Incisors Research Articles

Effectiveness and side effects of orthodontic traction of impacted maxillary incisors in a labially inverted position: A systematic review

Treatment of impacted upper incisors in a labially inverted position is challenging for orthodontists, and its prognosis has not been established in the literature. Thus, this systematic review aimed to determine the effectiveness and side effects of orthodontic traction of impacted maxillary incisors in a labially inverted position. A comprehensive search was conducted in multiple databases, including MEDLINE (via PubMed), Scopus, Embase, Science Direct, and LILACS, up to June 30, 2024. Initially, 1640 articles were identified, and after applying specific selection criteria, 11 articles were selected for full-text evaluation. Following the review, only six studies were deemed relevant, comprising one before-and-after study, two longitudinal retrospective studies, and three cross-sectional studies. Newcastle-Ottawa and Risk of Bias (ROB-2) tools were used to assess the risk of bias in the selected studies. The average duration of traction for maxillary labially inverted impacted central incisors ranged from 8.60±1.26months to 18±6.0months, with all cases being successfully treated. Following traction, the clinical crown height of the incisors was significantly higher compared to the control group (P<0.01). Similarly, the root length of the impacted incisors after traction was shorter in the impaction group (approximately 2mm) compared to the control group. Likewise, the thickness of the alveolar bone varied among different studies. Some authors noted that the treatment group had a smaller thickness (about 0.5mm) compared to the control group (P<0.05), while other authors found similar thickness after treatment. Although there are few reported studies with a low risk of bias, it is clear that it is possible to successfully treat labially inverted impacted maxillary central incisors with apparently few side effects. Following traction, the clinical crown height of these incisors increased, while the root length was shorter than their normally erupted contralateral teeth.

Obturator prostheses with intramucosal retention system in patients with maxillectomy.

To evaluate the intramucosal retention system in patients' masticatory efficiency and quality of life in this case series. A total of 3 individuals with maxillectomy were included for rehabilitation with a complete obturator prostheses with an intramucosal retention system(OPI). The complete obturator prostheses was made for 60days, and electromyography assessments and bite force were applied before, after 30, 60, and 90days of surgery and prostheses installation. The University of WashingtonQuality of Life Questionnaire (UW-QoL) and the Obturator Functional Scale (OFS) were also administered at baseline and in the same follow-up periods. The electromyography was evaluated on both sides of the masseter, temporalis, and buccinator muscles while chewing hard and soft food. The maximum bite force was recorded in the central incisors and both sides of the first molar region. Bite force values increased in the first molar region, and muscular electrical activity remained constant. Items related to the taste and swallowing of the UW-QOL impacted. Most OFS questionnaire data responses indicated that patients improved in swallowing liquid foods and appearance. The rehabilitative capacity improves masticatory efficiency and QoL in adults maxilectomized and rehabilitated with OPI analysis in the study. Further clinical studies should be encouraged to determine the effectiveness of this retentive system.

Biomechanical analysis of the effect of Class II traction configurations and aligner overtreatment on molar distalization: a finite-element study.

This study aimed to evaluate the biomechanical effects of aligner overtreatment on molar distalization using clear aligners. Various models were created and integrated into finite-element software. Six distinct study models were devised for analysis. The first three models examined second molar distalization with different configurations of attachments, i.e. no attachment, horizontal or vertical attachment on the second molar. For the fourth and fifth models, Class II elastic traction, either implemented via a precision cut or button on canines, was applied. Lastly, aligner overtreatment with varying degrees of root distal tipping (0°, 2°, 4°, 6°, 8°, 10°, and 12°) for the second molar was designed in the last study model. Distalization of the second molar produced buccal tipping, distal tipping and intrusion of the second molar, and labial proclination and intrusion of the central incisor. These displacement tendencies were enhanced by adding attachments on the second molar, especially the vertical attachment. Class II elastic tractions enhanced molar distalization and diminish anchorage loss, with the precision-cut configuration being biomechanically superior to the button design. Aligner overtreatment produced bodily molar distalization and mitigated adverse biomechanical effects on anchorage teeth. The study's limitations include the use of finite-element models, which may not fully represent real clinical scenarios, and the lack of consideration for individual patient variability. We suggest that Class II elastic traction via the precision-cut configuration and the design of vertical attachment on the second molar be applied for molar distalization. Appropriate aligner overtreatment helps achieve bodily molar distalization and minimizes adverse biomechanical effects on anchorage teeth.

