Dental Trauma Research Articles

Does reduced taper canal preparation increase the load capacity of endodontically treated teeth?

Objectives: The aim of this in-vitro study is to assess and compare the load capacity of teeth with canals prepared using progressive taper versus regressive taper. Methods: Twenty-seven extracted mandibular molars were categorized into three equal groups. The negative control group involved teeth that were accessed and restored with composite resin without canal preparation. The regressive canal preparation group used the TruNatomy file system, while the progressive canal preparation group employed the ProTaper Gold system. Subsequently, all samples underwent loading using a universal testing machine until tooth fracture occurred. The force required to fracture each tooth was recorded in Newton. Results: The highest value was found in samples without preparation 1009.68±57.28 N, followed by TN group 979.04±31.16 N, while the lowest value was found in PTG 966.47±17.51N. There was no significant difference between different groups (p=0.118). Conclusions: The root canal taper did not exert a significant influence on the longevity or fracture resistance of the tooth.

Relationship between mental health and tooth fracture among Korean adolescents: analysis using data from the 19th Korea Youth Risk Behavior Survey, 2023

Objectives: This study aimed to evaluate the relationship between tooth fractures and overall mental health by data from the 19th Korea Youth Risk Behavior Survey, 2023. Methods: The participants were 52,880 adolescents attending middle and high schools. The chi-square test and multiple logistic regression analysis were used to examine the association between mental health and tooth fractures. Data were analyzed using SPSS 21.0. Results: Overall, 26.0%, 82.6%, 13.5%, and 55.6% of participants experienced sadness and despair, stress cognition, suicidal ideation, and loneliness, respectively. In the groups that experienced sadness·despair, stress, and loneliness, the experience of tooth fractures was significantly higher (1.28 [95% confidence interval, CI: 1.20-1.38], 1.09 [95% CI: 1.00-1.19], and 1.12 [95% CI: 1.05-1.20] times, respectively). Conclusions: We found an association between mental health and tooth fractures among adolescents.

The impact of alcohol consumption and binge drinking on the risk of dental trauma in South Korean adolescents

Objectives: This study aimed to investigate the impact of alcohol consumption and binge drinking on the occurrence of dental trauma in South Korean adolescents. Methods: Data were analyzed from the South Korean Youth Risk Behavior Survey, which used a complex sampling design to ensure representativeness. A total of 52,875 adolescent were included in this study. Logistic regression analysis was conducted to assess the association between alcohol consumption and tooth fractures. Confounders such as gender, education, city, academic performance, economic status, etc. were adjusted. Results: Logistic regression analysis revealed that alcohol consumption was significantly associated with tooth fractures in adolescents. After adjusting for all factors in Model 3 of binge drinking, the odds ratio remained statistically significant at 1.331 (95% CI: 1.064-1.664). Conclusions: Alcohol consumption and binge drinking increase the risk of tooth fractures in adolescents. Preventive measures targeting alcohol-related behaviors in this population are crucial for improving oral health outcomes.

Replantation of an Avulsed-Tooth by Using Trepanation: A Case Report

Tooth avulsion is one of the common types of orofacial and dental trauma that frequently occurs in sports and requires prompt management and a good treatment plan to achieve satisfactory outcomes. The aim of this case report is to present an overview of the tooth replantation using a trepanation procedure that has not been previously discussed in any formal publication. A clinical case concerning the management of tooth avulsion applying trepanation principles is narratively described along with a follow-up on the periodontal tissue condition after 2 years of treatment. The findings revealed the absence of inflammatory resorption, the most severe form of resorption typically seen within the initial 2 years following the replantation of an avulsed tooth. Nonetheless, caution should still be exercised regarding signs of surface root resorption, which although more favorable than inflammatory resorption and replacement resorption, should not be overlooked. Trepanation has demonstrated its ability to prevent inflammatory resorption for a minimum of 2 years post-replantation with no indication of ankylosis observed. Further investigation into trepanation is warranted to delve into the potential advantages of this procedure.

