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Background: Maxillary central incisors (MCI) are the third most impacted teeth. Timely multidisciplinary management is indicated as unerupted incisors can cause functional‐ and appearance‐related distress. Aim: To assess the patient journey for children with unerupted MCI, including referral, clinical assessment, surgical management and follow‐up treatment, and highlight areas for improvement, as well as identify factors impacting orthodontic treatment burden (OTB). Design: A retrospective service evaluation of children aged 6–16 years who had surgical management of unerupted MCI under general anaesthetic (GA) between 2018 and 2021. Results: Fifty‐two children with 62 unerupted MCI were identified. Mean age at referral was 8.8 years. Most children (82.7%) had supernumerary teeth in the anterior maxilla. Mean time between listing for GA and surgery increased from 4.3 to 15.2 months following the COVID‐19 lockdown. Mean age at surgery was 10.4 years. Supernumerary removal and incisor exposure and bond was the most common treatment (56.6%). Most patients required hospital orthodontic treatment post‐surgery (65.4%). Conclusion: Most children referred were below 9 years (60.1%); these children had reduced OTB compared to those who had been referred at an older age. Stage of root development was also a significant predictor in OTB. An unexpected finding was that conical supernumeraries were found to prevent MCI eruption. [ABSTRACT FROM AUTHOR]

(1) Background: A missing bilateral maxillary lateral incisor (MBMLI) causes aesthetic and functional problems and a multidisciplinary approach is required for treatment. This study aimed to compare the changes in the mesiodistal axial angulations of the maxillary canines and central incisors with orthodontic treatment of MBMLI. (2) Methods: A total of 56 patients with MBMLI were included in the study, and three groups were formed: the control group (Group 1, n = 20) with untreated ideal occlusion and the space opening (Group 2, n = 20) and space closure (Group 3, n = 16) groups as treated study groups. The mesiodistal angulations between the long axes of the maxillary right canine (tooth no 13), right central incisor (tooth no 11), left central incisor (tooth no 21) and maxillary left canine (tooth no 23), and the bicondylar plane, were measured on the panoramic radiographs taken pre (T0) and post treatment (T1). p < 0.05 was accepted for statistical significance. (3) Results: At T0, while there was no significant difference between the mesiodistal angulations of the right–left maxillary canines and central incisors in all groups (p > 0.05), the mesiodistal angulations of the canines in the Group 1 were significantly higher than the study groups (p < 0.05). With treatment, while the mesiodistal angulation of the canines increased in Group 2, it decreased in Group 3 (p < 0.05). On the other hand, the mesiodistal angulation of the central incisors decreased in Group 2 and did not change in Group 3 (p > 0.05). At T1, the mesiodistal angulation of the canines was found to be lower in Group 3 than in Groups 1 and 2, while the angulation of the central incisors was found to be lower in Group 2 compared to Group 1 (p < 0.05). (4) Conclusions: In the orthodontic treatment of MBMLIs, changes in the mesiodistal angulations of the maxillary canine and central incisors should be taken into account for satisfactory outcomes. It was concluded that there should be a tendency to select the space closure method in which normal mesiodistal angulations are obtained in maxillary central incisors for aesthetics and planned incisor position, and also at a low cost. [ABSTRACT FROM AUTHOR]

Aim: To assess and compare the fracture strength of polyetheretherketone (PEEK) post materials with fiber posts on endodontically treated maxillary central incisors. Materials and Methods: In this in vitro comparative study, two dental post materials were evaluated: fiber-reinforced post and PEEK post. Simple random sampling was done and 30 specimens were fabricated using extracted, decoronated, and endodontically treated maxillary central incisors (n = 15 for each group). Post-space preparation was done 5 mm short of the apex and restored with prefabricated fiber post (n = 15) and customized PEEK post (n = 15). Samples were mounted in a cold cure acrylic cylindrical block, at 45° angulation for testing the fracture strength using a universal testing machine. The data were analyzed and compared statistically, using an independent t test. Results: Mean fracture strength of the PEEK post was 65.79 kg and the fiber post was 59.32 kg with no statistically significant difference in the fracture strength between the two groups. Conclusion: Within the limitations of the study, it can be concluded that the PEEK post has similar mechanical properties to the fiber post and could be considered as an alternative to the fiber post having the advantages of being custom-made requiring conservative canal preparation with minimal dentin removal. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The treatment of impacted maxillary permanent incisors is challenging due to its importance for facial aesthetics. This anomaly has several detrimental effects that can lead to aesthetic and dental occlusal problems. Dental impactions can be associated with various factors. The most common factors associated with impacted teeth include extra teeth, odontomas, cysts, root anomalies, deviation from the eruption pathway, retention of supernumerary deciduous teeth, genetics, bone disease, and trauma to primary teeth. In addition, the highest probability of the transposition phenomenon was observed in the upper permanent canines. Transposition of the upper permanent canines occurs in 80% of cases with the first premolar and in 20% of cases with the lateral incisor. Both general and local factors can be responsible for tooth displacement. Local factors include genetic factors as well as dental anomalies (congenital absence of lateral incisors, conically shaped lateral incisors, rotation, hypodontia), migration of the tooth buds from their natural growth path, root dilaceration, dental trauma and enamel formation disorders. Cone beam computed tomography (CBCT) is the most accurate imaging procedure for diagnosing tooth misalignment. Intraoral surgery with sequential movements of impacted and displaced teeth helps to achieve an optimal treatment result. This study reports a case of the patient in whom an impacted central incisor was radiographically detected in the late mixed dentition together with transposition of the maxillary permanent canine.

Background and Objectives: According to the modified Williams theory, the shape of the maxillary central incisor corresponds to the shape of the maxillary alveolar ridge (dental arch) and the shape of the face. Moreover, the standards of beauty suggest that the center of the face of an individual with a full set of teeth should match the center of the maxillary and mandibular dental arches. The purpose of this study is to conduct a comparative cross-sectional study on the matching of the shape of the face, maxillary central incisor and maxillary dental arch as well as the matching of the midfacial line and dental arches in subjects with complete dentition. Materials and Methods: The study included 90 subjects of both sexes. The matching of the shape of the face and midfacial line, i.e., dental arches and maxillary incisors, was determined by analysing photographs, whereas the shape of the dental arch was determined by analysing plaster models. Results: No significant gender-related differences were found either in the shape of the maxillary central incisor that matched the shape of the maxillary dental arch (p = 0.349) or in the shape of the dental arch that matched the shape of the face (p = 0.697). However, a significant difference was noted in the shape of the teeth that matched the shape of the face (p = 0.043), which was more significantly impaired in men. In addition, the matching of the mid-face and the mid-dental arch was significantly greater in women (p = 0.016). Conclusions: The modified Williams theory was confirmed in most subjects, thus it can be considered a relevant guideline when determining the shape of teeth after their loss. The highest percentage of matching in both sexes was with the shape of the face and dental arch. There was no positive correlation between the middle of the maxillary and mandibular dental arch in most cases. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate a correlation between the cusp dimensions of the first molar and mesiodistal crown diameters of the central incisors in the maxilla. The study materials were composed of dental casts from 29 modern Japanese female subjects with a mean age of 20 years and 8 months. The mesiodistal crown diameters of the maxillary central incisors were measured. The mesiodistal and bucco-lingual crown diameters and the cusp diameters of the maxillary first molars, such as the paracone, metacone, protocone, and hypocone, were also measured. The crown areas and indices of the first molars were calculated. The Spearman's single rank correlation coefficients between the mean values for the crown dimensions of the first molars and the mesiodistal crown diameters of the central incisors were calculated. The hypocone cusp diameter and the hypocone index were the largest compared to those of the paracone, protocone, and metacone cusps. The bucco-lingual diameter and hypocone cusp diameter of the first molars positively correlated with the mesiodistal crown diameters of the central incisors on the same sides. There were positive correlations between the hypocone index of the first molars and the mesiodistal crown diameters of the central incisors. Based on the results, if a large hypocone is observed in eruption of the maxillary first molars, it will be predictable that of the mesiodistal crown diameter of the maxillary central incisor large. [ABSTRACT FROM AUTHOR]

