Anterior Teeth Research Articles

Effectiveness of low-intensity electrical current in accelerating the en-masse retraction of the upper anterior teeth following first-premolar extraction in young adult patients with Class II division 1 malocclusion: A randomized controlled clinical trial

Many efforts have been made to shorten fixed appliance orthodontic treatment time by accelerating the rate of tooth movement. Low-intensity electrical stimulation (LIES) is one of the proposed physical methods that has not yet been well studied in the medical literature. This study aimed to evaluate the effectiveness of LIES in accelerating orthodontic tooth movement in cases of en-mass retraction of the upper anterior teeth. Patients who attended the Department of Orthodontics at the Faculty of Dentistry, University of Damascus, between September 2019 and February 2021, for treatment were carefully checked. All patients who met the eligibility criteria were invited to participate in this RCT. Young adult patients having class II division I malocclusion were equally and randomly assigned into the low-intensity electrical stimulation group (LIES), and traditional en-masse retraction group (TRAD). The mini-implants assisted en-masse retraction technique was used to close the extracted upper first premolar spaces in both groups. NiTi closed coil springs (250g/side) were used. Electrical stimulation of 15-20μA for each tooth was applied on the upper anterior teeth using a recently developed intraorally removable device in the LIES group. The primary outcome was the en-masse retraction rate, the secondary outcomes were changes in the first molar position, intermolar width, and intercanine width. These outcomes were measured on the digital photographs of the maxilla cast using the Image J program. Two-sample t-test with Bonferroni's correction was utilized to explore any significant differences between the two groups in all studied variables. Of the 168 patients examined by the researcher, 38 patients with Class II division I malocclusion (30 females and 8 males; mean age: 21.1±2.31 years) were finally recruited in this RCT. The overall en-masse retraction rate was significantly greater in the LIES group compared to the TRAD group (1.02±0.08, 0.73±0.04mm/month respectively; P<0.001). In addition, the monthly rate of space closure was significantly greater in this group at all evaluation times (P<0.001). A small increase was noted in the intercanine width (1.60±0.27, and 1.65±0.33mm respectively). Negligible changes were noted in the first molar positions and intermolar width, with insignificant differences between the two groups. LIES according to the protocol applied in this trial accelerated the upper anterior teeth en-masse retraction rate by approximately 28% compared to the traditional en-masse retraction method. While this acceleration was statistically significant, may not have substantial clinical implications. This trial protocol was registered in the Clinical Trials database (ClinicalTrials.gov NCT05350280).

The effect of soaking blimbi (Averrhoa blimbi, L) fruit extract on the roughness of nanofiller composite resin

Background Nanofiller composite resin is a restorative material or filling material that is activated by visible light to restore anterior and posterior teeth. One of the characteristics of the composite resin surface is surface roughness. Surface roughness is greatly influenced by acidic solutions, namely the acid in drinks. Objective: To determine the effect of soaking blimbi fruit extract (Averrhoa blimbi L.) on the roughness of nanofiller composite resin. Research Method: This research uses laboratory experimental research. The sampling method used 6 sample groups in each group, consisting of 4 groups, namely 2 treatment groups and 2 control groups. The treatment group consisted of 50% and 100% blimbi fruit extract, then the control group consisted of a positive control grup (citric acid) and a negative control (aquadest). Then a surface roughness test was carried out on each group using a Surface Roughness Tester tool, then the test data was analyzed using the One-Way Anova test with the condition that the data had to be normal and homogeneous, the condition for the One-Way Anova test was that the sig value Sig &lt;0.05. Results: Based on analysis using One-Way Anova, the sig 0.518 (p&gt;0.05), which means there are no significant differences in each sample group. Conclusion: There is no influence on the roughness of the nanofiller composite resin by soaking in star fruit extract (Averrhoa blimbi, L) because the value difference is not significant.

