Left Lateral Incisor Research Articles

Conventional open-tray impression versus intraoral digital scan for implant-level complete-arch impression

Statement of problemThe best-fit method is frequently used to evaluate the accuracy of different implant impression techniques. However, the method includes inherent superimposition errors, which may accumulate and become more exaggerated in complete-arch impressions. PurposeThe purpose of this in vitro study was to evaluate and compare the trueness and precision of conventional open-tray impressions and intraoral digital scans at the implant level in an edentulous maxillary model with 6 implant replicas without superimposition. Material and methodsA master model was fabricated using epoxy resin by duplicating a maxillary edentulous cast that had 6 implant replicas in the right first molar, right first premolar, right lateral incisor, left lateral incisor, left first premolar, and left first molar positions. The conventional open-tray, splinted-coping impression technique was used to fabricate 10 definitive casts (group CI). Intraoral digital scans were performed, after which scan bodies were connected to each implant replica to fabricate 10 digital models (group IOS). For the master model and group CI, a computerized coordinate-measuring machine was used to determine the 3D spatial orientation of the implant replicas. For group IOS, the scan bodies were converted to implant replicas using a digital library, and an inspection software program was used to measure the implant replicas. To compare the accuracies of different impression techniques, a 3D part coordinate system was set to compute the centroid and projection angles of each implant replica. The changes in the centroid coordinates (linear displacement: Δx, Δy, Δz, and ΔD; ΔD=Δx2+Δy2+Δz2) and projection angles onto XY and ZX planes (angular displacement: ΔθXY and ΔθZX) were statistically compared (α=.05). ResultsGroup CI gave more accurate trueness values than group IOS for overall Δx (P<.001), Δy (P =.029), Δz (P<.001), and ΔD (P<.001). Furthermore, group CI had more accurate precision values for Δx, Δy, and Δz. Group IOS exhibited a statistically greater angular displacement in the ZX plane (P=.002), but the difference was only 0.24 degrees. No differences were found between the 2 groups for the angular displacement in the XY plane (P=.529). ConclusionsConventional open-tray impressions produced significantly smaller linear displacements than the digital scan obtained using an intraoral scanner at the implant level in a complete-arch model.

A 16-year-old boy with chronic discharging sinus on upper left lateral incisor tooth

This article has no abstract. The first 100 words appear below: A 16-year-old boy referred to our department with chronic discharging sinus during the course of root canal treatment on the upper left lateral incisor tooth from a private dental clinic. The patient had a history of trauma to the tooth 1 year back. On clinical examination, the coronal portion of the upper left lateral incisor tooth was found to have filled with temporary restorative material. The tooth was sensitive to palpation and percussion with the presence of a sinus tract. On vitality test, there was no response to heat and cold test.

Dental inclination with self-ligating and conventional fixed appliances, with and without rapid maxillary expansion.

To compare the labio- and buccolingual inclination of the anterior and posterior teeth in subjects treated with self-ligating and conventional fixed appliances with and without rapid maxillary expansion. Seventy-one subjects with Class I malocclusion were divided into three groups. Group 1 comprised 24 subjects (17 female; seven male, with a mean age of 13.94±2.87years), treated with Roth's pre-adjusted fixed appliances. Group 2 comprised 24 subjects (14 female; 10 male, with a mean age of 13.85±1.83years) treated with Rapid Maxillary Expansion followed by Roth's pre-adjusted fixed appliances. Group 3 comprised 23 patients (12 female; 11 male, with a mean age of 14.75±1.34years) treated with Damon self-ligating bracket system. Buccolingual inclination was measured on digital dental models using a 3D software. Intergroup changes comparison was performed with one-way ANOVA, followed by Tukey tests. The left maxillary lateral incisor showed labial inclination in the conventional and RME groups, and palatal inclination in the Damon group. The Damon group showed greater buccal inclination in most posterior mandibular teeth during treatment than the conventional and RME groups. The right mandibular canine and lateral incisor showed greater labial inclination in the Damon group than in the RME group. There was greater buccal inclination of the posterior mandibular teeth and labial inclination of the right mandibular canine and lateral incisor in the Damon group.

