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Primary failure of eruption (PFE) is a rare, nonsyndromic condition in which non-ankylosed teeth fail to erupt either fully or partially due to malfunction of the eruption mechanism. Three young patients are presented in this article with features consistent with a diagnosis of PFE. The features of this condition are described together with different modalities of treatment planning for such patients. The following is a discussion about zygoma implants as a new approach to treatment for patients with PFE requiring full-mouth rehabilitation. [ABSTRACT FROM AUTHOR]

Numerous surgical techniques have been developed as effective means to facilitate orthodontic treatment, but they may cause significant postoperative discomfort. Piezocision was established as a flapless and minimally invasive technique to accelerate orthodontic tooth movement by combining small vertical incisions and piezoelectric corticotomies. Computed tomography is combined with the Piezocision technique to fabricate CAD/CAM surgical guides to prevent iatrogenic damage. A method to combine computer-assisted dynamic navigation with Piezocision is introduced here. CBCT was combined with motion-tracking technology to allow real-time tracing of the piezoelectric instruments during the surgical procedure. This technique delivers the location of the piezoelectric knife in regard to roots and important anatomical structures to increase the safety and accuracy during corticotimies. [ABSTRACT FROM AUTHOR]

Objectives: The consecutive case series accesses the results and experiences of ridge augmentation using an umbrella screw tenting technique. Method and materials: In total, 279 patients were treated between 26 May 2015 and 16 June 2021, including horizontal and vertical ridge defects. Sex, age, smoking behavior, jaw, graft material, soft tissue thickness, extent of horizontal/vertical augmentation, resorption rate, and occurrence of early/late exposure were evaluated. Bone gain was determined by resorption at the screw head. Only cases without premature screw removal were evaluated metrically (n = 201). All other augmentations were evaluated according to whether implantation was possible with or without further augmentation (n = 27). A target performance index was calculated, which should enable evidence-based comparability of different augmentation methods in future. Results: In total, 54 wound dehiscences (39 early, 15 late exposures) occurred, which corresponds to 24.08% of the augmented sites; 42 umbrella screws were removed prematurely. In all cases an implantation was possible at the desired position afterwards. Cases with a vertical augmentation component showed a higher prevalence of exposure (early, P = .000; late, P = .024). The extent of the vertical augmentation was only relevant for early exposure (P = .048). Mean bone gain of 4.23 ± 1.69 mm horizontally and 4.11 ± 1.99 mm vertically could be achieved. Regression analysis showed that there was no limit in horizontal/vertical direction. Mean percentage target performance index was 75.90 ± 20.54 for vertical and 82.25 ± 16.67 for horizontal portions. Conclusion: The umbrella technique is an effective augmentation method, which can be applied to any defect morphology. [ABSTRACT FROM AUTHOR]

Background: Establishing accurate, reliable, and convenient methods for enamel segmentation and analysis is crucial for effectively planning endodontic, orthodontic, and restorative treatments, as well as exploring the evolutionary patterns of mammals. However, no mature, non-destructive method currently exists in clinical dentistry to quickly, accurately, and comprehensively assess the integrity and thickness of enamel chair-side. This study aims to develop a deep learning work, 2.5D Attention U-Net, trained on small sample datasets, for the automatical, efficient, and accurate segmentation of enamel across all teeth in clinical settings. Methods: We propose a fully automated computer-aided enamel segmentation model based on an instance segmentation network, 2.5D Attention U-Net. After data annotation and augmentation, the model is trained using manually annotated segmented enamel data, and its performance is evaluated using the Dice similarity coefficient metrics. A satisfactory image segmentation model is applied to generate a 3D enamel model for each tooth and to calculate the thickness value of individual enclosed 3D enamel meshes using a normal ray-tracing directional method. Results: The model achieves the Dice score on the enamel segmentation task of 96.6%. This study provides an intuitive visualization of irregular enamel morphology and a quantitative analysis of three-dimensional enamel thickness variations. The results indicate that enamel is thickest at the incisal edges of anterior teeth and the cusps of posterior teeth, thinning towards the roots. For posterior teeth, the enamel is thinnest at the central fossae area, with mandibular molars having thicker enamel in the central fossae compared to maxillary molars. The average enamel thickness of maxillary incisors, canines, and premolars is greater than that of mandibular incisors, while the opposite is true for molars. Although there are individual variations in enamel thickness, the average enamel thickness graduallly increases from the incisors to the molars among all teeth within the same quadrant. Conclusions: This study introduces an automatic, efficient, and accurate 2.5D Attention U-Net system to enhance precise and efficient chair-side diagnosis and treatment of enamel-related diseases in clinical settings, marking a significant advancement in automated diagnostics for enamel-related conditions. [ABSTRACT FROM AUTHOR]

This case report describes a minimal intervention dentistry approach for a tense-cooperative boy with an enamel hypoplastic defect in an incisor as a result of a traumatic dental injury to its predecessor. The primary mandibular left central incisor (tooth 0) was avulsed when the child was 2.7 years of age. At a follow-up visit 2.5 years later, the permanent mandibular left central incisor (tooth 24) was erupting and presented a change in color along with a reduction in the enamel thickness. A temporary restoration of the hypoplastic defect was performed when the child was 7.7 years of age. This conservative approach was chosen based on the child's behavior and because the lesion boundary was located near the free gingival margin due to the eruption stage of the tooth. The procedure was carried out without local anesthetic, utilizing a resin-modified glass ionomer cement and cotton roll isolation. This patient-friendly approach allowed simplification of the steps involved in the process. The child and his guardian were satisfied with the temporary restoration, and the boy regained his self-reliance regarding dental care. The family and the boy were reminded again of the importance of follow-up visits after a traumatic dental injury. [ABSTRACT FROM AUTHOR]

Background: Molariform second premolar is a rare dental anomaly where the second premolar resembles a molar in size and shape. This condition is often linked to macrodontia, a rare enlargement of teeth that disrupts dental proportions and can manifest in isolated, relative, or generalized forms. Although mandibular second premolars are more prone to morphological variability, the occurrence of bilateral molariform premolars, induced by a unique form of gemination, is exceptionally uncommon and infrequently documented, thus making this case clinically significant. Case presentation: This case report illustrates a rare bilateral presentation of molariform second premolars in the mandibular arch of a young patient. Both premolars displayed exaggerated mesiodistal dimensions, molar-like occlusal morphology with multiple cusps, and disproportionate faciolingual dimensions. Diagnosis was established through detailed clinical examination and radiographic evaluations. The report explores the treatment challenges posed by the enlarged tooth size and abnormal morphology, including their impact on orthodontic alignment and restorative planning. The patient was scheduled for reshaping of the macrodont premolars after finishing orthodontic treatment, which was planned for correction of overjet, overbite, as well the deep curve of spee. Conclusions: Molariform premolars, though uncommon, have a profound impact on dental alignment and treatment outcomes. Their morphological uniqueness might potentially be ignored; therefore, dental professionals should remain vigilant for such anomalies during routine examinations to prevent complications like crowding, malocclusion, and caries. Early diagnosis and strategic intervention are crucial for prevention and interdisciplinary management of unexpected complications during dental procedures. This case emphasizes the importance of routine examination and interdisciplinary collaboration in identifying and treating such anomalies. [ABSTRACT FROM AUTHOR]

