Tooth Area Research Articles

The Effect of Aqueous and Alcoholic Extract of Ziziphus Spina-christi on some Bacterial Isolates Causing Gingivitis

Bacterial gingivitis is a most common and mild form of periodontal disease that causes bleeding, redness and swelling (inflammation) of gingiva, around the cervical area of teeth. Untreated gingivitis can progress to periodontal disease, periodontitis, by spreading to supporting tissue of teeth involving bone and periodontal ligament, a much more serious condition that can lead to tooth loss. The study was conducted to investigate the bacteria causing gingivitis with an attempt to investigate the bacterial inhibitory effect of seder leaves extract. Samples consist from (230) gingivitis swab were collected from the patients which are admitted to dental clinics in Tikrit city , among the period extended from March 2016 to February 2017 .Cultural, microscopical and biochemical tests were performed to identify the bacteria causing gingivitis .The results showed 165positive heavy culture of causative bacteria as follows :Gram positive ; Streptococcus mutans (% 18.78 ) , Streptococcus pyogens (% 8.48 ), Streptococcus salivarius (% 6.06 ) , Streptococcus angiosus (% 4.84 ) ,Streptococcus pneumoniae (%3.03 ), Staphylococcus aureus (% 16.96 ), Staphylococcus epidermidis (% 9.09 ) ,while gram negative included Pseudomonas aeruginosa (% 13.93),Escherichia coli (% 9.69 ) ,Klebsiella .spp (%6.66) , and finallyPseudomonas monilli (%2.42).The present study showed that the aqueousand alcoholic extract of Ziziphus spina-christi leaves had inhibitory activity agiants the bacterial species . At the concentration of (200 mg/ml) of seder leaves extract showed the highest effect on bacteria . All the types of bacteria that isolated from the patients with gingivitis had revealed disproportionately sensitivity against antibiotics : Amikacin , ampicillin , tetracycline , gentamicin , chliromphenicol , nalidixic acid , amoxicillin , trimethoprim .The mixture of aqueous extract of seder leaf and antibiotic Gentamicin , Amikacin and amoxicillin revealed high inhibitory synergetic effect against aginst resistant bacteria.

The Effect of Aqueous and Alcoholic Extract of Ziziphus Spina-christi on some Bacterial Isolates Causing Gingivitis

Bacterial gingivitis is a most common and mild form of periodontal disease that causes bleeding, redness and swelling (inflammation) of gingiva, around the cervical area of teeth. Untreated gingivitis can progress to periodontal disease, periodontitis, by spreading to supporting tissue of teeth involving bone and periodontal ligament, a much more serious condition that can lead to tooth loss. The study was conducted to investigate the bacteria causing gingivitis with an attempt to investigate the bacterial inhibitory effect of seder leaves extract. Samples consist from (230) gingivitis swab were collected from the patients which are admitted to dental clinics in Tikrit city , among the period extended from March 2016 to February 2017 .Cultural, microscopical and biochemical tests were performed to identify the bacteria causing gingivitis .The results showed 165positive heavy culture of causative bacteria as follows :Gram positive ; Streptococcus mutans (% 18.78 ) , Streptococcus pyogens (% 8.48 ), Streptococcus salivarius (% 6.06 ) , Streptococcus angiosus (% 4.84 ) ,Streptococcus pneumoniae (%3.03 ), Staphylococcus aureus (% 16.96 ), Staphylococcus epidermidis (% 9.09 ) ,while gram negative included Pseudomonas aeruginosa (% 13.93),Escherichia coli (% 9.69 ) ,Klebsiella .spp (%6.66) , and finallyPseudomonas monilli (%2.42).The present study showed that the aqueousand alcoholic extract of Ziziphus spina-christi leaves had inhibitory activity agiants the bacterial species . At the concentration of (200 mg/ml) of seder leaves extract showed the highest effect on bacteria . All the types of bacteria that isolated from the patients with gingivitis had revealed disproportionately sensitivity against antibiotics : Amikacin , ampicillin , tetracycline , gentamicin , chliromphenicol , nalidixic acid , amoxicillin , trimethoprim .The mixture of aqueous extract of seder leaf and antibiotic Gentamicin , Amikacin and amoxicillin revealed high inhibitory synergetic effect against aginst resistant bacteria.