Pulp Tooth Ratio as an Aid in Age Estimation: Odisha Specific Regression Formula

Objective: Age estimation in adults is an important issue in forensic science. This study aimed to validate the estimation of chronological age through previously suggested regression equation using pulp tooth ratio (PTR) of left lower lateral incisor, canine, and first premolar tooth in Odisha population. Method: The digital orthopantomographs of subjects aged 13 years above (n = 200) were collected from Institute of Dental Sciences, Siksha ‘O’ Anusandhan, Deemed to be University, Bhubaneswar, Odisha. The pixels of tooth area and pulp area ratio of lower left lateral incisor, canine, first premolar using histogram was observed by Adobe Photoshop CS6. Data were subjected to correlation and regression analysis of respective teeth. Result: Application of previously suggested regression equation to PTR of left lateral incisors, canines, first premolar teeth in Odisha population resulted in mean absolute error of more than 4,5 and 8 respectively. Therefore, we developed an Odisha specific polynomial regression equation for mandibular left lower lateral incisor, canine, and first premolar with coefficient of correlation as 0.08, 0.8 and 0.7 respectively. Conclusion: PTRs of mandibular canine and first premolar incorporated in the Odisha specific regression equation may predict age with better accuracy.

Applicability of the Existence of Golden Standard and Golden Percentage in the Population of Jaipur, Rajasthan, India: A Comparative Study

An evaluation for the existence of the golden percentage and golden standard in Jaipur population: a comparative study. Sample includes a total of 300 dentulous casts of participants including 150 males and 150 females. The cast belongs to the students, patients, and their attendants of Jaipur origin by birth who visited the Jaipur Dental College and Hospital. The width and height of maxillary teeth were measured by using a digital caliper. A grid was used to measure apparent widths of teeth. Student's t test was used to analyze the data using SPSS for Windows software (version 21) at the level of significance p < 0.05. The mean and standard deviation (SD) for the golden percentage of right and left central incisors, right and left lateral incisors, and for right and left canines was found to be statistically significant from the ideal golden percentage (p < 0.05). The difference between mean and SD of the golden standard for right and left central incisors from the standard (80%) was statistically significant (p < 0.05). The golden percentage and golden standard did not exist in Jaipur population. The result of this study shows deviation from the ideal golden percentage and golden standard for Jaipur population which can be used clinically as a guideline for esthetic results.

Developmental Disturbance of a Maxillary Permanent Lateral Incisor Following Trauma at the Age of 16 Months: A 6-Year Follow-Up.

A 3 year and 8 months old Chinese boy was referred for a consultation regarding his missing maxillary anterior teeth. He had a history of trauma to his primary maxillary anterior teeth due to a fall at the age of 16 months. Clinical examination of the patient indicated multiple carious lesions and inadequate oral hygiene. Radiographic examination revealed intrusion of the primary left lateral incisor, with evidence of damage to the permanent tooth germ. Subsequently, the patient was followed-up for almost six years during which his permanent maxillary left lateral incisor erupted exhibiting an unusual morphology. Clinically enamel hypoplasia and radiographically dens invaginatus were evident in affected tooth.

Coincidence of Fusion and Concrescence in Mandibular Deciduous Incisors: A Case Report

The aim of this paper is to report a rare case in which two dental anomalies in primary dentition coexisted-fusion and concrescence in a 4-year-old boy. This highlights the significance of the accurate early diagnosis of these dental anomalies. Odontogenic anomalies are frequently encountered in dental practice. These anomalies can occur due to abnormalities during the differentiation stage and lead to abnormalities in the hard tissue formation. Dental anomalies in number and form include fusion, gemination, and concrescence. Primary dentition with fusion between the right central and lateral primary incisors with increased mesiodistal width. Concrescence between the left central and lateral primary incisors with a groove through the incisal edge. Clinical observation along with radiographic evaluation using intraoral periapical (IOPA) radiographs and orthopantomogram (OPG) were used to arrive at a diagnosis. Early diagnosis of concrescence will reduce the risk of possible complications associated with any need of extraction later on. Monitoring the patient and long-term follow-up is required to manage the case with coexisting anomalies of true fusion and acquired concrescence. A thorough history taking and clinical and radiographic evaluation of fusion and concrescence at an early stage result in an accurate diagnosis. A careful monitoring plan is a key to reduce the risk of possible complications later on.

