Incisors Research Articles

Double Teeth and Coexistent Anomalies: Examples From Continental Africa.

Whether gemination or fusion, double teeth are rare worldwide, including Africa based on few published data. New cases from the continent are tallied, and anomalies potentially associated with double teeth are identified. These findings should interest a range of dental researchers. The presence of double teeth was recorded in 97 modern and premodern North and sub-Saharan African samples (5631 inds.). They and coexistent anomalies are described relative to published examples. Prevalence was estimated as possible, using a Poisson model for 95% confidence intervals (CI). Three maxillary double teeth were identified: a primary left lateral incisor in a Nubian child (1938-1756 BC), permanent left central incisor in an adult Egyptian (3650-3500 BC), and permanent right central incisor in a modern (19th century) adult from Guinea. Each co-occurs, respectively, with a talon cusp, peg lateral incisor and, in the latter individual, second premolar crown variation with rotation, and third molar dens evaginatus. Double tooth prevalence is 0.048% (CI 0.001%-0.270%), with regional variation, in premodern, and 0.000% in modern North Africans. It is 0.000% for premodern and 0.048% for modern sub-Saharan Africans (0.008%-1.714%). The double incisors are comparable to other global examples, indicative of common developmental processes during odontogenesis. Prevalence is lower than published modern rates, to suggest some exceptionality in Africans as reported earlier for other dental variants. Finally, though circumstantial, double teeth and accompanying anomalies may share an etiology. Continuing research overall, and in Africa specifically, will promote an improved understanding of double teeth formation and expression.

Modified Surgical Guide for Root Sectioning in the Socket Shield Technique-In Vitro Study.

This in vitro study aimed to evaluate the effectiveness of a printed surgical guide for root sectioning in the socket-shield technique. A typodont model of the maxilla with augmented filler was used for the upper right central incisor, and CBCT images were obtained. Two types of vertical root sectioning guides were tested: one with a buccal sleeve (Group A, n = 10) and another with a buccal orientation slit (Group B, n = 10). Control group (n = 10) performed freehand cuts on printed models. After crown cutting with diamond burs, root sectioning was conducted using an ultrasonic tip with the guides. Mean and standard deviation were calculated for the remaining root length, width, and volume. Data were analyzed using the Kruskal-Wallis test and Dunn's post hoc test. Statistical analysis showed significant differences in root width between the control group (2.0 mm) and both Groups A (2.655 mm; p < 0.0001) and B (2.460 mm; p < 0.0001). Group B (5.585 mm) also showed a significant difference in root remnant compared with the control (13.880 mm; p < 0.0043). Groups A and B did not differ significantly from each other. The socket shield technique is safe and effective, this study aimed to add improvements through the introduction of surgical guides, facilitating the root section, which is the critical phase so that the parameters that are requisite for success are achieved in terms of width, length, and volume of the root remnant. Both guided techniques effectively facilitated root sectioning, maintaining satisfactory root thickness and length. Sectioning the root is challenging for the correct angulation to remove the palatal portion in the socket shield technique. Therefore, modifying this technique with the use of the presented guides, it is possible to prevent damage to the soft tissues and to plan the surgery with the help of cone beam computed tomography (CBCT) scans to remove the root apex and maintain the root remnant with a thickness greater than 1.5 mm, making the socket-shield technique more predictable.

Accuracy, Time, and Comfort of Different Intraoral Scanners: An In Vivo Comparison Study

Background: The purpose of this study was to compare the accuracy of three different intraoral scanners (IOSs) and to evaluate the patients’ experience. Methods: Thirty subjects were scanned with three different IOSs (TRIOS Color®, iTero Element 5D®, and iTero Lumina®): a sample of 90 maxillary casts was collected. The inclusion criteria were permanent dentition, absence of defects during the dental impression, and complete record of the palatal vault. After the scanning procedure, patients were asked to answer a questionnaire (10 answers, scale from 1 to 10) to compare their experiences with iTero Element and iTero Lumina in the scanning procedure. Results: Differences were recorded in the upper central incisor region (f-ratio of 4.186 for Mesiodistal 1.1 and f-ratio of 4.222 for Mesiodistal 2.1, p &lt; 0.05), while intercanine width Upper 13–23 showed the smallest f-ratio (0.226) when compared to the other results, followed by Mesiodistal 1.4 (0.433). Patients reported more comfort, less pain, decreased duration, and a better technology visualization of the impression with iTero Lumina. No significant differences concerning dryness of the mouth and gag reflex were found. Conclusions: The examined IOSs offer comparable accuracy in capturing dental arch dimensions. The interviewed patients expressed an overall preference for digital impressions performed with iTero Lumina, linked to increased comfort, painless practice, and a better technology visualization of the impression.

Evaluating the efficiency of mandibular molar protraction using Herbst appliances versus temporary anchorage devices: a retrospective case-controlled study

