Incisors Research Articles

Accuracy of Color Determination by Intraoral Scanners in Bleached and Unbleached Teeth: A Clinical Study.

This clinical study aimed to evaluate the color measurement ability of intraoral scanners (Trios 3, (3Shape, Copenhagen, Denmark) and Cerec Omnicam, (Dentsply Sirona, Charlotte, NC, USA) in comparison to VITA Classical and VITA 3D-Master shades obtained by a spectrophotometer (Easyshade V, VITA, Zahnfabrik, Bad Säckingen, Germany). Four hundred eighty teeth from thirty patients were included in the study. Fifteen patients had never undergone bleaching, and the other fifteen had undergone professional bleaching within the last 6 months. VITA Classical and VITA 3D Master shades were determined using Trios 3 (T3), Cerec Omnicam (CO), and EasyShade V from cervical, middle, and incisal/occlusal areas of maxillary and mandibular central and lateral incisors, canines, and first premolars. Color accuracy rates (cAR) were assessed by categorizing the color data according to the Munsell color system for bleached and unbleached teeth, maxillary and mandibular, and teeth arranged from anterior to posterior in each quadrant. McNemar, Mann-Whitney U, and Wilcoxon tests and Point Biserial Correlation Analysis were used for statistical analysis (significance level α=0.050). The bleached teeth had a significantly higher cAR for T3 in VITA 3D Master and VITA Classical guides (p<0.05). The cAR of the incisal area in VITA 3D Master was significantly lower in both scanners (p<0.05) except for the lightness/hue/chroma of bleached teeth. T3 cAR increased statistically significantly from anterior to posterior (p<0.001); however, no significant difference was found for CO (p=0.482). The color accuracy rates of both scanners for shade guides that included all color components in this study were below 30%, which was not clinically satisfactory for color measurement. Confirming the measurements with a spectrophotometer is recommended.

Coincidence of the facial and maxillary dental midlines in the Peruvian population. A cross-sectional study.

This study aimed to determine the percentage of perfect and acceptable coincidence between the facial and maxillary dental midlines in individuals from Peru. This was a cross-sectional study of a group of Peruvian individuals gathered from private offices in Lima, Peru, from January to June 2024. A total of 279 patients (133 males and 146 females) aged between 18 and 30 were included. We selected patients with permanent teeth up to their second molars, while those with gaps between their front teeth, ongoing or previous orthodontic treatment, or any craniofacial anomalies were excluded. Using a professional camera, we took frontal photographs of the participants at rest and while smiling. The facial morphological index was used to classify facial biotypes into three categories: mesofacial, dolichofacial, and brachyfacial. We then used the PowerPoint program to analyze perfect and accepted coincidence (deviation to either side of up to 2 mm) between the facial and dental midline. The data was analyzed by chi-square tests and binary logistic regression (p>0.05). Perfect coincidence of the dental midline was present in 23.3% of the cases, while an accepted coincidence was observed in 95.7% of the individuals. When considering facial structure, the percentage of alignment of the maxillary dental midline (perfect or accepted) with the facial midline did not show a significant association (p=0.145, p=0.870, respectively). Furthermore, there were no significant differences in the percentage of alignment between men and women (p=0.241 for perfect coincidence, p=0.322 for accepted alignment). Most Peruvian individuals assessed had an accepted coincidence (up to 2 mm) between the facial midline and the maxillary dental midline, although it is not always perfect. In these cases, orthodontic treatment is needed for optimal occlusal relationships and stable facial esthetics. Key words:Esthetics, Facial midline, maxillary dental midline, Peruvian.

