Incisor Region Research Articles

Efeito do tempo e do substrato dental na resistência de união de um sistema adesivo universal: estudo in vitro

Abstract Introduction Dentin adhesives provide union between the dental substrate and composite resin, but this union can be influenced by the cleaning agent. Objective Evaluate the use of ozonated water as a cavity cleaning solution. Material and method 40 bovine dental crowns were selected, divided into four groups: AD (dentin cleaning with distilled water) and AO (dentin cleaning with ozonized distilled water). Each group was divided into two storage periods (24h and 30 days) kept at 37 °C. The selected universal system adhesive was employed according to the manufacturer's instructions and light cured for 20 seconds. At that time, three cylinders were made (Tygon matrix with an internal diameter of 2 mm and a height of 2 mm) of composite resin in the crowns in the cervical, médium, and incisal regions and light cured for 30 seconds. After storage, the bonding strength was tested by micro-shear, and fracture type analysis was performed. The data were submitted to statistical analysis using the Shapiro-Wilk test with a significance level of 95%, ANOVA, and Turkey. Result There was a statistically significant difference between the bond strength values, only in the intergroup analysis for the time of 24 hours, between the middle third of the groups (LDAO24 = 2.70 (± 2.39); LDAO30 = 3.82 (± 2.31)). The predominant fracture type for both groups was an adhesive fracture, except in the medium and incisal thirds of the AD, which was a cohesive dentin fracture. Conclusion The utilization of ozone did not change the bond strength adhesive.

Fractal dimension, lacunarity, and cortical thickness in the mandible: Analyzing differences between healthy men and women with cone-beam computed tomography.

The objective of this study was to assess the fractal dimension, lacunarity, trabecular microarchitecture parameters, and cortical linear measurements in the mandibles of male and female individuals to identify differences between them. In total, 116 cone-beam computed tomography scans of healthy individuals of different ages (57 men and 59 women, aged between 20 and 60 years) were selected. The following bone parameters were measured: 1) buccal, lingual, and basal cortical bone thickness in 5 standard parasagittal sections (the midline, the left and right sides of the lower lateral incisors, and the left and right sides of the lower canines); 2) the bone volume fraction of 10 sequential axial sections from each patient by creating a volume of interest in the area between the lower canines; and 3) fractal dimension and lacunarity using grayscale images of the same region of the volume of interest in the anterior mandible. Spearman correlation coefficients and the Mann-Whitney test were used. A significant and positive correlation was found between age and cortical thickness, especially in the region of the central incisors. Significant differences between sexes in terms of fractal dimension, lacunarity, and bone volume were found. Women revealed lower fractal dimension values and higher lacunarity and bone volume ratio values than men. Fractal dimension, lacunarity, trabecular bone volume, and cortical thickness were different between men and women of different ages.

Microsurgical Approach for the Coverage of Gingival Recession Defects using Vestibular Incision Subperiosteal Tunnel Access (VISTATM) Technique- A Case Report

Gingival recession which is described as the loss of gingival attachment due to apical migration of the gingival margin from the cementoenamel junction leading to the exposure of the root surface, is one of the most prevalent diseases in the world. The treatment of gingival recession is therefore essential to achieve good aesthetics, relieve root hypersensitivity, prevent root caries and cervical abrasions. Till date, many root coverage techniques have been implicated for the coverage of recession defect. This case report focuses on the Vestibular Incision Subperiosteal Tunnel Access (VISTATM) technique for the root coverage procedure and simultaneous application of the microsurgical principles helps in executing the procedure in the most minimally invasive manner. Here, this technique has been accomplished in a 24-year-old female, with the chief complaint of poor aesthetics in the region of maxillary central incisors due to recession defects. Furthermore with the use of microsurgical instruments and magnifying loupes; complete coverage of the recession defects was achieved in a single stage surgery along with superior aesthetics, causing minimal trauma to the patient that was followed by an uneventful inflammatory phase.

