Lower Molar Teeth Research Articles

Radiographic association of chronological age based on the root pulp and periodontal ligament visibility in lower second molar teeth in a subset of the Pakistani population.

To find radiographic association of the root pulp visibility and periodontal ligament visibility stages of lower second molar teeth with chronological age. The prospective, analytical, cross-sectional study was conducted after approval from the ethics review committee of Ziauddin University, Karachi, and comprised digital orthopantomograms from 2020 to 2022. The orthopantomograms related to lower second molar teeth from the left side of the mandible of individuals of either gender aged 18-40 years. The orthopantomograms were subjected to stage classification to assess the radiographic root pulp visibility and periodontal ligament visibility of the lower second molar teeth. Data was analysed using SPSS 25. Of the 260 orthopantomograms, 140(53.8%) belonged to female subjects and 120(46.2%) to male. The overall median age of the subjects was 24 years (interquartile range: 7 years). There were 164(63.1%) subjects aged 18-25 years, 70(26.9%) aged 26-33 years, and 26(10%) aged 34-40 years. A positive correlation was noted between age and stages of radiographic root pulp visibility and periodontal ligament visibility (p<0.05). The individuals found at stages 0 and 1 for root pulp visibility were aged at least 18 years, and for stage 2, the corresponding value was 21 years. For periodontal ligament visibility, the minimum age for stage 0 was 18 years, while for stages 1 and 2, the corresponding values were 21 and 25 years. Lower age was found to be associated more with stage 0 of root pulp visibility and periodontal ligament visibility.

The Relationship between Impacted Mandibular Third Molar and Mandibular Canal on Orthopantomogram – A Retrospective Study

Background: Surgical removal of the impacted lower third molar teeth require thorough investigations and assessment, one of these very important investigations is orthopantomogram (OPG) which is the primary assessment method, to determine the relationship between impacted mandibular third molar and mandibular canal. The study aims to determine the relationship between impacted mandibular third molar and mandibular canal on orthopantomogram. Materials and methods: A retrospective of 300 OPGs out of 947 OPG were selected using simple random sampling method. Rood’s criteria was used in assessing the relationship between the apex of the roots and upper border of the inferior alveolar canal. Statistical analysis was performed to assess the relationship between the canal and the impacted lower third molar in relation to the age ,gender and type of impaction.Results: From 300 OPG, 473 impacted teeth were identified, the relation showed, the highest percentage was superimposed with 47.3%, followed by close contact (35.7%), and only 21.7% of the impacted teeth examined has distance between the roots and the upper border of mandibular canal.Conclussion:Mesioangular impaction has higher percentage of superimposition with the mandibular canal with the higher percentage of female58% to male42% ratio.

Three-Dimensional Evaluation of Impacted Mandibular Third Molar Angulation and its Impact on Lingual Cortical Bone Thickness: A Retrospective Cone-Beam Computed Tomography Study

Background: The removal of impacted lower third molars surgically can cause complications, and the lingual cortical bone thickness in this region becomes a determining factor in the risk of perforation and injury to the lingual nerve (LN). This study was conducted to assess the relationship between different angulations of impacted lower third molars based on Winter’s classification and the thickness of the lingual cortical bone. Variations in lingual cortical bone thickness among the genders were evaluated as well. Methods: Cone-beam computed tomography (CBCT) scans of 50 impacted lower third molar teeth of 50 patients (26 men and 24 women) were evaluated in this study. The lingual bone thickness surrounding impacted lower mandibular teeth was measured at three key points, namely, the cemento-enamel junction of the second mandibular molar, the mid-root of the impacted third molar, and the root apex of the impacted third molar. Mesiodistal angulation and buccolingual angulations of the impacted mandibular third molars underwent investigation. Statistical analysis was conducted using SPSS 23. Data were analyzed using the independent sample t test, one-way ANOVA, multiple linear regression analysis, and Fisher’s exact test. Results: There was a statistically significant relationship between the means of lingual cortical bone thickness surrounding the third molars based on Winter’s classification of third molars impacted at mesiodistal angulation (P=0.00). Regarding gender, buccolingual angulation demonstrated a statistically significant relationship among the means of lingual bone thickness around the third molars (P=0.022). Conclusion: In our study, the thickness of the lingual cortical bone was notably affected in the middle and apical areas of the impacted third molar region. The variable position of the LN near the mandible third molar region was significant in dental procedures due to its proximity. Three-dimensional (3D) imaging CBCT provides preoperative risk assessment that reduces preventable complications that cannot be answered by 2D imaging.