UPPER LIP FRENECTOMY IN A PEDIATRIC DENTAL PATIENT: Clinical case report of a ten-year-old patient from the city of Mato Verde - MG

Lip brakes have the function of limiting the movement of the lips, stabilizing the midline and inhibiting accentuated gingival exposure. The superior labial frenulum is a fold composed of mucous membrane and fibrous tissue. It is attached on one side to the inside of the upper lips and on the other side to the gums in the middle of the jaw. The objective of this study was to report a case of upper lip frenectomy in a pediatric dentistry patient. This is a study with a qualitative approach with a descriptive/observational objective. A survey was carried out in the municipality of Mato Verde-MG at Faculdade Verde Norte (FAVENORTE). A ten-year-old male patient was taken by the guardian to the dental clinic at Faculdade Verde Norte - FAVENORTE, with the following main complaint: “Large space in the front teeth”. After anamnesis, it was found that the patient had no systemic changes. On clinical examination, the presence of diastema between the permanent upper central incisors and a wide and voluminous upper labial frenulum was observed during the upper laboratory treatment. The treatment was surgical removal: Frenectomy using the Modified Archer Technique. In the case reported, it was demonstrated that the surgical technique was performed successfully, where the repositioning of the labial frenulum and new reinsertion were observed, promoting an improvement in the patient's quality of life.

416. SUCCESSFUL TREATMENT OF ESOPHAGO-MEDIASTINAL FISTULA DUE TO ESOPHAGEAL CANCER WITH IMMUNE CHEMOPOINT INHIBITOR FOLLOWED BY ROBOTIC RADICAL ESOPHAGECTOMY

Abstract Background Esophagomediastinal fistula caused by intrathoracic esophageal cancer perforation poses significant challenges in treatment. We present a case of such a patient successfully treated by achieving complete resolution through surgical resection following chemotherapy with 5-FU, cisplatin, and pembrolizumab. Methods Clinical and surgical findings of the patient were reviewed through chart analysis. A 46-year-old male presented to the emergency room with fever and cough. Computed tomography (CT) indicated esophageal-mediastinal fistula due to mid-thoracic esophageal cancer and perforation. Endoscopic examination revealed a 5cm circumferential mass 20cm from the upper incisors, along with perforation. Biopsy confirmed poorly differentiated squamous cell carcinoma, with a PD-L1 CPS score of 80. The patient received multidisciplinary treatment involving chemotherapy followed by planned surgical intervention. Results First of all, the patient underwent peroral endoscopic gastrostomy for dietary intake. After 3-weeks interval three cycles of 5-FU (800mg/BSA, Day1-5), cisplatin (80mg/BSA, Day1), and pembrolizumab (200mg, Day1), complete resolution of the abscess cavity and significant reduction in esophageal cancer lesions were observed. Robotic transthoracic esophagectomy and Mckeown operation were performed, achieving complete resection of the esophagus including the primary lesion. Pathological examination revealed complete remission of the primary lesion and absence of metastatic nodes among the 51 dissected lymph nodes. After subsequent additional three cycles of anticancer-immunotherapy combined therapy were done, no signs of recurrence were found on CT scan performed 3 months post-surgery. Conclusion We report a case of successful treatment of a patient with thoracic esophageal cancer complicated by difficult-to-treat esophago-mediastinal fistula, managed effectively with concurrent chemotherapy and surgical intervention.

Management Of Large Periapical Lesion With A Noninvasive Approach: A Case Report

Periapical lesions develop as a sequela to pulpal diseases. The majority of inflammatory periapical lesions are initially treated with conservative non-surgical procedures. The success of root canal treatment is based on thorough cleaning, shaping and obturation of the root canal system. Calcium hydroxide and triple antibiotic paste (TAP) are recommended as intracanal medicaments due to its antibacterial properties. This case report describes the non-surgical management of a large cyst-like periapical lesion in relation to the maxillary lateral incisor of a 19-year-old male with the chief complaint of periodic swelling and pus drainage from the palatine region with a history of a traumatic accident in the same area. The present case highlights the use of calcium hydroxide and TAP as an interappointment endodontic dressing for non-surgical management of large periapical radiolucency, which resulted in favourable clinical and radiographic outcomes

Management of white spot enamel lesions with resin infiltration: potentials and future research directions.