Background: To evaluate the prevalence and characteristics of taurodontism in northern China by using cone-beam computed tomography (CBCT) and assisting the treatment. Methods: The study involved CBCT scans of 8112 teeth from 507 participants of northern China, comprising 217 males and 290 females aged 18 to 60. Analysis was conducted using Shifman and Chanannel's criteria to assess the prevalence and attributes of taurodontism, examining differences based on tooth position (maxilla and mandible) as well as gender (P < 0.05). Specific morphology including C-shaped canal was recorded. The curvature of the canals was measured using a modified Schneider method. Moreover, we reported two failure cases with taurodontism referred to a retreatment. Results: Taurodontism was observed in 113 participants, affecting 23.50% of the males and 21.38% of the females in at least one tooth (P > 0.05). The prevalence was significant higher in maxilla (P < 0.05). The highest incidence of taurodontism was detected in premolars, 9.86% in the maxillary first premolars, and in molars, with 3.94% in the maxillary first molars. Regarding canal curvature, a higher incidence of curved canal could be found in maxillary and mandibular molars of taurodontism (47.50-66.67%), alongside an elevated prevalence of C-shaped taurodontism in mandibular second molars (71.43%). After follow-up, the healing response was satisfactory in both cases. Conclusion: The study highlighted a higher incidence of taurodontism in maxilla, indicating a significant association between taurodontism, C-shaped characteristics, and canal curvature. Dentists are advised to carefully consider the presence of special morphologies during taurodontism treatment. [ABSTRACT FROM AUTHOR]

Background: Changes in bone age and tooth development are late side effects of cancer therapy and can be identified by imaging examination. Aim: To evaluate the late effects of antineoplastic treatment on bone age and dental development in childhood cancer survivors. Design: This is a retrospective case–control study on paediatric cancer survivors of both sexes who underwent antineoplastic treatment with 5–15 years of survival. Carpal radiographs were assessed for bone age and growth curve, and panoramic radiographs were used to evaluate dental development and alterations. Carpal radiographs were analyzed using the Greulich and Pyle inspection method, and the Martins and Sakima method was used to analyze the growth curve. All tests were applied with a confidence level of 95%. Results: The study and control groups comprised 28 and 56 patients, respectively. There was no significant difference in bone age and growth curve between the study and control groups. Nonetheless, when sex was compared to chronological and bone ages, there was a significant difference in bone age (p = 0.019) and an underestimation in both groups and sexes in the Greulich and Pyle method. As to late dental effects, dental agenesia, microdontia, gyroversion, and unerupted teeth were found. Dental shape alterations mainly involve the root region. Conclusion: Close multidisciplinary collaboration is necessary during the follow‐up period of young patients who have survived cancer. [ABSTRACT FROM AUTHOR]

Background: Dens invaginatus is a developmental abnormality originating from tooth development, including coronal invaginatus and radicular invaginatus. The reported incidence varies greatly due to diagnostic techniques, classification criteria and race. The incidence of dens invaginatus in China was not clear, and the impact of dens invaginatus on periodontal support tissue were rarely reported. This study aims to clarify the incidence of maxillary lateral incisor dens invaginatus and its impact on periodontal supporting tissues. Methods: From the cone-beam computed tomography database, images of 212 maxillary lateral incisors from 106 Chinese patients were selected. Teeth that met the Oehlers classification criteria for coronal invaginatus were recorded as coronal invaginatus, and teeth with radicular cystoid invaginatus or radicular groove were classified as radicular dens invaginatus. The complexity of radicular groove was determined by Gu's classification standard. Both of coronal invaginatus and radicular dens invaginatus were recorded as dens invaginatus. For 15 patients with unilateral radicular dens invaginatus, the periodontal ligament area of the affected teeth and the corresponding natural teeth in the same jaw were measured and compared. Results: The overall incidence of maxillary lateral incisor invaginatus in China is 25.0%. The incidence of coronal invaginatus is 12.3%, and the incidence of radicular dens invaginatus is 14.6%. No significant differences were observed between genders or sides. In this study, all radicular dens invaginatus exhibited as radicular groove, of which 87.1% were Gu type I, 9.7% were Gu type II, and 3.2% were Gu type III. Although the difference was not statistically significant, the average periodontal ligament area of the maxillary lateral incisor with radicular dens invaginatus was 148.93 ± 35.62mm2, smaller than that of the control teeth (152.28 ± 40.22mm2). Conclusions: The dens invaginatus of the maxillary lateral incisor is common. There is no significant difference in the incidence between genders or between sides. The main manifestation of the radicular dens invaginatus is the radicular groove (Gu's type I). This anatomical abnormality may reduce the periodontal ligament area. The presence of the additional root of the maxillary lateral incisor is not rare and was supposed to be highly concerned by dentists. [ABSTRACT FROM AUTHOR]

