Incisors Research Articles

Bilateral Supplemental Permanent Maxillary Lateral Incisor in a Non-syndromic Pediatric Patient: A Rare Case Report

Bilateral Supplemental Permanent Maxillary Lateral Incisor in a Non-syndromic Pediatric Patient: A Rare Case Report

Prevalence of different types of interproximal contacts in the permanent dentition – a study cast evaluation

Background A new classification called OXIS was proposed for categorizing the interproximal contacts of primary molars, modified for the primary canines and its prevalence was established. No such information is available for the permanent dentition. Hence, the aim was to establish the variations in interproximal contacts of the permanent dentition and thereby modify the OXIS classification of primary molars and primary canines to the permanent dentition. Methods We propose a study-cast-based classification of interproximal contacts of the permanent dentition. Three hundred and forty-three pretreatment casts of patients based on an inclusion and exclusion criteria were selected. Contacts of posterior teeth were classified based on OXIS classification of interproximal contacts, and its modification was used for anterior teeth. Results Among the posterior contacts, the ‘O’ type of contact was least prevalent, while most prevalent was the ‘S’ type for second molar-first molar contact, ‘I’ type for the first molar-second premolar contact, and ‘X’ type for the second premolar-first premolar contact. Among the anterior contacts, least prevalent was ‘S1’ type for the first premolar-canine contact, and I type for the canine-lateral incisor and the lateral incisor-central incisor contacts. There was no statistical significance between right- and left-side contacts (P > 0.05) while significance was seen between maxillary and mandibular contacts (P < 0.05). Similarity of contacts ranged from 5.17% to 10.05%. Conclusion The OXIS classification is applicable to posterior permanent teeth, and its modification is representative of anterior permanent teeth.

Evaluation of different irrigation activation techniques for the removal of various medicaments from a simulated internal resorption cavity: an in vitro study.

This study aimed to assess the efficacy of different activation techniques in removing calcium hydroxide (Ultracal XS), Ledermix, and Bio-C Temp from simulated internal root resorption (IRR) cavities. 108 single-rooted maxillary incisors were prepared using Reciproc R50 files. Simulated IRR cavities, 2mm in diameter and located 8mm from the apex, were created. Ultracal XS, Ledermix, and Bio-C Temp were applied to the samples, grouped by irrigation activation techniques: Standard Needle Irrigation (SNI), EDDY, Passive Ultrasonic Irrigation (PUI), and XP-endo Finisher (XPF). Medicament removal efficacy was evaluated using a standardized scoring system. Statistical analysis was performed using the Kruskal-Wallis test. XPF and PUI were more effective than SNI in medicament removal across the groups, with no significant difference. EDDY showed no significant difference than other groups. Ledermix was more effectively removed in all activation groups compared to Bio-C Temp. The XPF was superior in removing Ultracal XS compared to Bio-C Temp. However, none of the groups achieved complete medicament removal. XPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments. Bio-C Temp could be removed from the canals less effectively compared to calcium hydroxide and Ledermix. Among the tested irrigation activation methods, XPF and PUI were found to be more effective at removing the tested medicaments.

Fusion of Supernumerary Teeth to the Mandibular Permanent Central Incisors: a case report

Aim: The fusion of supernumerary teeth with mandibular incisors is a rare occurrence. This case study presents the clinical presentation and management of an 8-year-old child with mandibular permanent central incisors affected by fusion with supernumerary teeth, leading to delayed eruption. Case Report: An 8-year-old girl with no history of medical issues was referred to the Orthodontics Department of Yazd Dental School, Iran. Clinical and radiographic examinations showed that two supernumerary teeth were fused to the buccal aspects of the mandibular permanent central incisors, with the incisal portions erupting into the buccal gingiva. Conclusion: The existence of one or more supernumerary teeth usually leads to occlusal and functional problems and interference with tooth eruption. In these cases, thorough clinical and radiographic examinations with precise history taking should be performed to plan a suitable surgical-orthodontic treatment.