The current study1 is a randomized controlled trial with two arm, multicenter and parallel group design. Study subjects were 38 orthodontic patients younger than 17 years who were being treated with metal braces. Patients with at least one white spot lesion (WSL) graded 1 to 2 according to the International Caries Detection and Assessment System (ICDAS) on the labial surface of permanent maxillary and mandibular canines and incisors were included for the trial. Teeth with carious lesions and restorations, anomalies of the enamel, and primary teeth were excluded. Patients were allocated by computer generated random sequence into resin infiltration and fluoride varnish intervention groups. Study subjects were blinded until the allocation, outcome assessors and statisticians remained blinded through the study, however the operators could not be blinded. Resin infiltration treatment involved removal of orthodontic wires and auxiliaries followed by cleaning the teeth with fluoride free prophylactic paste and completing the resin infiltration according to manufacturer's instructions. In the fluoride varnish group, a thin layer of the material was applied after isolating the teeth, and patients were asked not to eat or drink for 1 hour. This was continued twice a month for 6 months. Digital images of the teeth were obtained before, and 1 day (T1), 1 week (T2), 1 month (T3), 3 months (T4) and 6 months (T5) after treatment, using a DSLR camera and a matching polarization filter. The images were processed for calibration and color stability. Regions of interest representing WSL (white spot lesion) and SAE (sound adjacent enamel) were isolated in the images for comparison at different stages the images were captured. Statistical analysis was performed using SPSS version 28. Independent-samples t-test was utilized for comparison between the two groups, and paired-samples t-test for comparison within the groups. A statistical significance level of α = 0.05 was set. At T1, significant color difference was observed between white spot lesion and adjacent sound enamel in the resin infiltration group and it remained stable after 6 months. Whereas in the fluoride varnish group, there were no statistical differences from baseline to 6 months. A statistical difference of 3.27 CIELAB units (p < 0.001) was reported between the infiltration group and the fluoride group at T5. No significant changes were noted in SAE with respect to changes in lightness. Resin infiltration was found to be better at masking the demineralization produced by WSL and also enhanced the esthetic appearance of demineralized areas around the brackets. Resin infiltration did not produce any clinically visible effects in non-affected enamel. These changes remained stable for a period of 6 months.

Potential application of a combined extract of Channa striata and calcium hydroxide for inhibiting lymphocytes and interleukin-1β cells in the asymptomatic irreversible pulpitis of Wistar rats (Rattus norvegicus).

This study aimed to evaluate the effectiveness of combining Channa striata extract with calcium hydroxide (Ca(OH)2) in reducing lymphocyte counts and interleukin (IL)-1β levels in inflamed pulp teeth. A laboratory experimental setup with a posttest control group (CG) design was employed. Thirty-two rat incisor teeth were divided into four groups: a positive CG (100% Ca(OH)2), treatment 1 (25% C. striata extract + 75% Ca(OH)2), treatment 2 (50% C. striata extract + 50% Ca(OH)2), and treatment 3 (75% C. striata extract + 25% Ca(OH)2). These test materials were applied to Class 1 cavities extending to the pulp roof, with samples collected on days 1, 3, 5, and 7. Data were analyzed using analysis of variance and post hoc least significant difference tests. In all the groups, the highest levels of lymphocytes and IL-1β were observed on day 3, followed by a decline on days 5 and 7. The combination of C. striata extract with Ca(OH)2 significantly reduced inflammatory markers, particularly lymphocyte and IL-1β levels. The extract of C. striata holds significant potential as an innovative therapeutic approach for managing inflamed dental pulp.

A Comparative Evaluation of the Effect of Different Endodontic Irrigating Solutions on Microhardness of Root Canal Dentin: An in vitro Study.