Background: Aberrant occlusion and aging are two main risks for temporomandibular joint (TMJ) degeneration. Objective: To assess the combined impact of occlusion and age on TMJ disc. Methods: To avoid the confounding impact of gender, presently, 126 female C57BL/6J mice, 63 youngsters, 6‐week old and 63 adults, 28‐week old, were used. An experimental bilateral anterior crossbite (BAC) relation was created by installing metal tubes onto the mandibular incisors. Mice were sacrificed at 3, 7 and 11 weeks (n = 9). Additionally, the installed tubes were removed at 7 weeks in removal groups and the TMJs were sampled after another 4 weeks (n = 9). Disc changes were detected by histomorphology, immunohistochemistry, and western blot assays. Results: Disc deformation was obvious in BAC groups. The typical change was hyperplasia at the posterior region of the disc where there was significant infiltration of inflammatory cells. Expressions of the inflammatory markers, including tumour necrosis factor‐α and interleukin‐1β, and the catabolic markers, including fibronectin (FN), FN N‐terminal fragments, and vascular endothelial growth factor‐A, were all increased. The changes were more obvious in adults than in youngsters. Removal of BAC attenuated inflammatory and catabolic changes in the youngsters, but the inflammatory markers recovered little in the adults. Conclusion: TMJ disc responds to BAC by degeneration and inflammation, and respond to BAC removal by rehabilitation. Adult discs show severer degeneration responses to BAC and a lower level of anti‐inflammatory capability to BAC removal than the youngster's discs. Animals cannot be equated with humans. The human disc response to occlusion changes worth further exploration. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies have shown varying prevalence rates of dental anomalies worldwide, ranging from 5.2% to 56.9%, with a higher rate of 90.4% in patients with cleft lip and palate. In Saudi Arabia, studies have also reported varied prevalence rates, likely due to genetic differences or sampling variations. However, no research has yet evaluated the quality of these studies or provided an overall prevalence estimate, which is the aim of the present study. This systematic review aims to assess the prevalence and types of dental anomalies across various regions of the Kingdom of Saudi Arabia (KSA). Methods: A comprehensive literature search identified 10 relevant studies on different dental anomalies in Saudi Arabia. The quality of the enrolled studies was assessed using the Newcastle–Ottawa Scale (NOS), showing variability in the methodological quality of the included cohort studies, with several studies demonstrating a moderate to high risk of bias. Results: Common anomalies included hypodontia, hyperdontia, microdontia, and impacted teeth. This study highlights the varying prevalence of dental anomalies in different regions of Saudi Arabia, ranging from 2.6% to 45.1%. Conclusions: This review highlights the need for early diagnosis and tailored treatment approaches to mitigate the clinical challenges posed by these anomalies, underscoring the importance of standardized diagnostic criteria and further research to understand regional and demographic differences in the prevalence of dental anomalies in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to assess the clinical and radiographic effect of a bone graft material (β-tricalcium phosphate + hydroxyapatite) alone and in combination with platelet-rich fibrin in intrabony defects of periodontitis patients. Method and materials: This 6-month randomized controlled clinical trial was carried out in 42 intrabony periodontal defects (average age 40 years). Intrabony defects ≥ 3 mm along with associated probing depth of ≥ 5 mm following phase 1 periodontal therapy were treated either with open flap debridement with bone graft (β-tricalcium phosphate + hydroxyapatite; control group) or open flap debridement with bone graft plus platelet-rich fibrin membrane (test group). Individual customized acrylic stents with grooves were used to ensure reproducible and repeatable measurements of clinical and radiographic parameters, including probing pocket depth (PPD), relative clinical attachment level (RCAL), gingival marginal level (GML), vertical bone defect fill (VHD), and area of intrabony defects (AOD) on intraoral periapical radiographs. Clinical attachment level (CAL) gain was considered as primary outcome and PPD reduction and radiographic bone fill as secondary outcomes. Results: The preoperative Plaque Index, RCAL, GML, PPD, VHD, and AOD in the control group were 1.06 ± 0.08, 11.57 ± 2.29 mm, 5.24 ± 1.89 mm, 6.29 ± 1.52 mm, 14.36 ± 2.65 mm, and 7.79 ± 4.39 mm2, respectively. After 6 months these were 1.08 ± 0.14, 9.34 ± 2.54 mm, 5.81 ± 2.20 mm, 3.52 ± 0.93 mm, 12.64 ± 2.34 mm, and 5.34 ± 3.2 mm2, respectively. The preoperative PI, RCAL, GML, PPD, VHD, and AOD in the experimental group were 1.14 ± 0.05, 12.19 ± 2.86 mm, 4.38 ± 1.63 mm, 7.81 ± 2.6 mm, 13.46 ± 3.42 mm, and 10.31 ± 8.71 mm2, respectively. After 6 months these were 1.09 ± 0.12, 8.62 ± 2.62 mm, 4.90 ± 1.79 mm, 3.71 ± 1.68 mm, 10.10 ± 2.07 mm, and 4.38 ± 2.67 mm2, respectively. After 6 months of evaluation both the groups showed a significant reduction in PPD (P < .001) and a significant gain in CAL (P < .001), as well as significant improvement in radiographic VHD fill and AOD changes. Again, the test group showed significant changes (P < .001) over the control group considering the same outcomes. Conclusion: With the study limitations in mind, it can be concluded that for the treatment of intrabony defects with the bone graft material (β-tricalcium phosphate + hydroxyapatite; Biograft, IFGL Bio Ceramics) or the same bone graft with platelet-rich fibrin membrane results in statistically significant improvement in clinical (CAL and PPD) and radiographic (VHD and AOD) parameters, the latter having highly significant benefits. However, the bone graft material requires improvement. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess levels of 25-hydroxy vitamin D (25(OH)D3), calcium (Ca+2), phosphorus (P), and parathyroid hormone (PTH) and to determine delayed tooth eruption by examining their correlations. Material and method: The study included 101 paediatric patients, aged 6–14 years, who visited the Dicle University Paediatric Dentistry Clinic, had no systemic diseases, and had not received medication in the past three months. Among them, 60 patients exhibited delayed eruption of their permanent central and first molar teeth, while 41 did not. Serum levels of 25(OH)D3, Ca+2, P, and PTH were measured. Statistical analyses were performed using IBM SPSS software, with statistical significance set at p < 0.05. Results: Serum levels of 25(OH)D3 and Ca+2 were significantly lower in the patient group, whereas PTH levels were significantly lower in the control group (p < 0.05). However, serum P levels did not differ significantly between the groups (p > 0.05). Conclusions: Serum parameters play a significant role in tooth eruption. The significance of vitamin D has increased because of its physiological effects and involvement in metabolic pathways, highlighting the need to examine Ca+2, P, and PTH levels, which contribute to its regulation. Low levels of vitamin D and Ca+2, along with elevated PTH levels, have been identified as potential factors contributing to delayed tooth eruption, whereas P levels do not appear to have a significant impact. In view of the ongoing growth and development in this patient group, regular monitoring of vitamin D, Ca+2, and PTH levels, along with timely interventions, is essential. Trial registration: TCTR identification number: TCTR20240729001; registered on 29 July 2024. The trial was registered retrospectively. [ABSTRACT FROM AUTHOR]

Some medical conditions present with missing or malformed teeth and other unusual oral manifestations that complicate prosthodontic treatment. Outlining the simple and complicated treatment options to the patient allows them to make an informed decision about the treatment they wish to pursue. This report describes the management of a patient diagnosed with pseudohypoparathyroidism. Taking a patient-centred approach, with their involvement in the planning process, was essential to a successful outcome. CPD/Clinical Relevance: Adopting a holistic approach to treatment planning enables patients to make informed decisions, ensuring patient-centred care that not only targets the condition, but supports overall wellbeing. [ABSTRACT FROM AUTHOR]

This is the second article in a three-part series that discusses joint orthodontic–restorative care for the adult patient. Part 2 considers the clinical presentations, challenges and strategies for developmental conditions presenting in adulthood, including the management of hypodontia, ectopic canine teeth and disorders of tooth structure. CPD/Clinical Relevance: The challenges and treatment strategies for providing orthodontic–restorative care for an adult patient presenting with developmental conditions and anomalies are outlined. [ABSTRACT FROM AUTHOR]

The article describes interdisciplinary dentistry (ID) and how it can be applied to better care for pediatric patients. Topics discussed include the interdisciplinary dental treatment process, ID treatment plan, and University of Washington interdisciplinary dentistry example interdisciplinary problem list template.