Assessment of parental attitude, knowledge and awareness towards preventive dentistry in south zone of Chhatrapati Sambhajinagar: A questionnaire based cross sectional survey

Introduction: Oral health is a pivotal aspect of overall well-being. In early childhood, primary teeth play a vital role in development of speech, chewing, maintaining proper spacing, and guiding the eruption of permanent teeth. Common oral conditions comprise dental caries, malocclusion, childhood caries, and trauma. Aim: The present study was conducted to assess paternal knowledge towards the forestallment of oral conditions and application of preventive dental procedures in children in South zone of Chhatrapati Sambhajinagar. Materials and Methods: A cross-sectional questionnaire was administered to parents of pediatric patients of age group 3 to12 years in South zone of Chhatrapati Sambhajinagar, Maharashtra, with a sample size of 270 participants. A structured questionnaire, comprising 14 questions in English, was developed, translated and back translated into the local language Marathi by experts to ensure better comprehension by the parents. The questionnaire was divided into two sections: the first focused on demographic information, while the second included 14 multiple-choice, close-ended questions. These questions included topics such as preventive treatments for dental caries, childhood caries, topical fluoride application, fluoridated toothpaste, pit and fissure sealants, habit-breaking dental appliances, malocclusion, mouth guards, and space maintainers. Additionally, the survey addressed harmful habits such as thumb-sucking, tongue-thrusting, and nail-biting. Result: 56.6% of parents sought dental care only after experiencing pain. Additionally, parents of paediatric patients have restricted knowledge about preventive dentistry. Conclusion: Parental knowledge about preventive dental procedures is limited, as is the utilization of these measures.

Dental Emergency Rates at an Expeditionary Medical Facility Supporting Operation Inherent Resolve.

A core objective of U.S. medical services is to ensure the medical and dental readiness of military personnel. Oral diseases, resulting in pain, infection, or functional impairment, greatly affect the operational effectiveness of military personnel. This study aimed to compare the current causes of dental emergencies and the rates of dental disease nonbattle injuries in a deployed setting with those documented in previous research. Additionally, the study sought to determine if these rates have decreased because of preventive measures or potential improvements in overall oral health. Each soldier reporting to the health facility for dental care was screened by a dentist to determine the presence of a dental emergency. The reason for seeking care was classified into 1 of 7 categories and the rate of dental emergencies per 1,000 military members per calendar year was calculated. The majority of emergencies (38.60%) were due to tooth fractures and/or caries. The second most common reason for visiting the dental clinic was pain from a tooth requiring endodontic therapy (16.81%). This was followed by musculoskeletal or nonendodontic tooth pain (16.10%), most often associated with stress. Periodontal issues accounted for 14.33% of emergencies. Teeth requiring extraction made up 7.16% of all emergencies, prosthodontic bonding complications accounted for 5.16%, and orthodontic bonding complications affected 1.84% of individuals. The dental disease nonbattle injuries rates determined from the current study were 154 emergencies per 1,000 personnel per year for Air Force members and 264 emergencies per 1,000 personnel per year for Army members, which align with previous research findings. The results of this study confirm that dental emergencies continue to be a threat to overall readiness in deployed environments. The primary etiologic factor in the current study was as a result of tooth fracture and/or caries.

The influence of different extraction indications on the morphological changes in the maxillary sinus: A retrospective cohort study.