(1) Background: A missing bilateral maxillary lateral incisor (MBMLI) causes aesthetic and functional problems and a multidisciplinary approach is required for treatment. This study aimed to compare the changes in the mesiodistal axial angulations of the maxillary canines and central incisors with orthodontic treatment of MBMLI. (2) Methods: A total of 56 patients with MBMLI were included in the study, and three groups were formed: the control group (Group 1, n = 20) with untreated ideal occlusion and the space opening (Group 2, n = 20) and space closure (Group 3, n = 16) groups as treated study groups. The mesiodistal angulations between the long axes of the maxillary right canine (tooth no 13), right central incisor (tooth no 11), left central incisor (tooth no 21) and maxillary left canine (tooth no 23), and the bicondylar plane, were measured on the panoramic radiographs taken pre (T0) and post treatment (T1). p < 0.05 was accepted for statistical significance. (3) Results: At T0, while there was no significant difference between the mesiodistal angulations of the right–left maxillary canines and central incisors in all groups (p > 0.05), the mesiodistal angulations of the canines in the Group 1 were significantly higher than the study groups (p < 0.05). With treatment, while the mesiodistal angulation of the canines increased in Group 2, it decreased in Group 3 (p < 0.05). On the other hand, the mesiodistal angulation of the central incisors decreased in Group 2 and did not change in Group 3 (p > 0.05). At T1, the mesiodistal angulation of the canines was found to be lower in Group 3 than in Groups 1 and 2, while the angulation of the central incisors was found to be lower in Group 2 compared to Group 1 (p < 0.05). (4) Conclusions: In the orthodontic treatment of MBMLIs, changes in the mesiodistal angulations of the maxillary canine and central incisors should be taken into account for satisfactory outcomes. It was concluded that there should be a tendency to select the space closure method in which normal mesiodistal angulations are obtained in maxillary central incisors for aesthetics and planned incisor position, and also at a low cost.

Copyright of Acta Stomatologica Croatica is the property of Acta Stomatologica Croatica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study compared the stress distributions in teeth with simulated external cervical resorption defects restored with different restorative materials and identified areas of high stress concentration. A maxillary central incisor created in a scanned model using HyperWorks software (Altair Engineering Inc, Troy, MI) served as the control. External cervical resorption defects based on Shanon Patel's classification were created (1Bd/2Bd/3Bd) in the scanned model. The defects were restored using mineral trioxide aggregate, Biodentine, glass ionomer cement, and Bioaggregate. On all the models, a force of 100 N was applied on the palatal aspect 2 mm incisal to the cingulum directed at 45° along the long axis of the tooth. The stresses generated in dentin and cementum are less, with a restorative material having a high Young's modulus. For the 1Bd defect, MTA and Bioaggregate showed least stresses in dentin and cementum, respectively, whereas Biodentine had consistently lower stresses in dentin and cementum. Larger defects like 2Bd and 3Bd restored with Bioaggregate exhibited minimum stresses in dentin and cementum. Bioaggregate and Biodentine replace dentin with maximum stress and maximum strain. Elastic moduli similar to or higher than dentin are preferred for restoring cervical third resorptive lesions of the tooth. [ABSTRACT FROM AUTHOR]

To develop a coupled-lines system to determine the anteroposterior position of maxillary central incisors (U1) for smiling profile esthetics. Thirty Asian females with ordinary and good facial harmony were selected as the study sample and the control sample, respectively. Three-dimensional facial images and 45°- and 90°-angled profiles were collected. The anteroposterior relationships between U1 and upper- and mid-facial soft tissue landmarks were measured. By morphing photos of the study sample, two artificial images were created to represent the well-balanced 45°- and 90°-angled profiles and were further processed with combined variations of soft tissue subnasale (SSn)–Glabella and the mid-point of facial axial points of the bilateral central incisor (mFA)–SSn distances. Esthetic assessments were performed on these images by layperson (n = 94) and orthodontist (n = 94) raters. Both upper- and mid-facial soft tissue landmarks were indispensable in assessing anteroposterior positions of U1 for well-balanced smiling profiles. As assessed in 45°- and 90°-angled profiles, the most esthetically sensitive parameters were mFA-Glabella and mFA-SSn distances. A coupled-lines system was constructed, comprising the Glabella and SSn vertical lines. In smiling profiles with optimal esthetics, the mFA point was at 2 to 5 mm posterior to the Glabella vertical and concomitantly 4 to 7 mm posterior to the SSn vertical, as perceived by orthodontists. Laypersons gave a wider range for mFA-Glabella distances, at 2 to 6 mm. The coupled-lines system could serve as a reliable reference for determining esthetically optimal anteroposterior positions of U1 for female facial profiles. [ABSTRACT FROM AUTHOR]

Maxillary incisors are typically straightforward cases for root canal therapy. While it is commonly assumed that maxillary central incisors have a single root canal, they may occasionally exhibit variations in their root canal system anatomy. In this report, we present a case of a maxillary central incisor with multiple root canals and provide a review of relevant literature on this anatomical variation. A 13-year-old female with deep carious lesion in tooth 11 was admitted in Department of Endodontics. Following a precise clinical and radiographic examination, a maxillary central incisor with necrotic pulp and chronic apical periodontitis along with unusual root anatomy was found and considered for non-surgical root canal treatment. Successful treatment results depend on various factors and awareness of root canal system anatomy is one of them. Due to an increasing number of reported cases of maxillary central incisors with different anatomy, it is imperative to consider anatomical variations even in the most routine cases. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the average dentin wall thickness (DWT) of the maxillary central incisor (MCI) required for performing finite element analysis (FEA) models of root development. Material and methods: A total of 137 intraoral periapical radiographs of MCI in children aged 7 to 11 years were examined and then classified into 5 groups according to root development stages, which included 1/2 of root development (S1), 3/4 of root development (S2), more than 3/4 of root development (S3), complete development with wide-open apex (S4) and complete development with closed apex (S5). DWT was measured at three reference (horizontal) lines: at a distance of 1 mm from the apex (M), 4 mm from the apex (L) and at the cervical line (K). The distal dentin wall thickness (M1, L1, and K1), the pulp thickness (M2, L2, and K2), the mesial dentin wall thickness (M3, L3, and K3), and the apex thickness (N) were measured using the diagnostic software Soredex Scanora 5.1.2.4. Statistical analysis compared the values of the parameters K, L, and M between developmental stages (multivariate ANOVA) and the linear correlations between the parameters (Pearson’s correlation analysis). All analyses were performed at significance level α = 0.05. Results: There were statistically significant differences between the developmental stages for parameters L and M, while no significant differences were found for parameter K. Most of the correlations between the parameters were statistically significant, with the values of the Pearson correlation coefficient R > 0.6 considered practically significant. All parameters on the same reference line for distal and mesial dentin wall thickness and for pulp thickness correlated well with each other (R = 0.46 – 0.68), but there was no statistically significant correlation with total root thickness on the same reference line (parameters K, L, or M), except for parameter K3 (R = 0.42). Conclusion: Despite the limitations of this study, the mean values of the selected parameters for the 5 groups of developmental stages of the maxillary central incisor could be used to model dentin wall thickness using finite element analysis.