Autotransplantation for Restoration of Dentition Defects After Excision of Jaw Cysts.

Bone defect caused by jaw cystectomy has always been the main factor affecting postoperative wound healing and is also the common cause of maxillofacial bone defect, which brings challenges to the subsequent restoration of missing teeth. In this paper, the authors report a 22-year-old young woman who had a mandibular cyst in the left lower posterior tooth area. She underwent mandibular bone cyst excision and simultaneous extraction of teeth 36 and 37. One and two months after the removal of the mandibular bone cyst, autologous tooth transplantation was performed in stages from tooth 28 to tooth 36 and from tooth 18 to tooth 37. The case shows that tooth autotransplantation is a viable option for the restoration of dentition defects after the excision of jaw cysts, which can promote the healing of the bone defect after the operation.

Multivariate analysis of alveolar bone dehiscence and fenestration in anterior teeth after orthodontic treatment: A retrospective study.

To compare the prevalence of fenestration and dehiscence between pre- and post-orthodontic treatment and to explore the factors related to fenestration and dehiscence in the anterior teeth after treatment. This study included 1000 cone-beam computed tomography (CBCT) scans of 500 patients before (T1) and after (T2) orthodontic treatment. These images were imported into Dolphin 11.9 software to detect alveolar fenestration and dehiscence in the anterior teeth area. The chi-square test and Fisher's exact test were performed to compare the prevalence of alveolar bone defects between time points T1 and T2. A total of 499 patients were selected for logistic regression analysis to examine the correlation among age, sex, crowding, sagittal facial type, extraction, miniscrew use and fenestration or dehiscence post-treatment. Except for the maxillary lingual fenestration and labial fenestration of mandibular canines, a significant change in the prevalence of fenestration and dehiscence was noted between time points T1 and T2 (P < .025). Multinomial logistic regression showed that age, miniscrew use and extraction highly influenced the prevalence of anterior lingual dehiscence (P < .05). Dehiscence of the mandibular labial side (skeletal Class III vs. I, OR = 2.368, P = .000) and fenestration of the mandibular lingual side (skeletal Class II vs. I, OR = 2.344, P = .044) were strongly correlated with the sagittal facial type. Dehiscence of the maxillary labial side (moderate vs. mild, OR = 1.468, P = .017) was significantly associated with crowding. Older age, maxillary moderate crowding, skeletal Class III, extraction and miniscrew potentially significantly affect the prevalence of anterior teeth dehiscence. Adult females, skeletal Class III patients on the mandibular labial side and skeletal Class II patients on the mandibular lingual side should be monitored for anterior teeth fenestration.

Research Progress on Titanium Implants for External Maxillary Sinus Augmentation

In patients with missing maxillary posterior teeth, the negative pressure generated by breathing leads to an increase in the gasification of the maxillary sinus cavity, as well as the absorption of alveolar bone due to the lack of physiological stimulation due to missing teeth. This often leads to insufficient bone height during implant restoration in the maxillary posterior tooth area, and maxillary sinus floor elevation surgery can effectively solve this problem. At present, there are two main techniques for lifting the maxillary sinus floor: internal lifting through the top of the alveolar ridge approach and external lifting through the lateral wall approach. Among them, the maxillary sinus alveolar ridge lifting surgery is widely used due to its advantages of small wound size, short surgical time, fewer postoperative complications, low cost, and easy acceptance by patients. With technological innovation, the indications for maxillary sinus floor elevation surgery have gradually expanded to cases with residual bone height (RBH) greater than 2 mm.