Prevalence of tooth agenesis and supernumerary teeth related to different Thai cleft lip and cleft palate populations

BackgroundPattern of dental anomalies encountered in cleft patients shows subtle signs of genetic involvement. This study aimed to evaluate the prevalence and pattern of tooth agenesis and supernumerary teeth in Thai cleft population according to the cleft type.MethodsData collected from patients with cleft lip and palate, who had been treated at Tawanchai Cleft Center, Khon Kaen University, Thailand, available during year 2012–2022, were investigated. Records from 194 patients with non-syndromic clefts met the inclusion criteria. Standard dental records, and at least either orthopantomogram (OPG) or cone beam computed tomography (CBCT), were examined. Statistical analysis was performed using chi-square and binominal test (p ≤ 0.05).ResultsPrevalence of tooth agenesis was higher (77.3%) than that of supernumerary teeth (5.7%) and was more common in bilateral cleft lip and palate (BCLP) (88.1%) than in unilateral cleft lip and palate (UCLP) (72.6%) (p = 0.017). The upper lateral incisor was more frequently affected (46.4%), followed by the upper second premolar. The number of missing teeth observed on the left side was significantly higher. Patients with left UCLP (ULCLP) had the highest prevalence of tooth agenesis. A total of 41 tooth agenesis code (TAC) patterns was found. The prevalence of supernumerary teeth was comparable with 6.6% of ULCLP, 5.1% of BCLP, and 4.5% of URCLP. Tooth-number anomalies were observed more often in the BCLP and were most likely to occur on the left side of the maxilla. Both types of anomalies could be featured in a small proportion of cleft patients.ConclusionsMore than half of the patients with non-syndromic cleft lip and palate in this study, presented with tooth-number anomalies. Tooth agenesis was approximately 10-time more prevalent than supernumerary teeth. Tooth agenesis was likely to appear on the left-side of the maxilla regardless of the laterality of the cleft.

Perception and Acceptance of Shade Variances in the Smile.

(1) This study aimed to evaluate the influences of differences in denture teeth shade on harmony ratings and esthetic quality. Particular attention was paid to the question of how the overall variance of shade differences in the dental arch influences the perception of shade differences between adjacent teeth. (2) A total of 51 pictures of upper front teeth with standardized different colors of the left central incisor and different color variance of the dental arch were created. Eighty participants without dental knowledge and of different age, sex and educational level rated the pictures on a visual analogue scale from 0 (strongly disagree) to 100 (strongly agree) with regards to esthetic and color equality. (3) Results: The color differences between two teeth were judged in a negative linear correlation to the evaluation of color and esthetic quality. There was a sex- and education-specific difference in color and harmony ratings. In relation to the age of the participants, there was a significant difference in the color rating (p = 0.01) but not in the harmony rating (p = 0.27). Lower rating of color difference and harmony was found for a color difference in the dental arch up to ΔE = 3.1. In contrast, higher color differences resulted in higher ratings. (4) There is an influence of personal parameters on color perception. Color inhomogeneity in a dental arch leads to significant differences in color and harmony rating in a non-linear relation.

A comparative study to evaluate the influence of the incisal inclinations of maxillary central incisors in gujarati men and women on the perception of smile esthetics among orthodontists, general dentists and lay persons

The aim of this study is to investigate the influence of different incisal inclinations of the maxillary central incisors in an analysis of full face and close up views of the smile on the perception of smile esthetic in Gujarati men and women between orthodontists, general dentists and laypersons. Frontal smile and Lateral profile photographs were digitally altered at full-face view and close-up view of adult men and women aged 15-30 years were used. The patient wase made to sit with a natural head position. Six incisal labial and lingual inclinations of the central incisors were simulated with changes of 5 degree. Alterations in the labially inclined direction were labeled as positive and those in the palatally inclined direction were labeled as negative. The positions were denominated as follows: 5 ͦ, 10 ͦ, 15 ͦ, ‐5 ͦ, ‐10 ͦ and –15 ͦ, according to incisal inclination changes of the central incisors. To simulate the different incisal inclinations adobe Photoshop CS 8.0 was used. The top limit of the full-face image was a region little above the top of the head and the bottom limit was the base of the neck. The images were randomly assembled in an album that were presented to 40 orthodontists, 40 general dentists and 40 laypersons who evaluated the attractiveness of the images by using Visual Analogue Scale. 10was found to be most attractive incisal inclination.