Effectiveness of a customized intraoral photobiomodulator for accelerating orthodontic tooth movement

The aim of this study was to evaluate effectiveness of a Customized Intraoral Photobiomodulator for accelerating orthodontic tooth movement using a split mouth design as only limited studies have been done to compare the effectiveness of LLLT and their iatrogenic effects between experimental and control group in the same individual (split mouth technique) with the help of a customised intraoral photobiomodulator. Consented Patients (n = 15) undergoing orthodontic therapy, diagnosed with Class 1 bimaxillary malocclusion were subjected to experiment based on randomly assigned split mouth design for both experiments in all 4 quadrants. At retraction phase, a customized introral photobiomodulator was given to all patients and the amount of anterior teeth retraction was measured at 1 month interval for 4 months (T0-T4). Apical root resorption was measured by CBCT taken at the beginning of study phase (t0) and end of 4th month (t1). PBM showed an increase in the rate of tooth movement of 4.12fold in the 1st, 2nd and 3rd month. Mandibular canine showed the maximum amount of root resorption whereas the maxillary and mandibular premolars the least. There were similar results when pulp vitality was evaluated where all the teeth in experimental and control side showed positive results to cold test. From our study, PBM is a better method compared to control group as it has shown increased rate of orthodontic teeth movement.

Visibility of alveolar bone thicknesses on CBCT images-a study on minimum bone requirements using various reconstruction techniques, viewing modes, and resolutions.

To evaluate at which thickness marginal bone becomes visible to the observer on cone-beam computed tomography (CBCT) images and how reconstruction technique and viewing mode affect assessment. Fourteen anterior teeth from six human mandibles were examined with two CBCT resolution protocols: standard- and high-resolution. Distance from the cementoenamel junction to the visible marginal bone level (MBL) was measured in three groups of reconstructed CBCT images: multiplanar reformation (MPR) with grey scale, MPR with inverted grey scale, and 3D rendering. These measurements were used to identify the bone level where marginal bone width should be measured on histological photographs of sliced teeth. Gold standards comprised measurements of bone thickness at the superior MBL on histological photographs. MPR grey scale images exposed at high-resolution settings yielded highest validity: bone widths of 0.173mm (buccal) and 0.356mm (lingual) were necessary for visibility on a CBCT image. 3D-rendered lingual surfaces exposed with high-resolution settings had lowest validity. Intra-observer agreement for all CBCT and histological measurements was high. The best CBCT resolution protocol, reconstruction technique, and viewing mode for analyzing buccal and lingual surfaces of the alveolar bone margin are images exposed with a high-resolution protocol, reconstructed using MPR, and viewed in grey scale. Bone thickness required to be visualized was twice lingually compared to buccally. The visualization of bone thickness in CBCT requires a greater thickness on the lingual side compared to the buccal side. 3D-rendered reconstructions should be avoided when evaluating thin bony structures.

Thirty-Year Clinical Performance of Double-Crown Retained Removable Partial Dentures - A Practice Based Retrospective Study.

This retrospective study evaluated the clinical long-term survival of 1405 double-crown retained removable partial dentures (DRPDs) over 30 years of follow-up. Kaplan Meier survival rate for DRPDs was 96.6% after 5 years, 88.2% after 10 years, 61.7% after 20 years, and 38.3% after 30 years. Survival rates of abutment teeth were 94.3% after 5 years, 80.2% after 10 years, 51% after 20 years, and 27% after 30 years. Key failure risk factors of DRPDs were age, £3 abutment teeth, and complete denture in opposing jaw. Abutment teeth failure risk factors included age, anterior abutment teeth, punctual support, and non-vital teeth.

Biomechanical effects of different mandibular movements and torque compensations during mandibular advancement with clear aligners: a finite element analysis