The comprehensive effects of maxillary posterior tooth extraction on the maxillary sinus (MS) morphology remain to be thoroughly elucidated. This retrospective cohort study aimed at evaluating the influence of different extraction indications on the morphological changes in the MS by utilizing cone-beam computed tomography (CBCT). One hundred and seventy-eight of maxillary posterior tooth extractions underwent CBCT scans before and after extraction using 3D Slicer software. Parameters such as maxillary sinus pneumatization (MSP, the primary outcome measure), buccal bone height (BBH), palatal bone height (PBH), mucosal thickness (MT), and other anatomical structures were measured for patients undergoing extraction due to periodontitis, periapical lesions, or tooth fracture. Multiple linear regression analysis was employed to assess the effect of extraction indications on the MS. While the primary outcome, MSP, did not reveal statistically significant differences across various indications for tooth extraction (p > .05), extraction itself resulted in MSP (p < .05). The rate of this pneumatization was influenced by the position of the extraction site (p < .05). Additionally, baseline values of bone height and mucosal thickness showed an inverse correlation with the rate of change in these parameters following tooth extraction (p < .001). Tooth extraction led to increased pneumatization of the maxillary sinus while simultaneously reducing bone height and mucosal thickness. However, these outcomes were not influenced by the reason for tooth extraction.

Accuracy and Consistency of Gemini Responses Regarding the Management of Traumatized Permanent Teeth.

The aim of this cross-sectional observational analytical study was to assess the accuracy and consistency of responses provided by Google Gemini (GG), a free-access high-performance multimodal large language model, to questions related to the European Society of Endodontology position statement on the management of traumatized permanent teeth (MTPT). Three academic endodontists developed a set of 99 yes/no questions covering all areas of the MTPT. Nine general dentists and 22 endodontic specialists evaluated these questions for clarity and comprehension through an iterative process. Two academic dental trauma experts categorized the knowledge required to answer each question into three levels. The three academic endodontists submitted the 99 questions to the GG, resulting in 297 responses, which were then assessed for accuracy and consistency. Accuracy was evaluated using the Wald binomial method, while the consistency of GG responses was assessed using the kappa-Fleiss coefficient with a confidence interval of 95%. A 5% significance level chi-squared test was used to evaluate the influence of question level of knowledge on accuracy and consistency. The responses generated by Gemini showed an overall moderate accuracy of 80.81%, with no significant differences found between the responses of the academic endodontists. Overall, high consistency (95.96%) was demonstrated, with no significant differences between GG responses across the three accounts. The analysis also revealed no correlation between question level of knowledge and accuracy or consistency, with no significant differences. The results of this study could significantly impact the potential use of Gemini as a free-access source of information for clinicians in the MTPT.

Oral Health-Related Quality of Life in Dutch Adults With Osteogenesis Imperfecta.

To explore the oral health-related quality of life and its possible risk factors among adults with Osteogenesis Imperfecta using the Oral Health Impact Profile (OHIP)-49 questionnaire. Secondary objectives were to investigate the impact of self-reported Osteogenesis Imperfecta, Dentinogenesis Imperfecta, and age on various dental parameters. A cross-sectional questionnaire was distributed online to 417 Dutch adults with Osteogenesis Imperfecta at three national referral centers. Multivariate linear regression was performed to identify indicators for OHIP-49 Scores. The effect of Osteogenesis Imperfecta, Dentinogenesis Imperfecta, and age on various dental parameters was investigated using logistic regressions (p < 0.05). One hundred and fifty-five questionnaires (37.2%) were suitable for analysis. Osteogenesis Imperfecta type III was significantly associated with higher OHIP-49 scores as compared to type I. Symptoms of temporomandibular disorders, missing teeth or dentures also increased the OHIP-49 scores significantly. Osteogenesis Imperfecta type IV and increasing age were associated with missing teeth. There was a 31.94 times (95% CI: 8.56-119.13) higher odds of tooth fracture with self-reported Dentinogenesis Imperfecta. Adults with Osteogenesis Imperfecta type III report a lower oral health-related quality of life compared to Osteogenesis Imperfecta type I adults.

Efficacy of vital pulp therapy for carious pulp injury in permanent teeth: a study protocol for an open-label randomized controlled noninferiority trial.