Assessment of mini-aesthetics in Class I malocclusion subjects who underwent orthodontic treatment with or without extraction of four premolars – A prospective study

Smile and facial attractiveness are strongly correlatedThis study aimed to assess the effect of extraction or non-extraction orthodontic treatment on mini-aesthetics in patients with Class I malocclusion by measurement of the smile variables.A total of 56 subjects were selected and grouped as Group 1- treated non-extraction, Group 2A-treated with extraction of first premolars and groups 2B- treated with extraction of second premolar teeth. Each subject was photographed with a posed smile and NHP using DSLR camera. The images were then imported into a computer software and the following smile parameters were assessed: gingival display, smile index, maxillary incisor display on smile and buccal corridor ratio.The mean measured maxillary incisor display was 1.39±0.34, 2.31±0.50 and 0.90±0.19mm in Group 1, Group 2A and Group 2B. The mean measured gingival display on smiling was 0.07±0.07, 0.38±0.65 and 0.07±0.15mm in Group 1, Group 2A and Group 2B. The mean measured smile index was 0.15±0.68, 1.20±0.22 and 0.95±0.41 in Group 1, Group 2A and Group 2B. The mean measured buccal corridor ratio was 0.83±0.39, 1.59±0.26 and 1.26±0.31 in Group 1, Group 2A and Group 2B. There was an increase in maxillary incisor display after fixed Orthodontic treatment in the non-extraction group and a decrease in first premolar extraction group while second premolar extraction group showed no changes. Smile index was increased post-treatment in first premolar and second premolar extraction group while non-extraction group showed no significant difference. Buccal corridor ratio decreased in first premolar and second premolar extraction groups while non-extraction group showed no changes.

Delayed replantation and reattachment of avulsed and fractured fragment of central incisors – Resurrecting the original

Delayed replantation and reattachment of avulsed and fractured fragment of central incisors – Resurrecting the original

A Novel Interdisciplinary Approach for the Management of Micrognathia (Brodie Syndrome).

This study describes a multidisciplinary approach for correcting a severe Class II malocclusion with reduced mandibular transverse dimension. A 35-year-old woman presented with an increased overjet, complaining chiefly of forwardly placed upper front teeth and unpleasant smile esthetics. The patient had a convex profile with severe mentalis strain on lip closure. Intraoral examination indicated a bilateral Class II canine relationship, scissor bite, and narrow lower arch. The skull lateral view assessment revealed a skeletal Class II relationship with reduced lower facial height. According to the diagnostic records and after consultation with the patient, surgically assisted expansion of the mandibular symphysis with a bone distractor, comprehensive orthodontic treatment, and combined jaw surgery were planned, followed by dental implant placement and prosthetic full-mouth rehabilitation. Restorative dentistry, orthodontics, and orthognathic surgery were the 3 disciplines that helped in achieving the best esthetic and functional results in this patient.

CBCT Evaluation of Alveolar Bone Change and Root Resorption after Orthodontic Treatment: A Retrospective Study.

For years, there has been a long debate about the impact of orthodontic treatment on the periodontium of patients. Therefore, it is important to understand the effects of orthodontic forces on the periodontium. The objective of this study was to evaluate the height of the alveolar bone at the four surfaces of specific teeth and the root length of the central incisors before and after orthodontic treatment. CBCTs from a group of fifty patients were evaluated before (T0) and after orthodontic treatment (T1). Evaluations of the alveolar bone were performed by measuring the distance from the most apical point of the marginal portion to the CEJ at the buccal (B-ABL), lingual (L-ABL), mesial (M-ABL), and distal (D-ABL) surfaces of the central incisor (CI), first premolar (1st PM), and first molar (1st M). Meanwhile, root resorptions were evaluated by measuring the distance from the center of the tooth at the CEJ to the most apical point of the central incisor. The reduction in the alveolar bone level was highest at the buccal segment (75%) and lowest at the distal (42%) segment, although the decrease was not statistically significant. Root resorption, in terms of reduction in the total length, was detected in the upper central incisor. Fixed orthodontic treatment can produce a significant reduction in root length, but not at the level of the alveolar bone.

How accurate is predicted root movement achieved in four first-premolar extraction cases with Invisalign?

This study aims to compare the achieved and predicted root movements in adults after four first-premolar extractions and Invisalign treatment. Thirty-three consecutive adults (22 Class I, 9 Cusp-to-cusp Class II and 2 Cusp-to-cusp Class III) from a single clinical division who completed the first series of aligners after premolar extractions were included in this retrospective study. A pretreatment cone-beam computed tomography model was registered onto the pretreatment surface-scanned dental model (SSDM) to locate the pretreatment root apices of the whole dentition. These were copied and transferred to the predicted and achieved post-treatment SSDMs to acquire the locations of the predicted and achieved post-treatment root apices. The differences between predicted and achieved root movements (DPARMs) were tested using the paired t-test or Wilcoxon signed rank test. In the anteroposterior direction, posterior root movements of maxillary and mandibular anterior teeth were poorly achieved (3.24-5.74 mm DPARMs, p < .05). In the vertical direction, roots of maxillary anterior teeth achieved greater intrusion (0.70-0.93 mm DPARMs, p < .05), while those of mandibular incisors achieved less intrusion (0.57-0.65 mm DPARMs, p < .05) than predicted. In the mediolateral direction, lateral incisor roots did not move distally (-0.65 to -0.96 mm DPARMs, p < .05), while those of canines did not move buccally, compared with the prediction (-0.75 mm DPARMs, p < .05). In the four first-premolar extraction treatments with Invisalign, root movements were not achieved as predicted, particularly for anterior teeth in the anteroposterior direction.

