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Purpose: To investigate the effect of full-mouth disinfection on the sizes of the periodontal wound and periodontal inflammatory burden and whether it leads to a decrease in C-reactive protein (CRP) levels. Materials and Methods: The study included 20 systemically healthy subjects (11 women and 9 men) 30 to 68 years old with localised or generalised periodontitis (stage III, grade C). The sizes of the periodontal wound and periodontal inflammatory burden were measured with the web application “Periodontalwound”, which is based on measurements of average tooth cervices, as well as probing depths and bleeding on probing assessed at six sites around each tooth present in the oral cavity. The levels of hsCRP (high-sensitivity CRP) were measured with an immunochemical method. All three parameters were measured before initial treatment and 3 months after therapy. Full-mouth disinfection included removal of plaque and calculus with ultrasonic and hand instruments in one session. Results: The results showed a statistically significant decrease in the size of the periodontal wound (p < 0.001), a statistically significant decrease in the size of periodontal inflammatory burden (p < 0.001), and a decrease in hsCRP levels 3 months after therapy. Conclusion: Full-mouth disinfection leads to a decrease in the periodontal wound and periodontal inflammatory burden size, as well as a decrease in the levels of hsCRP in patients with localised or generalised periodontitis (stage III, grade C) [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the marginal leakage of three different types of bonding agents used with two posterior composites and a giomer, available commercially. Material and methods: Class II box-only cavities were prepared on 90 mandibular first molars with margins extending 1 mm beyond the cementoenamel junction. The samples were divided into nine groups based on three different bonding agents, two different composites, and a giomer. Cavities were restored per the manufacturer's description. Teeth were subjected to a thermocycling procedure (500Ã--, 5°C to 55°C) and dye penetration by immersing in a 2% methylene blue solution (Merck Specialties) for 24 hours. The marginal adaptation was evaluated as a continuous margin at the gingival level under a stereomicroscope. The results were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: The results of the groups with the total-etch technique showed no statistical difference between the nanohybrid Filtek Z250 XT (3M ESPE) and fine hybrid SwissTEC composite (Coltène\Whaledent AG). The groups with the self-etch technique showed no statistical difference when used with either of the two composites. The acid-etch technique showed better marginal adaptation than the self-etch technique. When the giomer (Beautifil II, Shofu) was used with the total-etch technique, it showed better adaptation than when used with the self-etch technique but overall showed more marginal leakage than the composites. Conclusion: The total-etch technique provided better marginal adaptation for the composites and giomer compared to the self-etch technique. Clinical significance: The demand for esthetic restorations continues to increase, and composite restorations are now considered the material of choice for Class II cavities. There are various concerns with composite restorations, one of them being good marginal adaptation to increase the life of the restoration. This study evaluated marginal leakage with the nanohybrid composite Filtek Z250 XT, fine hybrid composite SwissTEC, and a giomer when used with the total-etch technique and self-etch technique and reported satisfactory adaptation with the total-etch technique. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the fracture strength of endodontically treated molars filled with different composite resins with vs without fiber reinforcement. Materials and Methods: A total of 60 intact mandibular molars were selected and endodontically treated. A standardized mesio-occlusal-distal cavity was prepared with cervical margins 1 mm above the cementoenamel junction and oral and buccal walls with 1.5-mm thickness. Universal adhesive was used in all specimens in etch-and-rinse mode. Specimens were divided into four groups (n = 15 each) according to restoration technique: group CSM = adhesive overlay with hybrid ceramic; group EXP = direct restoration with short fiber-reinforced composite; group ESU = direct restoration with nanohybrid composite; and group EST = direct restoration with nanohybrid composite reinforced with horizontal bidirectional glass fibers placed over the pulpal chamber floor. After 7 days of storage in water, samples were loaded until fracture using a universal testing machine. The maximum breaking loads were recorded in Newtons, and statistical analysis was then conducted with two-way ANOVA and post hoc Tukey test. Fragments were analyzed using scanning electron microscopy. Results: Mean fracture resistance values were: CSM = 1,428.91 ± 316.90 N; EXP = 1,874.57 ± 299.47 N; ESU = 1,557.44 ± 355.65 N; and EST = 1,870.27 ± 145.11 N. The CSM and EXP groups showed the highest strength values when compared to the other groups. The variable fiber insertion did not significantly alter the fracture resistance. The origin of the fracture was always located on the occlusal surface, mainly in the major contact loading area. Conclusion: The use of fiber-reinforced composite showed great improvement in fracture resistance, similar to a cuspal coverage restoration. However, only short fiber-reinforced composites showed a favorable fracture pattern. [ABSTRACT FROM AUTHOR]

Introduction: Non Carious Cervical Lesions (NCCLs) represent a prevalent dental condition characterised by the erosion of tooth structure at the cementoenamel junction without the involvement of dental caries. These lesions pose significant challenges due to their aesthetic impact, potential for dentinal hypersensitivity, plaque accumulation, pulpal complications and compromised structural integrity of the teeth. Tooth preparation traditionally uses diamond abrasive points and tungsten carbide burs for micromechanical adhesion. Newer methods, like ultrasonic tips, offer a more conservative approach, but limited research has compared their effects on bond strength, particularly in cervical cavity restorations with nanohybrid composites. Aim: To compare the surface roughness of cervical cavity preparations utilising diamond abrasive points and ultrasonic tips, and to evaluate the shear bond strength of restorations with composite resin. Materials and Methods: The present in-vitro comparative study was conducted in the Department of Conservative Dentistry and Endodontics, Guru Nanak Institute of Dental Sciences and Research, Panihati, Kolkata, West Bengal, India, from October 2023 to December 2023. The study included 52 freshly extracted maxillary 1st premolar teeth extracted for orthodontic reasons. These teeth were divided into two groups: Group-I (n=26) underwent surface preparation using a diamond abrasive point (No. 835-012, Piranha, SS White, USA), while Group-II (n=26) was prepared using an ultrasonic tip (Woodpecker G 20, Guilin Woodpecker, China). Teeth were cleaned, disinfected and stored in 0.1% thymol solution before being prepared with diamond abrasive points or ultrasonic tips, following which the specimens were restored using nanohybrid composite material (Solare X, GC Corporation, Japan). Surface roughness was assessed using a digital profilometer before the restoration, and the shear bond strength of repaired specimens was measured with a Universal Testing Machine. Statistical analysis was performed using GraphPad Prism, with independent samples t-tests applied to compare results between groups, and a significance level set at 5%. Results: Group-I exhibited greater surface roughness (6.33±2.18 μm) compared to Group-II (4.91±1.57 μm). Group-I also showed higher shear bond strength (62±13 MPa) than Group-II (59.3±19.9 MPa), though this variation was not statistically significant (p-value=0.56). Conclusion: Within the present study's limitations, diamond abrasive points created significantly greater surface roughness compared to ultrasonic tips. However, no statistically significant variations have been observed in shear bond strength among the two methods, suggesting that ultrasonic tips may be considered as an alternative to diamond abrasive points in clinical settings, avoiding their drawbacks while achieving adequate restoration retention. [ABSTRACT FROM AUTHOR]

The "Journal of Veterinary Dentistry" contains abstracts from various studies related to veterinary dentistry. Studies include topics such as the use of videoscopes in periodontal surgery, the effects of stannous fluoride dentifrice on oral health, the relationship between periodontitis and systemic diseases, and the use of stem cells in regenerative endodontics. Other studies explore the properties of bioactive ceramic cements, the mobility of the mandibular symphysis in cats, and the anatomy of pulp cavities in feline teeth. Additionally, studies examine the outcomes of root canal treatments in fractured teeth, the prevalence of dentigerous cysts in dogs, and the impact of communication strategies on dog owners' adherence to dental care recommendations. [Extracted from the article]