Vital pulp therapy (VPT) has recently been reported as an effective approach for preventing and treating carious pulp injury in permanent teeth. Compared with root canal treatment (RCT), which involves complete removal of the pulp tissue, VPT effectively maintains pulp vitality and retains the physiological functions of the pulp. In the research pool, large-scale randomized controlled trials evaluating the treatment outcome of VPT using calcium silicate cements and RCT in cariously exposed permanent teeth are lacking. Here, we present a monocentric clinical protocol to compare the effects of VPT using iRoot BP Plus (Innovative Bioceramix, Vancouver, BC, Canada) as a pulp-capping material with RCT. The proposed trial is an open-label, single-centre, randomized, controlled, noninferiority trial. In total, 462 patients will be included in this trial according to the following criteria: adult patients (18-50years old), pulp exposure during the treatment of deep caries in mature permanent teeth, a diagnosis of reversible or partially irreversible pulpitis without apical translucency on X-ray, without periodontitis or systemic disease. Patients with signed informed consent forms will be enrolled and randomly divided into two groups (VPT and RCT) with a balanced treatment allocation (1:1). Clinical evaluations will be conducted at baseline and at 3, 6, 12, and 24months after treatment, with the potential for extension. The primary outcome measure will be the duration of success. The secondary outcomes will include the success rate at the 1-year follow-up and any adverse reactions. The Kaplan‒Meier method and log-rank test will be used to compare the duration of success of both treatments. For other outcomes, the χ2 test or Fisher's exact test will be used for categorical variables, and the t test or Mann‒Whitney U test will be used for continuous variables to assess the differences between groups. The results of this trial will provide a clinical reference for selecting treatments for carious pulp injuries in permanent teeth. ClinicalTrials.gov ChiCTR2100051369. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR) ( www.chictr.org.cn ). Registered on 21 September 2021.

Tratamento endodôntico em dentes decíduos associado à reabilitação oral estética e funcional: relato de caso

Pediatric dentistry is an area within dentistry dedicated to oral health care for babies, children and even teenagers. The main focus of this specialty, as well as the focus of this work, is to promote awareness about the importance of creating healthy habits for children and maintaining the deciduous tooth in the alveolus until it is naturally replaced by permanent teeth. Endodontic treatment is usually proposed for two main causes: caries and dental trauma, which is very common in early childhood. The objective of this work was to carry out an endodontic treatment in deciduous teeth (51 and 61) and subsequent aesthetic rehabilitation of elements 51, 61, 52, 62 with composite resin. It can be concluded that the rehabilitation of the anterior deciduous teeth was extremely important from the aesthetic, functional and psychological point of view of the child. The use of maneuvers such as endodontics in deciduous teeth as well as the association of restorations with composite resins became a viable alternative in this clinical case, allowing the reestablishment of form, function and aesthetics.

Perda precoce dos elementos 11 e 12 por trauma dental, com intervenção ortodôntica preventiva na odontopediatria: relato de caso

Dental trauma is one that affects the hard tissues embraced, supporting structures or soft tissues in the oral cavity. It is observed more frequently in male children of school age (07 to 12 years old). The most affected teeth in the trauma taken are central and lateral incisors. With regard to tooth avulsions, the protection of children's bone tissue favors a higher frequency in this population than in the adult population. Dental avulsion occurs after displacement of the element out of its alveolus. There is a break in the blood supply to the pulp of the tooth and when this happens the chance of replantation achieved is totally impossible. Thus bringing several harms to the patient such as difficulty in speech, poor aesthetics, or even mesialize or distalize some other acquired element. Space maintainers are used as removable or fixed appliances to treat malocclusion or esthetic defects. They are braces made of acrylics with two extended teeth. Choosing a removable appliance comes with benefits such as better hygiene, satisfactory aesthetics, low cost, and maintenance of the cervico-occlusal space, in addition to the mesio-distal space. The objective of this study was to report a clinical case of avulsion of element 11 and 12 caused by trauma in childhood with the use of a space maintainer. We conclude that it is possible to treat a patient with dentoalveolar trauma with intervention using a space maintainer, since in the present case success was obtained in the selection of therapy, restoring aesthetics and function to the patient. Thus reducing possible orthodontic problems of the child, with follow-up until his/her old age.