Association between health risk factors and apical periodontitis in fitted endodontically and non-endodontically treated teeth

This study investigates the effect of health risk factors on apical periodontitis in fitted endodontically and non-endodontically treated teeth in army soldiers (environmental risk factor) and diabetic patients (biomedical risk factor). This cross-sectional study included patients aged 25–40 years. After participants were filtered based on exclusion criteria and questionnaire (DASS-21) responses, 108 males were chosen and divided into three groups of 36 participants each (G1: soldiers, G2: diabetic, G3: healthy). The periapical status of the participants’ teeth according to OPG X-ray outcomes was independently evaluated using a periapical index. The healthy group showed a higher ratio of fitted teeth to both non-endodontically and endodontically treated teeth (98.8%, 70%) than diabetic patients (98.6%, 52.1%) and soldiers (95.6%, 35.3%). Meanwhile, soldiers showed higher apical defects of both non-endodontically and endodontically treated teeth (7.8%, 33.3%) than diabetic patients (6.4%, 12%) and healthy individuals (5.7%, 7.1%). A statistically non-significant relationship existed between being healthy and experiencing apical defects for all fitted non-endodontically and endodontically treated teeth among all groups. The higher prevalence of apical periodontitis in soldiers and diabetic patients suggests a positive relationship between worsened apical areas of teeth and health risk factors, such as diabetes mellitus disease and environmental stress.

A retrospective study of dynamic navigation system-assisted implant placement

BackgroundTo evaluate the accuracy of implant placement assisted by a dynamic navigation system, as well as its influencing factors and learning curve.MethodsAt Macao We Care Dental Center, 55 cases of implant placement using dynamic navigation were retrospectively evaluated. To evaluate their accuracy, the apex, tip, and angle deviations of preoperatively planned and postoperatively placed implants were measured. The effects of the upper and lower jaws, different sites or lateral locations of dental implants, and the length and diameter of the implants on accuracy were analyzed, as well as the variation in accuracy with the increase in the number of surgical procedures performed by dentists.ResultsThe implant had an apex deviation of 1.60 ± 0.94 mm, a tip deviation of 1.83 ± 1.03 mm, and an angle deviation of 3.80 ± 2.09 mm. Statistical differences were observed in the tip deviation of implants at different positions based on three factors: jaw position, lateral location, and tooth position (P < 0.05). The tip deviation of the anterior teeth area was significantly greater than those of the premolar and molar areas. There were no statistically significant differences in apex deviation, tip deviation, or angle deviation between the implants of different diameters and lengths (P > 0.05). There were significant differences in the angle deviation between the final 27 implants and the first 28 implants. Learning curve analysis revealed that angle deviation was negatively correlated with the number of surgical procedures, whereas the regression of apex deviation and tip deviation did not differ statistically.ConclusionsThe accuracy of dynamic navigation-assisted dental implants meets the clinical needs and is higher than that of traditional implants. Different jaw positions, lateral locations, and implant diameters and lengths had no effect on the accuracy of the dental implants guided by the dynamic navigation system. The anterior teeth area had a larger tip deviation than the posterior teeth area did. As the number of dynamic implantation procedures performed by the same implant doctor increased, the angle deviation gradually decreased.

Accuracy of different registration areas using active andpassive dynamic navigation systems in dental implant surgery: An in vitro study.

To gauge the relative accuracy of the use of passive and active dynamic navigation systems when placing dental implants, and to determine how registration areas affect the performance of these systems. Eighty implants were assigned to be placed into 40 total resin mandible models missing either the left or right first molars using either passive or active dynamic navigation system approaches. U-shaped tube registration devices were fixed in the edentulous site for 20 models each on the left or right side. Planned and actual implant positions were superimposed to assess procedural accuracy, and parameters including 3D entry deviation, angular deviation, and 3D apex deviation were evaluated with Mann-Whitney U tests and Wilcoxon signed-rank tests. Respective angular, entry, and apex deviation values of 1.563 ± 0.977°, 0.725 ± 0.268 mm, and 0.808 ± 0.284 mm were calculated for all included implants, with corresponding values of 1.388 ± 1.090°, 0.789 ± 0.285 mm, and 0.846 ± 0.301 mm in the active group and 1.739 ± 0.826°, 0.661 ± 0.236 mm, and 0.769 ± 0.264 mm in the passive group. Only angular deviation differed significantly among groups, and the registration area was not associated with any significant differences among groups. Passive and active dynamic navigation approaches can achieve comparable in vitro accuracy. Registration on one side of the missing single posterior tooth area in the mandible can complete single-tooth implantation on both sides of the posterior teeth, highlighting the promise of further clinical research focused on this topic.