Background: Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. Methods: Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. Results: There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P =.049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P <.001) and a statistically significant difference in surface area changes between the 4 subgroups. Conclusions: Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. Trial registration: The study protocol was retrospectively registered on Clinical Trials (NCT05931822–05/ 07/2023). [ABSTRACT FROM AUTHOR]

Background and Aim: One of the important clinical challenges in root canal treatment is the treatment of immature teeth. Following the stop of root formation, the tooth will have thin dentin walls and will be prone to cervical fracture. In vital pulp therapy (VPT), due to the preservation of the pulp, there is a possibility of completing and repairing the dentin pulp complex and increasing the dentin's thickness and length. In this report, VPT for hypoplastic immature permanent teeth (turner's tooth) has been investigated. Case Report: The patient was a five-year-old girl whose premolar tooth had severe caries due to a preapical infection caused by the corresponding primary tooth. Due to the incompleteness of the root, after the coronal pulp was removed, MTA was placed, and vital pulp therapy was performed. In the two-year follow-up, the tooth had normal clinical signs, and the length and thickness of the root increased favorably. Conclusion: Conservative pulp treatments, like VPT, can be suitable treatment options for necrotic, immature permanent teeth [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine the age-based prevalence of dens invaginatus cases and to learn the radiologic findings. In addition, fractal analysis of the periapical regions of unilateral dens invaginatus cases and contralateral teeth was performed to determine the effect of possible microleakage on fractal dimension. Methods: A total of 136 patients (170 teeth) identified in panoramic radiographs taken for diagnostic purposes between January 2018 and December 2023 at our Department of Oral and Maxillofacial Radiology were included in the study. Data were analysed using IBM SPSS V23. The Chi-square test was used for comparing categorical variables between groups. The relationship between the FD values calculated around the apexes of the teeth with unilateral dens invaginatus and the contralateral teeth was analyzed by paired t test. A significance level of p < 0.050 was adopted. Results: The mean age of the cases was calculated as 28.1 (8–63) years. 66 (48.5%) of the cases were female, and 70 (51.1%) were male. The lateral incisor was the most affected tooth among these cases. Bilateral cases were observed in 34 patients. Type 2 was detected in 93 patients, Type 1 in 35 patients, and Type 3 dens invagination in 8 patients. Dens invaginatus cases were observed in 134 maxillary and 2 mandibular teeth. Periapical lesions were seen in 22 of these cases. Conclusions: Dens invaginatus cases are a congenital anomaly encountered at any age. Early diagnosis is crucial to prevent the loss of pulp vitality due to these invaginations. It should be noted that these invaginations can affect both jaws. However, due to the prevalence of occurrence in the maxillary anterior teeth and asymptomatic nonvitality, particular attention should be paid to evaluating this region. [ABSTRACT FROM AUTHOR]

Aim: Childhood cancer survival has improved significantly with advances in multimodal treatment. However, treatment-related long-term side effects, including dental developmental abnormalities, remain a concern. The aim of this study was to investigate permanent tooth development and associated risk factors in childhood cancer survivors who were treated before the age of six years, focusing on non-leukemia cases. Materials and Methods: This study was conducted on childhood cancer cases treated with chemotherapy and/or radiotherapy at a single center. Patients diagnosed before the age of six and who were twelve or above at the time of assessment were included. Dental examinations, including Decayed, Missing, Filled Teeth index and radiographic assessments, were performed. Statistical analyses were performed in order to identify associations between treatment modalities and dental findings. Results: Of 914 patients, 90 met the inclusion criteria, with 35 participating in this study. The mean age at diagnosis was four years, with a mean follow-up duration of ten years. Root shortening, hypoplasia, and hypodontia were observed to be common dental anomalies. There was a significant association between alkylating agents, vinca alkaloid plus alkylating agents and root shortening (p<0.001, p<0.001). No significant differences in dental findings were found based on gender, tumor site, or other treatment modalities (p<0.05). As the age at diagnosis increased, the risk of root shortening (p=0.026) and the frequency of hypodontia significantly increased with the duration after diagnosis (p=0.048). Conclusion: Childhood cancer survivors treated during early dentition periods are at risk of dental developmental anomalies, with alkylating agents showing the most significant impact. This emphasizes the necessity of providing these patients and their families with information on the importance of maintaining oral and dental health during and after cancer treatment. [ABSTRACT FROM AUTHOR]

Cone beam computed tomography (CBCT) frequently captures unexpected structural abnormalities unrelated to the original intent of the diagnostic test. Once identified by dentists, these findings often require appropriate clinical referral for further investigation. This study reviewed recent literature using a comprehensive search to identify and curate common CBCT incidental findings (1Fs). Studies were included if they reported CBCT IFs and included more than 10 cases. The review included 16 primary studies in addition to 4 studies described in recent relevant systematic reviews. A total of 51 descriptive terms used to describe key IFs across studies were identified, and terms were organized semantically into 15 core finding categories. Recommendations for management and referral acuity were derived from otolaryngologic clinical practice guidelines and input from practicing otolaryngologists, and the results were integrated into a clinical management algorithm for acuity of referral. This comprehensive review offers practical recommendations to facilitate appropriate clinical management of CBCT IFs via otolaryngologic referral. [ABSTRACT FROM AUTHOR]

The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a fixed mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) based on deep learning (DL) algorithms has shown promise in enhancing the speed and accuracy of dental anomaly detection in paediatric dentistry. Aim: This systematic review aimed to investigate the performance of AI systems in identifying dental anomalies in paediatric dentistry and compare it with human performance. Design: A systematic search of Scopus, PubMed and Google Scholar was conducted from 2012 to 2022. Inclusion criteria were based on problem/patient/population, intervention/indicator, comparison and outcome scheme and specific keywords related to AI, DL, paediatric dentistry, dental anomalies, supernumerary and mesiodens. Six of 3918 initial pool articles were included, assessing nine DL sub‐systems that used panoramic radiographs or cone‐beam computed tomography. Article quality was assessed using QUADAS‐2. Results: Artificial intelligence systems based on DL algorithms showed promising potential in enhancing the speed and accuracy of dental anomaly detection, with an average of 85.38% accuracy and 86.61% sensitivity. Human performance, however, outperformed AI systems, achieving 95% accuracy and 99% sensitivity. Limitations included a limited number of articles and data heterogeneity. Conclusion: The potential of AI systems employing DL algorithms is highlighted in detecting dental anomalies in paediatric dentistry. Further research is needed to address limitations, explore additional anomalies and establish the broader applicability of AI in paediatric dentistry. [ABSTRACT FROM AUTHOR]

A peg-shaped maxillary lateral incisor is an underdeveloped, small, malformed permanent tooth that erupts following the loss of a primary tooth. The maxillary lateral irregularly shaped incisor may be unilateral, on both sides of the central incisors, or accompanied by a missing lateral tooth on the contralateral side of the arch. Peg-shaped maxillary lateral incisors receive a great deal of attention, play a significant role in the displayed smile, and present a treatment challenge during all stages of a patient's life. Clinicians are called to plan the treatment and the timing from as early as the beginning of growth and development. Careful diagnosis may dictate postponing a treatment to later stages of life, especially if the tooth is malpositioned in the arch. The goal of this clinical report was to present a combined treatment for a case with a palatal malpositioned peg-shaped maxillary lateral incisor and a missing contralateral permanent maxillary lateral incisor, creating an esthetic challenge. Moving the malpositioned peg-shaped lateral tooth to the arch simplified and eased the final prosthetic treatment procedure, increasing the treatment predictability. The presented sequence of therapy further stresses the importance of incorporating minor tooth movement, without referring to a specialist, in the daily practice of a prosthodontic-oriented general clinic, by simple accessible means. [ABSTRACT FROM AUTHOR]