The position of the maxillary central incisors (MCIs) is an important factor in treatment planning since it is related to esthetics and physiological function. This study aimed to evaluate maxillofacial morphology related to the proximity of the MCI to the incisive canal (IC) using cone-beam computed tomography (CBCT). In 157 patients, the distance between the MCI and IC was measured using CBCT images, and the maxillofacial morphology was measured using cephalograms. The relationship between age, sex, and cephalometric analysis was subsequently investigated using stepwise multiple regression analysis, with the distance between the MCI root apex and IC as the objective variable, and age, sex, and cephalometric variables as explanatory variables. The results demonstrated significant associations between the distance separating point A and the pterygomaxillary fissure projected on the palatal plane (B = 0.092, p < 0.01), the maxillary central incisal edge to the Frankfort horizontal plane (B = −0.058, p < 0.01), and the mandibular plane (B = −0.036, p = 0.031). Age and sex showed no association with the distance between the IC and MCI. Particular attention should be paid to the proximity of the tooth root to the IC in patients with short anteroposterior diameters of the maxilla and an anterior labial tilt of the dolichofacial type. [ABSTRACT FROM AUTHOR]

Maxillary central incisor is considered the tooth with least anatomical variations. In literature, the prevalence of single root and single canal in maxillary central incisor has been reported as 100%. Only a handful of case reports suggesting more than one root or one canal are available and are mostly associated with developmental anomalies such as gemination and fusion. This article describes a rare case report of retreatment of a maxillary central incisor with two roots with normal clinical crown which was confirmed by cone-beam computer tomography (CBCT). A 50-year-old Indian male patient presented with pain and discomfort on a root canal-treated anterior tooth. Pulp sensibility testing of left maxillary central incisor was negative. Intraoral periapical digital radiograph revealed an obturated canal with suspected outline of a second root which got confirmed with cone shift technique. The tooth was treated under dental operating microscope during which two canals were located and retreatment was completed. Postobturation, CBCT was performed to study the root and canal morphology. Clinically and radiographically, all the follow-up examinations revealed an asymptomatic tooth without any active periapical lesion. The present case report emphasizes the fact that clinicians should approach each case with an open mind having a thorough knowledge of the normal tooth anatomy and should suspect variations in every case to ensure successful endodontic outcome. [ABSTRACT FROM AUTHOR]

Abstract Background Failure of eruption of the maxillary permanent incisor teeth usually presents in the mixed dentition between the ages of 7 and 9 years. Missing and unerupted maxillary incisors can be regarded as unattractive and have a potentially negative impact on facial and dental aesthetics. The presence of a supernumerary tooth (or odontoma) is commonly responsible for failed eruption or impaction of the permanent maxillary incisors. The primary objective of this trial is to investigate the success of eruption associated with maxillary incisor teeth that have failed to erupt because of a supernumerary tooth in the anterior maxilla. Methods This protocol describes an interventional multicentre two-arm randomised clinical trial. Participants meeting the eligibility criteria will be randomised (unrestricted equal participant allocation [1:1]) to either space creation with an orthodontic appliance, removal of the supernumerary tooth and application of direct orthodontic traction or space creation with an orthodontic appliance, removal of the supernumerary tooth and monitoring. The primary outcome of this trial is to determine the prevalence of successfully erupted maxillary central permanent incisors at 6 months following removal of the supernumerary tooth. Secondary outcome measures include (1) the effect of initial tooth position (assessed radiographically) on time taken for the tooth to erupt, (2) time taken to align the unerupted tooth to the correct occlusal position, (3) gingival aesthetics and (4) changes in the self-reported Oral Health Related-Quality of Life (OHRQoL) (pre-and post-treatment). Discussion There is a lack of high-quality robust prospective studies comparing the effectiveness of interventions to manage this condition. Furthermore, the UK national clinical guidelines have highlighted a lack of definitive treatment protocols for the management of children who present with an unerupted maxillary incisor due to the presence of a supernumerary tooth. The results of this trial will inform future treatment guidelines for the management of this condition in young children. Trial registration ISRCTN Registry ISRCTN12709966 . Registered on 16 June 2022.

Abstract Background Canine relationship is a key reference identifying anterior malocclusion and an important implication for evaluating preimplantation bone morphology at maxillary esthetic zone. This study aimed to compare the differences of maxillary central incisor-related measurements (alveolar bone thickness and tooth sagittal angulation) between Class I and Class III canine relationship and further explore the risk factors for immediate implant placement in the anterior maxilla based on cone beam computed tomography (CBCT) data. Methods CBCT digital imaging and communications in medicine (DICOM) files of 107 patients (54 with Class I canine relationship and 53 with Class III canine relationship) were collected and the alveolar bone thickness at mid-root (mid-root buccal thickness/MBT; palatal/MPT), apical regions (apical buccal thickness/ABT; palatal/APT) and sagittal angulation (SA) of the maxillary central incisor at the examined side were measured on the mid-sagittal observation plane. Descriptive statistical analysis and frequency distributions of the measurements based on Class I or Class III canine relationship were established. Statistical analyses were performed using Fisher’s exact test, independent samples t test and Pearson correlation test with the significance level set at p

Objective: To evaluate and compare the resultant stress on the root and PDL of a Maxillary Central Incisor with various crown-root angles. Settings and Sample Population: Finite Element Models of Maxillary Central Incisor were used for simulation of stress on the root and PDL. Materials and Methods: Three FEM models of a Maxillary Central Incisor with different crown-root angles (170°, 175° and 180°) were constructed and subjected to a force of 2N respectively. The resultant stress generated in the periodontal ligament and root surface were recorded and compared between the models. Result: The model with the maximum change in crown-root angle (180°) showed the maximum stress in both PDL and root surface. The stress recorded on the root surface was more on the cervical 2/3rd in the palatal region of the tooth as compared to the labial region. Maximum stress in the PDL was seen only in the cervical 3rd of the third model. Conclusion: With increase in the crown-root angles of a tooth, the stress in the PDL and on the root surface increases. [ABSTRACT FROM AUTHOR]

Background and Objectives: According to the modified Williams theory, the shape of the maxillary central incisor corresponds to the shape of the maxillary alveolar ridge (dental arch) and the shape of the face. Moreover, the standards of beauty suggest that the center of the face of an individual with a full set of teeth should match the center of the maxillary and mandibular dental arches. The purpose of this study is to conduct a comparative cross-sectional study on the matching of the shape of the face, maxillary central incisor and maxillary dental arch as well as the matching of the midfacial line and dental arches in subjects with complete dentition. Materials and Methods: The study included 90 subjects of both sexes. The matching of the shape of the face and midfacial line, i.e., dental arches and maxillary incisors, was determined by analysing photographs, whereas the shape of the dental arch was determined by analysing plaster models. Results: No significant gender-related differences were found either in the shape of the maxillary central incisor that matched the shape of the maxillary dental arch (p = 0.349) or in the shape of the dental arch that matched the shape of the face (p = 0.697). However, a significant difference was noted in the shape of the teeth that matched the shape of the face (p = 0.043), which was more significantly impaired in men. In addition, the matching of the mid-face and the mid-dental arch was significantly greater in women (p = 0.016). Conclusions: The modified Williams theory was confirmed in most subjects, thus it can be considered a relevant guideline when determining the shape of teeth after their loss. The highest percentage of matching in both sexes was with the shape of the face and dental arch. There was no positive correlation between the middle of the maxillary and mandibular dental arch in most cases.