IntroductionThis study aimed to evaluate the biomechanical effects of different mandibular movements and torque compensations during mandibular advancement with clear aligners using finite element analysis.MethodsModels were constructed to include the mandible, teeth, periodontal ligament (PDL), and clear aligners with buccal wings. Five oral muscles (superficial masseter, deep masseter, medial temporalis, posterior temporalis, and medial pterygoid) were represented as springs. Muscle values were measured and applied during different mandibular movements, including advancement distances (1–7 mm) and occlusal opening distances (2–4 mm). Different torque compensation angles (0°, 1°, 2°, and 3°) were applied to the mandibular central incisor.ResultsWhen the mandibular advancement was equal to or slightly excessed the occlusal opening distance, stress on the posterior PDL decreased and became more evenly distributed. Increasing the occlusal opening distance significantly raised stress on the posterior PDL and caused grater labial inclination of the mandibular anterior teeth. As the torque compensation increased, the labial inclination of the mandibular central incisor decreased, but stress on the PDL increased. Nearly complete bodily movement of the lower central incisor was achieved with torque compensation angles of approximately 15°, 19°, and 20° in models M1-2, M2-3, and M3-4, respectively.ConclusionTo maintain periodontal health during mandibular advancement, it is recommended that the mandibular advancement distance be equal to or slightly excessed the occlusal opening distance. Excessive occlusal opening distance increases stress on the posterior PDL and the labial inclination of mandibular anterior teeth, requiring careful control. Additionally, proper torque control of the mandibular interior teeth is crucial for optimal outcomes.

In Vitro Microscopical and Microbiological Assessment of the Sealing Ability of Calcium Silicate-Based Root Canal Sealers

This in vitro study evaluated the sealing ability and microleakage of calcium silicate-based sealers compared to an epoxy resin-based sealer. One hundred twenty-five roots from anterior teeth were chemo-mechanically prepared and divided into four groups: AH Plus (AH), ProRoot MTA (PR), Medcem MTA (MC), and Total Fill BC Sealer/BC-coated gutta-percha (TF); n = 30. Confocal laser scanning microscopy was used to measure sealer penetration at three horizontal levels in 10 roots per group, while glucose leakage over 30 days was assessed in 20 roots. A lateral compaction technique was used for most groups, except for TF, which employed a single-cone method. Data were analyzed using Python with a Kruskal–Wallis test and Dunn’s post hoc test. TF showed significantly greater penetration in the coronal and middle sections, while PR had the least penetration in the apical section. PR exhibited the highest canal circumference penetration, especially compared to MC and TF. Glucose leakage increased over time in all groups, with TF showing the highest permeability after 30 days. Overall, calcium silicate-based sealers PR, MC, and TF performed similarly to the epoxy resin standard AH, with all groups exhibiting decreasing penetration from coronal to apical and increased leakage over time.

Success and Survival of Composite Resin Restorations for the Management of Localized Anterior Tooth Wear: A Systematic Review and Meta-Analysis.

To systematically review the literature and assess the success and survival rates of anterior composite restorations used in the management of anterior tooth surface loss, and to estimate complete posterior occlusion re-establishment when a Dahl approach is utilized. An electronic search was performed in the following databases: MEDLINE via Ovid and Scopus, for articles published from 1970 to November 2020. The systematic review was performed according to the PRISMA and Meta-analyses guidelines. Only randomized and non-randomized clinical trials, and Cohort studies that involved the exclusive use of direct/indirect anterior composite restorations for the management of localized anterior tooth wear were included. From the 724 studies identified through the initial search, six studies fulfilled the inclusion criteria and were included in the review; three prospective and three retrospective. In total, 141 patients received 1068 direct and indirect composite restorations. Follow-up periods ranged between 5 months and 10 years. The survival rate for anterior composite resin restorations reported in this review was 88% (95% CI: 70% to 98%) over a period of 2 and 10 years; however, high heterogeneity was observed amongst included studies; (I² = 97%). Sensitivity analysis reported survival rates of these restorations of 93% (95% CI: 85% to 98%) over a period of 2 and 7 years, (I² = 83%). Success rates were reported for these restorations of 68% (95% CI: 44% to 87%) over a period of 2 and 10 years, high heterogeneity; (I² = 98%). The success of composite Dahl in re-establishing posterior occlusion was 85% (CI: 73% to 94%). The result of this systematic review and meta-analysis support the use of anterior composite restorations as a short-medium term option for the management of tooth wear. In the long-term, patients should be informed that these restorations will require monitoring, repairs, or replacements.