Evaluation of pain perception during orthodontic debonding of metallic brackets with four different techniques.

ObjectiveThe aim of this study was to evaluate patients’ pain levels during four different debonding procedures. The null hypothesis was that the pain perception of the patients undergoing four different debonding applications was not statistically significant different.Material and MethodsOne hundred and twenty orthodontic patients who underwent orthodontic debonding were included in this study. The patients were randomly divided into 4 groups according to technique used in the patients. Debonding groups were as follows: Group 1) Conventional debonding group, Group 2) Medication group (acetaminophen was given 1 hour before debonding), Group 3) Soft bite wax group, and Group 4) Soft acrylic bite wafer group. The patients’ levels of anxiety and fear of pain were evaluated before debonding, and Numerical Rating Scale (NRS) was applied to evaluate their pain perception during debonding. Mann-Whitney U and Kruskal–Wallis tests were used to evaluate non-normally distributed data. Categorical data analysis were carried by chi-square and McNemar tests. The significance level was set at p<0.05.ResultsAnxiety scores of the patients were not statistically significant between both genders and debonding groups. In the quadrants in which the patients were perceived, the highest pain level was in the left side of the mandible. The teeth in which the highest pain level was perceived were the lower left and upper right lateral incisors. Although there was no statistically significant difference among the pain scores of the patients in each group, quadrant scores of female patients showed significant differences, being the lowest scores in the soft bite wax group.ConclusionsMajority of the patients had no fear of pain before debonding. Pain levels of the patients in the conventional debonding group were not significantly different from those of the other groups, except quadrant scores of females in the soft bite wax group. The null hypothesis was accepted.

Comparison of Optical Properties of Laminate Veneers Made of Zolid FX and Katana UTML Zirconia and Lithium Disilicate Ceramics.

Objectives:This study aimed to compare the optical properties of Zolid FX, Katana UTML, and lithium disilicate laminate veneers.Materials and Methods:In this in-vitro experimental study, the maxillary left lateral incisor of a phantom received a laminate veneer preparation. An impression was made, and a die was fabricated using dental stone. The die was scanned using a computer-aided design/computer-aided manufacturing scanner. Ten dies were fabricated from each of the A1, A2, and A3 shades of composite resin. Laminate veneers were fabricated using A1 shade of Katana UTML, Zolid FX, and IPS e.max CAD ceramics (n=10) and placed on composite abutments using bleach and white colors of trial insertion paste (TIP). The optical properties were measured at the incisal, middle, and cervical thirds using a spectrophotometer. Data were analyzed using three-way analysis of variance and Tukey’s test.Results:The effect of laminate material on the L*, a*, and b* parameters was significant in all areas (P<0.001), except for the L* parameter in the middle and cervical thirds. All color parameters were affected by TIP color in all three regions in most samples (P<0.05). The effect of composite abutment shade was also significant in most cases (P<0.05). The effect of laminate material, abutment shade, and TIP color on the b* parameter was significant (P<0.001). The L* parameter was almost the same in the two zirconia and lithium disilicate ceramic groups.Conclusion:The composite abutment shade, TIP color, and laminate material should be carefully selected to achieve optimal aesthetics in laminate veneers.