Efficacy of bioresorbable plating system in the treatment of pediatric maxillary fractures: A short clinical study.

The aim of this study was to evaluate the efficacy, stability, and clinical outcomes of a bioresorbable plating system in the treatment of pediatric maxillary fractures. Twenty pediatric patients with maxillary fractures (13 males and 7 females) were included in this study. The 1.5- and 2.0-mm resorbable plates were used and secured with monocortical resorbable screws 6 mm and 7 mm in length. All patients were followed up for 6 months. Clinical parameters, such as pain, swelling, soft-tissue infection, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Fall from height (50%) was the most common cause of etiology, followed by road traffic accidents (35%). Maxillary alveolar # (40) was the most common fracture site, followed by nasal complex # (25%) and zygomatic complex # (25%). Appropriate fixation and adequate primary bone healing was achieved in 100% of the cases. Few minor complications were observed: (1) soft-tissue infection (5%) and (2) paresthesia (10%). There was a significant increase in bite force in the incisor and molar regions. Observation in clinical parameters shows that there was a significant reduction in postoperative pain and swelling at different follow-up periods. Bioresorbable plating system is used as a load-sharing plate in a semirigid fixation technique after anatomic fracture reduction. Although its high costs limit its feasibility for use low infection rates, minimized second surgery for implant removal attracts its use. 1.5- and 2-mm resorbable plating system along is a good treatment modality for moderately displaced maxillary fractures in pediatric patients. Larger sample size and longer follow-up studies are required for conclusive results.

Comparative evaluation to study the effect of implant support on complete fixed dental prosthesis fabricated with peek framework when implants placed in all-on-4 and all-on-6 situation, by strain gauge analysis and finite element analysis - An in vitro study.

To evaluate and compare the strain development and distribution of maxillary implant-supported complete fixed dental prosthesis (ISCFDP) with computer-aided design-computer-aided manufacturing milled PEEK BIO-HPP superstructure when placed using All-on-4 and All-on-6 situation using a strain gauge and finite element analysis (FEA). This is an in vitro study to evaluate and compare the stress minimization and strain developed at implant in premolar and in two clinically simulated situation of All-on-4 and All-on -6 ISCFDP. The study involved converting a human skull into. stl format to create 3D-printed stereolithography models with a modulus of elasticity closer to bone. Implants were placed in two models (M1 nad M2) in incisor, premolar, and pterygoid regions. A fixed dental prosthesis framework was fabricated on both models, and strain gauge sensors were attached. Descriptive and analytical statistics were done. The normality of data was analyzed by the Shapiro-Wilk test. The results obtained were tabulated and it showed strain around the neck of ISCFDP under 100N configuration in strain gauge analysis. Stress was found more in the molar region when compared to the premolar region. This design showed that the largest stress around the neck of ISFDP under 100 N load was found more in the premolar region when compared to the molar region due to the reduction of stresses in the pterygoid region in FEA. In the present study, strain gauge analysis at 100 N for loading at the premolar and molar region shows the reduced strain on tilted implants in All-on-6 situation due to stress dissipation to the terminal pterygoid implant using strain gauge.

Correlation of Gingival Stippling with Periodontal Phenotypic Features: A Cross-Sectional Study.

This study aimed to determine the correlation between gingival stippling (GS) and other phenotypic characteristics. Adult subjects in need of CBCT scans and comprehensive dental treatment in the anterior maxilla were recruited. Facial gingival thickness (GT) and buccal bone thickness (BT) were assessed utilizing CBCT. Standardized intraoral photographs were obtained to determine keratinized tissue width (KTW), presence of GS in all facial and interproximal areas between the maxillary canines, and other variables of interest, such as gingival architecture (GA), tooth shape, and location. Statistical analyses were conducted to assess different correlations among recorded variables. A total of 100 participants and 600 maxillary anterior teeth constituted the study population and sample, respectively. Facial GS was observed in 56% of men and 44% of women, and it was more frequently associated with flat GA, triangular and square/tapered teeth, central incisors, and men. Greater mean GT, BT, and KTW values were observed in facial areas that exhibited GS. Interdental GS was present in 73% of the sites, and it was more frequently observed in men, in the central incisor region, and when facial GS was present. Multilevel logistic regression revealed a statistically significant association between the presence of GS and KTW, BT measured at 3 mm apical to the bone crest, and tooth type. This information can be used to recognize common periodontal phenotypical patterns associated with specific features of great clinical significance.