Cisto dentígero pós-traumático: relato de caso

The dentigerous cyst is an odontogenic cyst associated with the crown of unerupted teeth, inflammation or after trauma. It is asymptomatic, unilocular, predominantly in the mandible and male. The objective of this case was to report the diagnosis and treatment of the dentigerous cyst. The anamnesis, clinical examination and complementary tests were carried out in order to obtain a thorough diagnosis and the best possible treatment. The diagnosis through radiographic examinations and CT scans was extremely important, allowing the visualization of anatomical conditions and structures, dental fracture, presence of fixed plates and appearance of the lesion. Surgical treatment by means of enucleation was the most indicated technique according to the conditions presented, considering the circumstances of the patient and the size of the lesion. Complete removal of the lesion, extraction of element 45 and partial removal of the miniplate were performed. Therefore, the biopsy is essential to corroborate a differential diagnosis, the excisional type is recommended for small and benign lesions.

Evaluation of validity and reliability of AI Chatbots as public sources of information on dental trauma.

This study aimed to assess the validity and reliability of AI chatbots, including Bing, ChatGPT 3.5, Google Gemini, and Claude AI, in addressing frequently asked questions (FAQs) related to dental trauma. A set of 30 FAQs was initially formulated by collecting responses from four AI chatbots. A panel comprising expert endodontists and maxillofacial surgeons then refined these to a final selection of 20 questions. Each question was entered into each chatbot three times, generating a total of 240 responses. These responses were evaluated using the Global Quality Score (GQS) on a 5-point Likert scale (5: strongly agree; 4: agree; 3: neutral; 2: disagree; 1: strongly disagree). Any disagreements in scoring were resolved through evidence-based discussions. The validity of the responses was determined by categorizing them as valid or invalid based on two thresholds: a low threshold (scores of ≥ 4 for all three responses) and a high threshold (scores of 5 for all three responses). A chi-squared test was used to compare the validity of the responses between the chatbots. Cronbach's alpha was calculated to assess the reliability by evaluating the consistency of repeated responses from each chatbot. The results indicate that the Claude AI chatbot demonstrated superior validity and reliability compared to ChatGPT and Google Gemini, whereas Bing was found to be less reliable. These findings underscore the need for authorities to establish strict guidelines to ensure the accuracy of medical information provided by AI chatbots.

Treatment Modalities of Uncomplicated Crown Fracture in Anterior Maxillary Permanent Teeth: A Systematic Review.

Several treatment modalities have been used to restore crown fractures in case of uncomplicated crown fractures. Although many treatment modalities have been reported, there is no consensus on which one has the best results in terms of success and durability. This systematic review of treatment modalities in uncomplicated crown fractures aims to provide the most common and successful treatment modality for each patient's unique needs, balancing conservation, aesthetics, and long-term durability. Three electronic databases (PubMed, Scopus, and Google Scholar) were searched for articles regarding treatment modalities in uncomplicated crown fractures in anterior maxillary teeth. Following the application of the inclusion and exclusion criteria, 10 case reports, four case series, and two retrospective studies were selected for the review. These studies reported on fragment reattachment, direct composite resin, and veneers for the management of uncomplicated crown fractures. Fragment reattachment was the most preferred treatment modality, with milk, water, or sterile saline used as storage mediums. Direct composite restoration was preferred for missing or bad-shaped fragments or longevity. Veneers were given for aesthetic consideration and fracture resistance when the crown structure was majorly affected by the fracture. Fragment reattachment was favored in 63% of the articles included in the review followed by direct composite restoration in 26% of the articles. Venners were used in about 11% of the articles. Composites depicted a higher survival rate and a better outcome than fragment reattachment. Follow-up periods ranged from 1 week to 4 years, and all articles successfully re-established function and aesthetics, except for one tooth that required root canal treatment. Fragment reattachment, direct composite restoration, and veneers are successful treatment modalities in uncomplicated crown fractures of anterior teeth. The choice of treatment depends on various factors like availability of fragments, age, and financial condition of the patient. PROSPERO Registration ID: CRD42020153091.