Aim: This study aims to compare and evaluate the fracture resistance of endodontically treated maxillary anterior teeth restored using new postplacement techniques. Methodology: Forty-five single-rooted maxillary anterior teeth (n = 15) were selected and decoronated at the cementoenamel junction. The working length was determined using a 15K file. Biomechanical preparation was done up to size 70 and the teeth were obturated. After 1 week, the root-filling material, gutta-percha, was removed, and postspace was prepared using a size 3 and 4 peeso reamer. The samples were divided into three groups (n = 15). Group I: Coltene Tenax fiber Post-reinforced with composite (anatomical post). Group II: Coltene Tenax fiber postreinforced with a leno-woven polyethylene; Ribbond fibers. Group III: Coltene Tenax fiber Post-luted with a dual cure cement. After postcementation, core buildup was done. Fracture resistance was measured using a universal testing machine. Results: Statistical analysis was done using one-way analysis of variance and Tukey's post hoc tests. A statistically significant difference was seen in the mean maximum load (N) between the groups. Group I showed the highest mean maximum load (N), followed by Group II and Group III. A significant P value (P = 0.025) was noted. Conclusion: Coltene Tenax fiber postreinforced with composite (anatomical post) showed the highest fracture resistance in endodontically treated maxillary anteriors. [ABSTRACT FROM AUTHOR]

Background: Silver diamine fluoride (SDF) has gained popularity for its caries-arresting properties, yet its tendency to cause esthetic concerns due to black-staining limits its widespread acceptance. Aim: The aim of the study was to evaluate and compare the shear bond strength of Activa BioActive and Giomer restorative material with different protocols of SDF pretreatment on carious dentin. Materials and Methods: Ninety-two extracted teeth were decoronated at the cementoenamel junction, sectioned 1 mm into dentin, mounted in acrylic resin and randomly divided into four (n = 8) control and six (n = 10) experimental groups. Seventy-six samples underwent demineralization process for a period of 14 days for artificial carious dentin (ACD) formation. The samples categorized based on the dentin substrate (sound or ACD) were subjected to various SDF pretreatment protocols, i.e., only SDF, SDF with potassium iodide (KI), and SDF with glutathione (GSH). Further, bioactive restorative materials, i.e., Activa BioActive and Giomer (Beautifil II), were placed on it, and the samples were subjected to shear bond strength testing. Statistical Analysis: Independent t -test was run to analyze the values obtained. Results: Giomer exhibited better mean bond strength with SDF, SDF + KI, and SDF + GSH (6.56, 4.67, and 3.34 mega-pascals [MPa], respectively) compared to Activa BioActive (3.42, 3.27, and 2.96 MPa, respectively). Conclusion: This study contributes to understanding the interplay between SDF application protocols, esthetic concerns, and the adhesive properties of bioactive restorative materials. Giomer exhibited enhanced bond strength after SDF application, unlike Activa BioActive. In addition, incorporation of KI or GSH adversely affected the bond strength of both the restorative materials, underscoring the critical need for cautious clinical application. Clinical Relevance: This study highlights the importance of selecting appropriate dentin pretreatment agents to maximize the bond strength of bioactive restorative materials with carious dentin. SDF application significantly enhanced the bond strength of Giomer with carious dentin compared to Activa BioActive, thus, making it a good choice for restoring nonesthetic areas. In addition, the application of KI or GSH to mitigate discoloration of carious dentin negatively affected the bond strength of both, Activa BioActive and Giomer. Thus, the clinicians should weigh the benefits of SDF against potential bond strength reductions when using KI or GSH, especially for esthetic restorations. [ABSTRACT FROM AUTHOR]

Aim: To prepare experimental adhesive (EA) with 1% and without chitosan nanoparticles on dentin conditioned with a conventional technique phosphoric acid (PA) compared with two different contemporary techniques: photodynamic therapy (PDT) and femtosecond laser (FSL). Method: The methodology consisted of synthesis of EA and 1% chitosan-modified adhesive (CMA). Scanning electron microscopy, dentin adhesive interface assessment, energy-dispersive spectroscopy, shear bond strength (SBS), degree of conversion (DC), and bond failure were assessed. Teeth were selected, disinfected, and mounted in acrylic up to the cementoenamel junction. Occlusal enamel was removed and teeth were randomly allocated into groups and conditioned. These included Group 1: samples treated with PA; Group 2: specimens conditioned with methylene blue photosensitizer (MBP) activated by PDT; and Group 3: samples conditioned with FSL. Following different conditioning regimes, specimens were bonded using 1% CMA and EA. The composite buildup was followed by SBS testing and a bond failure assessment. DC was assessed for both EA and CMA. Analysis of variance and Tukey's post hoc test were used to compare the mean and standard deviation of SBS and DC in different experimental groups, with a significance level of p < 0.05. d Results: Dentin pretreated with etch and rinse demonstrated the highest bond strength with 1% CMA. Dentin conditioned with MBP activated by PDT and bonded to EA showed the lowest bond scores. Overall SBS values of 1% CMA were better than EA irrespective of the conditioning regime of dentin. The DC was higher in EA adhesive. This was followed by DC in 1% CMA. DC in EA was found to be comparable with 1% CMA. Conclusions: PA remains the gold standard for dentin conditioning. The incorporation of 1% chitosan in adhesive improves SBS and results in no change in DC. The use of FSL in dentin conditioning can be used as an alternative approach as it results in SBS within acceptable limits. The study was approved by the ethical board of King Saud University. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key points Plain language summary Non‐carious cervical lesions (NCCLs) refer to the loss of dental hard tissue in the cervical region due to physical and/or chemical factors, often associated with the disappearance of the cemento‐enamel junction (CEJ), posing challenges in both diagnosis and treatment of gingival recessions (GR). This case study introduces two protocols for multidisciplinary CEJ reconstruction prior to the root coverage therapy (RCT).Two patients with GR and NCCLs were treated using two CEJ reconstruction techniques: both, analogically and digitally guided. For each case, the position of the therapeutic CEJ was predetermined using a combination of the methods described by Zucchelli and Cairo. Then, an analog or digital diagnostic wax‐up was performed accordingly. In the analogically guided technique, a transparent silicone guide matrix was used to transfer information from the dental wax‐up. In contrast, the digitally guided technique employed a rigid, translucent resin prosthetic guide matrix that was designed and printed. Restorations were fabricated using direct composite resin and RCT was performed 1 week later in both techniques.At 6 months, both cases demonstrated complete root coverage and effective healing of the soft tissues surrounding the restorations.Dimensional changes in materials and precise guide adjustment in the analog technique are operator‐dependent and can affect the outcomes. Digital procedures, though effective, are costly and may limit their use. The usage of these two CEJ reconstruction techniques enhances communication within the multidisciplinary team and ensures optimal aesthetic outcomes and precise placement of the gingival margin. There are no established clinical protocols described in the literature for reconstructing the cemento‐enamel junction (CEJ) once the position of a therapeutic CEJ has been predetermined and prior root coverage therapy (RCT). Performing a diagnostic wax‐up (analogically or digitally) to reconstruct the therapeutic CEJ is crucial and facilitates the creation of a prosthetic guide that accurately reproduces the defined CEJ position. The reconstruction of the CEJ may improve the prognosis of RCT. This study looked at a dental issue called non‐carious cervical lesions, which happens when the hard tissue near the gum line of a tooth wears away, making it harder to treat gum recession. Two different approaches were tested to rebuild the lost tissue in the gum area before performing a procedure to cover the exposed roots. One approach used traditional methods with physical guides to help place the new tissue, while the other used advanced digital techniques to create a precise guide using 3D printing. After 6 months, both methods successfully covered the exposed roots and helped the gums heal properly. However, the traditional method's results can vary depending on the dentist's skill, while the digital method, although more accurate, can be expensive. Using these methods can improve teamwork among dental specialists and lead to better‐looking results by ensuring the gum line is placed exactly where it should be. [ABSTRACT FROM AUTHOR]

