measurements at four locations (mid‐buccal, mid‐lingual, mid‐mesial and mid‐distal). The mean marginal gap (MMG) was calculated for each crown and each individual tooth surface. Results: The MMGs of CAD/CAM LDS crowns constructed by TRIO/MCX5 were 72.31 at 50, 63.73 at 100 μm and 46.23 μm at 200 μm, which were smaller than E4DS/E4DM at each cement space. Conclusions: Increasing the cement space decreased the MMG in both scanner/milling unit combinations. The smallest MMG was found using the newer scanner/milling unit at the 200 μm cement space. © 2024 Australian Dental Association. [ABSTRACT FROM AUTHOR]