What’s new for the clinician – summaries of recently published papers

Interdental cleaning devices in the form of dental floss and interdental brushes have traditionally being used as adjuncts to plaque removal in the interproximal areas of teeth. However, their routine use among younger adolescents has been reported in many studies to be less than optimal. In orthodontic patients, fixed braces promote supra- and subgingival accumulation of biofilm by impeding oral hygiene resulting in an altered oral microbiome, enamel decalcification and gingivitis1. It was recently shown that patients with upper and lower multibracket appliances are affected significantly more frequently by gingivitis (65%) and white spot lesions (30%).1 Additionally, in the predominantly young orthodontic patients, interdental spaces are often too narrow to use interdental brushes and flossing is challenging and time-consuming. Oral irrigators are easy to use even in the presence of orthodontic braces and are therefore favoured by many patients. Most oral irrigators use a stream of water only to mechanically remove plaque from interproximal areas but there are also oral irrigators which use a mixture of air and water, called microburst technology.

Effect of substrate adjacent to the scan region on the trueness of four intraoral scanners: An in vitro study

ObjectivesThe purpose of this in vitro study was to evaluate the trueness of four commercially available intraoral scanners (IOSs) on scanning different substrates that existed in the adjacent proximal contact area. MethodsFour IOSs (TRIOS 4, TRIOS 3, Primescan, Omnicam) were used for scanning the intact enamel surface of a molar tooth, and six restorative materials (zirconia, lithium disilicate glass-ceramic, composite resin, hybrid ceramic, feldspathic ceramic, metal) that were located at the adjacent proximal contact area of the same tooth. Reference scans were obtained using an extraoral scanner (inEos X5). A 3-dimensional analyzing software (Geomagic Control X) was used to compare the reference and tested scans. The two-way analysis of variance (ANOVA) followed by Bonferroni correction was performed for statistical analyses (α=0.05). ResultsTRIOS 3 and TRIOS 4 showed higher trueness than Primescan, and Primescan showed higher trueness than Omnicam (p<0.001), while there were no differences between TRIOS 3 and TRIOS 4. Metal showed significantly higher Root Mean Square values (0.273 ± 0.24 mm) than other substrates. No difference was found between the scanners’ zirconia, lithium disilicate glass-ceramic, composite, and feldspathic ceramic scans (p > 0.05). For the metal, TRIOS 3 and TRIOS 4 showed higher trueness than Primescan and Omnicam, while Omnicam showed lower trueness among all scanners. For the hybrid ceramic, TRIOS 3 showed higher trueness than Omnicam (p<0.001). For the enamel, TRIOS 3 showed higher trueness than Primescan and Omnicam (p<0.001). ConclusionsThe trueness of IOSs can be affected by the substrates that exist in the proximal contact area. Amongst all, the metal substrate affected most the trueness of the IOSs. Clinical SignificanceThe clinician should decide on the impression system, taking into account that the IOS and the surfaces to be scanned affect the trueness of the digital data. The deviation of the digital impression would be high in the presence of a metal restoration on the adjacent proximal surface.

TREATMENT OF GRANULOMATOUS EPULIS USING LASER

Background: Epulis is an epithelial tumor that is non-osteogenic. Epulis can be found in the oral cavity both on the gingiva and in the alveolar mucosa. Epulis is a benign enlargement of soft tissue. Granulomatous epulis is one type of epulis that is often found. This granulomatous epulis is a granulative tissue reaction with the characteristics of bleeding easily and having a reddish color. This epulis can disturb the patient both psychologically because there is a large mass in the oral cavity, causing it to be unaesthetic if it occurs in the anterior teeth area, disrupting the chewing process and even disrupting the speech process if it is in the posterior teeth. Apart from causing discomfort to the patient, there are several types of epulis that can cause pain. Objective: To find out how to make a diagnosis of granulomatous epulis accompanied by treatment using a laser. Case: A 45 year old female patient came with complaints of enlarged gums since 1 year ago. The patient initially used dentures, but currently the dentures cannot be used and the patient feels uncomfortable because he cannot chew food due to a large lump in the oral cavity. Case Treatment: At the first visit, an etiotropic phase is carried out in the form of elimination of local factors, then the patient is referred for supporting examinations in the form of panoramic radiography and FNA-B examination. This examination functions to determine whether there is malignancy or not. After the results showed no malignancy, we continued with the surgical phase in the form of excision of granulomatous epulis using a laser. Conclusion: Granulomatous epulis therapy using laser accompanied by removal of remaining tooth roots shows satisfactory therapeutic results. Keyword: Epulis, Epulis Granulomatosa, Excision, Laser

The morphoanatomy of Serjania erecta Radlk (Sapindaceae) provides evidence of biotrophic interactions by endophytic fungi within leaves.