Cysts of Oral Cavity: Odontogenic Keratocyst; A Rare Case Report with a 6-Year Follow-Up

Aim: Odontogenic keratocyst is one of the rare odontogenic cyst, commonly affecting the mandible. It has a special mention in the field of oral surgery due to its varied presentation and high recurrence rate. There have been a few cases reported of outcomes of treatment of odontogenic keratocysts. The aim of this report was to illustrate the case of OKC in a patient and to describe the follow-up information and successful treatment of its. Methods: A 18-year-old Turkish girl was referred by her dentist to the periodontology clinic of the Faculty of Dentistry in November 2017, for the treatment of cyst in the mandibulary incisor region. The diagnosis of odontogenic keratocyst suggested clinically and radiographically was confirmed by the histopathological study. Treatment consisted of oral hygiene instruction, periodontal-endodontic treatment and resection of cyst. Results: Four weeks after surgery healing was occurred and six years later area of the lesion appeared completely normal as clinical and radiographically. There were no signs of local recurrence after a 6-year follow-up. Conclusion: The odontogenic keratocyst was treated successfully by surgical periodontal treatment.

Análise biomecânica de implantes de diâmetro reduzido para reabilitação da região anterior da maxila

Abstract Introduction Narrow diameter implants biomechanics knowledge indicates safe dimensions for clinical use. Objective Purpose of the present study was biomechanically to compare regular and narrow diameter implants to support single implant-supported prosthesis in the anterior region of the maxilla by 3D finite element analysis (3D-FEA). Material and method Four 3D-FEA models were developed form CT scan recompositing and literature data: a bone block in the right upper lateral incisive region with implant and crown. M1: 3.75 x 13 mm, M2: 3.75 x 8.5 mm, M3: 2.9 x 13 mm and M4: 2.9 x 8.5 mm. It was applied load was of 178 N at 0, 30 and 60 degrees in relation to implant long axis. Von Mises stress, maximum principal stress and microdeformation maps were evaluated. Result M3 and M4 did show higher tension and higher microdeformation values than M1 and M2, especially when inclined forces were applied. However, M3 presented enhanced biomechanical behavior than M4. Conclusion It can be concluded that reduce the diameter of the implants can disadvantage to the biomechanics during the application of forces, but the distribution and intensity of the stresses, as well as the micro deformation values can be improved if the length of the implant is increased.

Advanced Platelet-rich Fibrin-mediated Regeneration of Necrotic Immature Permanent Teeth: A Clinico-radiographic Observational Study.

The objective of the study was to assess the regenerative potential of advanced platelet-rich fibrin (APRF) in the regenerative treatment of necrotic immature permanent teeth (NIPT) in the maxillary incisor region. After institutional review board clearance, 10 children aged between 8 and 14 years with NIPT in the maxillary incisor region undergoing APRF treatment were enrolled in a prospective clinico-radiographic exploratory observational study. Baseline clinical, radiographic, and vitality testing before the start of treatment were noted. Patients were followed up at 3, 6, and 12 months posttreatment. After 3, 6, and 12 months of follow-up, all patients (100%) showed complete resolution of clinical signs and symptoms. All patients (100%) showed periradicular healing, and 9 out of 10 patients (90%) showed a clear hard tissue bridge formation at various levels in the root canal on postoperative radiographs. None of the patients (0%) showed a positive response to vitality testing. APRF is a promising biomaterial in regenerative endodontic treatment (RET). Future randomized trials can be planned to establish superiority or equivalence to conventional PRF. Wakhloo T, Shukla S, Chug A, et al. Advanced Platelet-rich Fibrin-mediated Regeneration of Necrotic Immature Permanent Teeth: A Clinico-radiographic Observational Study. Int J Clin Pediatr Dent 2022;15(4):402-406.