Background: Connective tissue graft substitutes have been used widely to overcome autogenous graft limitations. Nevertheless, they do not provide comparable results in the treatment of periodontal and peri‐implant soft tissue defects. Based on the principles of tissue‐engineered materials, injectable platelet‐rich fibrin (i‐PRF) has been combined with collagen matrices (CMs) to enhance their clinical efficacy. To the best of our knowledge, this is the first case series demonstrating the use of i‐PRF for the biofunctionalization of a volume‐stable collagen matrix (VCMX) as an adjunct to coronally advanced flap (CAF) to treat single gingival recession (GR) defects. Methods & Results: The study included 10 patients. Bleeding on probing, probing depth, GR height, clinical attachment level, esthetics, and dentin hypersensitivity were evaluated. After 6 months, a significant GR reduction (RecRed: 2.15 ± 0.7 mm; p = 0.005) and percentage of root coverage (% RC) of 81.13% were observed. Additionally, 40% of the sites showed complete root coverage. Gingival thickness increased 0.64 mm. Patient‐centered evaluations demonstrated dentin hypersensitivity and esthetics improvements by the end of follow‐up. Conclusion: VCMX biofunctionalized with i‐PRF associated with CAF technique showed promising clinical outcomes in the treatment of single RT1 GR defects. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify the risk factors for gingival invagination during orthodontic treatment after premolar extraction. Materials and Methods: The medical records of 135 patients who had undergone interdental space closure after premolar extraction were collected, and cone beam computed tomography was performed to determine the presence of gingival invagination. The risk factors were examined using mixed‐effects models and generalized propensity score weighting (GPSW) to develop a predictive model. Results: Univariate analysis revealed that the extraction site, buccal bone thickness 4 mm apical to the cemento‐enamel junction (MB1), mid‐root buccal bone thickness (MB2) and vertical skeletal relationships were related to gingival invagination (p <.05). Furthermore, a subsequent multivariable mixed‐effects model analysis indicated a significantly increased risk of gingival invagination at MB1 < 1 mm (p <.001; odds ratio [ORMB1≤0.5mm] = 29.304; 95% confidence interval [CI]: 8.986–93.807; OR0.5

Objectives: Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case–control study was to explore the risk factors for NCCLs. Methods: Cone‐beam computed tomography was used to determine whether a wedge‐shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing‐related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self‐administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs. Results: Significant variables in the univariate analysis (i.e., p <.2) included frequency of carbonated beverage consumption, sella‐nasion‐point B angle (SNB) and Frankfort‐mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039–9.532), FMA (OR = 1.100; 95% CI, 1.004–1.204) and SNB (OR = 0.896; 95% CI, 0.813–0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607–0.792; p <.001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612–0.796; p <.001). Conclusions: The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to present optimized device‐specific low‐dose cone‐beam computed tomography (CBCT) protocols with sufficient image quality for pre‐surgical diagnostics and three‐dimensional (3D) modelling of cleft defects. Methods: Six paediatric skulls were acquired, and an artificial bony cleft was created. A high‐resolution CBCT scan acted as a reference standard (Accuitomo 170, Morita, Kyoto, Japan) for comparing eight low‐dose protocols of Newtom VGi‐evo (QR Verona, Cefla, Verona, Italy), which included Eco and Regular protocols with different field of views (FOVs). Delineation of lamina dura, cementoenamel junction (CEJ), trabecular bone and bony bridge were assessed. A 3D model of the defect was also evaluated. Result: The dose area product of low‐dose protocols ranged from 31 to 254 mGy*cm2. Despite the dose difference of up to eight times between applied protocols, trabecular bone and CEJ exhibited appropriate image quality in all scans. However, Regular small FOV protocols (5 × 5 and 8 × 5 cm2), for both lamina dura and bony bridge, demonstrated a significant improvement in image quality compared to Eco FOV counterparts. Based on 3D defect analysis, no significant difference existed between low‐dose protocols and the reference standard. Conclusion: The findings highlight the possibility of achieving a considerable reduction (up to eight times) in the radiation dose using low‐dose CBCT protocols while maintaining sufficient image quality for assessing anatomical structures and 3D modelling in cleft cases. [ABSTRACT FROM AUTHOR]

Objective: To determine the influence of the presence/absence of third molars and intact/loss of cortical plate of the maxillary tuberosity on the amount of distal movement of the maxillary first permanent molar during distal movement of the maxillary dentition with mini-implants. Materials and methods: Thirty six maxillary tuberosity sites were evaluated in eighteen young adult patients. The distal movement of the entire maxillary dentition was performed with mini-implants with 200 g of distalising force applied from the mini-implant placed in the maxillary posterior buccal region to attachments placed on the arch wire between the maxillary lateral incisor and canine bilaterally. The distal movement of the maxillary first permanent molars was measured on lateral cephalograms. The maxillary tuberosity sites with intact cortical plate due to congenitally missing third molars or atraumatic extraction of third molars (G1), partial loss of cortical plate due to surgical removal of third molars (G2), fully erupted third molars (G4), third molars located at (G3), and below the cementoenamel junction (G5) were evaluated with cone beam computed tomography. One way Anova and Fisher LSD test was done. Results: The order of greater to lesser amount of distal movement of the maxillary first permanent molar depending on the integrity of maxillary of tuberosity was partial loss of cortical plate, third molars at the cementoenamel junction, third molars below the cementoenamel junction, intact cortical plate and fully erupted third molars. Conclusion: The integrity of the cortical plate and the relative position of the maxillary third molar to the second molar influence the amount of distal movement of the maxillary first permanent molar during distal movement of the maxillary teeth with TADS. Clinical relevance: The amount of distal movement of the maxillary dentition appears to depend on the presence or absence of the third molars and the condition of the cortical plate in the region of the maxillary tuberosity and thereby greatly influence the outcome of treatment. [ABSTRACT FROM AUTHOR]

Gingival recessions with noncarious cervical lesions (NCCLs), also called combined defects, are common problems, and patients often seek treatment due to esthetic concerns or dentin hypersensitivity. This case series evaluates the effectiveness of the non-coronally advanced flap (CAF) technique combined with restorative treatment for Miller Class III gingival recessions with NCCLs. A total of 16 combined defects were included. The combined defect height (CDH), recession depth (RD), pocket depth (PD), keratinized tissue width (KTW), and presence of dentin hypersensitivity were recorded at baseline and 6 months postsurgery. The mean root coverage (mRC) was 83%, and 50% of defects presented complete root coverage (CRC). In the group with an initial KTW = 2 mm, mRC and CRC were significantly higher. Further randomized controlled studies with larger sample sizes are needed to verify the prognostic factor of combined non-CAF techniques and restorative treatment for gingival recessions with NCCLs. [ABSTRACT FROM AUTHOR]

To evaluate changes in the periodontium of teeth restored with ultrathin (0.2 to 0.39 mm) ceramic laminate veneers (CLVs) placed subgingivally without a finish line compared to the same teeth before restorative treatment and to nonrestored antagonist teeth in healthy periodontium patients. Materials and Methods: A total of 73 CLVs were bonded onto the enamel surface of teeth without a finish line and with the cervical margin placed about 0.5 mm subgingivally. The gingival crevicular fluid was collected before bonding (baseline) and at 7, 180, and 365 days after bonding to quantify S mitis, P intermedia, and P gingivalis by quantitative polymerase chain reaction analysis. Visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR), and marginal adaptation were evaluated from baseline to 365 days in both groups. Results: No statistically significant differences were observed in VPI, PD, or BOP at any time point in the intragroup or intergroup comparisons (P > .05). All restorations obtained the alpha concept for marginal adaptation (ie, the restoration margin remained ideal at all time points). There was a statistically significant difference for S mitis between 180 and 365 days (P = .03). No statistically significant difference was observed for P gingivalis at any time point (P > .05). Conclusion: The periodontium in the restored group showed a clinical behavior similar to baseline. Overcontouring of the ultrathin (up to 0.39 mm) CLV, similar to the cementoenamel junction convexity, did not contribute to plaque accumulation or changes in the oral microbiota of patients with a healthy periodontium and proper oral hygiene instruction. [ABSTRACT FROM AUTHOR]

This study compared root trunk measurement methods--measuring parallel to the tooth axis (TA) vs parallel to the root surface (RS)--to assess the implications for decision-making regarding crown lengthening surgery. A total of 672 root trunks were measured by CBCT in both TA and RS planes. The possibility of performing crown lengthening in each clinical situation, based on the distance from the cementoenamel junction (CEJ) to the crestal bone (CB) after ostectomy (CEJ--CB), was judged and compared between groups. The proportions of cases with CEJ--CB values of 4, 5, and 6 mm in which crown lengthening was judged possible were 83.63%, 59.08%, and 39.18%, respectively, when RS was used as a reference point. When TA was used as a reference point, those proportions decreased 3.87% to 7.29%. The lingual root trunk of the mandibular first molar (LFL) with a CEJ--CB of 4 to 5 mm emerged as the most problematic area where the decision (based on each plane) shows a high rate of inconsistency, with differences between TA and RS measurements occurring in every 1 out of 5 to 6 teeth (16.67% to 18.75%). Within the limits of this study, utilizing TA for treatment-planning of surgical crown lengthening may not be ideal, as it may lead to extraction of many teeth that could otherwise be saved. [ABSTRACT FROM AUTHOR]