Purpose: To verify a novel method that improves the accuracy of static computer-aided implant surgery (sCAIS) through intraoperative measurement. Materials and Methods: Forty-seven patients were selected for this study, each with a missing tooth or a tooth that required extraction from the anterior area. The patients were divided into the intraoperative measuring guide (MG) and conventional guide (CG) groups. Following the preoperative implant planning, the surgical guides were designed and fabricated. In the MG group, the drill was guided by double-armed zirconia sleeves, and the axial direction of the drill was assessed using the indicator components. The implant was guided using a resin guide tube. In the CG group, the drills were guided using a metal sleeve and handles, and the implants were placed with the guidance of the metal sleeve only. The angular and linear deviations at the entry and apex between the planned and actual implant positions were measured after matching the preoperative and postoperative CBCT data. The independent-samples t test was used to compare the deviation between the MG and CG groups. Results: The 3D deviations for the MG group at the entry and apex were 0.67 ± 0.44 mm and 0.93 ± 0.40 mm, respectively. The angular deviation was 2.27 ± 0.96 degrees. Statistical differences were found in the 3D deviation at the entry point and apical position between the MG and CG groups, yielding relatively smaller deviations in the MG group. Conclusion: The use of an intraoperative measuring guide could improve the accuracy of implant placement in sCAIS. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) in children presents multifaceted challenges, impacting various aspects of health, including oral health. This narrative review provides a comprehensive synthesis of literature focusing on the oral health status of pediatric CKD patients, encompassing oral manifestations, dental considerations, and management challenges associated with hemodialysis and kidney transplantation. A comprehensive search strategy was employed, utilizing databases such as PubMed, Scopus, Web of Science, and Google Scholar, to identify relevant literature on oral manifestations in children with CKD, including those undergoing hemodialysis or renal transplantation. Search terms were carefully selected to capture studies examining enamel hypoplasia, dental caries, delayed tooth eruption, gingival diseases, periodontal diseases, radiographic alterations, craniofacial development, dry mouth, and changes in the oral mucosa. Our narrative review meticulously selected articles through a systematic process. Ultimately, 12 studies meeting the inclusion criteria were included in the review. Relevant data from each included study were independently extracted and synthesized, focusing on oral manifestations and their implications in pediatric CKD patients. The synthesized findings were organized and presented in a structured manner within the review article, considering their clinical implications and informing recommendations for dental management of children with CKD. This article highlights the importance of a coordinated effort between nephrologists, dentists, and other healthcare professionals in providing holistic care for pediatric CKD patients. A comprehensive understanding of the oral health status of these children, along with proactive dental management strategies, contributes to improved overall health outcomes and a better quality of life. This review aims to serve as a valuable resource for the oral healthcare providers involved in the care of pediatric CKD patients. [ABSTRACT FROM AUTHOR]

Background: Regenerative endodontic procedures (REPs) are innovative treatments aimed at restoring damaged dental structures. However, the effect of orthodontic movement on REP-treated teeth is not well understood and may have significant long-term consequences. This study aimed to evaluate the impact of orthodontic movement on a mature permanent tooth associated with dens invaginatus that has undergone a regenerative endodontic procedure (REP). Case presentation: This report describes the case of a 13-year-old healthy male who presented with pulp necrosis and a chronic apical abscess (tooth number 2.2). Following REP according to the American Association of Endodontists' guidelines, the patient began non-extraction orthodontic treatment with fixed appliances after a 9-month healing period, which lasted 17 months in the upper arch. Subsequent follow-ups at 24, 36 and 48 months post-REP revealed an asymptomatic state with minimal cervical discoloration and diminished cold sensitivity. Radiographic analyses revealed periapical healing, mild apical remodeling on tooth 2.2, and moderate apical remodeling on other maxillary incisors. The treated tooth displayed a positive response to both REP and orthodontic treatment, yet further research is required to determine the long-term effects of orthodontics on REP-treated teeth. Conclusion: Orthodontic movement following REPs in mature permanent teeth is feasible and do not seem to prone teeth to orthodontic tooth resorption. Our experience indicates that a 9-month healing period allows successful orthodontic outcomes following REPs. Nonetheless, the predictability of outcomes and the ideal healing period before orthodontic movement is initiated remain to be established. [ABSTRACT FROM AUTHOR]

Background: Pattern of dental anomalies encountered in cleft patients shows subtle signs of genetic involvement. This study aimed to evaluate the prevalence and pattern of tooth agenesis and supernumerary teeth in Thai cleft population according to the cleft type. Methods: Data collected from patients with cleft lip and palate, who had been treated at Tawanchai Cleft Center, Khon Kaen University, Thailand, available during year 2012–2022, were investigated. Records from 194 patients with non-syndromic clefts met the inclusion criteria. Standard dental records, and at least either orthopantomogram (OPG) or cone beam computed tomography (CBCT), were examined. Statistical analysis was performed using chi-square and binominal test (p ≤ 0.05). Results: Prevalence of tooth agenesis was higher (77.3%) than that of supernumerary teeth (5.7%) and was more common in bilateral cleft lip and palate (BCLP) (88.1%) than in unilateral cleft lip and palate (UCLP) (72.6%) (p = 0.017). The upper lateral incisor was more frequently affected (46.4%), followed by the upper second premolar. The number of missing teeth observed on the left side was significantly higher. Patients with left UCLP (ULCLP) had the highest prevalence of tooth agenesis. A total of 41 tooth agenesis code (TAC) patterns was found. The prevalence of supernumerary teeth was comparable with 6.6% of ULCLP, 5.1% of BCLP, and 4.5% of URCLP. Tooth-number anomalies were observed more often in the BCLP and were most likely to occur on the left side of the maxilla. Both types of anomalies could be featured in a small proportion of cleft patients. Conclusions: More than half of the patients with non-syndromic cleft lip and palate in this study, presented with tooth-number anomalies. Tooth agenesis was approximately 10-time more prevalent than supernumerary teeth. Tooth agenesis was likely to appear on the left-side of the maxilla regardless of the laterality of the cleft. [ABSTRACT FROM AUTHOR]