Evaluation of the correlation between facial index and the cortical bone thickness of the maxilla and mandible—A computer tomography based study

Objectivescortical bone thickness confines the position of teeth and thus can be a limiting factor for orthodontic tooth movement. The study is aimed to correlate the cortical bone thickness of the maxilla and mandible with that of different face types, viz; dolichofacial, brachyfacial, and mesofacial. MethodsForty CT scans were analysed for the face types and were grouped into dolichofacial (13), brachyfacial (13) and mesofacial (14) face types. The scans were measured for the right and left side buccal and lingual cortical bone thickness at the central incisor, first and second molar regions on both the maxilla and mandible. Other parameters like basal cortical bone thickness, height, and width of cortical bone were also measured. To determine the correlation and difference between the different parameters, the obtained data was subjected to the correlation coefficient, t test, and ANOVA statistical analysis. ResultsMaxillary buccal cortical bone thickness of central incisors was found to be highly correlated to facial index with a correlation coefficient of − 0.833 * *. Mandibular buccal bone thickness correlated with face type and cortical bone thickness at the central incisor, first, and second molars by-0.531 * *, − 0.474 * *, and − 0.589 * *, respectively. There was a significant difference between the right and left side cortical bone thickness (p < 0.05) and also for all the parameters amongst the different face types (p < 0.05). ConclusionThere exists a definite correlation between the face type and the certain anatomical measurements of cortical bone morphology. Dolichofacial face types show thin buccal cortical bone, which implies the limitation of orthodontic tooth movement in these types of individuals.

Calcifying odontogenic cyst causing an atypical complication: Case report

Introduction: Calcifying odontogenic cyst (COC) is a benign cystic type of odontogenic tumor, without neoplastic character and unusual in nature. Its development is slow and asymptomatic, being characterized by a mass that affects the maxilla and mandible. Case Report: A 40-year-old male presented with mild extra and intraoral facial swelling in the region of the right upper incisors, without symptoms. On intraoral examination, he observed intact and normal colored buccal mucosa. Radiographic examination showed a radiolucent lesion between teeth 11 and 12. Excisional biopsy was performed. The histological diagnosis was calcifying odontogenic cyst. Conclusion: Calcifying cyst is an uncommon odontogenic cyst that most often occurs in the maxilla. However, it should be in the differential diagnosis of other odontogenic lesions. In addition, after conservative surgical removal, long-term follow-up is recommended. Because, although rare, recurrence can occur.

Genetic, Epigenetic and Environmental Factors Influence the Phenotype of Tooth Number, Size and Shape: Anterior Maxillary Supernumeraries and the Morphology of Mandibular Incisors

The aim of this study is to investigate whether the genetic, epigenetic and environmental factors that give rise to supernumeraries in the maxillary incisor region and larger dimensions of the adjacent maxillary incisors are also associated with variations in the morphology of the mandibular incisors. If so, this would contribute to understanding the distribution and interactions of factors during dental development and how these can be modelled. The sample consisted of 34 patients with supernumerary teeth in the maxillary anterior region, matched for gender, age and White Caucasian ethnicity with 34 control subjects. The average ages of the supernumerary and control groups were 12.8 and 12.2 years, respectively. Study models of all subjects were constructed and imaged using a previously validated system. Using custom software, each of the mandibular incisor teeth were measured to obtain 17 parameters from the labial view and 17 from the occlusal view. Principal component analysis (PCA) was used to summarize the measurements into a smaller set representing distinct features of the clinical crowns, followed by a comparison between the supernumerary and control groups using 2-way ANOVA. Seven factors of tooth size of the mandibular central incisors and six factors of the mandibular lateral incisors were identified as major features of the clinical crowns. All parameters of both mandibular incisors were greater in the supernumerary group than in the control, with three of these, located in the incisal and cervical regions of the mandibular lateral incisors, being statistically significantly larger. The findings of this study indicate that the aetiological factors associated with supernumerary teeth in the maxillary anterior region also affect tooth crown dimensions of mandibular incisors. This new evidence enhances several models of the interactions of genetic, epigenetic and environmental components of dental development and supports a multi-model approach to increase understanding of this process and its variations.