During endodontic therapy, irrigation solutions applied in the root canal may affect the physicochemical properties of the dentinal wall, thereby changing its microhardness. This may adversely affect the sealing ability and adhesion of dental materials. Therefore, many studies have focused on the search for an ideal root canal irrigant that has a minimal effect on dentinal microhardness. This in vitro study was conducted to determine the changes in dentin microhardness after root canal irrigation with different endodontic irrigants. Ninety-five freshly extracted maxillary central incisor teeth with straight single canals were selected. These teeth were sectioned transversely at the level of the cementoenamel junction. The working length of each tooth was determined, and canal space was prepared by the HyFlex CM rotary file system. During instrumentation, normal saline was used for irrigation. Then, teeth were split longitudinally into two segments. According to the irrigating solution employed, samples were divided into five groups (n=19): normal saline (Group A), 3% sodium hypochlorite (Group B), 2% chlorhexidine (Group C), 5% calcium hypochlorite (Group D), and 0.2% nanochitosan (Group E).3 mL of the corresponding irrigating solution was administered for total15 minutes in each prepared sample. The Vickers micro-hardness tester was then used to assess micro-hardness. The data was analyzed using one-way analysis of variance (ANOVA). All tested irrigating solutions decreased the dentinal microhardness. Samples irrigated with 5% calcium hypochlorite demonstrated dentinal microhardness of 42.43±1.62, which is the lowest among all the tested groups, followed by nano chitosan, sodium hypochlorite, and chlorhexidine. Samples treated with control group (saline) demonstrated the maximum microhardness of dentin in the present study. Within the limitations of this research, it can be concluded that the tested novel irrigating solutions, 5% calcium hypochlorite and 0.2% nanochitosan, were more detrimental to radicular dentin microhardness when compared with conventional endodontic irrigants.

Comparing Skin Tones to Shades of Upper Anterior Teeth: An Observational Study among Nigerian Adults.

Skin tones may be predictive of anterior tooth shade. An analysis of the relationship of skin tone to anterior tooth shade within a population may facilitate the prescription of complete dentures with optimal esthetics and realism. This study aimed to assess the relationship between skin tones and shades of upper anterior teeth among a diverse Nigerian adult population. The study was conducted between February and December 2022 among consecutive healthy adults recruited from dental clinics of five teaching hospitals in four cities located across four geopolitical zones of Nigeria. Skin tones were recorded using the National Immigration Service (NIS) Skin Color scale. The Vitapan Classic® shade guide was used to record the tooth shade of the upper central incisors and canines. Bivariate and multivariate tests of associations were performed, and predictive probabilities were developed. A total of 1070 adults with a mean age of 30.8 ± 10 years participated in the study. NIS skin tones 6 (29.8%) and 5 (27.7%) were the most common, while hues A (48.7% in incisors and 48.4 % in canines) and B (41.1% in incisors and 40.1% in canines) were predominant. The values of the incisors and canines were positively related to skin tone (P = 0.001) and age (P = 0.001 for incisors and P = 0.003 for canines). Hue was also significantly associated with skin tone for canines (P = 0.01) and gender (P = 0.001). Regression models showed increasingly darker skin tones were positively related to duller values for incisor teeth (β = 0.173, OR =1.19, P < 0.001). The values for canines were more likely to be >2 (β = 0.118, OR =1.12, P = 0.01), but without significant positive relationship to increasingly darker skin tones (β = -0.99, OR =0.91, P = 0.22). Skin tones were associated with upper anterior tooth shade. There was a positive relationship between skin tones and the shades of upper anterior teeth. Skin tones could guide the clinician in shade selection during complete denture prescriptions.

Healing of periapical lesion by non-surgical endodontic therapy: A case report

Periapical lesions often arise as a consequence of pulpal diseases, and most inflammatory periapical lesions are initially managed with conservative non-surgical methods. The success of root canal treatment hinges on the thorough cleaning, shaping, and obturation of the root canal system. Calcium hydroxide and triple antibiotic paste (TAP) are preferred intracanal medicaments due to their effective antibacterial properties. This case report details the non-surgical management of a periapical lesion associated with the mandibular central incisors in a 18-year-old female who presented with periodic swelling and pus drainage in the labial sulcus, due to traumatic accident in the that area. The case underscores the effectiveness of using calcium hydroxide and TAP as interappointment endodontic dressings, leading to favorable clinical and radiographic outcomes for managing a periapical radiolucency.

An In-Vitro Study on the Impact of Light-Emitting Diode (LED) and Laser-Activated Bleaching Techniques on the Color Change of Artificially Stained Teeth at Varying Time Intervals.