The leaves of Serjania erecta Radlk (Sapindaceae) are renowned in ethnobotany for their medicinal properties and are significant as a medicinal resource for traditional Brazilian communities. As necrotic spots are common on these leaves, indicating interaction with phytopathogenic fungi, it was hypothesized that biotrophic fungal species colonize the leaf tissues of S. erecta. To test this hypothesis, we employed standard techniques in plant anatomy, which enabled us to investigate the interaction of fungal structures with plant tissues and describe the morphoanatomical and histochemical characteristics of the epidermis and limbus of S. erecta. The anatomical analysis showed the existence of leaf teeth on the leaf tips. Additionally, hyphae, conidiospores, and spores of Bipolaris/Curvularia species were detected on the adaxial epidermis. Moreover, melanized microsclerotia were found in glandular areas of the leaf teeth and the phloem, providing evidence of biotrophic behavior. The hypothesis that biotrophic phytopathogenic fungi interact with S. erecta leaf tissues was confirmed, despite the presence of many bioactive compounds (such as flavonoids, alkaloids, and essential oils), as evidenced by histochemical analyses. The presence of tector, glandular, and scabiform trichomes on the leaf teeth and epidermis was also revealed. This study presents, for the first time, the synthesis of essential oils and alkaloids in the leaves of S. erecta. Additionally, it investigates previously unexplained aspects of the anatomy and histochemistry of the species, as well as its interaction with resident microorganisms. Therefore, it is recommended that future research focus on extracting and characterizing the oils and alkaloids of S. erecta, as well as exploring other aspects related to its microbiome and its relationship.

The difference distance between the apical foramen and the anatomical apex in primary teeth-An in vitro study.

The apex area in the primary teeth changes continuously due to the physiologic resorption, therefore; the apical foramen (AF) may not correspond to the anatomic apex (AA), which gives a big challenge to achieve successful endodontic treatment. The aim of this research was to study the difference distance (DD) between the position of the AA and AF, besides the difference acceptance (DA) in primary teeth, and the effect of the following variables: root canal curvature, resorption degree, and canal size on DD and DA separately. In this research, 180 root canals from 60 primary teeth were studied. Two lengths of each canal were measured by a K-file from a certain point in the crown; the first length was until the AA and the second was until the AF. Then DD was obtained by calculating the difference between those two lengths. Statistical analysis tests were done. A p value of <.05 was considered significant at a 95% confidence level. The percentage of canals with 0 mm DD was 34.4%, while it was 1.1% with DD of 6 mm. The percentages of acceptable ( ≤ 2 mm) and unacceptable ( > 2 mm) difference were 84.4% and 15.6%, respectively. There was a significant difference in the DD value between the three groups of curvature degree and the three groups of canal size. There was a significant difference between the DA in the three groups of canal size. DD has a wide variation value in primary teeth regardless of the degree of root resorption, which has not affected this value or the accepted difference; however, DD and acceptable difference values are somehow affected by the degree of root curvature and canal size. We recommend adding acceptable difference as a criterion when considering pulpectomy treatment in primary teeth.