Frenectomy for supporting diastema closure correction in orthodontic patients

Introduction: The maxillary frenulum can cause aesthetic problems or jeopardize orthodontic results in cases of central diastema, causing relapse after treatment. One of the etiologic factors of central diastema persistence is an aberrant frenulum. The most common way to diagnose frenulum attachment is with the blanch test. One of the treatments for aberrant frenulum is frenectomy. Frenectomy can reduce the risk of relapse from central diastema closure. The purpose of this case report is to describe the stages of frenectomy in a case of maxillary central diastema. Case report: A 24-year-old woman came to the Periodontics Specialist Clinic due to a referral from the Department of Orthodontic, Dental Hospital Universitas Airlangga with complaints of loose maxillary front teeth and planned to be treated using fixed orthodontic devices at Department Orthodontic. The blanching test examination showed that the labial frenulum was in the high frenulum category. Case management: Frenectomy was performed using a scalpel. After extraoral and intraoral asepsis, infiltration anesthesia was performed on the labial and palatal sides of tooth 11,21. Clamp the maxillary labial frenulum using a hemostat and then incise the frenulum using blade no 15c in a V shape, then incise the frenulum attachment on the interdental to the palatal region with an elliptical incision. Interrupted suturing using Nylon thread size 4.0. The surgical area was closed using a periodontal pack. Suturing was removed on day 14. Follow-up at 19 months showed no diastema in the anterior maxilla, the patient wore a retainer in the maxilla and a fixed retainer in the mandible. There were no further complaints after the treatment. Conclusion: Frenectomy before orthodontic treatment helps accelerate the treatment progress to correct the central diastema.

TRAUMATISMOS DENTAIS NA INFÂNCIA E SUAS IMPLICAÇÕES NA POLPA: REVISÃO DE LITERATURA

Childhood dental trauma is common, especially in the 2-7 age group, and affects the upper central incisors more due to their exposure in impact situations. When the trauma involves the dental pulp, the treatment is to preserve the vitality of the tooth, with pulp capping and pulpotomy procedures being the most recommended. Currently, there has been a shift from invasive practices to conservative techniques in order to minimize long-term damage and improve the child's prognosis. The International Association of Dental Traumatology (IADT) guidelines contribute to this conservative approach, affirming the importance of immediate treatment and follow-up to avoid complications. The objective of this study is to demonstrate the implications of dental trauma in childhood, as well as how the pulp reacts to trauma. This literature review is based on articles published between 2014 and 2024, searched in the Scielo, Pubmed, Google Scholar and Periódico Capes databases. It was possible to conclude that, when subjected to trauma, the affected tooth may present some pulp responses, with pulp necrosis was the most frequent alteration.

Interdisciplinary Management of a Class II Bimaxillary Protrusion Case With a Traumatized Maxillary Central Incisor: A Case Report

Interdisciplinary Management of a Class II Bimaxillary Protrusion Case With a Traumatized Maxillary Central Incisor: A Case Report

A comparative evaluation of the displacement and stress distribution of Kilroy spring, ballista spring and temporary anchorage devices during traction of palatally impacted canine using a 3 dimensional finite element analysis