Introduction Tooth color is a key factor in the perception of an attractive smile, making bleaching a widely sought-after cosmetic dental procedure. Valued for its minimally invasive approach, this technique effectively lightens teeth to achieve desired aesthetic outcomes. As the desire for immediate results grows among patients, various bleaching agents, and energy sources have been developed to expedite the bleaching process. The study aims to evaluate and compare the efficacy of 35% hydrogen peroxide activated by light-emitting diode (LED) and laser on artificially stained teeth, assessing color changes at different time intervals. Methodology Sixty maxillary central incisors with intact crowns were selected for the study. An artificial staining solution was prepared, and the samples were immersed in it for 15 days to simulate staining. After this period, the teeth were removed from the solution, rinsed with water, and dried. Baseline photographs of each tooth were taken for comparison. The teeth were then divided into two groups, one treated with LED activation and the other with laser activation of 35% hydrogen peroxide as the bleaching agent. The color changes were measured and recorded at different time intervals. Data were presented as mean and standard deviation, with statistical analysis conducted using independent sample t-test and repeated measures ANOVA to compare the efficacy of the two methods. Results Both LED and laser activation of 35% hydrogen peroxide demonstrated significant color changes in the stained teeth. The initial color improvement was noticeable in both groups, with LED and laser treatments producing comparable whitening effects. The mean color change values indicated that both activation sources were effective in enhancing the bleaching process, providing immediate and substantial results. Statistical analysis showed no significant difference between the two methods, suggesting their equivalency in clinical efficacy for tooth bleaching. Conclusion The study concludes that both LED and laser activation of 35% hydrogen peroxide are efficient methods for in-office tooth bleaching, providing immediate and enhanced whitening effects. The comparable results between the two energy sources indicate that can be effectively used to meet the increasing demand for rapid aesthetic improvements in a clinical setting. This finding supports the adoption of both LED and laser bleaching techniques as viable options for dental practitioners aiming to achieve optimal patient satisfaction with minimal invasiveness.

Effectiveness of Papain-Based Organic Dentifrices Versus Commercial Whitening Dentifrice on Tea-Induced Tooth Stains: An In Vitro Study.

Tooth discoloration is a common issue for oral health practitioners. Whitening treatments remove surface and deep stainsusing either chemicals or over-the-counter products. Due to harmful chemical effects, organic whitening products are increasingly preferred. This study compared the effectiveness of organic papain-based dentifrices (Perfora Magic Teeth Whitening Serum, Gurugram, India) on tea stains to commercially available Colgate whitening dentifrices (Colgate-Palmolive, New York, NY). Sixty maxillary central incisors for periodontal reasons were used and divided into two groups. Each sample was soaked in freshly brewed tea for 10 minutes daily and stored in artificial saliva (Nanochemazone, Kurukshetra, India) for 24 hours. After four weeks, group 1 was treated with papain-based dentifrices, and group 2 with Colgate Visible White teeth whitening paste(CVWP) daily for four weeks. Spectrophotometric analysis (VITA Easyshade V, VITA Zahnfabrik, Bad Säckingen, Germany) was performed pre-treatment and at four weeks post-treatment. Data were compiled and statistically analyzed. Compared with group 1, group 2 exhibited an optimal color change (ΔE). Statistically significant differences were observed between the mean ΔL (lightness) and Δb (blueness -b or yellowness +b) values. CVWP showed better color achievement and stain reduction due to abrasive and peroxide components. Although Perfora Teeth Whitening Serum has low efficacy in upgrading the color of the enamel surface, it is safe for long-term use.

Correction to “Maxillary impacted canine replacing a central incisor with root resorption: Multidisciplinary treatment in a preadolescent patient”

Correction to “Maxillary impacted canine replacing a central incisor with root resorption: Multidisciplinary treatment in a preadolescent patient”

Efficiency of dry versus wet Er,Cr:YSGG laser debonding of lithium disilicate veneers using different power outputs

