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Purpose The primary aim of this study was to evaluate the buccal bone concavity position and depth in the anterior maxilla. The accuracy of cone beam computed tomography (CBCT) to measure the buccal bone concavity was also investigated. Material and methods Eleven fresh cadaver heads were used in this study. CBCT images were first acquired, on which the location and depth of the buccal bone concavity were measured in maxillary incisors and canines. After full-thickness mucoperiosteal flap reflection, the corresponding measurements were made directly on cadavers. The accuracy and correlations between direct and image-derived measurements were analyzed statistically. Results A total of 53 sites were measured. The mean depths were 2.88 ± 1.37 mm and 2.40 ± 1.29 mm (with direct and CBCT measurement, respectively). The deepest concavities were found in the lateral incisors sites (3.15 ± 1.32 mm). There was a statistically significant underestimation of the depth of concavity (0.2 to 0.6 mm) by CBCT. Nevertheless, there is a high statistical correlation (r = 0.8) between the direct and CBCT measurements. Conclusions Within the limitations of this study, it can be concluded that buccal bone concavity is the most prominent at the lateral incisor sites. The CBCT readings were highly correlated but underestimated to the direct measurements.

Introduction The purpose of this study was to examine the frequency and bilateral consistency of distolingual roots (DLRs) in permanent mandibular first molars (PMFMs) and root canal configurations in PMFPs (permanent mandibular first premolars) and to determine the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs. Methods A total of 932 cone-beam computed tomographic images of PMFMs and PMFPs were collected from 233 patients. The frequency and bilateral consistency of DLRs in PMFMs along with root canal configurations (root number and canal number) of PMFPs were recorded and evaluated ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs. Results The prevalence of PMFMs with DLRs was 24.7%, and the incidence of complicated root canal configurations of PMFPs was 26.6%. The incidence of complicated root canal configurations of PMFPs was 19.6% in the non-DLR group, 37.2% in the unilateral DLR group, and 44.7% in the bilateral DLR group. After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMFPs in the unilateral DLR and bilateral DLR groups compared with the non-DLR group were 2.472 (95% confidence interval, 1.434–4.263; P = .001) and 3.392 (95% confidence interval, 1.976–5.823; P Conclusions An increasing and corresponding trend between the presence of DLRs in PMFMs and complicated root canal configurations in PMFPs was noted in Taiwanese individuals. These results suggest that the clinicians should familiarize themselves with the anatomic variants of PMFMs and PMFPs before endodontic treatment.

The aim of this study was to determine the prevalence of C-shaped canal configurations (CSs) and radicular grooves (RGs) in permanent mandibular first premolars (MPs) and to investigate the relevance of such complexities with the presence of distolingual roots (DLRs) in permanent mandibular first molars (MMs).A total of 800 pairs of MPs and MMs were investigated using a cone-beam computed tomographic system (NewTom 5G; QR srl, Verona, Italy). The frequency and symmetry of DLRs in MMs along with the occurrence of RGs and CSs in examined MPs were evaluated. Multivariable logistic regression analysis was applied to examine the correlation between the CSs of MPs with the appearance of DLRs in MMs.In the examined teeth, 23.0% of MMs had a DLR, whereas 16.6% of MPs had RGs and 12.5% of MPs had C-shaped canals. Although the most common canal configuration in MPs is the single canal (74.1%), the other 25.9% still possess complicated root canals. Of these MPs that have different canal configurations, 54.6% had 2 canals, whereas 44.4% had CSs. Specifically, the CS showed a high prevalence of C3 morphologies at 98.9% followed by C1 at 1.1%. A corresponding and increasing frequency was noted in CSs and RGs of MPs and MMs with DLRs (P .001). After adjusting for related categoric variables, the adjusted odds ratios for CSs of MPs in the bilateral DLR group compared with the non-DLR group was 3.294 (P .001).This study showed an increased appearance of CSs in MPs when DLRs were present in MMs in the Taiwanese population.

The aim of this study was to assess the prevalence of complicated root canals in permanent mandibular central incisors (PMCIs) and its correlation with the presence of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone-beam computed tomographic imaging in a Taiwanese population.A total of 400 patients (800 pairs of PMCIs and PMFMs) were qualified for further analysis. The prevalence of DLRs in PMFMs along with root canal configurations of PMCIs were assessed at subject and tooth levels. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMCIs with the existence of DLRs in PMFMs.The prevalence of PMFMs with DLRs and complicated root canal configurations in PMCIs was 23.0% and 15.6%, respectively. A significant difference in age (50 years vs ≥50 years) was found for complicated root canal configurations in PMCIs. The most prevalent root canal system in PMCIs was Vertucci type I (84.4%) followed by type III (13.5%). A positive correlation between the presence of DLRs in PMFMs and complicated root canal configurations in PMCIs was noted. After adjusting for categoric variables including sex, age, and side, the odds ratios for the occurrence of complicated root canal configurations of PMCIs in the unilateral DLR group and the bilateral DLR group compared with the non-DLR group were 2.13 and 2.53, respectively.The concurrent appearance of DLRs in PMFMs and complicated root canal morphology in PMCIs is prominent in Taiwanese individuals.