Load-deflection characteristics of coated and noncoated nickel-titanium wires in self-ligating brackets using a modified bending test: An in vitro study

To determine and compare the force-deflection values of different types of nickel-titanium (NiTi) wires during unloading phase at varying deflections, that is 1 mm, 1.5 mm, 2 mm, and 2.5 mm, with the use of self-ligating ceramic brackets using modified bending test on a typodont under controlled temperature conditions. In this in vitro study total of 45 wires of ovoid shape of three different NiTi wires - pseudoelastic NiTi (Group I), heat activated NiTi (Group II), and esthetic coated NiTi (Group III) for maxillary arch were tested after insertion in ceramic self-ligating brackets bonded to plastic teeth of phantom jaw. The maxillary left lateral incisor was removed to simulate a malpositioned tooth which acted as the load site, and load-deflection characteristics were measured during unloading using Instron, and data analyzed statically by two-way analysis of variance, Tukey's post hoc test, intraclass correlation coefficient and Pearson correlation coefficient. A two-sided (α = 2) P < 0.05 was considered statistically significant. When wires were compared at each deflection statistically significant difference was observed between the three groups of wires (Group I > Group II > Group III) at all the four levels of deflection except for Group II versus Group III at 1 mm, 1.5 mm, and 2 mm of deflection. Statistically significant difference was noted in mean load values for comparisons made at different deflections for each wire except for the comparison made at 1.5 versus 2 mm for Group II and Group III. Overall comparison showed esthetic coated Ni-Ti wires gave significantly lower mean load values, followed by heat activated and pseudoelastic NiTi wires. Thus, heat activated NiTi wires are best suited in patients with severe malpositions/periodontitis, while for esthetically conscious patients esthetic coated NiTi can be used.

A combined management of a rare case of a maxillary lateral incisor with accessory root and deep mesio-radicular groove

This case report describes the combined nonsurgical endodontic retreatment and surgical intervention of a failed root canal treatment associated with a maxillary lateral incisor with an accessory root and deep mesio-radicular groove. A 42-year-old female Malay patient presented with persistent infection associated with deep mesial pocket from her maxillary left lateral incisor (#22). The medical history was noncontributory and the tooth was previously root treated. Following comprehensive clinical and radiographic examination, a combined nonsurgical endodontic retreatment and surgical management of tooth #22 were carried out. The inability to debride the periodontal defect necessitates the amputation of the accessory root, and surgical debridement of the deep radicular groove was carried out. The clinical and radiographic examination 1 year after completion of treatment revealed evidence of healing. The early recognition of root and canal variation, correct diagnosis, and appropriate management of tooth with accessory root and deep radicular groove is essential to ensure favorable treatment outcome.

Dimensional Relationship between Maxillary Anterior Teeth and Inter Hamular Distance

Introduction: Selection of anterior teeth for the fabrication of artificial denture during Prosthodontic rehabilitation is a complex process. Different authors have suggested various methods, however no single method can be used reliably to select artificial teeth. This study aims to assess dimensional relationship of maxillary anterior teeth with inter hamular distance which may assist in the artificial teeth selection.&#x0D; Materials and methods: This clinical study was carried out on 95dentate subjects meeting the inclusion criteria. Prior to impression making, hamular notch was located precisely with T-burnisher and was marked with indelible pencil. Impression of maxillary arch was made using irreversible hydrocolloid impression material and casts were poured using Type III dental stone. Measurements were made directly on the cast using digital vernier caliper. The contact point widths of maxillary right and left maxillary central incisors, lateral incisors and canines were measured. The distance between the right and left hamular notch was measured. The sum of contact point widths of all maxillary anterior teeth was calculated. All the data were recorded and statistically analyzed.&#x0D; Result: There is a positive correlation between combined width of maxillary anterior teeth and inter-hamular notch distance with Pearson’s correlation coefficient (r) 0.217 and p value 0.035 which is statistically significant.&#x0D; Conclusions: There is significant correlation between combined width of maxillary anterior teeth and distance between right and left hamular notch. This correlation is valuable and practicable in estimating the six maxillary anterior teeth width.

Finite element analysis of stresses on adjacent teeth during the traction of palatally impacted canines.