Maryland Bridges: A Conservative Approach to Aesthetic Tooth Replacement – A Case Report

Restoring missing central incisors in the mandibular jaw is a challenging esthetic challenge in dentistry, especially for younger patients. Maryland bridges are a highly effective treatment option, restoring oral function and aesthetics, and resulting in high patient satisfaction. These bridges have advantages over conventional fixed dental prosthesis, such as minimal removal of the tooth structure, minimal pulpal trauma risk, and reduced time and cost. Provisional restorations are usually not required. Maryland bridges are cemented to the abutment tooth using electrolytic etching to retain the metal framework. The bond is strengthened after etching, and the development of resin cements has enhanced bridge retention. A missing anterior tooth poses an esthetic, functional, and rehabilitative problem, especially for younger patients. Resin bonded bridges are minimally invasive, offering advantages such as minimal removal of the tooth structure, minimal pulpal trauma risk, and reduced time and cost. This case report describes the fabrication technique for a single missing lower anterior tooth, focusing on conservative, economical, and esthetic treatment outcomes.

Dental Functional Status as a Possible Risk Factor of Sarcopenia: A Computed Tomography-Based Study.

Functional dentition may be associated with sarcopenia by affecting chewing activity. The objective of this study is to determine the sarcopenia status of participants using computed tomography (CT)-based data and to investigate the association of sarcopenia with functional dentition, as well as denture condition. The study included 309 patients. The number of teeth was recorded. Functional dentition was evaluated based on the following parameters: (1) ≥ 1 tooth in the maxilla and mandible; (2) ≥ 10 teeth in each arch; (3) the presence of 12 anterior teeth; (4) 3-4 premolar posterior occlusal pairs (POPs) and (5) ≥ 1 molar POP bilaterally. The denture condition was also evaluated. CT-based assessment of sarcopenia was performed via measurement of the psoas muscle area at the level of the L3 vertebra and its hounsfield unit (HU) radiodensity on non-contrast-enhanced images. HU average calculation (HUAC), which is an imaging marker of sarcopenia, was performed. Gender-specific quartiles were then generated, and the lowest quartile of HUAC scores within each gender group was set as the cut-off point. A total of 76 (24.5%) of the patients had sarcopenia, and 233 (75.5%) did not have sarcopenia. The mean number of teeth in the sarcopenia group was 17.12 ± 8.39, compared to 22.24 ± 6.72 in those without sarcopenia (p < 0.001). The relationship between functional dentition and sarcopenia was also significant. There was a positive relationship between ill-fitting dentures and sarcopenia (p < 0.001). This unique perspective of the study contributes to the existing knowledge regarding the role of tooth loss in sarcopenia, highlighting the importance of functional occlusion.

The Effectiveness of Triton Used With XP-3D Adaptive Files and Active Irrigation on Smear Layer Removal During Root Canal Preparation: A Qualitative Scanning Electron Microscopy (SEM) Study.

Standard irrigating protocols during root canal treatment call for the use of sodium hypochlorite during chemo-mechanical preparation, followed by final irrigation with ethylenediaminetetraacetic acid (EDTA). This study determined the effectiveness of a new irrigant, Triton (Brasseler, USA), on smear layer removal during root canal treatment compared to that of 5.25% sodium hypochlorite and CanalPro EDTA 17% (Coltene). Twenty-one extracted anterior teeth were prepared for root canal treatment. The teeth were divided into three groups: five teeth were used as control with saline as the irrigant, eight teeth with sodium hypochlorite and 17% EDTA as irrigants, and eight teeth with Triton as the irrigant. Root canal preparation was done using the XP-3D shaper and finisher files (Brasseler, USA) for all teeth with respective irrigants. A single operator performed all root canal treatment procedures. The teeth were prepared for scanning electron microscopy (SEM), and analysis was performed by a second investigator. The smear layer removal was qualitatively assessed to determine the effectiveness of irrigants. Smear layer removal was most effective for teeth irrigated with 5.25% sodium hypochlorite, followed by 17% EDTA (Group B). Teeth irrigated with Triton (Group A) showed a similar appearance to the hypochlorite/EDTA group but with isolated instances of inter-tubular debris. Sodium hypochlorite use followed by a final rinse with EDTA remains the gold standard for the removal of the smear layer created during canal instrumentation.

Bleaching Gels and Light-Emitting Diodes: Comparison of Tooth Color Change.