Introduction The aim of this study was to assess the root canal configurations in permanent mandibular lateral incisors (PMLIs) and the correlation between the root canal configurations of PMLIs with the appearance of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone-beam computed tomographic (CBCT) imaging. Methods A total of 1200 CBCT images (300 patients) of PMFMs and PMLIs were investigated. The frequency and distribution of DLRs in PMFMs along with root canal configurations of PMLIs were assessed ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMLIs with the appearance of a DLR in PMFMs. Results The prevalence of PMFMs with a DLR was 24.3%, and the incidence of complicated root canal configurations in PMLIs was 25.0%. The most prevalent root canal systems of PMLIs were Vertucci types I (75%) and III (23.0%). The incidence of complicated root canal configurations in PMLIs was 19.5% in the non-DLR group (ie, no DLR was found on either side of the PMFMs), 33.3% in the unilateral DLR (Uni-DLR) group (ie, a DLR was found in 1 of the PMFMs [the left or right side] and a DLR was not found on the other PMFM), and 39.8% in the bilateral DLR (Bil-DLR) group (ie, a DLR was found in both the right and left PMFMs). After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMLIs in the Uni-DLR and Bil-DLR groups compared with the non-DLR group were 2.12 (P = .003) and 2.707 (P Conclusions The simultaneous appearance of DLRs in PMFMs and complicated root canal configurations in PMLIs is prominent in Taiwanese individuals. Clinicians should be aware of the correlation between the anatomic variants of PMFMs and PMLIs, which are important before endodontic treatment.

Use of statins on adult patients with chronic periodontitis shows a positive effect on their periodontal status. However, effect of locally delivered statins on periodontal treatment has not yet been systematically analyzed. Hence, the present systematic review and meta-analysis aims to evaluate efficacy of statins on treating localized periodontal intrabony defects (IBDs).An electronic search of three databases (PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature) between January 1, 1965 and March 1, 2016, and a hand search of peer-reviewed journals for relevant articles were performed. Controlled randomized clinical trials (RCTs) and prospective studies with data on comparison between adjunctive locally delivered statin use to mechanical scaling and root planing (SRP) and placebo in each group, with minimum 10 participants and follow-up period of at least 6 months, were included.Ten studies, eight RCTs and two prospective studies, were included. Each study included 15 to 105 patients between 25 and 55 years of age. Statistical results were recorded; weighted mean difference (WMD) and confidence interval (CI) were calculated; and meta-analyses were performed for defect fill, probing depth (PD) reduction, and clinical attachment level (CAL) gain in both statin and placebo/no treatment groups. Overall analysis of defect fill presented WMD of 1.37 mm (95% CI = 0.96 to 1.77; P0.0001), PD reduction presented WMD of 1.76 mm (95% CI = 1.04 to 2.47; P0.0001), and CAL gain presented WMD of 1.58 mm (95% CI = 0.89 to 2.28; P0.0001). However, comparison presented considerable heterogeneity among studies.This systematic review and meta-analysis find that adjunctive use of locally delivered statins to mechanical SRP is beneficial to increasing bone fill percentage. Improved inflammatory and bleeding control as well as PD reduction and CAL gain are possible advantages to using these drugs in treating patients with periodontal IBDs.

This case report describes the continued root formation following replantation and conventional root canal therapy of a traumatically avulsed open-apex tooth with suppurative apical periodontitis. A 7-year-old male patient had an avulsed upper left central incisor (tooth 21) replanted approximately 50 min after traumatic avulsion. A root canal procedure was initiated due to pulp necrosis and periapical abscess detected in the follow-up period. After endodontic treatment with calcium hydroxide (Ca(OH)(2)) dressing, a normal root length developed including an apical segment beyond the hard tissue barrier. Regeneration of the root occurred without pathology or ankylosis at 1-year of follow up.

Teeth with traumatic crown-root fractures extending subgingivally and involving the entire width of the tooth may have problems in endodontic isolation, periodontal maintenance, and restoration. A number of techniques, such as crown lengthening, and orthodontic or surgical extrusion, have been described for treatment of crown-root fractures. However, all of these techniques have limitations in terms of the extended time required for treatment, cost, and esthetic considerations. Intra-alveolar transplantation is an alternative treatment option in the management of complicated crown-root fractures. We describe a case of intra-alveolar transplantation with 180( degrees ) rotation and suture fixation. At 1-year follow-up, the replanted tooth has normal function and no obvious inflammatory root resorption on radiographic examination.

A case of a retained root tip simulating apical periodontitis on radiographic examination is described. The retained root tip, originating from the left lower first molar, floated under the left lower second premolar apical region mimicking apical periodontitis. It appeared as an ill-defined periapical radiolucency containing a smaller radiodense mass on radiograph. The differential diagnosis included focal sclerosing osteomyelitis (condensing osteitis) and ossifying fibroma. Upon exicisional biopsy, a retained root associated with granulation tissue was found. After 1-year follow-up, the patient was asymptomatic and the periradicular lesion was healing. Meanwhile, the associated tooth showed a normal response to stimulation testing.