Background: Parameningeal rhabdomyosarcoma (PM-RMS) is a rare and aggressive soft tissue malignancy that primarily occurs in the head and neck region. The standard treatment approach for RMS involves a multimodal therapy regimen, which includes surgery, chemotherapy, and radiotherapy. However, the routine use of radiotherapy and chemotherapy in young patients with RMS in the head and neck region can lead to adverse effects on dental development and thereby, pose a challenge in planning dental intervention. Case presentation: This case report outlines the dental and facial developmental consequences in a 13-year-old child, who received chemo-radiotherapeutic intervention at the age of 7 years for the management of PM-RMS. Following treatment, the child exhibited significant dental complications, including arrested root growth and restricted mouth opening. Conclusions: This case highlights the necessity for interdisciplinary collaboration between oncologists, dentists, and other healthcare professionals to mitigate the adverse effects on dental health and overall quality of life in patients undergoing chemo-radiotherapy for rhabdomyosarcoma. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the effect of the use of remineralization agents before the application of resin infiltration on the treatment of initial enamel lesions. Materials and methods: Eighty buccal enamel samples were prepared from human molars, and artificial initial lesions were formed after 96 h of incubation with a demineralizing solution. The samples were randomly divided into 8 groups (n = 10) including a remineralizing agent (Tooth Mousse, Medical Mineral Gel, Remin Pro), resin infiltration (ICON), and a combined treatment of both. Remineralizing agents were applied in pH cycle for 7 days. Baseline, demineralization, and after-treatment fluorescence (FluoreCam and DIAGNOdent Pen), surface microhardness (HMV-2T), surface roughness (M300C), OCT (Maestro-2) and ultrasonic system (Novascope 4500) data were obtained for all groups. The sample surfaces were examined under SEM/EDX (SU3500) at x1000. Data were statistically analyzed using the Two-Way Robust ANOVA and Bonferroni tests (p < 0.05). Results: There was no statistically significant difference between the groups for microhardness, roughness, OCT, DIAGNOdent Pen, ultrasound, and FluoreCam size/intensity values (p = 0.582; p = 0.963; p = 0.884; p = 0.923; p = 0.051; p = 0.268; p = 0.793 respectively). The effect of the treatment procedure showed a significant difference (p < 0.001), except for the roughness values (p = 0.984). The lowest Calcium (Ca) ratio (%atomic) was observed in the RI group in the EDX analysis. Conclusion: Remineralizing agents and resin infiltration methods may be used in combination or alone in the treatment of initial enamel lesions. Combining remineralizing agents with resin infiltration does not alter the efficacy of the treatment. Highlights: The use of remineralizing agents before resin infiltration does not alter the effectiveness of treatment for the start of demineralization located on the outer half of the enamel. [ABSTRACT FROM AUTHOR]

Hearing impairments and dental anomalies are found in many genetic syndromes. Otodental syndrome is a rare combination of hearing loss and the presence of a pathognomonic dental phenotype known as globodontia, in which the tooth exhibits an abnormal globe shape. There is no histologic evidence of structural anomalies in the enamel, dentin, or pulp. This report describes the case of a 12-year-old boy who had hearing loss and 2 supernumerary globe-shaped teeth in the sites of the permanent maxillary central incisors. The diagnosis of otodental syndrome was established based on the clinical, radiographic, and histologic features, but other conditions, including dens evaginatus, talon cusp, dens invaginatus, and compound odontoma, should be included in the differential diagnosis. Dental treatment consisted of the extraction of both anomalous teeth, allowing spontaneous eruption of the impacted permanent central incisors. Early diagnosis of otodental syndrome permits a multidisciplinary approach to prevent other pathologic conditions, reduce functional damage, and avoid social problems, [ABSTRACT FROM AUTHOR]

Establishing the identity of a person is important in the field of forensic odontology. This field can be helpful in identifying charred corpses in cases involving intense heat. Bones and body tissues can be extremely damaged due to heat, in such cases dental records have become a reliable source of identification. Dental Identification of charred human remains begins with the examination of dental features such as teeth anatomy, morphology, dental implants, oral health, restorations, fillings, dental anomalies and overall dental structure. These features remain resistant to extreme heat and can thus be compared with that of the ante-mortem records. When the postmortem and ante-mortem records match a successful identification is done. Dental features may also be damaged and become less effective for identification when temperatures rise above a particular range. In order to help with the identification of charred human remains, this research intends to give forensic experts a clear understanding of the circumstances in which dental records can be used by examining the effects of extreme temperature within the 400--800°C range. By gaining insights into this particular range and its effects on dental tissues and records gives forensic experts a chance to solve complex cases involving burned corpses. [ABSTRACT FROM AUTHOR]

Background: In order to generate a normal set of teeth, fine‐tuning of Wnt/β‐catenin signaling is required, in which WNT ligands bind to their inhibitors or WNT inhibitors bind to their co‐receptors. Lrp4 regulates the number of teeth and their morphology by modulating Wnt/β‐catenin signaling as a Wnt/β‐catenin activator or inhibitor, depending on its interactions with the partner proteins, such as Sostdc1 and Dkk1. Aim: To investigate genetic etiologies of dental anomalies involving LRP4 in a Thai cohort of 250 children and adults with dental anomalies. Design: Oral and radiographic examinations and whole exome sequencing were performed for every patient. Results: Two novel (p.Leu1356Arg and p.Ala1702Gly) and three recurrent (p.Arg263His, p.Gly1314Ser, and p.Asn1385Ser) rare variants in low‐density lipoprotein receptor‐related protein 4 (LRP4: MIM 604270) were identified in 11 patients. Oral exostoses were observed in five patients. Conclusion: Antagonism of Bmp signaling by Sostdc1 requires the presence of Lrp4. Mice lacking Lrp4 have been demonstrated to have alteration of Wnt–Bmp–Shh signaling and an abnormal number of incisors. Therefore, the LRP4 mutations found in our patients may disrupt Wnt–Bmp–Shh signaling, thereby resulting in dental anomalies and oral exostoses. Root maldevelopment in the patients suggests an important role of LRP4 in root morphogenesis. [ABSTRACT FROM AUTHOR]

A complete understanding of canal morphology is essential to achieve successful endodontic treatment. Although mandibular second premolars are reported to have usually only one root canal at the apex, in this case we reported a mandibular second premolar with three root canals and taurodont morphology. A patient was referred to the endodontic department at Mashhad Faculty of Dentistry with a chief complaint of pain in her mandibular right second premolar tooth. The diagnosis of pulpal necrosis and chronic apical periodontitis was established. The initial radiograph showed a taurodont premolar with two roots. However, with cone-beam computed tomography assistance, three root canals were confirmed. The root canal treatment process was successfully managed with a dental operating microscope. Using cone-beam computed tomography and a dental operating microscope greatly facilitated the determination of tooth morphology and successful following nonsurgical endodontic treatment. [ABSTRACT FROM AUTHOR]

Dens invaginatus (DI) is one of the developmental dental anomalies that results in an invagination of the enamel organ into the dental papila during odontogenesis. The purpose of this study is to report a case of nonsurgical endodontic treatment of an Oehlers type II DI in a right maxillary lateral incisor with an extensive periapical damage, along with the two-year clinical and tomographic follow-up. A 30-year-old patient was referred for endodontic treatment of tooth #12. On clinical examination, a change in the shape and color of the crown was observed. The tooth responded negative to pulp sensibility, percussion, palpation and mobility tests. After tomographic evaluation, an Oehlers type II DI was visualized, in addition to an extensive periradicular lesion. The diagnosis was asymptomatic apical periodontitis. The treatment was carried out in two sessions, through intense enhancement of the auxiliary chemical substance with passive ultrasonic irrigation, XP-Endo Finisher and the use of hydroxide-based intracanal medication. Appropriate treatment in cases with anatomic variations requires an accurate and early diagnosis based on clinical examination and radiographic images. A two-year follow-up of the present case showed that the correct diagnosis associated with appropriate instrumentation techniques, supplementary disinfection, and adequate three-dimensional sealing of the canal with filling material, resulted in regression of the periradicular lesion and bone repair. [ABSTRACT FROM AUTHOR]