To evaluate stresses on maxillary teeth during alignment of a palatally impacted canine (PIC) under different loading conditions with forces applied in vertical and buccal directions. A three-dimensional finite element model of the maxilla was developed from a cone beam computed tomographic scan of a patient with a left PIC. Traction was simulated under different setups: (1) palatal spring extending from a transpalatal bar (TPB) anchored on the first molars (M1) and alternatively combined with different archwires (0.016 × 0.022-inch; 0.018 × 0.025-inch) with and without engaging second molars and (2) a buccal force against 0.018-inch, 0.016 × 0.022-inch, and 0.018 × 0.025-inch archwires with and without engaging the left lateral incisor (I2). Without fixed appliances, stresses were assumed by M1; with fixed appliances, stresses were distributed on all teeth, decreasing mesially toward the midline. Direct buccal pull exerted most stress on neighboring I2 (19-20% with different wire sizes) and first premolar (12-17%), decreasing distally, along a similar pattern with different archwire sizes. When I2 was bypassed, stresses on adjacent teeth increased only by 3-6%. Higher stresses occurred with the lighter round wire. This first research on stresses on adjacent teeth during PIC traction provided needed quantitative data on the pattern of stress generation, suggesting the following clinical implications: use of distal-vertical pull from posterior anchorage (TPB) as initial movement and when using a buccal force, bypassing the lateral incisor and using heavier wires that would minimize side effects.

Developing white spot lesion (WSL) in patients with Fixed orthodontic appliance in Erbil city of Iraq

AIMS: of this cross sectional study is to specify the occurrence of white spot lesion (WSLs) in patients with orthodontic attachment in Erbil, Iraq. MATERIALS AND METHODS: This cross-sectional study was carried out on 20 subjects (7 male – 13 female) their age ranged between 12-34 years old. During fixed orthodontic treatment each tooth in four quadrants was examined by naked eye to detect the occurrence of WSLs from the 1 month to 6 month of treatment duration. RESULTS: The prevalence of WSL according to age, gender, and duration of the orthodontic treatment. The mean age of male were 19.43 (S.D= 6.37) and the mean age of female were 19.00 (S.D= 7.37) ; but statistically calculated non- significant (P-value >0.05). In the first visit the mostly affected teeth are upper right canine, upper left canine, and upper left lateral incisor, In second visit the most affected teeth are upper left canine, upper left lateral incisor, and lower right canine. In the third visit the mostly affected teeth are upper left canine, upper left lateral incisor, and lower right canine, In the fourth visit the most affected teeth are upper left canine and upper left lateral incisor. The frequency of WSLs increased with each visit of orthodontic treatment, the maximum occurrence of WSLs was found in the sixth visit (21.25%) followed by fifth visit (21%), fourth visit (19.25%), third visit (16.25%), second visit (13.75%), and finally first visit (7.25%). The mean of all visit equal to 16.45%. . CONCLUSION: 21.25% of patients in developing WSLs during orthodontic treatments were more attend in the upper than lower arch; they occurred most often on the upper left canine and upper left lateral incisor. There was statistically no significant male and female difference, females had a 65% of developing WSLs than males 35% (P-value <0.05).Key words: Coenzyme Q10; Wound healing; Wound contraction ratio.

Symmetry of dental agenesis in Down Syndrome children

Background/purposeDown syndrome (DS) may affect the mouth, influencing its function, feeding and hence overall health status. We aim at investigating the frequency and type of dental agenesis in a school-age DS sample, evaluating gender, laterality, upper or lower side, and mono- or bi-laterality. Materials and methodsOral clinical and radiological exams were performed. Forty-six (20 female and 26 male) panoramic radiographs, done when DS patients were 8–12 years old, were examined, from patients between 3 and 25 years old at the first visit. ResultsThe percentage of missing teeth was compared with chi-squared test: 65% of patients presented agenesis of one or more teeth. The most frequently missing teeth were the upper left lateral incisor, the lower second premolars and the upper right lateral incisor. Usually, the absence was bilateral. There was no difference between sexes, between mandible and maxilla, either in the left or in the right side. ConclusionA high occurrence of dental agenesis was observed in DS patients: some teeth were mostly affected and bilateral agenesis was frequent. Due to the high prevalence of teeth agenesis in DS patients, special care is devised for correct development of oral functions and for avoidance of oral pathologies.