Background: No universally accepted parameter exists for selecting/restoring the form of maxillary central incisors (MCIs). Aim: The purpose of this cross-sectional, observational clinical study was to digitally determine the prevalent form of MCIs among males and females of the Central Indian population with AutoCAD software. Materials and Methods: This is a clinical study comprising 200 dental and engineering students (female: 100; male: 100) aged between 18 and 35 years. The pictures of the right (MCI) of each participant were clicked. The images were calibrated in the vertical position to standardize according to the long axis of the tooth. The AutoCAD computer program was used to evaluate the geometric form of the tooth graphically. The results revealed that the tooth form was classified as oval, triangular, or quadrangular. The intergroup comparison using one-way analysis of variance was made, followed by the intragroup comparison using Tukey's test for quantitative data. For comparison between males and females based on tooth form, the data were assessed using Student's t-test as quantitative analysis, and for qualitative assessment, Chi-square test was used. The significance level was set at 0.05. Remeasuring 40 samples from each group tested intraexaminer consistency by applying Bland–Altman and scatter regression analysis. Results: Males had 57% oval, 29% tapered, and 14% quadrangular, while females had 60% oval, 23% tapered, and 14% quadrangular tooth form. Conclusions: The oval tooth form was the most common, both in males and females, followed by the tapered and the quadrangular form. No gender variation was seen in tooth forms.

Introduction: Customised Zirconia postcore exhibits high strength, toughness and superior aesthetics. The stress distribution in the root of endodontically treated teeth has been found to improve with use of ferrule. Aim: To evaluate the effect of different ferrule heights on stress distribution in endodontically treated maxillary central incisor restored with zirconia postcore system using three-dimensional (3D) finite element analysis. Materials and Methods: The in-vitro experimental study was conducted at Maharashtra Institute of Dental Sciences and Research, Latur, Maharashtra, India, from December 2014 to July 2016. The external shape of the right maxillary central incisor was obtained by the micro computed tomography scan of previously extracted maxillary central incisor. The scanned profiles were then assembled and a 3D-finite element model of five dentin ferrule heights was designed with customised zirconia postcore (1.2 mm diameter) and all ceramic crown. Total five models of different ferrule heights (0 mm, 0.5 mm, 1 mm, 1.5 mm, 2 mm) were made. Von mises stress was determined by applying a load of 100 N at 45° and at a distance of 2 mm from the incisal edge on the palatal surface of crown. Descriptive statistical methods and Pearson correlation test were used to analyse the data. Results: The maximum von Mises stress at the postdentin interface decreased from 2.808 MPa to 0.512 MPa and that of zirconia post reduced from 57.163 MPa to 48.29 MPa when the ferrule height increased from 0 to 2 mm. The maximum von Mises stress in the radicular dentin decreased from 15.219 MPa to 11.321 MPa. Conclusion: There was association between increased height of ferrule and reduced von Mises stress in the zirconia post, postdentin interface and in remaining radicular dentin. Also, with increase in height of ferrule there was an evident shift of von mises stress to the cervical end of root from midroot and apical end of root.

Background: Failure of eruption of the maxillary permanent incisor teeth usually presents in the mixed dentition between the ages of 7 and 9 years. Missing and unerupted maxillary incisors can be regarded as unattractive and have a potentially negative impact on facial and dental aesthetics. The presence of a supernumerary tooth (or odontoma) is commonly responsible for failed eruption or impaction of the permanent maxillary incisors. The primary objective of this trial is to investigate the success of eruption associated with maxillary incisor teeth that have failed to erupt because of a supernumerary tooth in the anterior maxilla.Methods: This protocol describes an interventional multicentre two-arm randomised clinical trial. Participants meeting the eligibility criteria will be randomised (unrestricted equal participant allocation [1:1]) to either space creation with an orthodontic appliance, removal of the supernumerary tooth and application of direct orthodontic traction or space creation with an orthodontic appliance, removal of the supernumerary tooth and monitoring. The primary outcome of this trial is to determine the prevalence of successfully erupted maxillary central permanent incisors at 6 months following removal of the supernumerary tooth. Secondary outcome measures include (1) the effect of initial tooth position (assessed radiographically) on time taken for the tooth to erupt, (2) time taken to align the unerupted tooth to the correct occlusal position, (3) gingival aesthetics and (4) changes in the self-reported Oral Health Related-Quality of Life (OHRQoL) (pre-and post-treatment).Discussion: There is a lack of high-quality robust prospective studies comparing the effectiveness of interventions to manage this condition. Furthermore, the UK national clinical guidelines have highlighted a lack of definitive treatment protocols for the management of children who present with an unerupted maxillary incisor due to the presence of a supernumerary tooth. The results of this trial will inform future treatment guidelines for the management of this condition in young children.Trial Registration: ISRCTN Registry ISRCTN12709966 . Registered on 16 June 2022. [ABSTRACT FROM AUTHOR]

Root perforations can occur as a consequence of pathological processes or during routine endodontic treatment that can result in significantly compromised endodontic treatment outcomes, especially when bacterial infection is allowed to establish with the seal between the root canal obturation material and the periradicular tissue is compromised. Hence, one of the most difficult challenges in dentistry is the reconstruction of an endodontically treated tooth with perforation, maintaining aesthetics and functional integrity. Mid-root perforations can be further complicated by its close proximity to the gingival sulcus, pre-empting proper precautions to avoid future contamination. Use of the proper biomaterial, along with adhesive posts enhances the longevity of such compromised teeth. This case report describes the successful management of iatrogenic root perforation in an endodontically treated maxillary central incisor with Mineral Tri-oxide Aggregate, as well as the use of Fibre-reinforced composite post for composite core build-up to enhance the strength and fracture resistance of the tooth. During the first appointment the sealing of the perforation defect was achieved with the placement of Mineral Trioxide Aggregate. On the second appointment, post space preparation was done followed by luting of the fibre post using dual cure resin luting cement and Composite resin was layered around the post to form the core. Tooth preparation was carried out and during the subsequent appointment, Zirconia crown was cemented with dual cure resin luting cement. The patient was regularly recalled for follow up visits during which the tooth remained asymptomatic clinically and significant healing was observed radiographically. [ABSTRACT FROM AUTHOR]