The above study comprises a comparative evaluation of the displacement and stress distribution of Kilroy spring, Ballista spring and Temporary anchorage devices during traction of palatally impacted canine using a 3 dimensional finite element analysis. Palatally impacted canine is a common phenomenon occuring in around 8% of individuals. The Finite Element Analysis/Finite Element method (FEA/FEM) is the most intricate and dependable study that significantly revolutionized the world of dentistry and biomechanical research. Stresses and displacements can be precisely located using this type of numerical analysis. The orthodontist can better comprehend the physiological reactions that take place within the dentoalveolar complex because of the quantitative information it gives them. A Cone Beam Computed Tomography (CBCT)scan of the maxilla was obtained from a patient who reported to the Department of Orthodontics and Dentofacial Orthopaedics after he satisfied the inclusion and exclusion criterion. Finite element 3-D models of Kilroy spring, Ballista spring, Cantilever spring, miniscrew, lingual button, 0.022-inch-slot brackets, 0.019x0.025-inch SS archwire, stainless steel bands with molar tubes were constructed using a three-dimensional computer-aided design program (SolidWorks 2017; Solid Works K.K., Tokyo, Japan). All these components were imported and individually assembled in the ANSYS Software (Version 2021 R2, ANSYS, Canonsburg, Pa) and stress analysis was carried out. On the basis of this study following conclusion were drawn: The maximum amount of impacted canine displacement, with initial simulation, wasobserved with Kilroy spring followed by Ballista spring and miniscrew assisted Cantilever spring and the maximum amount of displacement of adjacent teeth i.e. lateral incisor and 1st premolar is observed with Ballista spring followed by kilroy spring and miniscrew assisted Cantilever spring. Furthurmore stress concentration on the canine is highest in case of ballista spring followed by Kilroy spring and miniscrew assisted Cantilever spring. Over all, miniscrew assisted Cantilever spring can be an efficient treatment option for traction of a palatally impacted canine.

Major approaches and clinical outcomes of gingival correction procedures for improved aesthetic smile: a concise systematic review

Introduction: Well-being is directly related to health, people with a balanced smile, between health and beauty, tend to smile more and this generates a condition of wellbeing. A small gingival plastic can modify the smile as a whole, also changing the other variables. In gingival correction, process-specific techniques are used for each case, thus individualizing the patient and the proposed treatment. Objective: It was to present a concise systematic review of the main approaches and clinical outcomes of gingival correction procedures to achieve the best aesthetic smile. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from August to September 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 68 articles were found and 20 articles were evaluated in full and 08 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 15 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=89.6%&gt;50%. It was concluded that a gummy smile consists of the visualization of more than 3 mm of gum above the maxillary incisors. For the success of an aesthetic correction, one must be aware of the causes of the change in normality, added to the patient's reasons. The ideal planning is when post-surgical effects directly influence cause removal and patient satisfaction, which is in line with our research results. Digitally assisted esthetic crown lengthening helps to shorten the operation time and reduces the possibility of human errors during measurements. This will be useful to help professionals achieve better results.

Comparison of Intrusive Effects and Amount of Root Resorption in Maxillary Incisors Using Two Conventional Intrusion Arches and Mini-Implants

ABSTRACT Aim and Objective: This study aimed to compare the amount of maxillary incisor intrusion and root resorption using three methods: mini-implants, utility arches, and Connecticut intrusion arches. Materials and Methods: Eighteen patients aged 15 to 25 years with deep bite were divided into three groups: 10 patients each for mini-implant, utility arch, and Connecticut intrusion arch groups. Bilateral mini-implants were used in Group 1, while utility and Connecticut arches were used in Groups 2 and 3, respectively. Intrusion was performed over four months. Lateral cephalograms and orthopantomograms were taken at the start (T1) and after four months (T2). Results: The mean incisor intrusion measured by U1-PP was 2.08 mm in Group 1, 1.55 mm in Group 2, and 1.75 mm in Group 3 (P &lt; 0.05). CR-PP measurements showed 1.91 mm in Group 1, 1.56 mm in Group 2, and 1.66 mm in Group 3 (P &lt; 0.05). Incisors in Group 1 showed minimal protrusion compared to significant protrusion in Groups 2 and 3 (P &lt; 0.05). Maxillary molars showed no significant changes in Group 1 but distal tipping in Groups 2 and 3 (P &lt; 0.05). No root resorption was observed in any group. Conclusion: Mini-screws demonstrated the most effective maxillary incisor intrusion with minimal side effects compared to utility and Connecticut intrusion arches.