BackgroundMandibular second premolar agenesis is a common problem in orthodontics and is often treated in conjunction with maxillary counterbalancing extractions. However, in cases without maxillary crowding or dental protrusion, space closure may pose challenges leading to compromised occlusal results or patient profile. Multiple techniques have been described to treat these patients; nevertheless, there is a paucity of data comparing effectiveness of space closure utilizing various anchorage techniques. The goal of this study is to assess the effectiveness of the Herbst device during mandibular molar protraction and compare it to the use of temporary anchorage device (TADs) in patients with mandibular second premolar agenesis.Materials and methodsThis retrospective study included 33 patients with mandibular premolar agenesis treated without maxillary extractions. Of these patients, 21 were treated with protraction Herbst devices and 12 with TADs. Changes in molar and incisor positions, skeletal base positions and occlusal plane angulations were assessed on pretreatment (T0) and post-treatment (T1) lateral cephalograms. Scans/photographs at T0 and T1 were used to evaluate canine relationship changes representing anchorage control. Space closure and breakage/failure rates were also compared. Data was analyzed with paired and unpaired t-tests at the significance level of 0.05.ResultsWithin the Herbst group, changes in mandibular central incisor uprighting and mandibular molar crown angulations were statistically significant. However, no significant differences were noted between the Herbst and TAD groups. Protraction rates as well as overall treatment times were comparable (0.77 mm/month vs. 0.55 mm/month and 3.02 years vs. 2.67 years, respectively). Canine relationships were maintained or improved toward a class I in 82.85% of the Herbst sample, compared to in 66.7% of the TAD sample. Emergency visits occurred in 80.1% of the Herbst group, with cementation failures or appliance breakages as the most common reasons.ConclusionThe Herbst device could be a viable modality in cases with missing mandibular premolars where maximum anterior anchorage is desired, or if patients/parents are resistant to TADs. Furthermore, they could be beneficial in skeletal class II patients with mandibular deficiency who also need molar protraction. However, the increased incidence of emergency visits must be considered when treatment is planned.

Treatment of absent maxillary lateral incisors: orthodontic space closure and associated procedures.

Missing maxillary lateral incisors can be treated either with orthodontic space closure or preservation of the edentulous space for tooth replacement. Orthodontic space closure coupled with non-invasive post-orthodontic cosmetic dentistry is a compelling option compatible with optimal function, favourable aesthetics, and periodontal health in the long-term. We present the rationale for space closure and detail contemporary clinical strategies underpinning interdisciplinary treatment planning and excellence in finishing.

Association between maxillary incisor width and craniofacial measurements: A cone beam computed tomography study

Accurate prediction of maxillary central incisor width (CIW) is essential in prosthodontics for selecting appropriately sized denture teeth. While traditional methods exist, the digital era may offer more reliable techniques for anterior tooth selection. The purpose of this study was to investigate the correlation between CIW and craniofacial measurements derived from cone beam computed tomography (CBCT) scans to identify predictors for CIW and examine possible sexual dimorphism. A retrospective analysis was conducted on 80 three-dimensional skull models (40 men, 40 women; age range: 20 to 48 years) generated from segmented CBCT scans. Measurements included CIW, interpterygoid hamulus distance, bi-orbital width, interorbital distance, and piriform aperture width. Statistical analyses comprised independent t tests, bivariate correlations, and multiple linear regression (α=.05). Significant sexual dimorphism was observed in CIW, interpterygoid hamulus distance, and bi-orbital width (P<.05). CIW positively correlated with bi-orbital width (r=.75, P<.001) and piriform aperture width (r=.49, P<.001). Multiple regression analysis revealed bi-orbital width, and interorbital distance, along with sex, as significant predictors of CIW (R²=.59, P<.001). Bony bi-orbital width, interorbital distance, and sex can be used to estimate the maxillary CIW.

Management of complicated crown fracture in maxillary incisor using fragment reattachment - 5-year follow-up

Complicated crown-root fractures of maxillary incisors are a relatively common occurrence in cases of trauma to the facial region. Patients with such fractures are in acute pain and usually require emergency care on their first clinical visit. Pain management and restoration of function, esthetics, and phonetics should be the prime objective in handling such patients. The reattachment of fractured tooth fragments is a relatively simple procedure that provides natural esthetics and conservation of tooth structure. This case report describes such a reattachment procedure in a complicated crown-root fracture and its success at 5 years of follow-up.

Evaluation of the biomechanics of Aramany class I obturators of different designs using numerical and experimental methods. Part II: Stress distribution

Evidence regarding stress evaluations of removable obturators with Aramany class I defects is lacking. Whether the stress distribution on Aramany class I prostheses can be improved by modifying the currently used designs is also unclear. The purpose of part II of this study was to evaluate the stress distribution in different designs of Aramany class I obturators using finite element analysis (FEA) and photoelastic stress analysis. Four finite element and 8 photoelastic models, including 2 acrylic resin base obturators retained with 2 Adams clasps, 2 linear, 2 tripodal, and 2 fully tripodal design obturators, were used in this study. The frameworks were fabricated on the casts obtained from a modified printed model. Vertical and oblique loads were applied on 2 points (anterior and posterior) of the models. The quantitative measurement was done by measuring the fringe orders and von Mises values to compare the influences of occlusal forces on the obturator components and their supporting structures. The qualitative evaluation was done by visual color mapping to identify the stress concentration. In the photoelastic analysis, the anterior abutments of the tripodal showed the highest stress, followed by the fully tripodal obturators, while, in FEA, the anterior abutments of the linear design received the most in both vertical and oblique load. The central incisor received the most stress in photoelastic (3 or more fringe orders) and FEA (687.3 and 150.1MPa for vertical and oblique loads, respectively), followed by the lateral incisors. Upon posterior loading, the base of the defect of the linear design demonstrated the most stress in photoelastic (3 or more fringes) and FEA (94.3 and 130.5MPa for vertical and oblique loads, respectively). The acrylic resin base obturator retained with Adams clasps demonstrated the lowest stress distribution in abutments and their supporting bone upon anterior and posterior loads. Upon vertical and oblique load application, the fully tripodal design was comparable with the tripodal in terms of stress distribution. Both designs were better than the linear in response to the same loading. The stress was concentrated at the anterior palatal part of the obturator, the base of the defect, and the junction of the metal and acrylic resin part of the prostheses upon anterior and posterior loading, respectively.

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.