The aim of this prospective study was to evaluate the efficacy of a cross-linked xenogeneic volume-stable collagen matrix (CCM) in treating gingival recessions (GRs) at teeth presenting with cervical restorations or noncarious cervical lesions (NCCLs). Fifteen patients with esthetic concerns for multiple sites with GRs and cervical restorations were consecutively enrolled. The sites were treated with a coronally advanced flap (CAF) design in combination with a CCM. When present, the previous restoration was removed, and the cementoenamel junction was reconstructed with a composite material. The CCM was stabilized on the root surface(s) previously occupied by the restoration. The CAF was sutured to completely cover the graft. Clinical measurements and intraoral digital and ultrasonographic scans were collected at baseline and at 3 and 6 months postsurgery. Limited postoperative discomfort was reported by patients during the healing. The mean root coverage at 6 months was 74.81%. Average increases in gingival thickness of 0.43 mm and 0.52 mm were observed when measured with ultrasonography 1.5 mm and 3 mm apical to the gingival margin, respectively (P < .05). Relatively high patient-reported satisfaction and esthetics were associated with the treatment outcomes. The treatment resulted in a significant reduction in dental hypersensitivity (mean: 33 VAS points). The present study demonstrated that CAF + CCM is an effective approach for treating GRs at sites with cervical restorations or NCCLs. [ABSTRACT FROM AUTHOR]

Background: The determining effect of facial hard tissues on soft tissue morphology in orthodontic patients has yet to be explained. The aim of this study was to clarify the hard-soft tissue relationships of the lower 1/3 of the face in skeletal Class II-hyperdivergent patients compared with those in Class I-normodivergent patients using network analysis. Methods: Fifty-two adult patients (42 females, 10 males; age, 26.58 ± 5.80 years) were divided into two groups: Group 1, 25 subjects, skeletal Class I normodivergent pattern with straight profile; Group 2, 27 subjects, skeletal Class II hyperdivergent pattern with convex profile. Pretreatment cone-beam computed tomography and three-dimensional facial scans were taken and superimposed, on which landmarks were identified manually, and their coordinate values were used for network analysis. Results: (1) In sagittal direction, Group 2 correlations were generally weaker than Group 1. In both the vertical and sagittal directions of Group 1, the most influential hard tissue landmarks to soft tissues were located between the level of cemento-enamel junction of upper teeth and root apex of lower teeth. In Group 2, the hard tissue landmarks with the greatest influence in vertical direction were distributed more forward and downward than in Group 1. (2) In Group 1, all the correlations for vertical-hard tissue to sagittal-soft tissue position and sagittal-hard tissue to vertical-soft tissue position were positive. However, Group 2 correlations between vertical-hard tissue and sagittal-soft tissue positions were mostly negative. Between sagittal-hard tissue and vertical-soft tissue positions, Group 2 correlations were negative for mandible, and were positive for maxilla and teeth. Conclusion: Compared with Class I normodivergent patients with straight profile, Class II hyperdivergent patients with convex profile had more variations in soft tissue morphology in sagittal direction. In vertical direction, the most relevant hard tissue landmarks on which soft tissue predictions should be based were distributed more forward and downward in Class II hyperdivergent patients with convex profile. Class II hyperdivergent pattern with convex profile was an imbalanced phenotype concerning sagittal and vertical positions of maxillofacial hard and soft tissues. [ABSTRACT FROM AUTHOR]

Objectives: The abutments produced with circular symmetry failed to accurately replicate the natural teeth's cervical shapes. The purpose of this study was to measure cervical cross‐sections of maxillary anterior teeth using cone beam computed tomography (CBCT) images to design anatomic healing abutments. Materials and Methods: CBCT data of 61 patients were analyzed using Ez3D Plus software. Measurements were taken at the cemento‐enamel junction (CEJ) and 1 mm coronal to CEJ for maxillary central incisors, lateral incisors, and canines. Various parameters, including area, perimeter, and eight line segments in the distal (a), disto‐palatal (b), palatal (c), mesio‐palatal (d), mesial (e), mesio‐labial (f), labial (g), and disto‐labial (h) directions, were used to describe dental neck contours. The ratios (f/b and h/d) were analyzed, and differences based on sex and dental arch morphology were explored. Results: Significant differences were found in area and perimeter between males and females, but not in f/b and h/d ratios. Differences in the f/b ratio were observed among dental arch morphologies for maxillary central incisors, lateral incisors, and canines. Conclusions: CBCT measurements of cervical cross‐sections provide more accurate data for designing anatomic healing abutments. The fabrication of anatomical healing abutments needs to consider the influence of gender on cervical size and to explore the potential effect of arch shape on cervical morphology. Clinical Significance: The novel method provides detailed measurements for the description of dental cervical contours for patients with bilateral homonymous teeth missing. The measurements of this study could be utilized to design more accurate anatomic healing abutments to create desired morphology of peri‐implant soft tissue. [ABSTRACT FROM AUTHOR]

Objective: The present study investigated bone remodelling in the upper and lower incisor regions depending on the inclination pattern during the alignment phase of orthodontic treatment (OT). Materials and Methods: This prospective clinical study included 71 patients undergoing OT without premolar extraction. Cone beam computed tomography scans were taken before and after the alignment phase and the changes in the inclination, alveolar bone height (ABH) and bone thickness (BT) at levels 2, 3, 4, 6, 8 and 9 mm starting from the cementoenamel junction (CEJ) were determined. Results: Teeth were divided into 'Retroinclination' (lingual crown inclination <0°), 'Proclination‐low' (buccal crown inclination between 0° and 5°), or 'Proclination‐high' (buccal crown inclination >5°). The alignment phase of OT resulted in ABH loss. The highest ABH loss in the maxilla was observed on the buccal side in the 'Proclination‐high' and was 0.71 mm. ABH loss by 1.1 mm was observed in the mandible on the lingual side in the 'Retroinclination' group. The most significant changes in BT by up to 2 mm were observed at levels 6, 8 and 9 mm and these changes exhibited a moderate to strong correlation with the alterations in the inclination of individual incisors. At levels 2, 3 and 4 mm, the highest decrease in BT by up to 0.83 mm was observed on the palatal side of upper incisors in the 'Proclination‐high' group. Conclusion: The direction and amount of tooth inclination partially determine changes in the bone parameters during the alignment phase. [ABSTRACT FROM AUTHOR]

Background: The placement of ligatures in the cervical area of rat molars is considered as a predictable model to induce periodontitis. Objectives: The present explorative study aimed to compare the efficacy of metal wires (MWs), without or with sandblasting, versus silk ligatures (SLs) in inducing periodontal bone loss in rats. Materials and Methods: Twenty‐four Wistar rats were randomly divided into three groups of eight rats that received three different types of ligatures (MW, sandblasted wire [SMW], and SL) around their first right mandibular molar, while the contralateral tooth was left without the ligature and served as a control. Bone loss was assessed by measuring the distance from the cementoenamel junction (CEJ) to the bone crest at the distal aspect of the first molar on central mesiodistal sections generated from micro‐CT scans taken 24 and 35 days after ligature placement. Results: In the SL group, only in two rats the ligatures were retained until the end of the 24‐day period; in all other animals, the ligatures were lost at some time point. In the SMW, the ligatures were retained only for the 24‐day period. In the MW group, no ligatures were lost. Irrespective of the group or experimental period, the difference in the crestal bone level between ligated and control teeth was in most cases z < 0.20 mm, that is, in 19 out of 25 pairs of teeth. In a few cases, the bone crest was more apically located at the control teeth compared to the ligated ones (four cases each, during both 24‐ and 35‐day experimental periods). Conclusions: Bone loss was minimal during the experimental period, with no significant differences between the test and control teeth, or among the three types of ligatures. MWs, not even roughened, do not seem to be a better alternative to SLs for inducing bone loss in the experimental periodontitis model in the rat. This assumption, however, has to be confirmed in a larger, well‐powered study. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the distance between the maxillary central incisor root and the incisive canal based on skeletal malocclusion classification and to analyze the morphology of the incisive canal using cone-beam computed tomography (CBCT). Skeletal malocclusion was categorized into Class I, II, and III using lateral cephalometric analysis. Measurements of the distance between the maxillary central incisor root and the incisive canal were taken at two levels: 2 mm (L1) and 4 mm (L2) superior to the labial cementoenamel junction of the maxillary central incisor. At L1, the distance was found to be closer in the Class II group compared to the Class I or Class III groups. Similarly, at L2, the Class II group exhibited a closer distance than the Class III group. Interestingly, females showed a closer distance compared to males at both L1 and L2. Further analysis revealed a significant gender difference in the Class I and III groups, but not in the Class II group. These findings emphasize the significance of evaluating the distance between the maxillary central incisor root and the incisive canal in patients with skeletal Class II malocclusion, regardless of gender. [ABSTRACT FROM AUTHOR]