Comparing the effects of three different fluoride-releasing agents on white spot lesion prevention in patients treated with full coverage rapid maxillary expanders.

The aim of this study was to assess the effects of three different fluoride-releasing agents on preventing white spot lesions that occur during treatment with full coverage rapid maxillary expanders. A total of 48 patients with transverse maxillary deficiency were randomly assigned to four equal groups. A fluoride-containing agent was applied to teeth before cementation of the full coverage acrylic-bonded rapid maxillary expanders in the three experimental groups (gel, varnish, and sealent in groups 1, 2, and 3, respectively), while the control group received no agent application. Quantitative light-induced fluorescence (QLF) images of the patients were obtained before cementation and after decementation of the appliances. Four parameters (ΔF, ΔFmax, A, and ΔR) were evaluated on maxillary ten anterior teeth. In the fluoride gel group, upper central and lateral incisors, right first and left second premolars showed significant decreases in fluorescence levels indicating demineralization. Right central and left lateral incisors showed significant white spot lesion formation in the fluoride varnish group. Right and left central incisors and left first premolar were the teeth that mineral loss was observed in the sealent group, while all of the teeth except canines and first premolars showed significant demineralization in the control group. Multifluorid varnish and Proseal sealant were effective on preventing demineralization and should be applied to teeth clinically before appliance cementation. Demineralization is a major problem during orthodontic treatment. The application of effective fluoride-releasing agents could prevent this major iatrogenic complication.

In vitro variation measurement of mandibular denture displacement resistance involving 1 to 3 implants

Statement of problemSingle-implant–retained mandibular overdentures (1-IODs) may be an alternative to 2-IOD for maladaptive denture patients giving comparable satisfaction, lower cost, and shorter treatment times. However, studies evaluating the effect of the number of implants on the strain exerted around the implants of IODs using strain-gauge analysis are lacking. PurposeThe purpose of this in vitro study was to evaluate the effect of the number of implants on the strain in an IOD under various loading and dislodging conditions. Material and methodsA mandibular IOD with the Locator attachment system (pink nylon inserts) was fabricated on artificial mucosa. Three implant positions recorded the loading: 1-IOD (mid-anterior), 2-IOD (bilateral lateral incisor), and 3-IOD (mid-anterior and bilateral canine) were prepared. Strain gauges attached to the mid-anterior implant replica for the 1-IOD, the left lateral incisor replica for the 2-IOD, and the anterior and left canine replicas for the 3-IOD. Vertical loads of 50 N were applied to the experimental overdenture in the mid-anterior and right molar and left molar regions. Three dislodging tests were performed in 3 different areas: mid-anterior, posterior, and mid-anterior and bilateral molar. Six measurements were made under each loading and dislodging condition for each IOD (N=6). During the calibration test, the resultant strain measured by strain gauge was converted into a lateral force (F) value by using linear regression: Fanterior-posterior(N)=1.08×strain (με), Fposterior-anterior(N)=0.192×strain (με), Fleft-right(N)=0.590×strain (με), Fright-left(N)=0.560×strain (με). Statistical analysis was performed by using 1-way ANOVA and the Tukey honestly significant difference test (α=.05). ResultsThe 3-IOD demonstrated the significantly highest strain under loading and dislodging conditions (P<.05). The 1-IOD demonstrated the significantly highest strain during right-side loading (P<.05). Upon anterior and left-side loading, no significant difference was noted in strain between the 1-IOD and 2-IOD (P=.413, P=.272). Under dislodging conditions, the 1-IOD exhibited the significantly lowest strain (P<.05). ConclusionsWithin the limitations of this study, the 3-IOD demonstrated the highest lateral resistance force during load and dislodge testing, whereas the 1-IOD exhibited the lowest.

The repeatability and reproducibility of gingival thickness measurement with an ultrasonic device.