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

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

Does different application modes of universal adhesives with universal resin composites affect the microleakage in class V cavities? An in vitro study.

Composite restorations often have gingival margins near the cemento-enamel junction (CEJ), where the microleakage of these margins can significantly contribute to the restoration failure, especially in the cervical lesions. It is important to determine the microleakage is crucial, as it typically occurs through the interfacial gap between the tooth and the restoration. Various resin composites and techniques have been developed to minimize this gap and reduce the risk of microleakage. The aim of this in vitro study was to evaluate the levels of microleakage of different modes of a universal adhesive and two novel resin composites in restoring class V cavities in the central incisors. Sixty-six freshly extracted sound human central incisors of the similar size were randomly assigned to 2 groups (n = 33 per group) according to the brand of resin composite. Each group was further divided into 3 subgroups based on the Scotch Bond Universal (3M ESPE, Saint Paul, MN, USA) application protocol used: (a) total etch, (b) self-etch and (c) selective etch. After composite restoration completed with Omnichroma (Tokuyama Dental Corp., Tokyo, Japan) and Filtek Universal Restorative (3M ESPE, Saint Paul, MN, USA), each tooth was immersed in a 0.5% basic fuchsin dye solution at 37C0 for 24h. After dye penetration, teeth were sectioned and evaluated with conventional (scoring) and digital methods (ImageJ). The intra- and inter-examiner agreement was estimated according to the Kappa statistics and the results were analyzed with the one-way ANNOVA and the Kruskal-Wallis test (p < 0.05). The rates of microleakage of the gingival and incisal margins are statistically similar, regardless of the composite brand and the method of application of the universal adhesive. The microleakage exhibited by current adhesives and resins is independent of the adhesive application mode and measurement method.

Designing mouthwash formulations with innovative molecular components to control initial dental erosion in vivo.

This study aimed to examine and compare the efficacy of mouthwashes containing different proteins and peptide on the prevention of enamel erosion in vivo, as well as to evaluate the participants' satisfaction with the formulations. Twelve participants were selected and underwent five cross-over mouthwash phases: Water (control); 0.1mg/mL CaneCPI-5; 0.5mg/mL MaquiCPI-3; 0.1mg/mL CsinCPI-2; and 0.037mg/mL Stn15pSpS. After prophylaxis, the participants rinsed (1min), followed by the acquired enamel pellicle (AEP) formation (2h). An erosive challenge was made (biopsy, citric acid 1%, 15s) on the buccal surface of the central maxillary incisors. The Relative Surface Reflection Intensity (%SRI) was assessed and analyzed by ANOVA/Tukey's tests. The calcium release in acid was measured by the Arsenazo method and verified by Kruskal-Wallis/Dunn's tests. The Spearman's correlation was used between analyses. A questionnaire evaluated the satisfaction of participants. For both analyses, the results showed that mouthwashes containing the proteins or peptide were significantly more effective in preventing enamel erosion compared to deionized water, with no significant differences among the active ingredients (p < 0.05). Also, there was a significant negative correlation between %SRI and calcium released (r=-0.5754). The questionnaire revealed that the volunteers were satisfied with the taste of the products. In addition, the experimental procedures were well tolerable, and no side effects were reported. All mouthwashes containing proteins or peptide were acceptable and effective in protecting enamel against initial dental erosion in vivo. This study highlights the potential of these pioneer organic components for the development of mouthwashes designed for people with risk of erosive tooth wear.

Being different during treatment: a qualitative study investigating patients' experiences of treatments for missing maxillary lateral incisors.