A comparative analysis of postoperative morbidity and alveolar bone regeneration following surgical extraction of ımpacted lower third molar teeth using piezosurgery and conventional ınstruments: a split-mouth clinical ınvestigation

Background-objective(s)This randomized, split-mouth study aimed to compare postoperative complications following the surgical extraction of impacted lower third molars using piezosurgery versus conventional rotary instruments.Materials and methodsTwenty-one patients, aged 18–35 years, with bilaterally and symmetrically impacted lower third molars, were randomly assigned to undergo extraction using piezosurgery on one side and conventional rotary instruments on the other.ResultsThe piezosurgery method required a longer operation time. However, it resulted in quicker resolution of postoperative swelling by the 7th day compared to the conventional method, where swelling persisted longer. Mandibular angle-tragus measurements were significantly higher with the conventional method on the 1st, 3rd, and 7th postoperative days. Although mouth opening decreased significantly after piezosurgery, it returned to preoperative levels by the 7th day, outperforming the conventional method. Postoperative pain was notably higher with the conventional method during the first four days but showed no significant difference from the 5th day onward. Alveolar bone healing was significantly better with piezosurgery at the 3rd and 6th months. Temporary paresthesia occurred in one patient from the conventional group, resolving within four weeks. Neither method resulted in alveolar osteitis.Conclusion(s)Within the study's limitations, piezosurgery demonstrated a reduction in postoperative discomfort, suggesting its advantage in enhancing patient recovery following lower third molar extractions.Clinical significancePiezosurgery, when used appropriately, can reduce postoperative complications compared to conventional methods. Clinicians should be aware of its indications, benefits, and potential challenges.Trial registration This study was registered as a clinical trial to the ClinicalTrials.gov, and the registration ID is NCT06262841 (https://clinicaltrials.gov/study/NCT06262841).

Evaluation of the Caries-Arresting Potential of Silver Diamine Fluoride Gel With Potassium Iodide Versus Sodium Fluoride Varnish: An Observational Study.

Introduction Silver diamine fluoride (SDF) with potassium iodide (KI) has emerged as a promising, aesthetic, non-invasive management by limiting the staining caused by SDF. However, no studies are comparing the caries-arresting potential of SDF gel with KI. The study aims to observe and evaluate the caries-arresting potential of SDF gel with KI compared to sodium fluoride (NaF) varnish. Materials and methods The present observational study was conducted with a split-mouth design. A total of 33 participants, in the age group of two to six years, with occlusal caries of the International Caries Detection and Assessment System (ICDAS) I and II involving both right and left upper or lower primary molar teeth, were included. SDF gel with KI and fluoride varnish (FV) was applied to the contralateral teeth on the same arch. Participants were recalled at 3, 6, 9, and 12-month intervals to monitor the progression or arrest of carious lesions. Result At the end of 12 months, 66.7% and 70.5% of the teeth showed arrest of caries with SDF gel with KI and FV, respectively. Intra-group analysis using the Friedman test shows significant differences in both groups across the timeline (p=0.001). Intergroup analysis using the Whitney U test reveals no significant difference in caries-arresting potential between the groups at various timelines (p=0.231). Conclusion There was no significant difference in arresting enamel caries of primary teeth between the use of 5% NaF and 38% SDF with KI. However, there was a significant difference within the group between the 3rd and 12th-month follow-up. Hence, the biannual application is recommended in both FV and SDF with KI.

Management of a solitary bone cyst using a custom-made surgical guide for a minimally invasive approach: technical note and case report

BackgroundSolitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion.Case PresentationA 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity.DiscussionThe 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications.ConclusionThe use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.

The Effect of Coffee Consumption on the Level of Adrenalin Blood Serum in the Periodontitis Model: An In Vivo Study

Background: Adrenalin was supposed to have an anti-inflammatory effect; hence adrenalin concentration in blood serum might be lower in inflammatory diseases. Coffee contains caffeine that is thought to have the potency to increase adrenalin secretion in inflammatory diseases. This study aimed to analyze the effect of coffee consumption on adrenalin blood levels in periodontitis rat model. Methods: This in vivo experimental study used the post-test-only control group design. Wistar male rats (Rattus novergicus) were divided into four groups (four rats/group) i.e. 1) Periodontitis (no coffee), 2) periodontitis + coffee, 3) Coffee (no periodontitis), 4) Control (no coffee, no periodontitis). The periodontitis rat model was made by injecting periodontitis bacteria Phorpyromonas gingivalis in the buccal mucosa of the lower molar tooth three times a week for 4 weeks. A single dose (0.6 mL d–1) of ground coffee infusion (equal to one cup per day for humans) was given to each rat in the coffee group, for 28 d. At the end of the study, all of the rats were sacrificed and blood was drawn intra-cardially. Blood serum adrenalin concentration was analyzed using Enzyme-linked immunosorbent assay (Elisa). Results: The Periodontitis group showed significantly lower serum adrenalin (p&lt; 0.05) than others. Coffee consumption in periodontitis rats affected a significantly higher adrenalin blood serum level (p &lt; 0.05). Conclusion: Coffee consumption could replenish the level of blood serum adrenalin which decreases in periodontitis. Further studies are needed to elucidate the modulation mechanism of coffee-adrenalin-inflammation.