Since water is the chromophore for the erbium, chromium-yttrium scandium gallium garnet (Er,Cr:YSGG) laser, the laser energy reaching the restoration decreases as part of it is absorbed by water. Theoretically, reducing the water or implementing dry debonding could reduce the energy consumed by water, increasing laser efficiency. Studies on whether it is suitable for removing veneers without using coolant are lacking. The purpose of this in vitro study was to evaluate the debonding time, intrapulpal temperature, and translucency of veneers during wet versus dry debonding with an Er,Cr:YSGG laser using different power outputs. Sixty-three maxillary central incisors were flattened labially to receive ceramic specimens. After cementation, ceramic specimens were irradiated with an Er,Cr:YSGG laser for debonding with different power outputs and water percentages (N=70): subgroup A1, 4W and 1% water; A20, 4W and 20% water; A40, 4W and 40% water; B1, 5W and 1% water; B20, 5W and 20% water; B40, 5W and 40% water; C1, 6W and 1% water; C20, 6W and 20% water; C40, 6W and 40% water, and a control group of unbonded ceramic specimens. During debonding, the temperature rise and debonding time were evaluated, followed by the evaluation of the translucency and surface topography of the debonded specimens. Two-way analysis of variance (ANOVA) and the Dunnett test were used to analyze the data (α=.05). The mean intrapulpal temperature rise varied significantly among groups B and C (P<.001), with the highest mean temperature rise found in subgroup B1 (4.00 ±0.00 ºC) and the lowest mean temperature rise in subgroup C20 (1.20 ±0.45 ºC). For the debonding time, the mean values of time required for debonding varied significantly among different groups (P<.001), with the longest time recorded in subgroup A1 (333.4 ±74.8s) and the shortest time recorded in subgroup C20 (17.0 ±6.0s). Only subgroups C1 (18.89 ±0.2) and C40 (18.60 ±0.2) showed a significantly lower translucency than the control group (19.44 ±0.06) (P<.001). Dry Er,Cr:YSGG laser debonding resulted in increased intrapulpal temperature when using high power outputs, but without exceeding the critical threshold of dental pulp temperature. Dry debonding also limited the transmission of laser energy, affecting the debonding efficiency. A power output of 5W and 20% water can be considered efficient and safe laser parameters for debonding lithium disilicate veneers if their reuse is intended.

Stress Analysis of Periodontal Tissue in en Masse Retraction With Integration of Maxillary Anterior Teeth: A Three-Dimensional Finite Element Method Study.

To simulate the en masse traction technique with the integration (EMTI) of six maxillary anterior teeth using a finite element model (FEM) and explore various protocols for maxillary protrusion. The study aimed to investigate root displacement and stress distribution in the periodontal ligament (PDL) by varying the retraction position and direction of EMTI applied to the maxillary anterior teeth. No actual participants were involved. The FEM model included six teeth (central and lateral incisors and canines) with a PDL thickness of 0.3 mm. The model encompassing the alveolar bone (ALB) and EMTI had 180,528 elements and 47,836 nodes. The EMTI integrated six anterior teeth via a 0.9-mm-diameter stainless steel lingual wire, equipped with three moment arms extending toward the root apex: one midline (central arm) and two distal to the canines (lateral arms). The position and direction of the traction force applied to the three moment arms of the EMTI were varied to assess crown and apex displacement, as well as PDL stress. Lingual tipping was consistent across all protocols, emphasizing controlled incisor tipping. The application of horizontal traction at 10 mm and traction at 7 mm from the central and lateral arms of the EMTI, respectively, demonstrated the most uniform stress distribution across the PDL of all six anterior teeth. The FEM analysis results suggest that the new EMTI method, which retracts the maxillary anterior teeth as a unit, is effective for tooth movement and PDL stress distribution. The EMTI technique, with its specific traction protocols and emphasis on controlled tipping, appears to be a promising approach for addressing maxillary protrusions.

Management of Ellis Class II Fracture in Young Permanent Maxillary Central Incisor

Background: Tooth fracture is a condition of missing or lost fragments of a complete tooth. Tooth fracture usually occurs simultaneously with another oral injury. Objective: This case report discussed the management of Ellis class II fractures on an immature permanent central incisor of a patient who reported to Jenderal Achmad Yani University (Unjani) Dental Hospital. Case: An 11-year-old girl revealed a broken upper left tooth, sensitive to cold drinks that interfered with her appearance one year ago. The patient had a good general condition, no abnormalities during an extraoral examination, and a history of pain on the lower back tooth since a year ago. Case Management: Management of Ellis class II fracture in young permanent central incisor was conducted by using a class IV composite resin restoration. Conclusion: The management of Ellis class II fracture should be conducted holistically and systematically with subjective, intraoral, extraoral, and adjunctive examinations which should be performed correctly and considering the child’s psychology.