Comparison of implant placement at crestal and subcrestal levels in aesthetic zone: A finite element analysis.

The success rate of the implant treatment, including aesthetics and long-term survival, relies heavily on preserving crestal peri-implant bone, as it determines the stability and long-term outcomes. This study aimed to demonstrate the stress differences in the crestal bone resulting from dental implant placement at various depths relative to the crestal bone level using finite element analysis. Three study models were prepared for implant placement at the crestal bone level (CL), 1 mm depth (SL-1),and 2mm depth (SL-2). Implants were placed in the maxillary central incisor region of each model, and 100 N vertical and oblique forces were applied. The von Mises, maximum principal (tensile), and minimum principal (compressive) stresses were evaluated. The CL model exhibited the highest stresses on the implant, abutment, and abutment screws under vertical and oblique forces. For maximum principal stress in the crestal bone under vertical force, the SL-2, SL-1, and CL models recorded values of 6.56, 6.26, and 5.77MPa, respectively. Under oblique forces, stress values for SL-1, SL-2, and CL were 25.3, 24.91, and 23.76MPa, respectively. The CL model consistently exhibited the lowest crestal bone stress at all loads and the highest stress values on the implant and its components. Moreover, considering the yield strengths of the materials, no mechanical or physiological complications were noted. Placing the implant at the crestal level or subcrestally beyond the cortical layer could potentially reduce stress and minimize crestal bone loss. However, further studies are warranted for confirmation.

The Relationship between the Length/Width of the Face and the Length/Width of the Crown of the Permanent Upper Central Incisors.

Background: The face, with its attractiveness, is positively connected with self-esteem and interpersonal relationships, and the maxillary central incisors are the most noticeable teeth and crucial for smile aesthetics. The aim of this study is to examine facial and permanent upper central incisors' clinical crown dimensions and their correlations to establish whether there is a relationship between the length/width of the face and the length/width of the clinical crown of the permanent upper central incisors. Methods: This study included 100 subjects (43 males and 57 females) with a mean age of 17.5 ± 3.4 years before orthodontic treatment. Facial length and width were measured using a cephalometer by the same orthodontist and the upper central incisors' clinical crown lengths and widths were measured using a sliding calliper by the same dental student. Data were analysed using SPSS version 29.0, presenting descriptive statistics for age, facial and upper central incisor crown dimensions, and indices. Pearson's correlation coefficient assessed the relationship between facial features and the upper central incisors' crown. The significance level was p ≤ 0.05. Results: Males exhibit a slightly higher mean value of the face length (11.6 ± 0.8 cm) compared to females' face length (11.2 ± 1.1 cm) and a statistically significant (p < 0.05) higher mean value of the face width (11.7 ± 0.8 cm) compared to females (11.1 ± 0.6 cm). The facial index shows no statistically significant gender difference (males: 99.1 ± 8.4; females: 101.2 ± 11.9, p > 0.05). The upper central incisor crown dimensions are without statistically significant differences between gender and tooth side: males have mean value clinical crown lengths of 10.2 ± 1.1 mm (left) and 10.1 mm ± 1.2 (right) while females have 9.9 ± 1.0 mm (left) and 9.8 ± 0.7 mm (right). Clinical crown widths are also comparable (males: left 9.0 ± 0.7, right 8.9 ± 0.6 and females: left 8.8 ± 0.7, right 8.8 ± 0.7), with no statistically significant differences observed. The tooth index shows no statistically significant difference but there is a statistically significant (p < 0.05) correlation between the facial index and tooth index. Conclusions: Knowledge of the presented data is important for diagnosis and treatment planning and may be useful for restorative dentists, orthodontists, prosthodontists, and maxillofacial surgeons to achieve an aesthetic result. Clinically, our study supports the development of more personalized treatment plans.

An innovative method for three-dimensional bone reconstruction of the anterior mandible with preserved dentition using an allogeneic bone block: A 6-month follow-up.