Aim: To describe a novel surgical method (crown rotation surgery) to manage inversely impacted central incisors with immature roots. Methodology: Two young patients each presented with an inversely impacted maxillary central incisor. To protect the apical tissues, the two impacted incisors were rotated downwards to a relatively normal position without extraction from their bony sockets. Results: After crown rotation surgery, spontaneous eruption, continuous root development, and periodontal healing of the rotated incisors were observed. The pulp retained vitality and blood flow was normal. Moreover, there were no obvious signs of pulp canal obliteration (PCO), as indicated by Cone Beam Computed Tomography (CBCT) imaging. Conclusions: By optimising protection of the vital pulp and apical tissues, crown rotation surgery represents a minimally invasive, conservative, and practical surgical technique for treating inversely impacted incisors with developing roots. In contrast to existing surgical methods, crown rotation surgery may avoid certain complications, including PCO and abnormal or arrested root development. Key learning points: By optimizing protection of the vital pulp and apical tissues, crown rotation surgery represents a minimally invasive, conservative and practical surgical technique for treating inversely impacted incisors with developing roots.In contrast to existing surgical methods, crown rotation surgery may avoid certain complications, including PCO and abnormal or arrested root development. [ABSTRACT FROM AUTHOR]

Background: The effect of the buccal gap width on the clinical outcome of socket graft and immediate implant placement (IIP) at maxillary central incisor sites has not been investigated. Thus, the aim of the present study was to evaluate the effect of the width of the buccal gap on the thickness of the newly formed buccal wall. Methods: Forty‐two patients and 51 maxillary central incisor sites treated with IIP and ridge preservation by means of graft of the buccal gap at the maxillary central incisor region were included in the study. The width of the buccal gap was measured and filled with deproteinized bovine bone mineral. Implant sites were divided into two groups: wide gap (WG, >2 mm; n = 34) and narrow gap (NG, ≤2 mm; n = 17). After at least 1 year in function (5 ± 4), CBCT scans were obtained and assessed by a calibrated examiner. The thickness of the buccal and palatal bone walls, the percentage of the implant height covered by bone in the buccal and palatal aspects and the position of the buccal and palatal crests were compared between the two groups. A linear regression model was performed to assess predictors of the thickness of the buccal bone. Results: The buccal bone was significantly thicker in the WG group than the NG group at all levels observed (overall 1.9 ± 0.9 mm and 0.5 ± 0.6 mm, respectively). The thickness of the palatal bone was similar between both groups (>2 mm). The percentage of the implant height covered by bone at the buccal aspect was significantly higher in the WG group (95 ± 16.6%) than in the NG group (59.4 ± 42.3%). The position of the buccal crest in relation to the implant shoulder was significantly more coronal (0.3 ± 2.2 mm) in the WG group than in the NG group (−4.7 ± 5.6 mm). The regression analysis model indicated that the width of the buccal gap was the only predictor of the thickness of the newly formed buccal bone wall (p < 0.001). Conclusion: Grafting of >2 mm‐wide buccal gaps following IIP promoted a thicker buccal bone wall. [ABSTRACT FROM AUTHOR]

Background: Canine relationship is a key reference identifying anterior malocclusion and an important implication for evaluating preimplantation bone morphology at maxillary esthetic zone. This study aimed to compare the differences of maxillary central incisor-related measurements (alveolar bone thickness and tooth sagittal angulation) between Class I and Class III canine relationship and further explore the risk factors for immediate implant placement in the anterior maxilla based on cone beam computed tomography (CBCT) data. Methods: CBCT digital imaging and communications in medicine (DICOM) files of 107 patients (54 with Class I canine relationship and 53 with Class III canine relationship) were collected and the alveolar bone thickness at mid-root (mid-root buccal thickness/MBT; palatal/MPT), apical regions (apical buccal thickness/ABT; palatal/APT) and sagittal angulation (SA) of the maxillary central incisor at the examined side were measured on the mid-sagittal observation plane. Descriptive statistical analysis and frequency distributions of the measurements based on Class I or Class III canine relationship were established. Statistical analyses were performed using Fisher's exact test, independent samples t test and Pearson correlation test with the significance level set at p < 0.05. Results: The frequency distributions of maxillary central incisors' MPT, ABT, APT and SA showed significant differences between Class I and Class III canine relationships (p = 0.030, 0.024, 0.000 and 0.000, respectively). MPT (2.48 ± 0.88 mm vs. 3.01 ± 1.04 mm, p = 0.005), APT (6.79 ± 1.65 mm vs. 8.47 ± 1.93 mm, p = 0.000) and SA (12.23 ± 5.62° vs. 16.42 ± 4.49°, p = 0.000) were significantly smaller in patients with Class III canine relationship. Moreover, SA showed a strong positive correlation with APT (R = 0.723, p = 0.000) and a moderate negative correlation with ABT (R = − 0.554, p = 0.000). Conclusions: In populations with Class III canine relationship, maxillary central incisors were significantly more labially inclined and have a thinner palatal bone plate at the apex compared with Class I relationship. Clinicians should avoid palatal perforation during immediate implantation at sites of originally protrusive maxillary incisors. [ABSTRACT FROM AUTHOR]

Impaction of permanent teeth during the replacement period is a relatively common occurrence in clinical practice. Tooth impaction occurs in the presence of factors that inhibit tooth eruption, such as supernumerary teeth or tumors. This is a report of permanent tooth impaction due to supernumerary teeth and pericoronal myxofibrous hyperplasia (PMH), a type of pericoronal hamartomatous lesion. An eight-year-old girl was diagnosed with an unerupted right maxillary central incisor. An inverted supernumerary tooth was present on the palatal side of the impacted central incisor, and PMH developed on the labial side of the central incisor. Interestingly, the alveolar bone on the labial side had completely disappeared. After the extraction of the supernumerary tooth and the removal of the PMH, the central incisors erupted, and the labial alveolar bone regenerated normally. Treatment for impacted teeth typically involves the removal of any existing lesions. This case is unique in that the alveolar bone of the impacted tooth regenerated following the extraction of the supernumerary tooth and removal of the PMH., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ishiyama et al.)

Mesiodens are classified as supernumerary teeth located in the maxilla, specifically in the palatal region between the central incisors. The prevalence of this condition varies between 0.15% and 1.9% among individuals. The presence of mesiodens can potentially affect the normal growth and development of teeth, leading to delayed eruption of permanent teeth, displacement or rotation of adjacent teeth, root resorption, and infectious pulpitis. This report discusses the case of a 14-year-old male patient who presented with a palatally placed mesiodens, which was completely erupted in the oral cavity. The patient underwent extraction for the removal of the mesiodens, and the procedure was successful with no complications reported during or after surgery. Early identification and surgical removal of mesiodens are crucial to preventing potential orthodontic and functional complications. This case highlights the importance of regular dental checkups for diagnosing supernumerary teeth. Timely intervention can lead to favorable outcomes, as demonstrated in this patient., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Hemnani et al.)