Jaw Morphology and Factors Associated with Upper Impacted Canines: Case-Controlled Trial

Introduction and aim: Orthodontic treatment of impacted maxillary canines is challenging and expensive. This study investigated factors associated with impaction risk and the need for surgical exposure. Methods: Seventy-five participants of similar age, skeletal maturity, and gender (32 impacted canines, 43 controls) were included in the case-controlled trial. Three-dimensional study models were created (Trios 3, 3Shape), and panoramic radiographs were taken. The 3D digital models were measured using software to obtain morphological characteristics of the maxilla, such as maxillary surface area (mm2) and volume (mm3). Results: The impacted canine group displayed a significantly higher prevalence of deep bite (OR = 5.01), hypoplastic lateral incisors (OR = 5.47), and rotated adjacent teeth (OR = 3.56) compared to the control group. The impacted canine group exhibited a smaller maxillary surface area and volume. Within the impacted canine group, factors associated with a greater need for surgical exposure included the presence of a persistent deciduous canine (OR = 10.15), a palatal canine position (OR = 7.50), and a steeper canine angulation (p &lt; 0.001). Conclusions: These findings suggest that several signs can serve as potential predictors of increased risk for maxillary canine impaction and the need for surgical intervention. Identifying these factors can aid in early diagnosis and treatment planning for improved patient outcomes.

Clinical Features of Molar Root-Incisor Malformation: A Retrospective Study

This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.

Retrospective epidemiological study of the width of maxillary diastema in patients from northeastern Bulgaria.

A maxillary diastema (MD) is identified when the gap between the central incisors exceeds 0.5 mm. It poses an a and phonetic concern, often seen in mixed dentition and occasionally continuing into permanent dentition.

Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A micro-computed tomography study

Aim: The aim of this study is to investigate the stress distribution created by two restorative techniques, adhesive reattachment of the fractured fragment and direct composite restoration, used in the treatment of a maxillary central incisor with enamel-dentin fracture. The analysis is conducted using the finite element stress analysis method on a three-dimensional (3D) model prepared based on micro-computed tomography data, following the application of different adhesive procedures on fractured teeth. Methodology: The avulsed left maxillary central incisor was scanned using a micro-computed tomography device. The obtained data was transferred to a computer and used for 3D modeling. In the models, a fracture line was created obliquely at a 45° angle, 3 mm away from the mesial surface towards the distoincisal corner of the tooth. Six restorations were planned on this model: three direct composite restorations and three adhesives, reattachments followed by composite application. The models for the adhesive reattachment method included: (1) internal dentin groove, (2) palatal composite laminate veneer, and (3) double palatal retentive groove. The models for the composite restoration technique included: (1) composite laminate veneer, (2) direct composite restoration following enamel beveling, and (3) composite application after double palatal groove preparation. Upon completion of the restorations, a 100-N force was applied from the palatal direction using the finite element stress analysis method. The results were analyzed to examine the amount and distribution of stress on the restorations and the tooth. Results: In all models, the highest stress values within tooth structures were observed in the enamel. The lowest stress value in the enamel layer was seen in model R-1, whereas the highest stress value was observed in model K-2. For direct composite restorations, the stresses on enamel, dentin, and restoration were relatively similar in each model, with no significant differences noted among these values. Among all applied composite restorations, the lowest stress value was observed in model R-3. When analyzing the stresses generated at the tooth-restoration and tooth-fractured fragment interface of the six models, the lowest stress in the enamel was observed in models R-1 and K-3, while the highest stress was seen in model R-3. Conclusion: According to the data obtained from the models, the shape of the restoration applied on the tooth, the technique used, and the location of the restoration affect the amount and distribution of stress accumulated in the tooth and restoration. However, the stress analysis results are not sufficient to evaluate the clinical success of restorations. There is a need for further studies utilizing different techniques to support the models used. How to cite this article: Olgaç Akgönül Ş, Çelenk S, Adıgüzel Ö. Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A finite element analysis based on micro-computed tomography data. Int Dent Res 2024;14(2):76-83. https://doi.org/10.5577/intdentres.535