Comparison of Prevalence of Oxis Contact in Primary Maxillary and Mandibular Teeth: A Retrospective Cohort Study

Aim: The purpose of the present study was to evaluate four different types of OXIS contact areas (open [O], point [X], straight [I], and curved [S]) in primary teeth using cone beam computed tomography (CBCT) among 3- to 9-year-old children.&#x0D; Methods: A retrospective cohort study was performed using cone-beam computed tomography images of children, available from January 1, 2022, to July 31, 2023 in Mathura district showing the presence of caries-free contact area between primary right maxillary and mandibular 1st and 2nd molar. In this study, 65 selected contacts using OXIS criteria from the occluso-cervical and axial view at coronal level using CBCT.&#x0D; Result: Based on the shapes observed, the results showed four distinct types of contact regions between the primary molars, namely, O type, X type, I type, and S type; hence, the suggested categorization is known as OXIS. I type was the most prevalent pattern in the maxilla (47.06%), while O type was the most prevalent pattern in the mandible (50%).&#x0D; Conclusion: There are four types of intact interproximal contact areas between primary molars, which can be evaluated in three dimensions. These types are O, X, I and S. In maxilla, pattern was&#x0D; I &gt; O &gt; X &gt; S whereas in mandible pattern was O &gt; X &gt; I = S.

Cleaning potential of interdental brushes around orthodontic brackets - an in vitro investigation.

This study evaluated the brushing efficacy of different interdental brushes around a multibracket appliance in vitro. In four models displaying misaligned and aligned teeth with and without attachment loss, the brushing capacities of three interdental brushes (IDB) were tested: A waist-shaped IDB with a diameter of 9 mm at both ends and 5 mm in the middle (B1), a cylindrical brush with a diameter of 9 mm (B2) and one with 5 mm (B3). Before cleaning, the black teeth in the respective models were stained white with titanium (IV) oxide and the percentage of cleaned surface was planimetrically assessed. In addition, the forces applied to the IDB were also recorded. The effect of brush and model on expected cleaning performance was examined using an analysis of variance (ANOVA). The cleaning performance of the brushes in decreasing order was B2>B3>B1; no significant differences between the different tooth areas and models were found. With regard to force measurements, significant differences were found with the highest and lowest forces IDB (2) and (1), respectively. There was a significant correlation between force and cleaning performance: The higher the force needed the higher was the cleaning performance. In summary, this study showed that cylindrical interdental brushes achieved a better cleaning performance than the waist-shaped IDB. Given some shortcomings of this first laboratory study, more research is still needed, but IDB may represent a valuable yet still clinically underused tools.

Cleaning potential of interdental brushes around orthodontic brackets – an in vitro investigation

This study evaluated the brushing efficacy of different interdental brushes around a multibracket appliance in vitro. In four models displaying misaligned and aligned teeth with and without attachment loss, the brushing capacities of three interdental brushes (IDB) were tested: A waist-shaped IDB with a diameter of 9 mm at both ends and 5 mm in the middle (B1), a cylindrical brush with a diameter of 9 mm (B2) and one with 5 mm (B3). Before cleaning, the black teeth in the respective models were stained white with titanium (IV) oxide and the percentage of cleaned surface was planimetrically assessed. In addition, the forces applied to the IDB were also recorded. The effect of brush and model on expected cleaning performance was examined using an analysis of variance (ANOVA). The cleaning performance of the brushes in decreasing order was B2&gt;B3&gt;B1; no significant differences between the different tooth areas and models were found. With regard to force measurements, significant differences were found with the highest and lowest forces IDB (2) and (1), respectively. There was a significant correlation between force and cleaning performance: The higher the force needed the higher was the cleaning performance. In summary, this study showed that cylindrical interdental brushes achieved a better cleaning performance than the waist-shaped IDB. Given some shortcomings of this first laboratory study, more research is still needed, but IDB may represent a valuable yet still clinically underused tool. Accepted for publication: April 3, 2023 Published online: April 25, 2023

Incidental finding of impacted supernumerary teeth in cone-beam computed tomography 3D

Objectives: To evaluate the value of cone-beam CT (CBCT) in the diagnosis and orientation of impacted supernumerary teeth in the dental arches.&#x0D; Case Report: A 50 year old man came to the Udayana University Hospital with the chief complaint of missing bilateral posterior teeth of the mandible and wanted to make denture. Before the treatment begin, a panoramic radiographic examination was performed. The panoramic image shows an impacted supernumerary teeth on the inferior from lower right premolar. Due to the inability to determine the precise position of those teeth within the mandible and the possible vital structures surrounding, a CBCT imaging was taken. Examination of the images from the CBCT shows an impacted supernumerary teeth in the area of teeth 44 and 46.&#x0D; Conclusion: The position of the supernumerary teeth is varied in the mandible, and often causes permanent dentition complications. In this case CBCT imaging two supernumerary teeth were found in the tooth area 44-45 and 45-46. apical of the two germ teeth appear to be fully formed. Supernumerary crowns between teeth 44-45 inclined buccally &amp; between teeth 45-46 lingually. CBCT is crucial for exact localization, for treatment planning, and for the surgical approach in cases of multiple supernumerary teeth.