Bone defects around the teeth affect a large portion of the population. Bone regeneration in the area of existing teeth is completely different from that in an edentulous area. To date, no method has been developed for three-dimensional (3D) bone reconstruction in regions with preserved teeth. This study aimed to radiologically evaluate the results of the new method of 3D mandibular bone reconstruction in preserved dentition using a custom-made allogeneic bone block with a 6-month follow-up. Alveolar ridge dimensions were radiographically assessed before and 6 months after reconstruction using cone beam computed tomography (CBCT) scans in 32 patients (192 teeth). Reconstruction used a bone block that had been previously planned and prepared using CAD/CAM technology. The observed changes in alveolar bone dimensions were highly significant in most cases (p < 0.001). The closer to the tooth root apex, the lower the bone growth in the sagittal dimension (average of the mean values for each tooth examined in the measured heights): CEJ2: 2.9 mm, ½ CEJ2: 2.7 mm, ¼ CEJ2: 1.9 mm, and API: 1.4 mm. The maximum bone growth in the vertical dimension was observed on tooth 43 (9.9 mm), followed by 32 (9.8 mm), 33 (8.5 mm), 31 (8.4 mm), 42 (8 mm), and 41 (7 mm). The degree of decrease in vestibular dehiscence of the bone was greater the closer the tooth was to the midline (average of -3.8 mm and -3.4 mm for the central incisors; average of -2.8 mm and -2.6 mm for the lateral incisors; average of -2.6 mm and -2.5 mm for the canines). The results prove that it is possible to prevent bone dehiscence in patients undergoing orthodontic treatment, increasing the ability and effectiveness of covering recessions and improving the morphology of the lower part of the face.

Impact of Surgical Parathyroidectomy on Craniofacial Morphology in Patients With Renal Failure.

Parathyroidectomy is beneficial in tertiary hyperparathyroidism (THPT) consequent to chronic renal failure. The craniofacial morphology of patients who undergo total parathyroidectomy and autologous transplantation (tPTX + AT) has not been widely studied. This study assessed the efficacy of tPTX + AT in THPT and evaluated possible improvements in craniofacial features. This retrospective analysis included patients who were diagnosed with medically refractory THPT and had undergone tPTX + AT between September 2013 and May 2021. The VAS was used to evaluate improvements in various symptoms including bone pain and pruritus. Changes in serum calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone (iPTH) levels were also assessed. The impact of the procedure was assessed by comparing two-photon X-ray bone mineral density measurements obtained 1 year before and after surgery. The VAS of pain and pruritus decreased significantly on the first postoperative day (P < 0.05). Calcium levels changed significantly (from 2.50 ± 0.22mmol/L to 2.10 ± 0.26mmol/L) on postoperative day 1 (P = 0.0000); iPTH levels also declined substantially on this day, reducing from 211.00 (122.10, 252.80) to 5.04 (2.96, 9.40) pmol/L. Bone mineral density increased significantly across various regions including the greater trochanter of the femur, intertrochanteric area, total hip, and third lumbar vertebra (P < 0.05). The angles between the upper incisor and mandibular plane and the lower lip and Ricketts E line (drawn from the tip of the nose to the soft tissue area) also improved (P = 0.043, P = 0.001). Total parathyroidectomy and autologous transplantation can rapidly alleviate bone pain and skin itching in THPT. It may also improve bone density and facial soft tissue.

The i-view® Video Laryngoscope Compared With the Macintosh Laryngoscope Does Not Enhance the Endotracheal Intubation Skills of Dental Students.

Background A disposable i-view® video laryngoscope (Intersurgical Limited, Berkshire, United Kingdom) is yet to be used to educate medical and dental students, who must learn endotracheal intubation skills. Additionally, the advantage of the i-view® use for the purpose, compared with the Macintosh laryngoscope, is unknown. We aimed to first determine whether the i-view® video laryngoscope enhances endotracheal intubation skills among dental students compared with the Macintosh laryngoscope. Methodology A prospective, observational, simulation study was conducted among 67 dental students in their sixth clinical year of education. Intubation skills were evaluated on a computer-assisted simulator with a standardized manikin. Each student was asked to intubate using the conventional Macintosh laryngoscope and the i-view® video laryngoscope in the trachea of the simulator's manikin. We collected objective data, including the retroflection angle of the manikin, the maxillary incisor contact pressure, time from picking up the laryngoscope to ventilation, intubation success, and intubation delay. Each student was further asked to grade their subjective evaluation concerning the visual field, Cormack and Lehane classification, operability, stability, needed force for intubation, and easiness during intubation. Results Enrolled dental students quoted that the i-view® video laryngoscope demonstrated better visual field, Cormackand Lehane classification, operability, and stability than the Macintosh laryngoscope. However, they felt intubation easiness could have been better using Macintosh than i-view®. Intubation time, failure rate, and delay rate did not differ between the two laryngoscopes. Nevertheless, the maxillary incisor contact pressure (medianinterquartile range (IQR)) during the intubation increased in the i-view® intubation compared with Macintosh (32 (24 to 41) vs. 25 (18 to 35) N, p = 0.010). Conclusions We first demonstrated that the i-view® video laryngoscope compared with the Macintosh laryngoscope does not enhance the endotracheal intubation skills of dental students. However, the possible repeated use as an educational simulator training tool may add some advantages to the experience of video laryngoscope in both medical and dental students.