To measure difference in tooth shade and color achieved via two different over-the-counter bleaching agents with and without their associated light-emitting diodes (LEDs). A total of 84 extracted human anterior teeth were randomly divided into seven groups. Gypsum models were made with 6 extracted teeth in an arch form (n = 12; 2 arches/group). Samples were kept hydrated throughout treatment (25°C). Bleaching treatment followed manufacturers' instructions with at least 1-h of rehydration between treatments. Control tooth arches were left untreated. L*a*b* values were measured with a Vita Easyshade (VITA North America, Yorba Linda, CA) three times per tooth using white and black backgrounds. ∆E (CIE 2000) was compared between and within treatment groups over time with ANOVA and post hoc Tukey (a = 0.05). Subgroup testing confirmed the data were normally distributed. Two-way ANOVA showed significant interaction between product (Control, Crest, Snow) and treatment (light only, product only, light and product) on ∆E values for black (p-value < 0.001, F = 15.28) and white (p-value < 0.001, F = 13.62) backgrounds. Post hoc pairwise Tukey tests showed a significant effect of light-and-product treatments in contrast to light- or product-only treatments. Repeated measures ANOVA of between-treatment change (∆E) by product showed significant interaction between time and treatment for Snow products (p < 0.001, F = 10.9) and independent effects of time and treatment for Crest products (Time: p-value < 0.001, Treatment: p-value < 0.01, F = 7.21) on a black background. On white backgrounds, only a significant effect of treatment was reported for both Snow (p-value < 0.01, F = 5.427) and Crest (p-value < 0.001, F = 5.61). Overall, a combination of light and gel produces significantly higher tooth color and shade change over time, with the highest change seen for Snow products. Many patients use over-the-counter tooth bleaching products because they are more cost effective and easier to access than in-office bleaching. However, these products may have adverse effects, such as increased sensitivity with repeated use, in addition to increased consumption of time and money. This project measured tooth shade between treatments which can help determine which product is most effective for at home use.

Comparison of two treatment modalities in the management of gingival enlargement during orthodontic treatment: a randomized clinical trial.

This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment (NSPT) in the management of gingival enlargement (GE) during orthodontic treatment. forty-five healthy, orthodontic patients with labial gingival enlargement on the 6 anterior teeth were selected and randomly assigned to one of the groups (Conventional, Laser, and NSPT). Clinical parameters including clinical crown length (CCL) , periodontal pocket depth (PPD), and vertical gingival overgrowth index (vGOi) were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1,3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months. Statistically significant results were obtained for mean reduction in PPD for conventional, laser, and NSPT groups (-1.43, -.1.75, and -0.9 mm, respectively; P < 0.001), CCL gain (1.45, 1.7, and 0.38 mm, respectively; P<0.001) and mean vGOi score (-1.14, -1.29 and -0.76, respectively; P<0.001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to NSPT (P<0.001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with conventional group showing statistical difference in mean pain score on days 1 and 3 compared to other groups. Both conventional and laser gingivectomies were more effective in controlling enlargement over non-surgical periodontal treatment alone at 1, 3, and 6 months. laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to NSPT alone in the treatment of GE and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.

Digital assessment of soft and hard tissue alterations after anterior maxillary tooth extraction

Objectives: This study aimed to assess dimensional alterations in soft and hard tissues 12 weeks post-extraction using novel computerized methods. Secondary objectives included exploring potential correlations between soft tissue changes and underlying bone variations, as well as investigating relationships between soft and hard tissue alterations and various contributing factors. Methods: For all patients, preoperative and postoperative CBCT scans and intra-oral scans were obtained. Soft and hard tissue dimensions before extraction and at 12 weeks post-extraction were measured using 3D-slicer software. Both DICOM and STL files were superimposed, and measurements were taken at 2mm and 4mm from the facial crestal level. Results: At twelve weeks, soft tissue thickness increased by 73.5% at 2mm and 51.2% at 4mm from the facial crestal bone. In contrast, there was a 42.5% and 33% bone resorption at 2mm and 4mm, respectively. Furthermore, the study found that smokers had a higher rate of soft tissue thickening and hard tissue resorption compared to non-smokers. The female group exhibited greater soft tissue thickening and bone resorption than the male group. Finally, the central incisor showed the highest bone loss rate, followed by the canine and the lateral incisor. Conclusions: Three months following tooth extraction, a physiological thickening of the facial soft tissue occurs concurrently with significant bone loss beneath it. Clinical Significance: This article’s novel digital assessment methods for evaluating soft and hard tissue alterations offer the potential to optimize treatment planning, enhancing patient outcomes and minimizing complications. By providing a comprehensive understanding of post-extraction tissue changes, it empowers clinicians to tailor treatments for individual patients, improving predictability and personalized care.