Case Description: Four cases of patients aged 41, 33, 43 and 68 years who presented periapical lesions and needed periodontal surgery for pre-prosthetic purposes. Clinical Findings: The first case presented an intra-radicular retainer that was difficult to remove and likely to generate a root fracture. In addition, asymmetry of the gingival zenith was observed. The second case presented a complete crown at 16 with mesial marginal mismatch and subgingival margins distally. The third case presented a vestibular fistula with inflammation at the cervical level. The fourth case presented a vestibular fistula in the upper right lateral incisor. All patients showed apical lesions. Treatment and Outcome: The first three cases received coronal lengthening and apical surgery in the same surgical procedure. In the fourth case, apical surgery was performed, and placement of implants 13 and 15 with a pontic of 14. During the clinical control and radiographs performed after the surgical procedures, bone filling of the lesion was found. Clinical Relevance: Considering the results obtained, performing the periodontal and endodontic surgery procedures in a single surgical act is suggested. This reduces costs, travel, number of appointments, medication intake and post-surgical complications. [ABSTRACT FROM AUTHOR]

Background: A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity's environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation. Methods: The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15–76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use. Results: Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05). Conclusions: The results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the prevalence of malocclusion and orthodontic features among schoolchildren in the West Bank, Palestine. Methods: A stratified cluster sample of 1278 schoolchildren (620 males, 658 females, mean age 12 years and 5 months (± 0.5)) were examined. Candidates who had not received any previous orthodontic treatment were only included. Dental anomalies like missing and ectopic teeth were recorded. The anteroposterior occlusal relationship was assessed based on Angle classification. Overjet and overbite were measured. Crowding and spacing were recorded subjectively. In addition, crossbite, openbite, and midline displacement were recorded. The chi-square test and descriptive analysis were used statistically. Results: The study found Angle Class I molar relationship in 65%, Class II div 1 in 17%, Class II div 2 in 6%, and Class III in 12% of the sample. An overjet (OJ) of more than 4 mm was present in 17%, and 4% had OJ of more than 6 mm; an OJ of at least 0 mm or less in 36%, and 6% had a reverse OJ. A normal overbite was observed in 53%, while 28% had an increase and 19% had a decreased overbite. An anterior openbite (AOB) was present in 9%, and a scissor bite or anterior crossbite in 6% and 14%, respectively. A posterior crossbite was observed in 12% (9% unilateral and 3% bilateral). Midline displacement was found in (9%). Crowding was observed in 35% and 31% and spacing in 24% and 15% of the maxillary and mandibular arches, respectively. A statistically significant relationship between gender and midline shift, a diastema, spacing in the upper arch, and most dental anomalies was found; males were more affected (p < 0.05). Conclusion: This study reported a high prevalence of malocclusion among schoolchildren in Palestine. A collaborative effort should be directed to obtain more monitoring and surveillance of malocclusion more frequently to prevent and control the exacerbation of the problem. [ABSTRACT FROM AUTHOR]

Statement of the Problem: As a developmental disorder characterized by an abnormal bend and angle in the longitudinal axis of the tooth root, dilaceration can cause complications in routine dental procedures such as endodontics, orthodontics, and surgical treatments. Purpose: The purpose of this study was to investigate the prevalence of dilaceration in maxillary and mandibular premolar teeth in a population of Shiraz city based on conebeam computed tomography (CBCT). Materials and Method: This is a retrospective cross-sectional study on 927 premolar teeth and 132 CBCT radiographs of patients obtained from four private radiology clinics in Shiraz (Iran). In this study, the presence, location, direction, and severity of dilaceration in premolar roots as well as its relationship with gender were investigated. Chi-square and Fisher tests were used to analyze the data. Results: The results showed that 17% of the studied 927 teeth had dilaceration. The prevalence of dilaceration was significantly higher in women than in men (20.3% vs. 13.6%, p= 0.005). The dilaceration rates were significantly higher in the mandibular first and second premolar teeth (31.6% and 26%, p= 0.002) than in the other teeth. In addition, the highest prevalence was in the distal direction with mild severity in the apical third of the root (p< 0.001). Conclusion: According to the results of this study, the prevalence of dilaceration was relatively high in mandibular premolar teeth especially in women. [ABSTRACT FROM AUTHOR]

Dens invaginatus is a developmental anomaly predominantly occurring in maxillary lateral incisors, resulting in the invagination of the enamel into the dentine. This infolded area creates a void enabling the stagnation of bacteria and development of dental caries. If left untreated the caries may progress and ultimately result in pulpal necrosis. The treatment of these teeth can be challenging due to the potential complexity of the lesion. It is essential that teeth with dens invaginatus are diagnosed early allowing prophylactic treatment and prevention of pulpal necrosis. This article aims to review the aetiology, prevalence, classification, diagnosis, treatment and orthodontic considerations of teeth affected by dens invaginatus. CPD/Clinical Relevance: Knowledge of dens invaginatus enables early diagnosis, effective management and, therefore, the best treatment outcomes. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to investigate regenerative process by immunohistochemical analysis and evaluate periodontal tissue regeneration following a topical application of BDNF to inflamed 3‐wall intra‐bony defects. Background: Brain‐derived neurotrophic factor (BDNF) plays a role in the survival and differentiation of central and peripheral neurons. BDNF can regulate the functions of non‐neural cells, osteoblasts, periodontal ligament cells, endothelial cells, as well as neural cells. Our previous study showed that a topical application of BDNF enhances periodontal tissue regeneration in experimental periodontal defects of dog and that BDNF stimulates the expression of bone (cementum)‐related proteins and proliferation of human periodontal ligament cells. Methods: Six weeks after extraction of mandibular first and third premolars, 3‐wall intra‐bony defects were created in mandibular second and fourth premolars of beagle dogs. Impression material was placed in all of the artificial defects to induce inflammation. Two weeks after the first operation, BDNF (25 and 50 μg/mL) immersed into atelocollagen sponge was applied to the defects. As a control, only atelocollagen sponge immersed in saline was applied. Two and four weeks after the BDNF application, morphometric analysis was performed. Localizations of osteopontin (OPN) and proliferating cell nuclear antigen (PCNA)‐positive cells were evaluated by immunohistochemical analysis. Results: Two weeks after application of BDNF, periodontal tissue was partially regenerated. Immunohistochemical analyses revealed that cells on the denuded root surface were positive with OPN and PCNA. PCNA‐positive cells were also detected in the soft connective tissue of regenerating periodontal tissue. Four weeks after application of BDNF, the periodontal defects were regenerated with cementum, periodontal ligament, and alveolar bone. Along the root surface, abundant OPN‐positive cells were observed. Morphometric analyses revealed that percentage of new cementum length and percentage of new bone area of experimental groups were higher than control group and dose‐dependently increased. Conclusion: These findings suggest that BDNF could induce cementum regeneration in early regenerative phase by stimulating proliferation of periodontal ligament cells and differentiation into periodontal tissue cells, resulting in enhancement of periodontal tissue regeneration in inflamed 3‐wall intra‐bony defects. [ABSTRACT FROM AUTHOR]