This article presents a case study of a 17-year-old female with a swelling in the upper front tooth region. The patient had a history of trauma to the area and clinical examination revealed a well-defined swelling with missing teeth and fractures. The patient underwent imaging and biopsy, leading to a diagnosis of Adenomatoid Odontogenic Tumor arising from a Dentigerous Cyst. The article discusses the characteristics and origins of this tumor and emphasizes the importance of thorough investigation for accurate diagnosis. [Extracted from the article]

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Context: Endodontic success hinges on a multifactorial interplay, with meticulous canal shaping, proper disinfection, and three-dimensional obturation being paramount. Among these factors, the amount of dentin remaining after instrumentation directly influences the biomechanical resilience and longevity of the tooth. Aims: This study aims to evaluate the impact of various rotary instrumentation systems, including single-file, two-file, and multiple-file configurations, on the remaining dentin thickness (RDT) following canal preparation. Settings and Design: This was an in vitro study, original research article. Materials and Methods: Sixty mandibular premolar human extracted teeth were decoronated at the cementoenamel junction with a diamond disc. Samples were randomly assigned to three groups using a simple random sampling technique (n = 60). Group I - Single-file system (One Curve, MicroMega) (n = 20), Group II - Two-file systems (2Shape, MicroMega) (n = 20), and Group III - Multiple-file system (Hero Gold, MicroMega) (n = 20). Preoperative cone-beam computed tomography (CBCT) scans were obtained after the sample was mounted on a modeling wax sheet. The biomechanical preparation of canals followed the manufacturer's protocols for every system. Postoperative CBCT scans were obtained. Pre- and postoperative scans were compared at standardized depths (4 mm, 7 mm, and 11 mm) within the canals (coronal, middle, and apical thirds), allowing for a comprehensive assessment of RDT throughout the canal. Statistical Analysis and Results: According to one-way ANOVA, the highest mean was seen in Group I, followed by Group II and Group III. Hence, a statistically significant difference was found between all the groups. Post hoc Tukey's test was done for intergroup comparison. Conclusions: A single-file system preserved more dentin with less aggressive cutting compared to two-file and multiple-file systems. [ABSTRACT FROM AUTHOR]

Aim: The objective of the present research was to assess and compare the residual dentin thickness after biomechanical preparation of teeth using three distinct rotary nickel-titanium (Ni-Ti) file systems. Materials and Methods: In the current experimental study, a total of 45 single-rooted teeth were selected for the analysis. The cementoenamel junction of each tooth was decoronated using a diamond disc. The teeth were randomly allocated to three groups, with each group representing a different rotary file system: Group 1: Hero GOLD (Micro Mega), Group 2: One Curve (Micro Mega), and Group 3: HyFlex electro-discharge machining (EDM) (Coltene-Whaledent, Altstatten, Switzerland). To evaluate the initial condition of the teeth, cone-beam computed tomography (CBCT) scans were conducted before the biomechanical preparation. The teeth were positioned on a modeling wax sheet, and the CBCT scans provided baseline measurements. The biomechanical preparation of the root canals followed the manufacturer's recommended guidelines for each file system. After the completion of the canal preparation, follow-up CBCT scans were conducted. The postprocedure CBCT scans were then compared with the initial scans to assess any changes in the residual thickness of dentin in the teeth. Statistical Analysis: Post hoc Tukey analysis of variance tests was utilized to examine differences between the groups. A statistically significant result was defined as P = 0.05 or less for every test. Results: The comparison of preinstrumentation and postinstrumentation CBCT images showed that the HyFlex EDM group removed less dentin clinically compared to the other two groups, i.e., Hero GOLD and One Curve. No significant statistical difference was found between Hero GOLD versus One Curve, One Curve versus HyFlex EDM, and Hero GOLD versus HyFlex EDM. Conclusion: Based on the results of this study, the HyFlex EDM file system exhibited superior cutting efficiency at various levels. Nonetheless, additional investigations are required to comprehensively assess the influence of Ni-Ti rotary file systems on the remaining dentin thickness. [ABSTRACT FROM AUTHOR]

Background: To analyze the anatomical characteristics of a posterior area in the mandible localized distally to the second molars and extending in the vestibular direction toward the bony step, which we define as "buccal step", in a patient with different skeletal patterns for mini-screw insertion. Methods: The sample included 85 CBCT (cone beam computed tomography) records selected from the digital archive. Analysis focused on the buccal step area. Sections were obtained in axial view using reference lines, and measurements of cortical and total bone were taken at specific points M0 (starting point, 6 mm apical from CEJc—cementoenamel junction crest), M2 (located 2 mm posterior to M0 in the apical direction), and M4 (positioned 4 mm posterior to M0 in the apical direction) in both directions. Six measurements were recorded for each scan root plane, assessing cortical and total bone depth. Results: The thickness of the bone increases toward the inside of the mouth at all tested sites (M0, M2, M4), which is good for placing mini-screws. Cortical bone thickness decreases toward the inside of the mouth, with no significant differences among the sites except for M0 vs. M4. People with a particular jaw shape (hypo-divergent) have a thicker cortical bone, indicating that facial structure affects bone thickness. Conclusions: The posterior buccal step insertion site has biomechanical advantages and reduces the risk of damaging roots during mini-screw insertions. [ABSTRACT FROM AUTHOR]

Purpose: Preoperative identification of the intraosseous posterior superior alveolar artery (PSAA) is critical when planning sinus surgery. This study was conducted to determine the distance between the cementoenamel junction and the PSAA, as well as to identify factors influencing the detection of the PSAA on cone-beam computed tomography (CBCT). Materials and Methods: In total, 254 CBCT scans of maxillary sinuses, acquired with 2 different scanners, were examined to identify the PSAA. The distance from the cementoenamel junction (CEJ) to the PSAA was recorded at each maxillary posterior tooth position. Binomial logistic regression and multiple linear regression were employed to evaluate the effects of scanner type, CBCT parameters, sex, and age on PSAA detection and CEJ-PSAA distance, respectively. P-values less than 0.05 were considered to indicate statistical significance. Results: The mean CEJ-PSAA distances at the second molar, first molar, second premolar, and first premolar positions were 17.0±4.0 mm, 21.8±4.1 mm, 19.5±4.7 mm, and 19.9±4.9 mm for scanner 1, respectively, and 17.3±3.5 mm, 16.9±4.3 mm, 18.5±4.1 mm, and 18.4±4.3 mm for scanner 2. No independent variable significantly influenced PSAA detection. However, tooth position (b= -0.67, P<0.05) and scanner type (b= -1.3, P<0.05) were significant predictors of CEJ-PSAA distance. Conclusion: CBCT-based estimates of CEJ-PSAA distance were comparable to those obtained in previous studies involving cadavers, CT, and CBCT. The type of CBCT scanner may slightly influence this measurement. No independent variable significantly impacted PSAA detection. [ABSTRACT FROM AUTHOR]