Agenesis of one or more teeth is common among patients who are referred for orthodontic treatment. The most common treatments are orthodontic space closure (SC) and implant replacement (IR), which are widely studied, but the experiences of patients receiving these treatments have received little attention. The aim of this qualitative study is to explore how treatments to address missing maxillary lateral incisors (MMLIs) are experienced by individuals who are treated using either orthodontic SC or IR. This study is conducted in Sweden and based on semi-structured interviews with 13 individuals who have completed treatment, either orthodontic SC (n = 7) or IR (n = 6), to address the lack of one or two maxillary lateral incisors. Data were analysed in accordance with the grounded theory approach. Findings were classified into the main category of being different during treatment and into three associated sub-categories. The first category, that is being different due to missing teeth, refers to when a person experiences being different because of the anterior spacing The second category, that is being different due to fixed appliance, refers to when the appliance itself makes a person different. The two first categories exemplify being different in terms of appearance. The third identified category, that is being different due to treatment appointments, refers to the need to spend time differently because of having appointments at the clinic for treatment. Patients MMLIs consider their treatment to start at the time of diagnosis. They experience feelings of being different irrespective of whether the type of treatment is orthodontic SC or IR. The experience of being different differs in timing and causes depending on the treatment method.

Effect of Salvadora persica chewing sticks on maxillary central incisors crown-root angulation in Western-Asian population &amp; correlation with Collum angle on 3D CBCT images

The main aim of the study was to identify the Collum angle classification for maxillary central incisors among individuals use vs not-use chewing sticks which could have beneficial role for immediate implant placement in respective individuals. Additionally, to identify the root-crown positioning and angulation in the Western Asian Saudi Arabian population for chewing sticks user’s vs non-users in order to develop guideline for the prosthetic procedures using Cone beam computed tompography (CBCT). A total number of 380 CBCT scans were included in the study for both of the groups based on the inclusion criterion of the patients reporting to the Dental OPD of Riyadh Elm University. The data was analyzed using 3D planner dental imaging software. Initially the teeth were classified based on root position in relation to facial plate of alveolar bone using Jung et al. classification. Additionally, the Collum angle and the root angulation of the maxillary central incisors was evaluated. The data was analyzed using one-way Anova with post-hoc Tuckey-Kramer test for pair-wise comparison. As per the Jung et al. classification, majority of the roots were observed with buccal placement. Based on the Collum angle classification majority of the maxillary central incisors were observed with facial placement (n=170), specially subtype I (n=78). But the root angulation was observed to be independent of Collum angle. Thus, it can be concluded, unlike root angulation, Collum angle has a correlation with root positioning. The angle for the individuals using chewing sticks of Salvadora Persica was similar to the individuals not using the miswak. Collum angle is correlated in all classified position of root. But the root angulation is independent of classification varies between miswak and non-miswak users.

Age-stratified assessment of orthodontic tooth movement outcomes with clear aligners

ObjectiveThis study compared the achieved tooth movement to that predicted in the preliminary simulated digital treatment plan between adults and teenagers.Materials and methodsRecords of 60 patients (30 adults; mean age: 36.6 ± 11.36 years, and 30 teenagers; mean age: 16.23 ± 2.25 years) were randomly selected. Initial and predicted models were obtained from the initial simulated treatment plan. The first model of the refinement scan was labeled as achieved. SlicerCMF software (version 3.1; https://www.slicer.org) was used to superimpose the achieved and predicted digital models over the initial ones with regional superimposition on relatively stable first molars. 600 teeth were measured in each group for horizontal, vertical, angular movements, and transverse dimensions. Accuracy was defined as the achieved amount of movement minus predicted and was calculated for each individual and compared between teens and adults.ResultsThe mandibular inter-canine width accuracy was statistically significant between groups (p = 0.050). Significant under-correction in horizontal movements was noted for mandibular first premolars in teenagers compared to adults (p = 0.037). There was considerable over-correction in horizontal movements for mandibular central and lateral incisors between groups (p < 0.05). No significant difference was observed between groups in the vertical plane. Rotations were underachieved for maxillary first premolars, more in adults than teenagers (p = 0.017).ConclusionThe accuracy of achieved versus predicted tooth movement between adults and teenagers was significant for the inter-canine width. Mandibular central and lateral incisors showed significantly greater over-correction in adults in the horizontal plane. The accuracy of rotations and vertical movements was comparable.