The position of the maxillary central incisors (MCIs) is an important factor in treatment planning since it is related to esthetics and physiological function. This study aimed to evaluate maxillofacial morphology related to the proximity of the MCI to the incisive canal (IC) using cone-beam computed tomography (CBCT). In 157 patients, the distance between the MCI and IC was measured using CBCT images, and the maxillofacial morphology was measured using cephalograms. The relationship between age, sex, and cephalometric analysis was subsequently investigated using stepwise multiple regression analysis, with the distance between the MCI root apex and IC as the objective variable, and age, sex, and cephalometric variables as explanatory variables. The results demonstrated significant associations between the distance separating point A and the pterygomaxillary fissure projected on the palatal plane (B = 0.092, p < 0.01), the maxillary central incisal edge to the Frankfort horizontal plane (B = −0.058, p < 0.01), and the mandibular plane (B = −0.036, p = 0.031). Age and sex showed no association with the distance between the IC and MCI. Particular attention should be paid to the proximity of the tooth root to the IC in patients with short anteroposterior diameters of the maxilla and an anterior labial tilt of the dolichofacial type.

Background/purpose: In the immediate implantation of maxillary central incisors, the height of the alveolar bone is lost, and there is often a risk of bone fracture due to the thin buccal bone wall (BBW). The purpose of this study was to assess the effects of smoking, age, and root position in the alveolar bone on the BBW and the distance between the cemento-enamel junction (CEJ) and the facial bone crest (FBC) of Chinese maxillary central incisors. Materials and methods: The patients were divided by smoking, gender, age, and root sagittal position in the alveolar bone. BBW thickness was measured at the following sites: the 4 mm apical to the CEJ, the middle of the root, and the apex. The distance from the CEJ to the FBC was also evaluated. Results: Cone beam CT (CBCT) data for the maxillary central incisors of 645 patients (323 males and 322 females) were selected and analyzed. The CEJ-FBC distance in patients who smoked (2.79 ± 0.78 mm) was significantly greater than that of non-smokers (2.54 ± 0.69 mm). The BBW in subtype III (0.74 ± 0.43 mm, 0.81 ± 0.36 mm) was thinner than that in subtypes I and II at 4 mm apical to the CEJ and in the middle of the root, with a statistically significant difference (p

Background: No universally accepted parameter exists for selecting/restoring the form of maxillary central incisors (MCIs). Aim: The purpose of this cross-sectional, observational clinical study was to digitally determine the prevalent form of MCIs among males and females of the Central Indian population with AutoCAD software. Materials and Methods: This is a clinical study comprising 200 dental and engineering students (female: 100; male: 100) aged between 18 and 35 years. The pictures of the right (MCI) of each participant were clicked. The images were calibrated in the vertical position to standardize according to the long axis of the tooth. The AutoCAD computer program was used to evaluate the geometric form of the tooth graphically. The results revealed that the tooth form was classified as oval, triangular, or quadrangular. The intergroup comparison using one-way analysis of variance was made, followed by the intragroup comparison using Tukey's test for quantitative data. For comparison between males and females based on tooth form, the data were assessed using Student's t-test as quantitative analysis, and for qualitative assessment, Chi-square test was used. The significance level was set at 0.05. Remeasuring 40 samples from each group tested intraexaminer consistency by applying Bland–Altman and scatter regression analysis. Results: Males had 57% oval, 29% tapered, and 14% quadrangular, while females had 60% oval, 23% tapered, and 14% quadrangular tooth form. Conclusions: The oval tooth form was the most common, both in males and females, followed by the tapered and the quadrangular form. No gender variation was seen in tooth forms. [ABSTRACT FROM AUTHOR]

Introduction: Customised Zirconia postcore exhibits high strength, toughness and superior aesthetics. The stress distribution in the root of endodontically treated teeth has been found to improve with use of ferrule. Aim: To evaluate the effect of different ferrule heights on stress distribution in endodontically treated maxillary central incisor restored with zirconia postcore system using three-dimensional (3D) finite element analysis. Materials and Methods: The in-vitro experimental study was conducted at Maharashtra Institute of Dental Sciences and Research, Latur, Maharashtra, India, from December 2014 to July 2016. The external shape of the right maxillary central incisor was obtained by the micro computed tomography scan of previously extracted maxillary central incisor. The scanned profiles were then assembled and a 3D-finite element model of five dentin ferrule heights was designed with customised zirconia postcore (1.2 mm diameter) and all ceramic crown. Total five models of different ferrule heights (0 mm, 0.5 mm, 1 mm, 1.5 mm, 2 mm) were made. Von mises stress was determined by applying a load of 100 N at 45° and at a distance of 2 mm from the incisal edge on the palatal surface of crown. Descriptive statistical methods and Pearson correlation test were used to analyse the data. Results: The maximum von Mises stress at the postdentin interface decreased from 2.808 MPa to 0.512 MPa and that of zirconia post reduced from 57.163 MPa to 48.29 MPa when the ferrule height increased from 0 to 2 mm. The maximum von Mises stress in the radicular dentin decreased from 15.219 MPa to 11.321 MPa. Conclusion: There was association between increased height of ferrule and reduced von Mises stress in the zirconia post, postdentin interface and in remaining radicular dentin. Also, with increase in height of ferrule there was an evident shift of von mises stress to the cervical end of root from midroot and apical end of root. [ABSTRACT FROM AUTHOR]

Coronal fractures of anterior teeth are the most common form of dental trauma that occur in children and adolescence. They cause functional, aesthetics and psychological problems for both their children and parents. Intact tooth fragment provides a very conservative approach for reattachment of dental fragment. Owing to its good long lasting aesthetics (as tooth's original anatomic form, color and surface texture are maintained) and functional restorability it provides a better alternative as compared to the resin based composite or crown restoration. It overcomes the problem of repeated reconstruction of composite with age and provides a positive psychological response. The article reports a case of a child with anterior tooth fracture that was successfully treated using tooth fragment reattachment. It aims to review and discuss the methodology along with different preparation techniques and adhesives used by various authors and analyze the advancement and most accepted procedure for of the treatment. It also highlights the shortcomings of the technique as patient cooperation determines the prognosis of the procedure and a long term follow up determines the success of the procedure.

The reason to use post is to retain the core that holds the definitive prosthesis. The maxillary central incisor always poses a challenge during reconstruction using the post and core system. Dentapreg PINPost, a pre-cured flexible post made of fiber-reinforced composite (FRC), has many advantages over metallic posts and fiber posts. The purpose of this case report is to present an innovative technique to place both FRC posts and FRC sheets as a single assembly into the canal which gives a monoblock effect. This technique is feasible and may eradicate some of the problems associated with the failure of the post and core., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Banka et al.)