TREATMENT OF TOOTH AVULSION: A CASE REPORT

Dental trauma (DT) refers to injuries caused by impacts to the teeth and/or the hard and soft tissues within or outside the oral cavity. Among the various types of DT, avulsion, characterized by the complete displacement of the tooth from its socket. The success of treatment depends on timely management and proper professional care during and after reimplantation in preserving the tooth in the oral cavity. This study describes a case report of an avulsion of the upper left central incisor (21) that underwent reimplantation. The patient, a 10-year-old boy, had a history of bicycle fall, presenting with extraoral injuries to the cheek and chin, lip abrasions, and avulsion of tooth 21. The tooth was stored in milk and reimplanted 30 minutes after the accident. Clinical and radiographic examinations showed no bone fractures but revealed mobility of teeth 11 and 12 and avulsion of tooth 21. Treatment included cleaning, repositioning of the avulsed tooth, stabilization with a semi-flexible splint, and administration of antibiotics and analgesics. Endodontic therapy with mechanical instrumentation was successfully initiated after 20 days. This case highlights the importance of proper tooth storage and timing of reimplantation, leading to the restoration of patient’s aesthetics, chewing function, and self-esteem.

Potential for pulp revascularization in mature anterior teeth with lateral luxation in relation to the patient's age at the time of injury-a retrospective cohort study.

The aim of this study was to investigate the potential for pulp revascularization in relation to patient age at the time of injury following luxation injury of mature anterior permanent teeth. A total of 93 teeth from 70 patients were included. The patients were divided into subgroups based on their age at the time of the injury. the Aalen-Johansen method was used to estimate the risks of pulp canal obliteration (PCO) and pulp necrosis (PN). The absolute 2year risks of PCO and PN were obtained with cause-specific Cox regression and reported separately for each cohort, standardised to age at injury and degree of repositioning. For the group younger than 15years of age, the risk of PN after 12months was 62.3% [95% CI 44.9; 79.7] in the cohort from 1972 to 1980 and 28.6% [95% CI 4.9; 52.2] in the cohort from 2012 to 2020. For the age group 16-20 years, the risk of PN after 12 months was 66.7 [95% CI 40.0;93.3] in the cohort from 1972 to 1980 and 25% [95% CI 0.0;55.0] in the cohort from 2012 to 2020. For the age group between 21 and 25, the risk of PN after 12months was 66.7% [95% CI 40.0; 93.3] in the cohort from 1972 to 1980 and 55.6% [95% CI 23.1; 88.0] in the cohort from 2012 to 2020. There is potential for pulp revascularization in mature anterior teeth with lateral luxation in patients up to 25 years of age. The risk of PN appears to increase with age.

Clinical application of CAD/CAM technology in 3D printed dental model used for removable splints fabrication in the treatment of traumatized anterior permanent teeth in children

ObjectivesTo evaluate the effectiveness of computer-aided design (CAD)/computer-aided manufacturing (CAM) in designing and manufacturing 3D-printed dental models used to make thermoplastic removable splints for children with traumatized anterior permanent teeth. MethodsA total of 28 patients with dental trauma (subluxation, extrusive luxation, and lateral luxation) were divided into experimental (14 patients) and control groups (14 patients). The experimental group was treated with the removable splint made using a new 3D printed dental model designed with CAD/CAM technology, while the control group received a wire-composite splint. Follow-up was performed at week 2 and 1, 2, 3, 6, 12, 18, and 24 months post-treatment, and every year after that. The traumatized teeth were evaluated according to clinical symptoms, tooth color, mobility, position, percussion pain, abnormal percussion sounds indicating ankylosis or other pathosis, swelling, fistula of gums, vitality test, and radiographic examination. ResultsNo significant difference was found in gender and age between the two groups. The experimental group had 23 traumatic teeth, and the control group had 24 traumatic teeth. Traumatic teeth in the two groups most commonly involved open apex teeth (>90 %). The average follow-up time for the experimental and control group was 35.47±14.23 and 32.92±14.79 months (P > 0.05), respectively. The pulp survival rate and periodontal healing rate in the experimental group (86.96 %, 91.30 %) were higher compared to the control group (62.50 %, 75.00 %) (all P > 0.05). ConclusionA removable splint made by a 3D printed dental model designed with CAD/CAM technology achieved an equivalent treatment effect to a wire-composite splint. Clinical significanceA 3D-printed dental model designed with CAD/CAM technology can be used to fabricate removable splints, which in turn can decrease iatrogenic injuries frequently encountered during the traditional model production process. For example, taking the impression directly from the patient's mouth can cause displacement of a traumatized tooth or even exfoliation. The removable splints produced using a new 3D-printed dental model can meet clinical treatment requirements of traumatized teeth, especially for children and adolescents with occlusal trauma in mixed dentition.