Biomechanical Comparison of Asymmetric Implant Configurations for All-on-Four Treatment Using Three-Dimensional Finite Element Analysis.

The aim of this study is to examine the effect of unilaterally more posterior placement of implants (Straumann BLT 4.1 mm in diameter and 12 mm long) applied according to the all-on-four concept on the stress distribution on bone, implants, and other prosthetic components, using the finite element analysis method. Three scenarios were modelled: For Model 1 (M1), anterior implants were placed symmetrically perpendicular to the bone in the right and left lateral incisor region, while the necks of the posterior implants placed symmetrically in the second premolar region were angled at 30 degrees. For Model 2 (M2) the implant in the left second premolar region was placed to the first molar region unilaterally. For Model 3 (M3) the implant in the left lateral incisor region was placed to the canine region unilaterally. Vertical and oblique forces (100 N) were applied in the right first molar region. The von Mises and maximum (Pmax) and minimum (Pmin) principal stresses were obtained. The highest stress concentration on the cortical bone was observed in the second premolar region in all models when oblique forces were applied. M1 was highest (8.992 MPa) followed closely by M3 (8.780 MPa) and M2 was lowest (3.692 MPa). The highest stress concentration on the prosthetic parts was observed in this framework when oblique forces were applied. M2 was highest (621.43 MPa) followed by M3 (409.16 MPa) and the lowest was M1 (309.43 MPa). It is thought that placing the implant further posterior to first molar region may prevent the bone resorption that occurs with high stress around the crestal bone. However, increased stress on the implants and prosthetic parts may lead to failures.

Evaluation of maxillary sinus dimensions and volume using cone beam computed tomography in patients with unilaterally displaced palatal and buccal maxillary canines

ObjectivesTo evaluate and compare the maxillary sinus (MS) dimensions and volume in unilaterally displaced palatal and buccal maxillary canines.MethodsCBCT images for 133 patients were included in the study. Maxillary canines were unilaterally displaced palatally in 83 patients (PDCs) and buccally in 50 patients(BDCs). The following variables were measured: canine position in relation to MS walls, MS pneumatization and MS dimensions and volume.ResultsMS was extended to the incisor region in 10% and 13% and to the canine region in 48% and 23% in BDCs and PDCs subjects, respectively. In BDC subjects, maxillary canine crown tip was more laterally (24.23 mm compared to 22.93 mm (p < 0.05)) and closer vertically (5.82 mm compared to 9.58 mm (p < 0.001)) to the MS, maxillary canine root tip was closer to the MS anterior (0 mm compared to 1.64 mm (p < 0.05)) and lateral (19.70 mm compared to 22.02 mm (p < 0.001)) walls and the MS volume (11.57mm3 compared to 9.09 mm3 (p < 0.001)) was increased in the displaced side compared to the non-displaced side. In PDC subjects, a significant difference between the displaced and non-displaced sides was detected in the vertical (3.28 mm compared to 5.89 mm (p < 0.001)) and lateral (21.63 mm compared to 24.25 mm (p < 0.001)) position of maxillary canine to the MS wall, the anterior (− 0.84 mm compared to 1.13 mm (p < 0.05)) and lateral (20.48 mm compared to 22.44 mm (p < 0.001)) position of canine root tip to the MS and the MS volume (7.71mm3 compared to 9.14mm3 (p < 0.001)). PDC sides differed from BDC sides in the lateral and vertical position of canine crown tip to MS and in MS volume. PDC showed negative association with MS volume and anteroposterior skeletal relationship and a positive association with MS height.ConclusionsPDCs subjects have a reduced MS volume and BDCs subjects have an increased MS volume. PDCs are associated with reduced MS volume, increased MS height and Class III skeletal relationship.