Successful periodontal and implant surgery as well as orthodontic treatment often depends on gingival and mucosal thickness. So far there has been no generally accepted protocol of measuring the thickness of gingiva by non-invasive methods. The aim of the study was to evaluate the repeatability and reproducibility (%R&R) of the 20 MHz A-Scan ultrasonic device in measuring gingival thickness (GT) in the mucogingival complex. A 2-stage study utilizing non-invasive ultrasonic methods was conducted. In the 1st stage, 3 operators got calibrated by measuring previously established GT in porcine cadaver jaws. In the 2nd stage, 1 periodontally healthy subject was recruited in the study. Three operators performed the measurements of GT in maxillary left central and lateral incisors and canines, using the 20 MHz A-Scan ultrasonic device with a probe of 1.7 mm in diameter. The thickness was measured in 4 standardized points located in the free gingiva (FGT), supracrestal gingiva (SGT), crestal gingiva (CGT) and the mucosa (MGT). The analysis of variance (ANOVA) method was used to quantify %R&R. The repeatability and reproducibility of the measurements was 8.4%. Interobserver reproducibility varied from 0.8% to 13.4%. The average intraobserver coefficient of variation (CV) was 6.6% (1.9-13.6%). The median of the reproducibility of all measurements was 8.1 %. Nevertheless, the median of CV was variable to the observer, i.e. 5.4%, 6.5%, 6.4%. The obtained results in %R&R prove the good recognition of methodology as well as the usefulness of the device. Non-invasive ultrasonic biometer GT measurements are crucial in periodontology as well as in other fields of dentistry.

Zircônia e resina composta nanoparticulada em dentes anteriores fraturados: relato de caso clínico Zirconia and nanoparticulate composite resin on fractured anterior teeth: a clinical case report

Introduction: Fractures at upper anterior teeth are common. In root fracture cases, a dental implant approach proves to be a viable alternative sometimes. Several materials can be used in implant rehabilitation processes. Zirconia, a proven material for restorative purposes, is being employed for biological, functional, and aesthetic ends. In other situations, only the fractured teeth’s restoration with composite resin can rehabilitate their aesthetics and use. Objective: The purpose hereof is to report the use of the immediate implantinstallation technique after an upper incisor extraction with the diagnosis of root fracture, and a coronary fracture zirconia rehabilitation and restoration with a composite resin. Case report: A 24-year-old patient fractured the left central and lateral upper incisors. Tooth 21 received a zirconia crown implant and tooth22 was treated with a composite resin made with nanotechnology. Conclusion: Zirconia and composite resin are materials that present satisfactory biological, functional, and aesthetic features to restore fractured anterior teeth.

A Comparative Analysis of Tooth Size Discrepancy between Male and Female Subjects Presenting with a Class I Malocclusion.

Objectives To evaluate the tooth size discrepancy and Bolton's ratios between male and female subjects with a Class I malocclusion. Materials and Methods The digital e-models of 100 male and 100 female 12-year-old southern Chinese children with a Class I malocclusion were selected. The mesiodistal widths from permanent first molar to the contralateral side first molar of the upper and lower dentitions were measured. Differences between the tooth size discrepancy, together with the anterior and overall Bolton's ratios between male and female subjects, were assessed using a two-sample t-test. A paired t-test was used to determine differences between antimetric pairs of teeth within the same arch. Results Females had statistically significant smaller teeth than males (P < 0.05) except the upper left and lower left lateral incisor and lower left and right central incisors. The mean values of anterior Bolton's ratios for males and females were 77.04 and 77.03, respectively (P > 0.05), while the mean values of overall Bolton's ratios of male and female are 90.48 and 90.65, respectively (P < 0.05). The clinical significant differences (Cohen's d > 0.2) for contralateral tooth size were shown on the maxillary canines, lateral incisors, and central incisors of males; and mandibular canines and lateral incisors of females. Conclusions Southern Chinese females presenting with Class I malocclusions have smaller mesiodistal tooth dimensions compared to males. Both males and females presented several tooth size asymmetries. There are no statistical differences in anterior and overall Bolton's ratios between the genders.