Quantitative Evaluation of Enamel Thickness in Maxillary Central Incisors in Different Age Groups Utilizing Cone Beam Computed Tomography a Retrospective Analysis

Background/Objectives: The presence of enamel on the tooth surface is crucial for the long-term success of minimally invasive adhesive restorations such as dental veneers. Our study aims to evaluate the enamel thickness in the incisal, middle, and cervical portions of the labial surface of the upper central incisors using cone beam computed tomography (CBCT). This imaging method provides detailed and accurate three-dimensional images with a low radiation dose, allowing an accurate assessment of enamel thickness. The analysis aims to identify variations in enamel thickness depending on the age and different levels of the labial tooth surface. Methods: 800 CBCT scans performed for diagnostic or therapeutic purposes on patients aged 18–60 years were analyzed. The data were gathered from the imaging archives of private practitioners from Targu Mures and the “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures. Enamel thickness measurements were conducted using the OnDemand3D Communicator CBCT evaluation program, with subsequent statistical analysis performed using GraphPad Instat Prism software. Results: Results showed significant variation in enamel thickness between the incisal, middle, and cervical segments of the labial surface of the upper central incisors. A decrease in enamel thickness with age has been observed. In patients aged 18–40, mean values of enamel thickness 1 mm and 3 mm above the cementoenamel junction (CEJ) were 0.48 ± 0.092, respectively, 0.819 ± 0.158. In patients over 40, the mean values were 0.454 ± 0.116 and 0.751 ± 0.067 at 1 mm, respectively, 3 mm above the CEJ. Statistically significant differences were found between the two age groups at 1 mm and 3 mm above the CEJ, with p &lt; 0.0001 and p = 0.0214. Conclusions: A statistically significant decrease can be observed in enamel thickness in almost the entire labial surface of the upper central incisors with aging. The varied thickness of the enamel at different tooth levels requires individualized planning for each patient to maximize the long-term aesthetic and functional results.

Endodontic and Surgical Management of Trauma-Induced Combined Internal and External Root Resorption with Periapical Cyst: A Case Report

Root resorption, involving the breakdown of hard tissues like dentin and cementum, can result from trauma and subsequent infection, potentially leading to tooth loss. This case report details the management of combined internal and external root resorption with a periapical cyst in a 32-year-old male. After trauma, the maxillary left central incisor (#21) presented with root resorption and a displaced apex. Endodontic treatment using MTA and surgical enucleation of the cyst were performed. A 12-month follow-up showed successful resolution and tissue regeneration. This case emphasizes the effectiveness of combining advanced endodontic and surgical techniques for complex resorption cases.

Marginal Discrepancy and Internal Fit of 3D-Printed Versus Milled Laminate Veneers: An In Vitro Study

The clinical success of laminate veneers depends upon their marginal discrepancy (MD) and internal gap (IG). This study aims to compare and evaluate the MD, overall discrepancy (OD), absolute marginal discrepancy (AMD), and IG of 3D-printed (Varseosmile TrinQ and Varseosmile Crown Plus) and computer-aided design and manufacturing (CAD/CAM)-milled (Brilliant Crios) laminate veneers using cone-beam computed tomography (CBCT). Thirty maxillary central incisors were prepared and divided randomly into three groups (n = 10). All teeth were scanned for veneer fabrication: Group PVT teeth with 3D-printed Varseosmile TrinQ, Group PVC teeth with 3D-printed Varseosmile Crown Plus, and Group BCM teeth with Brilliant Crios milled veneers. The specimens with respective veneers were scanned using CBCT, and the sectional images were measured for IG, MD, OD, and AMD. The mean values for MD recorded were 0.27, 0.31, and 0.40 for PVT, PVC, and BCM respectively). The mean values for IG recorded were as follows: PVT group—0.24, PVC group—0.28, and BCM group—0.39, and those for OD were as follows: PVT—0.22, PVC—0.32, and BCM—0.41. Intragroup significance was observed for IG and OD (p = 0.001). Findings revealed that milled veneers have a higher IG and MD than 3D-printed veneers, making them less clinically acceptable.