A modal analysis of implant-supported overdentures installed on differently positioned sets of dental implants

This study evaluated the three vibration characteristics, namely, natural frequency, damping ratio, and natural mode, together with maximum displacement of a two-implant-supported overdenture (IOD) at different locator attachment positions using experimental modal analysis (EMA). Edentulous mandibular models with a gingival thickness of 1 mm or 3 mm were prepared, into which dental implants were placed using a fully guided surgical template designed with simulation software, the locator abutments were fastened, and the IODs were then fabricated. The implant positions were bilaterally marked at the lateral incisor, first premolar, and first molar regions. EMA was performed by hammering the test structures to measure the impulse response and obtain the vibration characteristics (n = 5). The Kruskal–Wallis test was performed for natural frequency and maximum displacement, and the Games-Howell test for damping ratio. The significance level was set at α = 0.05. The study indicated that the gingival thickness had a significant effect on the vibration characteristics. Moreover, the natural frequency and damping ratio results showed that the vibration subsided faster when the attachment was placed on the molar implants in the thick gingival model. Furthermore, according to the effect of lateral force on IODs, the difference in maximum displacement between the anterior and posterior regions of the IOD was smaller when the attachments were designed on the pair of lateral incisors. Thus, within the limits of this experiment, our results suggested that two anterior implant-supported IODs are preferable treatment designs in terms of vibration engineering, especially when the gingiva is thick; the molar attachment design could be considered for thin gingival conditions. The differences in gingival thickness and abutment position affected the vibration characteristics of the IOD. Further in vivo studies would be necessary to validate the implant positions and their IOD designs for the mandibular edentulous shapes and the occlusal relationship.

Statistical analysis of parameters for the ramus, teeth, and biomechanical stress: A retrospective study

ObjectiveTo explore the correlation between the anterior border absorption of the mandibular ramus and the occurrence of supernumerary teeth, along with the biomechanical stress. DesignThe bone mass of mandibular ramus was evaluated on CBCT images by bone mass analysis. In addition, the number of supernumerary teeth and corresponding anatomical positions were recorded. ResultsThe CBCT images of 5100 patients were analyzed. Along with eruption of mandibular permanent molars in sequence, the width of the ramus increased from 29.02 mm to 36.02 mm (P < 0.001). The proportion of the width from the nerve canal to the anterior border of the ramus in the whole ramus decreased from 52.51% to 43.79% (P < 0.001). Meanwhile, among the 5100 participants, 278 supernumerary teeth were identified in 209 patients (4.1%). The predilection loci were close to the regions of central incisors (72.66%) in the maxilla and of the premolars (11.51%) in the mandible. ConclusionsBiomechanical stress, mainly pressure during tooth development, was the internal force of anterior border absorption of the mandibular ramus. The release of pressure after tooth eruption is a possible reason for the occurrence of supernumerary teeth.

Evaluation of Stress Distribution of Maxillary Anterior Segment during en Masse Retraction Using Posterior Mini Screw: A Finite Element Study

The current study aimed to perceive and estimate the distribution of stress generated by the forces on the maxillary anterior teeth during orthodontic retraction using the bilateral mini screw implant. Finite element models were generated from the three-dimensional (3D) reconstruction of the maxillary arch via cone–beam computed tomography (CBCT). These models imitate the retraction of maxillary anterior teeth with the mini screw placed as the skeletal anchorage. The titanium mini screw of 1.3 mm × 8 mm dimension was placed at a height of 9 mm between the first molar and second premolar on both sides of the maxilla. A nickel titanium (NiTi) coil spring of 9 mm length was attached from the mini screw implant to the power arm which generated a force of 250 gm/side. Two different power arms were placed between the lateral incisor and canine at a height of 4 mm (group 1) and 8 mm (group 2), respectively. There were no significant differences observed when the stress values were compared to the left side and the right side in group 1 with a power arm of 4 mm. In group 2, the stresses around the lateral incisors were found to be on the higher side when compared with the central incisors and canines. The length of the power arm shows no significant difference in stress distribution pattern on the left and right sides except for stresses moving from the canine region to the lateral incisor region with the increase in power arm height.