Background: Treating the coronal dens invaginatus (CDI) with pulp infection commonly involves the removal of invagination, which increases the risk of perforation and fracture, and compromises the tooth structure. Minimally invasive endodontic management of CDI is highly recommended. This report describes two cases of type II CDI with the application of personalized templates. Case presentation: Two cases of type II CDI, affecting the main root canal in a maxillary canine and a lateral incisor, were diagnosed. A guided endodontics (GE) approach was applied. Cone-beam computed tomography and intraoral scans were imported and aligned in a virtual planning software to design debridement routes and templates. The MICRO principle (which involves the aspects of Mechanical (M) debridement, Irrigation (I), Access cavities (C), Rectilinear routes (R), and Obstruction (O)) was proposed for designing optimal debridement routes for future applications. The templates were innovatively personalized and designed to preserve the tooth structure maximally while effectively debriding the root canal. Root canal treatment with supplementary disinfection was then performed. The follow-up of the two patients revealed favorable clinical and radiographic outcomes. Conclusions: The GE approach could be a feasible method for preserving healthy dental structure while effectively debriding the root canal, thereby achieving successful and minimally invasive endodontic treatment for CDI. [ABSTRACT FROM AUTHOR]

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]

Background: CACNA1C gene encodes the alpha 1 subunit of the CaV1.2 L-type Ca2+ channel. Pathogenic variants in this gene have been associated with cardiac rhythm disorders such as long QT syndrome, Brugada syndrome and Timothy syndrome. Recent evidence has suggested the possible association between CACNA1C mutations and neurologically-isolated (in absence of cardiac involvement) phenotypes in children, giving birth to a wider spectrum of CACNA1C-related clinical presentations. However, to date, little is known about the variety of both neurological and non-neurological signs/symptoms in the neurologically-predominant phenotypes. Methods and Results: We conducted a systematic review of neurologically-predominant presentations without cardiac conduction defects, associated with CACNA1C mutations. We also reported a novel de novo missense pathogenic variant in the CACNA1C gene of a children patient presenting with constructional, dressing and oro-buccal apraxia associated with behavioral abnormalities, mild intellectual disability, dental anomalies, gingival hyperplasia and mild musculoskeletal defects, without cardiac conduction defects. Conclusions: The present study highlights the importance of considering the investigation of the CACNA1C gene in children's neurological isolated syndromes, and expands the phenotype of the CACNA1C related conditions. In addition, the present study highlights that, even in absence of cardiac conduction defects, nuanced clinical manifestations of the Timothy syndrome (e.g., dental and gingival defects) could be found. These findings suggest the high variable expressivity of the CACNA1C gene and remark that the absence of cardiac involvement should not mislead the diagnosis of a CACNA1C related disorder. [ABSTRACT FROM AUTHOR]

Purpose: To assess the stress and anxiety levels of 3rd-year students in preclinical training along with their success rates under the background of Mozart’s music using a haptic virtual reality simulator (HVRS). Methods: Sixty 3rd-year dentistry students enrolled in preclinical endodontic training were selected based on the inclusion criteria. Participating students were randomly divided into two groups according to whether Mozart’s music was used during the access cavity preparation using HVRS. Stress and anxiety levels were evaluated with the Stress-VAS 1 and 2 scales and STAI S and T questionnaires, respectively. Manual dexterity was measured based on the target progress, accuracy, target volume, and outside volume. Data were analyzed with Fisher’s exact and Mann-Whitney U tests and the square of the Spearman linear coefficient. Results: There was no statistically significant difference between genders regarding stress and anxiety levels (p > 0.05). Music significantly reduced stress and anxiety levels and enhanced manual dexterity (p < 0.05). A significant negative association was observed between the target progress and Stress-VAS 2 (p < 0.05), whereas the correlation did not differ between accuracy and Stress-VAS 2 (p > 0.05). Conclusion: Mozart’s music positively affected stress and anxiety levels along with the manual dexterity of students in preclinical endodontic training using HVRS. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the stress distribution of endodontic nickel-titanium (Ni-Ti) rotary files with different pitches in bending and torsion tests using finite element analysis (FEA). Methods: Finite element models of superelastic Ni-Ti endodontic rotary instrument files with three different pitches (12, 15, and 18) were created using SolidWorks software. All endodontic files were modeled with the same length, apical diameter, and cross-sectional geometry. These models were transferred to ANSYS software for analysis. Tests to evaluate the flexibility and torsional stiffness of the files were performed using the FEA method, according to the ISO 3630-1 specification. The results obtained were calculated using the von Mises stress. Results: The stiffness and maximum stress decreased as the pitch value increased. According to the test results, the 18 pitch file system exhibited higher flexibility than the 12 pitch and 15 pitch file systems when subjected to bending. In terms of torsional resistance, the 12 pitch rotary file showed higher torsional resistance than the 15 pitch and 18 pitch endodontic files. Conclusion: Clinicians should be aware of the geometric differences in rotary files and use the appropriate file for clinical situations in addition to the manufacturer’s instructions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the efficacy of a resin-based canal sealer and a bioceramic canal sealer in obturating lateral canals, with and without the use of activation methods. Methods: Lateral canals were created at apical positions of 3, 5, and 8 mm in eighty 3D-printed maxillary central teeth. After root canal preparation, the teeth were embedded in 1.5% agar agar to simulate periodontal tissues. The teeth were divided into two main groups based on the type of root canal sealer and further categorized into four subgroups for activation methods: Conventional, EDDY, EndoActivator, and Passive Ultrasonic. Root canals were filled using the single cone technique, and images were captured at 17× magnification. Sealer penetration into lateral canals was measured using ImageJ software. Activation methods were compared using the Kruskal-Wallis test; root levels were compared using the Friedman test, and comparisons between sealers were made with the Mann-Whitney U test at a 95% confidence level. Results: Activation methods had no significant impact on sealer penetration for both types of sealers. In ultrasonic activation groups, the bioceramic sealer exhibited significantly higher penetration than the resin-based sealer at all root levels. In sonic activation groups, the bioceramic sealer showed significantly superior penetration, especially at the middle root level. Conclusion: Activation methods did not significantly alter sealer penetration into lateral canals. Bioceramic-based root canal sealer demonstrated enhanced penetration compared to resin-based sealer, especially with ultrasonic and sonic activation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the opinions of dental clinic students regarding the challenges of endodontic therapy and compare their responses based on their academic years. Methods: A survey was prepared to evaluate the difficulties experienced by students regarding anesthesia, taking radiographs, use of rubber dam, cavity preparation, identifying radiographic apex, instrumentation, irrigation, intracanal medicament application, root canal filling, and temporary restoration procedures. The survey, consisting of 13 main questions (with yes/no answers) and 13 sub-questions (multiple choice), was responded to by 60 fourth-year and 60 fifth-year dentistry students. The Pearson Chi-Square and Fisher’s Exact tests were applied to evaluate the students’ answers according to their academic years. Results: Taking radiographs, determining the master cone, and filling the root canal were the most challenging endodontic procedures. There was a statistically significant difference between the responses of fourth- and fifth-year students to the main questions regarding root canal filling and access cavity preparation (p<0.05). Conclusion: During training, more emphasis should be placed on taking radiographs, identifying the master cone, and filling the root canals. Fifth-year students performing endodontic treatment of anatomically difficult cases were found to have less self-efficacy in filling root canals and preparing the endodontic access cavity. [ABSTRACT FROM AUTHOR]