Assessment of the unwanted tooth movement associated with an extended maxillary fixed retainer (3D analysis)

BackgroundPosttreatment changes after orthodontic treatment are challenging. One of the main reasons for such a phenomenon is the lack of patient compliance with removable retainers especially in the maxillary arch, due to palatal coverage, deterioration of speech, decreased masticatory efficiency, and loss of retainers. Fixed retainers have been introduced to overcome patient compliance and provide longer stable results. However, teeth still show movements when a six-unit fixed retainer is in place. Thus, in this study, an eight-unit fixed retainer was evaluated in an attempt to eliminate unwanted movements.The aim of this researchwas to assess short-term positional changes associated with an eight-unit extended maxillary fixed retainer.Materials and methodsA single-arm clinical trial was conducted to address the aim of the study. This research was approved by the institutional review board of the Faculty of Dentistry, Alexandria University (IORG:0008839, No-0479–8/2022). The registration date of this study was 5/06/2023. Twenty-eight patients (19.8 ± 4.5 years) who had finished the active orthodontic phase and started retention had an eight-unit extended maxillary fixed retainer that was bonded to the palatal surface of the maxillary incisors, canines, and the first premolars or the second premolars. Pre-retention and one-year post-retention intra-oral scans were made to produce STL files that were superimposed to determine the amount of tooth change. Additionally, analysis of digital casts and lateral cephalometric radiographs was performed.ResultsStatistically significant changes in all planes and the rotation of teeth after one year of retention were found. The upper right lateral incisor exhibited the most evident change in the vertical plane, while the upper right central incisor exhibited the greatest change overall. Minimal changes in the cast measurements were observed. Lateral cephalometric measurements showed minimal changes after one year of retention, and these changes were not statistically significant except in the interincisal angle and the angle between the upper incisor and the line connecting the A-point to the pogonion.ConclusionIncreasing the extension of maxillary fixed retainers did not eliminate unwanted tooth movement in the first year of retention.

Expedited Treatment of a Fractured Tooth by Rebonding: A Case Report

Fractured maxillary anterior are a common occurrence when a person experiences trauma to the face. A patient sought treatment at a endodontics and prosthodontics practice after experiencing trauma to his maxillary right central incisor that resulted in a complete horizontal fracture. This case report describes a novel way to restore a fractured anterior tooth with a highly esthetic outcome that can be completed relatively easily in the clinic or in an austere environment.

A new species of lobe-lipped bat (Chalinolobus: Vespertilionidae) from southern Papua New Guinea

The Hoary Bat Chalinolobus nigrogriseus is the only species of the genus known from the island of New Guinea. A new species of Chalinolobus from Papua New Guinea is described based on DNA sequence and morphological criteria using material previously assigned to C. nigrogriseus. The new species most resembles the eastern Australian subspecies of the Hoary Bat C. n. nigrogriseus in general size and appearance but is easily distinguished by an enlarged, rather than rudimentary lobe at the terminal outer ear margin. The new species might also be confused on external characters with smaller individuals of Australian Gould’s Wattle Bat C. gouldii, from which it differs in having bifid first upper incisors and uniform dark dorsal fur. The inclusion of C. nigrogriseus in the bat fauna of New Guinea is now in doubt, pending a re-assessment of the identity of Chalinolobus specimens in world museum collections. Locality records of all Chalinolobus spp. from Papua New Guinea are reviewed. Most localities are below 60 m elevation in coastal savannah and woodlands. The identity of specimens of C. nigrogriseus and C. gouldii from northern Australia should be reviewed to determine whether the new species also occurs in Australia.