PECULIARITIES OF ORTHODONTIC TREATMENT FOR PATIENTS WITH GENERALIZED PERIODONTITIS AND PREDOMINANCE OF PARASYMPATHETIC NERVOUS SYSTEM ACTIVITY

The use of orthodontic treatment for patients with generalized periodontitis enhances the effectiveness of comprehensive care. However, it is important to consider the reduced capacity for alveolar bone regeneration in these patients. Therefore, as part of the complex treatment of generalized periodontitis, the inclusion of medications to support alveolar bone regeneration is essential. The course of various diseases can be influenced by the state of the patient’s autonomic nervous system. In this study, medications were administered to normalize parasympathetic nervous system activity in patients with generalized periodontitis undergoing orthodontic treatment. The objective of the study was to evaluate the effectiveness of orthodontic treatment in patients with generalized periodontitis, particularly those with a predominance of parasympathetic autonomic nervous system activity. This was assessed by the supplementary use of a combination of drugs designed to stimulate alveolar bone formation and regulate parasympathetic nervous system function. Materials and methods. This study involved 35 young patients (aged 18-35) with generalized periodontitis and a predominance of parasympathetic autonomic nervous system activity, all of whom presented with displacement of the maxillary frontal teeth. These patients underwent orthodontic treatment. To correct the state of the autonomic nervous system over the treatment of generalized periodontitis, patients were prescribed to take a complex of medicines including the preparation “Calcinova” for stimulating osteogenesis. A comprehensive periodontal examination, including the assessment of hygienic indices, was conducted to evaluate periodontal status throughout the treatment. Results. The periodontal examination revealed that almost all patients demonstated an improvement in oral health. Noticeable dynamics in the pathological process were observed as a result of the complex treatment. The analysis of these findings underscores the importance of orthodontic treatment for patients with generalized periodontitis, particularly when combined with methods to correct parasympathetic nervous system activity and promote osteogenesis. This approach was shown to positively affect periodontal tissues and enhance the effectiveness of generalized periodontitis treatment. Conclusions. Correction of parasympathetic autonomic nervous system function enhances the effectiveness of therapy. In this study, a complex of medications was used to improve parasympathetic nervous system activity. The addition of “Calcinova” to stimulate osteogenesis further contributed to achieving more stable treatment outcomes in patients with generalized periodontitis.

Effects of Mechanized Irrigation Protocols on Endodontic Obturation Using Calcium Silicate-Based Sealer

The aim of this study was to evaluate the effects of mechanized final irrigation protocols (XPE, XP-Endo Finisher; XPC, XP-Clean; and ECL, Easy Clean) compared to PUI (passive ultrasonic irrigation) on the debris incidence and open dentinal tubules, and their effects on the adhesion interface after 48 h and 6 months. One hundred twenty maxillary central incisors were submitted to chemical–mechanical preparation using a rotary instrument and 2.5% sodium hypochlorite. Specimens were distributed in 4 groups (n = 30) in accordance with the mechanized final irrigation protocol: XPE, XPC, ECL, or PUI. Forty specimens (n = 10/group) were submitted to SEM analysis to evaluate the residue incidence and dentin open tubules. The other specimens were obturated using Bio-C Sealer and submitted to push-out bond strength and adhesive failure mode evaluations in the cervical, middle, and apical thirds after 48 h or 6 months (n = 10/group). Only in the apical third, ECL presented the highest residue incidence and fewer open dentinal tubules when compared to the XPE, XPC, and PUI groups (p &lt; 0.05). In the cervical and middle root thirds, no significant differences were observed regardless of the group evaluated (p &gt; 0.05). After 48 h, ECL resulted in the lowest bond strength only in the apical third (p &lt; 0.05), while the XPE, XPC, and PUI groups remained similar in the cervical and middle thirds (p &gt; 0.05). At 6 months, all groups showed lower bond strength values regardless of the root third evaluated, but ECL showed the lowest bond strength in the apical and middle root thirds when compared to the other groups (p &lt; 0.05). The ECL protocol did not provide adequate residue removal on the apical radicular third and negatively affected the longevity of endodontic obturation using a calcium silicate-based sealer.