Maxillary Ameloblastic Fibroma: Two Case Reports of a Rare Tumor

Ameloblastic fibroma is a rare benign tumor usually affects the first two decades of life. The neoplasm is more predominant in mandibular molar-premolar region and rarely affects the maxilla. In this report, we present a couple of Ameloblastic fibroma cases, affecting boys at their 1st decade. The lesions were presented as swellings of their maxilla, which is atypical location. Radiographic images showed well-defined radiolucency containing areas of radio-opacities and impacted teeth. Differential diagnosis was established as cystic/neoplastic conditions. The lesions were incised and histopathologically diagnosed as Ameloblastic fibroma, since they were composed of immature odontogenic mesenchymal and epithelial cells showing different characteristic features.

855 Mirror-Image Large Complex Odontomes

Abstract Background This report outlines a nine-year follow-up of two 10-year-old patients who attended the paediatric dental department reporting an absent mandibular first permanent molar (FPM). Both reported no pain, no familial history of hypodontia and no altered sensation in the inferior dental (ID) nerve distribution. Clinical examination revealed mandibular expansion in the unerupted tooth area. Special Investigations Panoramic jaw radiographs revealed extensive radio-opaque masses in the mandibular FPM area in both children, in mirror-image sites. Subsequent cone beam CT identified extensive displacement of the FPM with an associated large mixed radiopaque/radiolucent lesion in the body of mandible. Interestingly, the mandibular second permanent molar (SPM) was present in one case and absent in the other. Diagnosis/Management The provisional diagnosis for both cases was a complex odontome however, heavily calcified ameloblastic fibro-odontoma could not be excluded. Management involved surgical removal of the odontogenic tumour with FPM maintenance. Histopathology confirmed the diagnosis of a complex odontoma in both cases. On long-term review in both cases the FPM failed to erupt. Cystic follicular enlargement of the FPM in one case prevented eruption, and a coronectomy was performed in the other on the FPM apices were too close to the ID nerve to be extracted. Discussion These cases highlight the importance of monitoring dental eruption patterns in childhood. Despite the mirror image diagnosis, multiple factors were considered when identifying treatment options for each individual patient. Aetiological questions regarding this particular odontogenic tumour type are raised by the presence or absence of the SPM.

Comparative Evaluation Shear Bond Strength of Resin Composite Cement to Coronal Enamel, Cementoenamel Junction and Root Cementum: An in Vitro Study

Aim: To compare shear bond strength of resin composite cement to coronal enamel, cementoenamel junction and root cementum. Materials and Methods: Twenty one extracted human permanent teeth were selected and randomly divided into three groups(n=21) according to area of adhesion. group 1(n=7): coronal enamel. group 2(n=7): cementoenamel junction. group 3(n=7): root cementum. An area of 5mm x 5mm was selected on tooth of each specified group. Area was etched for 15 seconds with 35% phosphoric acid and washed off. Bonding agent was applied on area and light cured, composite was applied and light cured for 30 seconds. Teeth were mounted in acrylic resin and stored in distilled water. Specimens were subjected to shear load using universal testing machine at cross head speed of 0.5mm/min. Results: According to results obtained from the study comparative shear bond strength (in Mpa) of resin composite cement to coronal enamel, cementoenamel junction and root cementum, highly statistically significant (p&lt;0.001) difference was observed among three groups. Discussion: The cervical area of teeth is most unpredictable region for durable adhesive bonding. This study was performed to evaluate adhesion potential of composite cement to coronal and cervical structures of teeth. Conclusion: Under this study, we can conclude that adhesion to root cementum is less favorable compared to adhesion to CEJ and coronal enamel.