Purpose: To assess the thickness of the palatal bone wall of maxillary anterior teeth in relation to age, sex, and tooth type. Materials and Methods: A total of 100 CBCT images of patients ≥ 18 years of age were used. The thickness of the palatal bone at the maxillary canines and incisors was assessed perpendicular to the long axis of the teeth at three locations: 4 mm apical to the cementoenamel junction (CEJ; MP1), halfway between the CEJ and the root apex (MP2), and at the root apex (MP3). Results: At the MP1 site, 96% of the maxillary anterior teeth had a palatal bone thickness of < 1 mm, with a mean thickness of 0.5 mm. At the MP2 and MP3 sites, 86% and 100% of the teeth had ≥ 1 mm bone thickness, and the means were 2 and 5 mm, respectively. There were no significant differences among the age or gender groups. Maxillary canines showed significantly greater bone thickness than maxillary incisors, particularly at MP2 and MP3 sites. Conclusion: Most of the examined teeth had thin palatal bone at the MP1 measurement site, and maxillary canines showed significantly thicker palatal bone than maxillary incisors. This finding should be considered when treatment planning for immediate implants in the maxillary anterior segment. [ABSTRACT FROM AUTHOR]

This study evaluated the use of a xenogeneic acellular dermal matrix (XADM) combined with a modified coronally advanced flap (MCAF) and partial resin composite filling (anatomic crown plus 1 mm of the root surface) to treat multiple Type 1 gingival recessions associated with B+ noncarious cervical lesions (NCCLs). The study included 24 recessions in 10 patients. Bleeding on probing, probing depth, combined defect height, relative gingival recession, clinical attachment level, esthetics, and dentin hypersensitivity were recorded. After 6 months, the treatment provided statistically significant outcomes: It reduced the combined defect height by 2.02 ± 0.65 mm, increased clinical attachment level by 1.96 ± 0.83 mm, and increased keratinized tissue thickness by 0.46 ± 0.47 mm, and shallow probing depths were seen. Significant dentin hypersensitivity reduction and esthetic improvements were observed. Therefore, XADM associated with MCAF and partial restoration might be a promising alternative to autogenous grafts used to treat multiple gingival recessions associated with B+ NCCLs. [ABSTRACT FROM AUTHOR]

Maxillary canines are the second most commonly impacted teeth. Two thirds of these impacted canines are palatal, and one third are labially impacted. Maxillary labial impactions comprise approximately 0.33% to 0.75% of the general population. Like palatal impactions, preventive and interceptive methods can be employed to help the impacted tooth erupt and avoid surgical uncovering. Early extraction of appropriate primary teeth and palatal expansion has helped some of these impactions erupt spontaneously. Most labially impacted canines are positioned "in the slot," in a midalveolar location between the lateral incisor and first premolar. If they do not erupt after preventive or interceptive means, they can be managed with simple closed-eruption uncovering techniques. The most difficult labial impactions are ectopically positioned. These are usually horizontally positioned, mesial to the lateral incisor. They can be very apically positioned, near the base of the nose and near the midline. The rarest labial impaction occurs between the central and lateral incisors or between the premolars. These are extremely rare and require special orthodontic and uncovering techniques. All of these ectopic impactions require a technique that leaves the impacted tooth uncovered so the orthodontist can employ the proper mechanics to move these teeth without damage to adjacent structures. This article elucidates the surgical uncovering techniques and the orthodontic mechanics to successfully move these teeth and minimize root resorption, bone loss, and recession. [ABSTRACT FROM AUTHOR]

Objective: The two commonly used diagnostic methods for taurodontism are susceptible to aging changes, mastication wear and other factors. Therefore, this study proposed an improved diagnostic method for taurodontism, and compared it with the previous two methods as a supplement for taurodontism diagnosis. Methods: The included patients were aged 10–89 years and admitted to the Department of Stomatology of Hebei Eye Hospital from June 1, 2022 to May 31, 2023. Eighty cone-beam computed tomography images were divided equally into 4 groups: 10–29, 30–49, 50–69, and 70–89 years old. The right mandibular first molars were selected as measurement objects. Firstly, |BD| and taurodontism index (TI)-related parameters were measured using Shifman and Chanannel's method and crown-body(CB) and root (R) lengths was measured by Seow and Lai's method. The improved method used the length from the cementoenamel junction(CEJ) to the root bifurcation point(body, B)and the root length(root, R)as the measurement objects. Finally, TI, CB/R ratios, and B/R ratios were calculated according to the formulas given below. One-way ANOVA analysis was mainly used to compare the differences in the values, indices and ratios of taurodontism among different age groups (p<0.05). Results: With the increase of age, |BD| and TI values decreased significantly (p<0.01). The CB/R ratios of 70–89 years group were significantly lower than those of the other three groups (p<0.01). Ratios derived from the improved method were significantly lower in the 70–89 years than in 10–29 years group (p<0.05). Conclusions: The |BD| and TI parameters proposed by Shifman and channel are significantly influenced by age. The measurements of Seow and Lai (CB/R ratios) were less affected by age compared with those of the former. The improved method(B/R ratios) was least affected by age, which would reduce error and bias in the measurement of taurodontism and obtain more objective results in older patients. [ABSTRACT FROM AUTHOR]

This experimental study investigated the effect of different intracanal irrigants on the push-out bond strength of dentin in damaged anterior primary teeth. The crowns of 90 anterior primary teeth were sectioned horizontally, 1 mm above the cementoenamel junction (CEJ). Following canal preparation with K-files, all groups except the negative control received normal saline irrigation. Canals were then irrigated with either 3% or 5.25% sodium hypochlorite (NaOCl), 2% or 0.2% chlorhexidine (CHX) solution (except negative and positive controls). The roots were filled with Metapex material and covered with a calcium hydroxide liner. In root canals, the bond was applied by self-etching and then light-cured for 20 seconds before canals were restored incrementally with composite. Stereomicroscopes were used to assess failure patterns. Push-out bond strengths (MPa ± SD) were: 3% NaOCl (16.92 ± 5.78), 5.25% NaOCl (8.96 ± 3.55), 2% CHX (14.76 ± 5.56), and 0.2% CHX (7.76 ± 2.93). Significant differences were seen across the irrigants regarding the push-out bond strength of dentin sections (P <0.001). The most frequent failures were adhesive and cohesive. NaOCl and CHX irrigants increased the push-out bond strength compared to controls. Compared to controls, both 3% NaOCl and 2% CHX irrigants significantly increased the push-out bond strength of dentin in non-vital anterior primary teeth. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence, distribution pattern, and development/progression of gingival recession in a population of dentists, followed up over an additional 15 years, after an initial and previously published follow‐up of 10 years. Methods: This 25‐year longitudinal gingival recession investigation started in 1994 at the Dental School with 60 final‐year dental students; among them, 40 were re‐examined in 2004, and 27 of those 40 were further examined in 2019 by the same examiner. A questionnaire session provided information on toothbrushing habits at each appointment. Results: In this study, 27 individuals aged 31–44 years (724 teeth) were followed up. The prevalence of gingival recession was 100% after 15 years. A total of 204 and 317 recessions found in 2004 and 2019, respectively, were valid for the longitudinal evaluation. The highest recession incidence was observed in the molars during both examinations (p < 0.0001). The mean recession heights were 1.66 ± 0.87 mm and 1.85 ± 1.08 mm, respectively (p = 0.024). The difference between the means was 0.19 mm after 15 years. The mean probing depth and bleeding on probing at the point of the maximum recession decreased (p < 0.0001). A multiple regression analysis on the tooth level was performed and indicated that the keratinized gingival width was negatively associated with the severity of the buccal recession height. Conclusions: Fifteen years after the initial follow‐up, the mean number of gingival recessions per dentist and the mean recession height increased, while toothbrushing habits remained nearly unchanged. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the microleakage between the gingival seat and base material and to assess the interface integrity between the base material and overlying composite in class II cavities restored using deep margin elevation. Materials and Methods: Thirty maxillary molars (n = 30) were taken, and class II cavities were prepared with a gingival seat extending below the cementoenamel junction. These teeth were divided into three groups for subgingival margin elevation using different materials: Group A (n = 10) - flowable composite, Group B (n = 10) - glass ionomer cement (GIC), and Group C (n = 10) - GIC with nanohydroxyapatite (GIC n-HAp). The remaining cavities were restored with bulk-fill composite. After undergoing 1000 thermocycling cycles, half of the samples were examined for microleakage using confocal laser microscopy, and the other half were assessed for interface integrity using scanning electron microscopy. Microleakage was statistically analyzed by one-way ANOVA, and interface integrity was analyzed by Kruskal-Wallis tests. Results: The study found that GIC n-HAp exhibited significantly lower microleakage between the base material and gingival seat than flowable composite and GIC. However, regarding interface integrity between the base material and bulk-fill composite, flowable composite, and GIC outperformed GIC n-HAp. Conclusions: Incorporating n-HAp into GIC effectively reduced microleakage at the dentin-base material interface. However, the interface integrity between GIC n-HAp and the composite poses a challenge. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to evaluate the 1-day fracture resistance of simulated immature teeth with an apical plug with ProRoot MTA, MTA Angelus, and RetroMTA after calcium hydroxide intracanal medication. Materials and Methods. Sixty extracted, single-rooted human mandibular premolars were randomly divided into six groups of 10 teeth each. Firstly, to standardize the 9 mm root length, the crowns were cut off at and 9 mm below the cementoenamel junction transversely. Simulations for immature apices were carried out by using No. 1–6 Peeso reamers to pass through the apex to obtain a diameter of 1.7 mm at the apical opening. One group served as a negative control without any treatment, while the other groups received 30 days of calcium hydroxide intracanal medication. Four groups were plugs with 4 mm of ProRoot MTA, MTA Angelus, RetroMTA, and gutta-percha, respectively. The last one was served as a positive control group without filling inside. After 1 day of incubation, specimens were vertically loaded in a universal testing machine at a crosshead speed of 1 mm/min until fracture occurred. The peak load to fracture (Newton) and fracture pattern were recorded. A one-way analysis of variance (ANOVA) followed by Tukey's HSD test was used for data analysis. Results. The highest mean load to fracture was shown in the negative control group (543.33 ± 37.17 N), followed by ProRoot MTA (432.82 ± 68.06 N), MTA Angelus (396.92 ± 59.93 N), RetroMTA (389.08 ± 56.25 N), and gutta-percha (283.28 ± 43.40 N), and the lowest belonged to the positive control group (239.98 ± 27.19 N). The significant differences were found between both the control and experimental groups with an apical plug with calcium silicate cement (p < 0.05). There were no significant differences among those three apical plugs (p > 0.05). Conclusion. Apical plugs with ProRoot MTA, MTA Angelus, and RetroMTA had an immediate strengthening effect on simulated immature teeth after calcium hydroxide intracanal medication had been used. [ABSTRACT FROM AUTHOR]