Evaluation of Wear on Primary Tooth Enamel and Fracture Resistance of Esthetic Pediatric Crowns Manufactured from Different Materials

Background and Objectives: Advances in dental materials and CAD-CAM technology have expanded crown options in primary teeth due to their improved appearance and mechanical properties. Thus, this study aimed to assess the enamel wear and fracture resistance of prefabricated, milled, and 3D-printed esthetic pediatric crowns. Materials and Methods: The study involved 60 extracted maxillary second primary molars and 60 3D-printed resin dies, divided into six groups based on different crown materials (n = 10): prefabricated zirconia, prefabricated composite, milled composite, milled resin matrix ceramic, milled PEEK, and 3D-printed resin. Prefabricated crowns were selected after the preparation of the typodont mandibular second primary molar tooth, while milled and 3D-printed crowns were custom produced. The specimens underwent mechanical loading of 50 N at 1.6 Hz for 250,000 cycles with simultaneous thermal cycling. The 3D and 2D wear amounts were evaluated by scanning the specimens before and after aging. Then, the fracture resistance and failure types of the restorations were recorded. Results: The results showed that the milled PEEK group had superior fracture resistance compared to the other groups, while prefabricated zirconia crown group had the lowest value. Milled resin matrix ceramic crown group displayed the lowest 3D wear volume, while 3D-printed crown group showed the highest 2D wear. Conclusions: The restorative material type did not have a significant effect on the wear of primary tooth enamel. The fracture resistance of the tested materials differed according to the material type. Although the milled PEEK group showed the highest fracture resistance, all tested materials can withstand chewing forces in children.

Oro-Dental Characteristics in Patients With Adult-Onset Hypophosphatasia Compared to a Healthy Control Group-A Case-Control Study.

Hypophosphatasia (HPP) is a rare inherited disease that affects multiple organ systems including bone and teeth. Limited knowledge exists on dental and oral health in patients with adult-onset HPP (aHPP). The aim of this study was to investigate oro-dental characteristics in patients with aHPP compared to healthy controls. This case-control study included 20 patients with aHPP compared to 31 healthy controls. Oro-dental manifestations were examined by standardised interviews, clinical examinations as well as radiological registrations on panoramic radiograph (OP) and cone-beam computed tomography (CBCT) scans. The subjective experience of tooth fractures (p = 0.010), caries in permanent teeth (p = 0.032) and early loss of permanent teeth (p = 0.002) was significantly higher in patients with aHPP compared to the controls. In the aHPP group, the presence of specific teeth (p ≤ 0.045) and attrition of 11 were significantly lower (p = 0.012) compared to the controls. Opacity of a few teeth (p ≤ 0.049), presence of denticles (p = 0.024), the distance between the enamel-cement junction (CEJ) and the marginal bone level at specific sites (p ≤ 0.021) and crown height of 11 (p = 0.017) were significantly higher in patients with aHPP than in healthy controls. The results indicate that patients with aHPP have a subjective experience of having poorer dental health. Loss of permanent teeth, less attrition, tooth opacities, denticles and larger distance between CEJ and marginal bone level are possible oro-dental findings in patients with aHPP.