Aim: To estimate the age of an individual based on 3D radiographic evaluation of pulp width of maxillary central incisor., Materials and Methods: This study included 185 CBCT images of individuals within age range of 14-64 years. Images were evaluated for maxillary central incisors and pulp width measurements were taken from cementoenamel junction and middle third of root. Obtained data was subjected to correlation and regression analysis from which the age of an individual was predicted. Results of the present study were compared with another study by the same authors., Results: A negative linear relationship was obtained between age and pulp width. The standard error of estimate (SEE) in sagittal section was 11.36 years and that in coronal section was 11.23 years. The coefficient of determination for sagittal section was 0.107 and for coronal section was 0.127. An obtained regression formula was highly significant. Division of samples into various age groups reduced SEE drastically., Conclusion: It can be concluded that pulp width of maxillary central incisor is a reliable indicator of age estimation., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction and Aims: Altering the position and orientation of the root canal access cavity passway, or modifying the reduction of dentin volume, can influence the strength of dentition. This study aimed to compare the effects of different access cavities on the biomechanical performances of maxillary central incisors with a finite element analysis., Methods: Based on the micro-computed tomography (CT) scan of a maxillary central incisor, the finite element models of the intact tooth and teeth with 4 access cavity designs: conservative incisal access cavity, incisal access cavity, conservative access cavity, and traditional access cavity were generated. Simulated occlusal forces were applied at the incisal edge of the incisor in the finite element analysis procedure., Results: The maximum von Mises stress and maximum principal stress in the cervical area are highest in the traditional access cavity group, followed by the conservative access cavity group, incisal access cavity group, and conservative incisal access cavity group., Conclusion: The conservative access cavities minimise the extent of dentin removal from the cervical region, protecting the mechanical behaviour of the incisor. Moving the access cavity entry point to the incisal edge also improves the fracture resistance of the incisor., Clinical Relevance: This study's findings would help clinicians select the most appropriate endodontics access cavity method when performing the root canal on maxillary central incisors., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim: The aim of the present research was to assess the mesiodistal angulation of the maxillary anterior teeth utilizing Image J computer software, a Profile projector, and a Custom-made jig., Materials and Methods: A total of 34 subjects (17 males and 17 females) were chosen from a group of 18-30 years old with bilateral Angle Class I molars and canine relationships. One manual approach (Custom-made jig) and two digital methods (J computer software, a Profile projector) were used to record the mesiodistal angulation in incisal view. The individuals had alginate impressions made, and a facebow was used to capture the maxilla's spatial relationship with the cranium. The articulated cast with the help of mounting ring moved to the specially customized jig, then the angulations was measured in the incisal view after the casts were placed in a semi-adjustable articulator. Data were recorded and statistically analyzed., Results: The mesiodistal angulation in the incisal view via three methods between the 17 males and 17 females has statistically significant different. Although the mesiodistal angulation for maxillary lateral incisor and canine did not show any statistically significant difference, the maximum and minimum values obtained were always greater in males in comparison with the females. This indicates that the positions of six maxillary anterior teeth in the males resulted in the creation of upward sweep of incisal edges of central and lateral incisors which was also referred to as "smiling line" producing masculine surface anatomy more squared and vigorous while feminine surface anatomy being more rounded, soft, and pleasant. There was no statistically significant difference between the right and left sides, indicating bilateral arch symmetry and the symmetrical place of the right teeth compared with the left side's corresponding teeth., Conclusion: On conclusion, according to the current study's findings, all three approaches can measure the mesiodistal angulations of maxillary anterior teeth in incisal view with clinically acceptable accuracy. The digital methods, which included using the Image J computer software and the profile projector, achieved more accurate results than the manual method., Clinical Significance: The outcomes of this study's mesiodistal angulations can be used as a reference for placing teeth in both fully and partially edentulous conditions. This study contributes to a better understanding of the importance of achieving the ideal occlusion in the Indian population by placing the maxillary anterior teeth at the proper mesiodistal angulation. How to cite this article: Shadaksharappa SH, Lahiri B, Kamath AG, et al . Evaluation of Mesiodistal Angulation of Maxillary Anterior Teeth in Incisal View Using Manual and Digital Methods: An In Vivo Study. J Contemp Dent Pract 2024;25(4):320-325.

OBJECTIVE: This study aims to determine the mean collum angle of maxillary central incisor and to compare it between high angle and low angle patients undergoing orthodontic treatment. METHODOLOGY: This cross-sectional, observational study was conducted using lateral cephalometric radiographs of 61 class II division 1 patients (comprised 32 males, 29 females, age range 13 to 30 years) from the record files of patients inducted for Orthodontic management from June 2020 till August 2020 at the Department of Orthodontics, Sindh Institute of Oral Health Science, Jinnah Sindh Medical University, Karachi, Pakistan. The sample was divided on the basis of Vertical Analysis (angulation of mandibular plane) into high and low angle cases. Collum angle was measured using the angulation of the Maxillary Central Incisor (MCI). Student t-test was used to compare the mean difference of the collum angle between skeletal vertical malocclusions. RESULTS: Mean value of the collum angle for high angle (Vertical Growth pattern) cases were mean ± standard deviation (4.35°±1.49°) while for low angle groups (Horizontal Growth pattern) were (2.41°±1.60°). CONCLUSION: There Collum angle of permanent maxillary central incisors differ significantly (p<0.001) among high angle and Low angle malocclusions cases (n=61) and showed pronounced axial bending in Class II division 1 incisors with high angle (4.35° ± 1.49°) as compared to low angle malocclusion (2.41° ± 1.60°). [ABSTRACT FROM AUTHOR]

Abstract Background Contrary to buccal orthodontics, lingual orthodontics has no reference for vertical bracket positioning on the maxillary central incisor. The aim of this study was to provide a reference point in relation to torque for lingual bracket positioning on the palatal surface curvature (PSC) of the maxillary central incisor. Methods Cone beam computed tomography (CBCT) radiographs of 50 right maxillary central incisors from archives of a dental radiographic center were transferred to Photoshop, where their PSC was traced using pen-tool. The PSC torque angle values of the incisors were calculated in Excel using cubic poly-Bezier curves at 0.5-mm increments and at the inflection point of PSC. Descriptive statistics for the torque angle values of the increments and for the inflection point for the 50 incisors were then calculated. One-way ANOVA test was used to detect systematic differences between the increments, and Tukey test was used post-hoc. Results For all incisors, increments incisal to inflection point exhibited progressive decrease in torque angle values from the first-calculated increment to inflection point while increments cervical to inflection point exhibited progressive increase from inflection point to last-calculated increment. Mean torque angle values of all the increments and inflection point showed high standard deviations and vast range of values. One-way ANOVA test was highly statistically significant (p

Objective: To determine Collum angle and crown to root angle of maxillary central incisor in different skeletal malocclusion. Study Design: Comparative cross sectional study. Place and Duration of Study: Orthondontics department, Bolan Medical College, Civil Sandman Hospital, Quetta, from Jun to Dec 2018. Methodology: Data sample consisted of 140 lateral cephalograms. Sample consisted of 74 female cephalograms and 66 male cephalograms. The mean age of sampled subjects ranged between 21.62 ± 5.96 years. The Colum angle of the maxillary central incisors in each group was measured. SPSS version 21 was used to enter and process data. Comparison between Class II division 1 and division 2 collum angles was made by applying student t-test. Results: The average value for Collum angle in class II division 1 sample was 4.38 ± 3.08 with minimum being 0 and maximum 15 degree. The average values for Class II division 2 was 10.52 ± 4.37 with minimum 30 and a maximum 23 degree. Conclusion: Maxillary central incisors in all malocclusions had significantly different mean Collum angles from zero. Paired sample t-test comparison showed that the Collum angle for maxillary central was much higher in Class II division 2. [ABSTRACT FROM AUTHOR]