Surgical treatment of inflammatory periapical cyst: a clinical case report

Among the odontogenic cysts, there are radicular cysts or also called periapical cysts, are the most common odontogenic cyst. They develop at the apex of a tooth with pulp necrosis, which may be the consequence of dental caries or trauma. they are asymptomatic, grow slowly, and are discovered on routine radiographs. With the proliferation of the ERM and its activation, there is an increase in osmotic pressure, causing the cyst to expand, normally this ERM is not activated, so only granulation tissue develops at the apex of the affected tooth. Granulation tissue is called periapical granuloma and, as such, histologically lacks an epithelial lining. In the present study, a case of a 65-year-old female patient with an inflammatory periapical cyst in the region of the lower incisors is reported.

Assessment of Alveolar Bone Height and Width in Maxillary Anterior teeth - A Radiographic Study Using Cone Beam Computed Tomography

Cone beam computed tomography (CBCT) can be used for determining the height and width of alveolar bone surrounding the implant site which are important factors in implant planning. This study was done to evaluate and compare alveolar bone height and width in maxillary anterior teeth based on CBCT images from Nepalese population. This retrospective study included patients who had done CBCT scan between January 2019 to December 2020. Sagittal section views perpendicular to alveolar ridge were taken in the middle of maxillary left and right central incisor, lateral incisor, and canine regions and the linear measurements were done to measure alveolar height (between floor of nasal fossa and alveolar crest) and width (between buccal and palatal cortical plate). The result revealed no significant difference in alveolar height among maxillary anterior teeth. Mean alveolar width for maxillary right central incisor (11), lateral incisor (12), and canine (13) were 12.09 ± 2.36, 8.27 ± 1.37 and 9.99 ± 1.44 mm, respectively and for maxillary left central incisor (21), lateral incisor (22), and canine (23) were 9.51 ± 1.47, 8.27 ± 1.32 and 10.35 ± 1.85 mm, respectively. Lateral incisors have less width as compared to other maxillary anterior teeth. Pearson’s correlation analysis for correlating alveolar height with width showed p&lt;0.05 among 13, 12, 21 and 22. There is weaker correlation between the mean of alveolar height and width. The alveolar height as well as width was greater in male than female in all the six anterior teeth except for the alveolar width in relation to 11.

An unusual repair of perforating internal inflammatory root resorption; a case report of endodontic treatment

Internal inflammatory root resorption (IIRR) can occur as a serious complication of dental trauma which leads to progressive loss of the root structure. An early diagnosis could influence the therapeutic approach, but endodontic treatment becomes a challenge with a doubtful prognosis. The present report described an unusual clinical presentation of an IIRR with perforation resulting from a trauma four years previous. A 15-year-old female patient was presented to our service with pain in the maxillary incisor region. Intraoral radiography revealed a large radioloucent area compatible with IIRR, communicating with the periodontium in the middle third on the distal root face of the right central incisor. The root canal of the right central incisor was chemo-mechanically prepared. The calcium hydroxide (CH) intracanal medication was used and renewed periodically four times. The root canal was filled only in the cervical region to the level of resorption by the inverted gutta-percha cone technique. Clinically and radiographically, all follow-up examinations revealed an asymptomatic tooth, evidencing periapical tissue repair and new bone formation. The tooth remained asymptomatic 3 years afterwards. The present case report supports the idea of executing satisfactory intracanal decontamination by chemo-mechanical preparation, thus creating a favourable environment for tissue repair.