Accuracy of occlusal splints printed in different orientations by liquid crystal display technology: an in vitro study.

To evaluate the accuracy of occlusal splints printed in different orientations by liquid crystal display technology. An occlusal splint was digitally designed, and additive manufactured using an LCD printer (Phrozen Sonic 4k, Phrozen) at three orientations relative to the printer bed: 0, 45, and 70 degrees (n=10). The 3D-printed occlusal splints were digitised using a desktop scanner, resulting in experimental meshes. The meshes were analysed in a metrology software program, comparing the experimental ones with the initially designed occlusal splint (trueness) and each other within the same group (precision). The discrepancies were shown in a colour map and the root mean square indicated the magnitude of the total discrepancy between the meshes. Kruskal-Wallis test was used (α=0.05) followed by post-hoc Dunn's test. There was no statistical difference in trueness among the groups (P=0.086); however, splints printed at 70 degrees showed better precision compared to those printed at 0 (P<0.001) and 45 degrees (P<0.001). The splints printed at 0 and 45 degrees exhibited a similar discrepancy pattern, with higher values in the posterior segment-positive on the buccal surface and negative on the lingual surface of molars. In contrast, splints printed at 70 degrees had higher discrepancy values in both anterior and posterior segments, with an inverted pattern on molars. The accuracy of occlusal splints was affected by the different orientation in terms of precision, with 70 degrees resulted in highest precision compared to 0 and 45 degrees. No difference was found in terms of trueness. Higher discrepancies were found located in molars and incisal edge of anterior teeth. 3D-printing using LCD technology stands out for its affordability and good resolution, however the optimal printing angle remains unclear. Vertical positioning allows more objects to fit on the print bed, while horizontal positioning reduces print time. For DLP printers, a 0-degree angle provides good accuracy for occlusal splints, whereas a 90-degree angle results in lower accuracy. This study found that for LCD printers, 0, 45, and 70 degrees had similar trueness, with 70 degrees offering the highest precision. Thus, vertical positioning at 70 degrees can be a safe choice for the accuracy of occlusal splints printed on LCD technology.

Periapical cemento-osseous dysplasia masquerading as asymptomatic chronic apical periodontitis in a Chinese woman: A case report.

Cemento-osseous dysplasia (COD) belongs to a group of fibrous osseous disorders that can masquerade as periapical inflammatory conditions in the jawbones. We present a rare case of COD occurring in a patient who also had periapical periodontitis concurrently. When faced with a patient exhibiting no symptoms, diagnosis may be challenging. COD is a fibrous osseous disorder similar to periapical chronic inflammatory conditions and other cysts in the jaw bones on the radiograph. There is a rare case of COD occurring in a 49-year-old Chinese woman who also had chronic periapical periodontitis concurrently. The lesions were incidentally discovered in the mandibular anterior tooth region during the patient's imaging examination. The patient exhibited no symptoms, and diagnosing the conditions may be challenging due to the confusingly similar radiological features that present as a radiolucent lesion in the periapical region. The final diagnosis was made through pulp vitality tests, cone beam computed tomography (CBCT), and clinical examinations. The COD was recommended for annual follow-up. Root canal therapy has been performed for chronic apical periodontitis. According to the diagnostic process of COD, a thorough history check, multiple clinical examinations, and imaging studies should be emphasized to prevent misdiagnosis and avoid unnecessary or inappropriate therapies. The patient was followed up for 6 years. The recovery of chronic apical periodontitis in tooth #31 and the transformation of osteolytic and osteogenesis of COD had been observed in CBCT.