In the immediate implantation of maxillary central incisors, the height of the alveolar bone is lost, and there is often a risk of bone fracture due to the thin buccal bone wall (BBW). The purpose of this study was to assess the effects of smoking, age, and root position in the alveolar bone on the BBW and the distance between the cemento-enamel junction (CEJ) and the facial bone crest (FBC) of Chinese maxillary central incisors. The patients were divided by smoking, gender, age, and root sagittal position in the alveolar bone. BBW thickness was measured at the following sites: the 4 mm apical to the CEJ, the middle of the root, and the apex. The distance from the CEJ to the FBC was also evaluated. Cone beam CT (CBCT) data for the maxillary central incisors of 645 patients (323 males and 322 females) were selected and analyzed. The CEJ-FBC distance in patients who smoked (2.79 ± 0.78 mm) was significantly greater than that of non-smokers (2.54 ± 0.69 mm). The BBW in subtype III (0.74 ± 0.43 mm, 0.81 ± 0.36 mm) was thinner than that in subtypes I and II at 4 mm apical to the CEJ and in the middle of the root, with a statistically significant difference (p < 0.05). In most Chinese people, smoking, gender, age, and the position of the root in alveolar bone are all important factors that must be considered before immediate implantation is undertaken. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to suggest a clinical guideline to properly position immediate implant placement in the anterior maxillary area. Materials and Methods: The computed tomography (CT) records of 250 patients (125 males, 125 females; mean age 49.5 years) were evaluated, and the relationship of the sagittal root positions of the maxillary central incisor teeth to their respective alveolar bony housing was classified as buccal (B), medial (M), or palatal (P). Then, the clinical guideline was suggested based on the implications derived from the classification. In the second investigation, the validity of the clinical guideline was confirmed by CT analysis. First, a reference line was defined using soft tissue landmarks. Then, a virtual rectangle representing the dental implant was created and merged on the CT image, symbolizing the space where the dental implant would be positioned. The rectangular frame was positioned on the image in accordance with the guideline. The frame on the image was thoroughly assessed to detect the possibility of perforation of the labial plate. The location of the initial drilling access on the respective crown was determined by extending the longitudinal axis of the frame in a coronal direction. Results: Of the 250 samples, 94.0% were classified as type B. Type M and P represented 5.6% and 0.4% of the samples, respectively. In 82.0% of the samples, the frame was safely positioned, not contacting the labial or palatal cortical plate in the alveolar bony housing. Moreover, when a frame representing a tapered implant form with an apical diameter of 3.5 mm was applied, 98.8% of samples were positioned safely in the alveolar bony housing. The longitudinal axis of the frame crossed the respective crown at the incisal tip in 54.4% of the cases. It crossed the labial side of the crown and cingulum of the crown in 42.0% and 3.6% of the cases, respectively. Conclusions: The root of the maxillary central incisor teeth tended to be positioning labially in the alveolar bony housing. The result of the CT analysis confirms the clinical guideline as a dependable clinical reference in immediate implant placement. [ABSTRACT FROM AUTHOR]

The crown form of maxillary central incisor tooth is one of the vital phenomenon for a person's esthetics. Its crown form has been compared with other anatomical parameters such as arch form and facial form. Three different classes of tooth forms which relate to square, tapered, and ovoid forms are identified. The aim of this study was to morphometrically evaluate the correlation between maxillary dental arch form and the maxillary central incisor crown form. Dentate cast models of fifty male and fifty female normal occlusion controls in the age group of 18–23 years were analyzed. The mesiodistal (MD) dimensions of the maxillary central incisors were measured at incisal (MD_I) and at gingival (MD_G) levels. The transverse widths of maxillary casts were measured at the first molar and at the first premolar levels. The measured data were statistically analyzed using the SPSS software. The MD dimensions of maxillary central incisor were significantly greater in males than females. The ratio between the two MD dimensions also varied significantly among genders. The intermolar width (IMW) and inter first premolar width (IPmW) between males and females were highly significant (P < 0.05), whereas the ratio between these two parameters in males and females was not significant (P = 0.43). Eighty-eight percentage of the participants were found to have an ovoid type of maxillary arch, while only 45% of them had the ovoid form of maxillary central incisors. The MD_I and the IMW were found to be in the ratio of 1:5.5 in both genders. The MD_G and the IPmW were in the ratio of 1:4.7 in males and 1:4.5 in females. There was a weak positive correlation between MD_I and IMW (r2 = 0.146) and between MD_G and IPmW (r2 = 0.05). No significant concordance between the maxillary central incisor crown form and the maxillary arch form was found in this study.

This study aimed to determine the effect of biomechanical distribution by means of occlusal adjustment when the maxillary incisor labial-palatal inclination changes. A mechanical model of the maxillary central incisors was established, where the couple distances between the roots buried in the periodontal tissue with different loads were chosen to show the effects on periodontal tissue under various bite forces, labial-palatal inclinations, and occlusal obliquities. In addition, a two-dimensional finite element model of the maxillary central incisors was created under different labial-palatal inclinations and occlusal obliquities, and the equivalent stress of the periodontal ligament was selected as the analytical index. The mechanical model suggested that: for the perpendicular load, a larger occlusal obliquity would reduce stress to the periodontal tissue when the labial-palatal inclination was fixed; and for the vertical load, occlusal obliquity had little effect on stress to the periodontal tissue, while a larger labial-palatal inclination reduced stress to the periodontal tissue. The results of the finite element analysis also showed that stress increased with a decrease in occlusal obliquity with the same labial-palatal inclination, and stress increased significantly under loads perpendicular to the occlusal surface. As for vertical loads, stress decreased with an increase in the labial-palatal inclination, but the stress was concentrated in the root tip area. The results showed that if the maxillary central incisor requires occlusal adjustment after orthodontic treatment, the treatment plan with the greater occlusal obliquity should be preferred. [ABSTRACT FROM AUTHOR]

The primary objective of root canal treatment is complete cleaning and shaping of all root canals so that microorganism and debris are removed from the root canal that result in hermetic seal of root canal space. The endodontic treatment of every tooth poses some endodontic challenges which have to be carefully managed by proper clinical and radiographic evaluation before treatment. The teeth with partial or complete obliteration of pulp canal results in endodontic challenge due to difficulty in negotiation of canal orifice. It is always important to take necessary precautions while locating canal orifice to apex, otherwise it will result in iatrogenic errors including perforation and separation of instrument. This present case describes the successful location and management of calcified canal in maxillary central incisor with proper knowledge of internal anatomy, thorough radiographic assessment and canal orifice locating instrument such as c+ files under microscope. [ABSTRACT FROM AUTHOR]

Coronal fractures of anterior teeth are the most common form of dental trauma that occur in children and adolescence. They cause functional, aesthetics and psychological problems for both their children and parents. Intact tooth fragment provides a very conservative approach for reattachment of dental fragment. Owing to its good long lasting aesthetics (as tooth's original anatomic form, color and surface texture are maintained) and functional restorability it provides a better alternative as compared to the resin based composite or crown restoration. It overcomes the problem of repeated reconstruction of composite with age and provides a positive psychological response. The article reports a case of a child with anterior tooth fracture that was successfully treated using tooth fragment reattachment. It aims to review and discuss the methodology along with different preparation techniques and adhesives used by various authors and analyze the advancement and most accepted procedure for of the treatment. It also highlights the shortcomings of the technique as patient cooperation determines the prognosis of the procedure and a long term follow up determines the success of the procedure. [ABSTRACT FROM AUTHOR]