Background: The impaction of the maxillary canine is a common occurrence, and orthodontists must be prepared to manage it. The purpose of this article is to present a study of the efficacy of a double-wire orthodontic appliance compared to a control group in the alignment of impacted maxillary canines in the dental arch. Methods: To diagnose an impacted maxillary canine, a panoramic radiograph was taken and a detailed analysis was performed by the same orthodontist. This article presents the results of 28 impacted maxillary canines with inclusion criteria of A2 (tooth angulation to the midline 16°–45°), V1 (vertical height of the tooth crown above the cementoenamel junction but less than half the length of the root of the maxillary lateral incisor), and O3 (medial position of the canine crown of more than half but less than the entire root width of the lateral incisor) positions in 21 patients (7 males and 14 females) with a mean age of 14.02 years (SD = 1.61) who were treated by the same orthodontist for impacted maxillary canines using a fixed double-wire orthodontic appliance. The analyzed data were compared with the control group (treated with a fixed orthodontic appliance and active ligature), which was matched for pretreatment age and the A2, V1, and O3 positions of the impacted maxillary canine. Results: With both methods, the impacted maxillary canines were aligned and guided into a correct position in the dental arch, but the mean active orthodontic traction of 31 ± 4.2 weeks in the SG was statistically significantly shorter (p < 0.05) in comparison to 37 ± 6.3 weeks in the CG, and the number of visits was statistically significantly (p < 0.05) fewer in the SG (5 ± 2) than in the CG (11 ± 5). Conclusions: The findings of this study are important to the field of orthodontics and show that the alignment of impacted maxillary canines with A2, V1, and O3 positions can be achieved with both methods, but with the double-wire appliance, the treatment time was shorter and the number of visits was statistically significantly fewer. The results of this study suggest that this approach may be more efficient and cost-effective compared to conventional methods. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to evaluate the efficacy of 30°-angled Er:YAG laser tip and different periodontal instruments on root surface roughness and morphology in vitro. Methods: Eighteen bovine teeth root without carious lesion were decoronated from the cementoenamel junction and seperated longitidunally. A total of 36 obtained blocks were mounted in resin blocks and polished with silicon carbide papers under water irrigation. These blocks were randomly assigned into 3 treatment groups. In Group 1, 30°-angled Er:YAG laser (2.94 μm) tip was applied onto the blocks with a 20 Hz, 120 mJ energy output under water irrigation for 20 s. In Groups 2 and 3, the same treatment was applied to the blocks with new generation ultrasonic tip and conventional curette apico-coronally for 20 s with a sweeping motion. Surface roughness and morphology were evaluated before and after instrumentation with a profilometer and SEM, respectively. Results: After instrumentation, profilometric analysis revealed significantly higher roughness values compared to baseline in all treatment groups(p < 0.05). Laser group revealed the roughest surface morphology followed by conventional curette and new generation ultrasonic tip treatment groups (p < 0.05). In SEM analysis, irregular surfaces and crater defects were seen more frequently in the laser group. Conclusion: Results of the study showed that the use of new generation ultrasonic tip was associated with smoother surface morphology compared to 30°-angled Er-YAG laser tip and conventional curette. Further in vitro and in vivo studies with an increased sample size are necessary to support the present study findings. [ABSTRACT FROM AUTHOR]

Mucogingival surgery is a procedure for the treatment of gingival recession, which is a shift of marginal gingival tissue to the cementoenamel junction (CEJ), exposing the surface of the root teeth. One treatment for gingival recession is the Langer and Langer bilaminar technique, which involves the use of the fascia lata (FL) membrane. This membrane is harvested from the aponeurosis of the external muscles. The purpose of this case report was to present the clinical results of a 2-year follow-up using the Langer and Langer bilaminar technique modified with FL in a patient with gingival recession. Recessions are a shift of marginal gingival tissue to the CEJ, which exposes the surface of the root teeth. At the 2-year follow-up, the patient presented with a gingival recession in tooth 41, which resulted in complete root coverage, reaching 83.3%; the amount of keratinized tissue increased to 3 mm in each tooth, changing the gingival biotype from thin to thick and scalloped. This case report supports the use of FL as a successful alternative treatment. [ABSTRACT FROM AUTHOR]

Polishing after the removal of brackets is the final step in orthodontic treatment. It is simple to perform, though some studies have reported that polishing causes damage to the enamel surface. An in vitro study was made of the influence of the buccal surface convexity of the tooth upon possible enamel loss when the remaining resin and adhesive are removed after bracket decementing using two different polishing modes: a tungsten carbide bur at low and high speeds. The convexity of the buccal surface was quantified in 30 incisors and 30 premolars. A stereoscopic microscope was used to obtain photographs of the profile of the crown, and Image J software was used to calculate convexity by dividing the length of a line from the cementoenamel junction to the incisal margin by another line from the mentioned junction to the maximum convexity of the buccal surface. Brackets were cemented on all the teeth and were decemented 24 h later. In both groups, the residual composite was removed with a tungsten carbide bur at a low speed in one-half of the teeth and at a high speed in the other half. The buccal surface of each tooth was then photographed again, and the convexity was calculated and compared against the baseline value. The difference between the two values were taken to represent the enamel loss. The convexity of the premolars was significantly greater than that of the incisors, but this did not result in greater enamel loss when the same polishing mode was used. However, the tungsten carbide bur at a high speed proved more aggressive, causing significantly greater enamel loss than when used at a low speed. [ABSTRACT FROM AUTHOR]

This report describes the bone reduction guide which was digitally obtained to improve diagnosis, treatment outcome and follow-up. Treatment of gingival smiles due to altered passive eruption should include interdisciplinary planning and smile design to facilitate the prediction of treatment outcome. Crown lengthening surgery can be supported by digital tools to improve surgical planning and follow-up. A 30-year-old female patient was referred to a private dental clinic seeking solutions for her gingival smile. Based on the anatomical crown length, a smile design was created, and the patient was presented with a simulated smile before treatment. In the surgical phase, a full-thickness flap was raised in the upper jaw to achieve the desired outcome. Using cone-beam computed tomography to determine cementoenamel junction for smile design and treatment planning brings many benefits. Patients and clinicians can foresee treatment results. From there, appropriate changes can be made. The bone reduction guide is designed to rest on the bone to help the clinician cut the bone accurately and thoroughly follow the established plan. [ABSTRACT FROM AUTHOR]