Management Of Skeletal Class Ii Malocclusion With Twin Block And Headgear: A Case Report

Background. The main concern of patients and their parents seeking orthodontic treatment has always been the sagittal relationship between the jaws and dentition. The most commonly observed sagittal problems are skeletal class II maxillomandibular relationship which affects about one-third of the examined patients who seek orthodontic treatment. This case report demonstrates the use of the Twinblock appliance and high-pull headgear in a skeletal Class II Division 1 patient with a prognathic maxilla and a retrognathic mandible. A 9 year old male patient reported to Department of Paediatric and Preventive Dentistry with a chief complaint of forwardly placed upper front teeth. On extraoral examination, it was found that the patient had a convex profile, incompetent lips, increased maxillary anterior teeth visibility, acute nasolabial angle, receded chin and deep mento labial sulcus. Superimposition of Post treatment with pre-treatment lateral cephalograms showed a reduction in the sagittal discrepancy. With the retraction and intrusion of maxillary anteriors by the use of head gear along with mandibular advancement by the use of twinblock gave the desired result.

Comparative evaluation of fracture resistance of wide and flared endodontically treated teeth with new techniques of postplacement – An in vitro study

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.

Effect of Silver Diamine Fluoride and Potassium Iodide on Microleakage of Composite Resin in Anterior Primary Teeth.

One of the preventive interventions for early childhood caries is the use of silver diamine fluoride (SDF), which works uniquely in the prevention of caries. The suggested method to minimize the discoloration of SDF is the use of potassium iodide (KI). However, there are concerns about the bonding properties of dentin after the application of SDF-KI. Therefore, this study aimed to investigate how SDF-KI affects composite resin microleakage in primary teeth. In this in vitro study, class V cavities were created on the buccal surfaces of 60 extracted primary canines. The samples were divided into three groups: Group I: 38% SDF solution was applied to the cavity; Group II: SDF-KI solution was applied to the cavity; and group III: the cavities were irrigated with distilled water. All cavities were filled with composite resin and subjected to a thermocycling regime (500 cycles). The dye penetration of samples was evaluated following a 24-h immersion in 1% methylene blue. Microleakage at the occlusal and gingival margins was evaluated using a stereomicroscope at 40× magnification. Data were analyzed using the Chi-squared test (p < 0.05). There was no statistically significant difference between microleakage scores at the occlusal margin (p = 0.128). At the cervical margin, the SDF-KI group had significantly more microleakage than the SDF and control groups (p = 0.001). Applying the SDF-KI significantly increased microleakage in the cervical margin but had no significant effect on the occlusal margin. Regarding the beneficial effects of SDF in preventing and arresting dental caries, application of it before composite resin is suggested in controlling caries without the negative effects on microleakage. How to cite this article: Meraji A, Asadian F, Hekmatfar S. Effect of Silver Diamine Fluoride and Potassium Iodide on Microleakage of Composite Resin in Anterior Primary Teeth. J Contemp Dent Pract 2024;25(7):691-695.

Optimizing Resin Infiltration Procedure in Molar Incisor Hypomineralization Lesions.

This article aims to describe a new technique for predicting the results of resin infiltration procedure in molar incisor hypomineralization lesions, named Infiltration Monitoring by Transillumination. The technique involves the use of transillumination together with ethanol application during the steps of lesion body opening and resin penetration. It provides color contrast that enhances the removal of the less porous surface layer and controls the effectiveness of resin infiltration within the lesion. The clinical procedure presented illustrates the steps involved in the resin infiltration procedure for color masking of molar incisor hypomineralization lesions in anterior teeth, highlighting the use of transillumination both for monitoring the lesion body opening step and the resin infiltration process. The monitoring with transillumination during the ethanol test can assist the removal of the enamel external layer over the lesion, necessary to expose the inner porosity to be infiltrated, in a very precise and conservative way. In addition, it can effectively help to determine the moment when the infiltrant resin has fully penetrated the lesion. The Infiltration Monitoring by Transillumination technique offers the possibility to precisely control the infiltration procedure in molar incisor hypomineralization lesions, thereby improving the predictability of the esthetic outcome.