Introduction: Success in endodontics depends on canal preparation, disinfection, and obturation. Cleaning and shaping play a pivotal role in successful endodontic therapy. An important factor in preventing procedural mishaps and further complications is the quantity of dentine removed during instrumentation because the fracture resistance of the root is directly influenced by the amount of dentine that remains after instrumentation. Aim: To evaluate and compare the remaining dentine thickness of the root canal after instrumentation with three different rotary file systems using Cone Beam Computed Tomography (CBCT) imaging. Materials and Methods: Thirty permanent extracted, singlerooted teeth were collected. The samples were decoronated at the level of the Cementoenamel Junction (CEJ). A preinstrumentation CBCT scan was taken. Access opening and working length were determined. The samples were randomly assigned to three groups: Group I - Edge Endo X7, Group II-Hero Gold, Group III - Neo-endo flex files. Biomechanical preparation was carried out using the respective files. To evaluate the remaining dentine thickness, a comparison was made with the pre-instrumentation CBCT scan. Statistical analysis was performed using One-way ANOVA. Results: Upon inter-group comparison of the pre-instrumentation group, no significant difference (p=0.05) was observed. Postinstrumentation, it was noted that the remaining dentine thickness in Group I (p=0.05) at the apical third was significantly less than in Group II (p=0.007) and Group III (p=0.042). Maximum preservation of dentine was seen with Hero gold files, whereas the minimum preservation of dentine was seen with Edge Endo X7. Conclusion: Hero gold files exhibited less removal of dentine apically, whereas Edge Endo X7 showed more removal of dentine apically. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: To determine association between gingival recession and various oral hygiene practices. METHODOLOGY: This cross-sectional study was conducted at Rawal Dental College, Rawal Institute of Health Sciences Islamabad, from June 2022 to August 2022. The data were collected from 169 periodontally healthy patients aged between 18 years to 50 years with the help of a questionnaire. Pre-defined structured questionnaire was modified. Questionnaire included demographic details, oral hygiene maintenance practices and history of use of prosthesis and orthodontic treatment. After interviewing every patient, periodontal examination was carried out on the dental chair using William's probe to check the gingival recession. Data was recorded and evaluated using SPSS version 26.0. RESULTS: Out of 169 subjects examined, the frequency of gingival recession was higher in females (56%) as compared to males (43%). The molars and premolars were the teeth most frequently affected as compared to anteriors. Use of horizontal tooth brushing method (48.5%), medium type of toothbrush (55.6%) and brushing once daily (46.2%) for 2 minutes showed the most common causative factors for the gingival recession. CONCLUSIONS: Results of this study clearly showed that the cause of gingival recession is multiple, and its manifestation is always the result of more than one factor operating together. The use of medium type of toothbrush, cleaning teeth once a day, and horizontal brushing technique were found to be most closely related to gingival recession. [ABSTRACT FROM AUTHOR]

Background.: Severe caries in early childhood is a concern for both children receiving dental treatment and their parents. This dental disease progresses rapidly and quickly damages the coronal part of the tooth. When there is insufficient coronal structure to support a coronal restoration, using intracanal components following root canal treatment increases tooth resistance and helps provide retention for the coronal restoration. This study compared the shear bond strength of three types of intracanal posts (composite resin post, reverse metal post, and fiber post) in severely damaged primary anterior teeth. Methods.: This in vitro study was conducted on 30 extracted anterior primary teeth with at least two-thirds of healthy roots and no prior pulp treatment. The teeth were randomly divided into three groups of 10: group 1: composite resin post with 8th generation universal bonding, group 2: reverse metal post with GC restorative glass cement, and group 3: fiber post with GC restorative glass cement. After placing the post, the samples were restored with a height of 3 mm from cementoenamel junction (CEJ) using an Anterior GC Gradia Packable composite resin. All the samples underwent 500 cycles of thermocycling in a hot water bath at 55±2 °C and a cold water bath at 5±2 °C. The shear strength of the samples was then evaluated using an electromechanical universal testing machine at a rate of 1 mm/min and at a location 2 mm coronal to the CEJ in terms of megapascals. Results.: The average shear bond strength of composite resin posts with 8th generation bonding application was 8.02220 MPa, reverse metal posts with glass ionomer application was 13.8600 MPa, and fiber posts with glass ionomer application was 9.7400 MPa. Conclusion.: Based on these findings, it can be concluded that the highest shear bond strength in this study was related to the reverse metal post, and the lowest shear bond strength was related to the composite resin post. According to the results, reverse metal posts demonstrated better shear bond strength than composite resin posts and fiber posts (P <0.05).> [ABSTRACT FROM AUTHOR]

BACKGROUND: The application of miniscrew in adolescents is increasing day by day, but at present, there are few studies on bone mass in the external oblique line of the mandible in adolescents at home and abroad, and there is no systematic study on bone mass in the external oblique line of the mandible in adolescents in different growth and development periods. OBJECTIVE: To measure the bone mass in the external oblique line of the mandible in adolescents with different cervical vertebral bone ages using a conebeam CT and to investigate the difference of bone mass in the external oblique line of the mandible in adolescents with different cervical vertebral bone ages and the correlation between bone mass in this area and the cervical vertebral bone age. METHODS: The cone-beam CT data of 105 adolescent patients before orthodontic treatment were collected and divided into CS3 group (n=24), CS4 group (n=26), CS5 group (n=29) and CS6 group (n=26) using the cervical vertebral maturation method. The adolescent mandibular buccal shelf was reconstructed by Mimics Medical 21.0 software. The width of buccal bone at 6 and 11 mm under the cemento-enamel junction and the bone height at 4 and 5 mm buccal to the cemento-enamel junction of right mandibular first and second molars were measured. The measured data were statistically analyzed. The measurement was made on four planes: plane 1 is the plane where the proximal mesial root of the mandibular right first molar is located; plane 2 is the plane where the distal mesial root of the mandibular right first molar is located; plane 3 is the plane where the proximal mesial root of the mandibular right second molar is located; and plane 4 is the plane where the distal mesial root of the mandibular right second molar is located. RESULTS AND CONCLUSION: In each group, the bone width on the buccal side of the external oblique line increased gradually from the first molar proximally to the second molar distally in adolescents, and the width of buccal bone at 6 and 11 mm under the cemento-enamel junction showed significant difference among different layers (P < 0.05). The bone width of buccal bone at 11 mm under the cemento-enamel junction was greater than that at 6 mm. The bone height on the buccal side of the external oblique line increased gradually from the first molar proximally to the second molar distally in all four groups, and the bone height at 4 and 5 mm buccal to the cemento-enamel junction showed significant differences at different layers (P < 0.05). The bone height at 4 mm buccal to the cemento-enamel junction was greater than that at 5 mm. On the fourth plane, the bone width at 11 mm buccal to the cemento-enamel junction was smaller in the CS3, CS4, and CS5 groups than in the CS6 group (P < 0.05). On the third plane, the bone heights at 4 mm and 5 mm buccal to the cementoenamel junction were smaller in the CS3 and CS4 groups than in the CS6 group (P < 0.05). On the fourth plane, the bone height at 5 mm buccal to the cementoenamel junction was smaller in the CS3 and CS4 groups than in the CS6 group (P < 0.05). On the fourth plane, the bone height at 4 mm buccal to the cementoenamel junction was smaller in the CS3 group than in the CS6 group (P < 0.05). Spearman correlation analysis showed that there was no correlation between bone mass and the cervical vertebral bone age, except that there was a weak correlation between bone mass at some measurement sites and cervical vertebral bone age. To conclude, the bone mass in the external oblique area of the mandible in adolescents does not change significantly with the increase of cervical vertebral bone age. The buccal side of the mesial root and distal root of the mandibular second molar in the external oblique area of CS3-CS6 adolescents meets the requirement of bone mass for miniscrew implantation, which is a site available for miniscrew implantation. [ABSTRACT FROM AUTHOR]