Finite element stress analysis in mandibular molars with apical root resorption and crown destruction after root canal treatment using various materials

Aim: The objective of this study is to analyze the stress distribution of root canal treated teeth under occlusal forces and aid in the selection of appropriate materials for teeth with root tip resorption and crown destruction, using the finite element stress analysis method (FEM). Methods: The study was conducted on two-rooted lower molar teeth, divided into five groups. The root length was 14 mm, the crown length was 7.5 mm, and the total length was 21.5 mm. It was assumed that the distal canals were resorbed by 4 mm. Group 1 consisted of untreated intact teeth. Group 2 involved filling the mesial canals with gutta-percha, filling the apical part of the distal canal with 4 mm Mineral Trioxide Aggregate (MTA), and fabricating the crown using glass fiber post and IPS e.max materials. Group 3 involved filling the mesial canals with gutta-percha, filling the apical part of the distal canal with 4 mm Biodentin, and manufacturing the crown using glass fiber post and IPS e.max materials. Group 4: The canals were filled with MTA, and an IPS e.max endocrown was used. Group 5: The canals were filled with Biodentin and an IPS e.max endocrown was used. The study examined the effect of a 100 Newton force applied in the occlusal direction on dental tissues using finite element stress analysis. Results: The study found that the application of fiber posts resulted in less stress accumulation in tooth tissues compared to endocrown. Conclusion: The use of Biodentin or MTA in endocrown teeth did not affect the stress in tooth tissues caused by applied force. In conclusion, while fiber posts increase durability by reducing stress in root-end resorbed teeth, the effect of Biodentin or MTA on stress resistance in dental tissues is limited. How to cite this article: Duran S, Şirin DA, Topbaş C. Finite element stress analysis in mandibular molars with apical root resorption and crown destruction after root canal treatment using various materials. J Med Dent Invest 2024;5:e240320. https://doi.org/10.5577/jomdi.e240320

Fibroblast growth factor signalling regulates the development of tooth root.

Fibroblast growth factor (FGF) signalling plays a crucial role in the morphogenesis of multiple tissues including teeth. While the role of the signal has been studied in tooth crown development, little is known about root development. Of several FGF ligands involved in hard tissue formation, we suggest that FGF18 regulates the development of murine tooth roots. We implanted FGF18-soaked heparin beads into the lower first molar tooth buds at postnatal day 6 (P6), followed by transplantation under the kidney capsule. After 3 weeks, FGF18 significantly facilitated root elongation and periodontal tissue formation compared to the control. Insitu hybridisation showed that Fgf18 transcripts were initially localised in the dental pulp along Hertwig's epithelial root sheath at P6 and P10 and subsequently in the dental follicle cells at P14. Fgf receptors were expressed in various dental tissues during these stages. Invitro analysis using the dental pulp stem cells revealed that FGF18 inhibited cell proliferation and decreased expression levels of osteogenic markers, Runx2, Alpl and Sp7. Consistently, after 1 week of kidney capsule transplantation, FGF18 application did not induce the expression of Sp7 and Bsp, but upregulated Periostin in the apical region of dental mesenchyme in the grafted molar. These findings suggest that FGF18 facilitates molar root development by regulating the calcification of periodontal tissues.

Influence of the radius of Monson’s sphere and excursive occlusal contacts on masticatory function of dentate subjects

ObjectiveTo determine the influence of the radius of Monson’s sphere, the number of posterior laterotrusive, mediotrusive, and protrusive contacts, and the chewing rate on food comminution. DesignSixty healthy dentate subjects, aged 21.22 ± 2.30 years, were selected. The three-dimensional coordinates of the cusp tips of the lower canine, premolar, and molar teeth were identified from the subjects’ digital models. Monson’s sphere was designed using the simplex method for function minimisation by adjusting the coordinates on its surface. The contacts were verified using 12 µm metal strips in jaw excursions at 0.5, 1.0, 2.0, and 3.0 mm. The masticatory performance and efficiency, swallowing threshold, and chewing rate were assessed through particle size fractionation. Data were analysed with multiple linear regression (α = 0.05). ResultsThe sphere’s radius, laterotrusive and protrusive contacts at 0.5 mm, and chewing rate were found to be negative predictor variables for masticatory performance until 20 chewing cycles (R2 = 0.429). For 40 cycles, the radius and total contacts (0.5 mm) were also explanatory factors (R2 = 0.223). Only the radius (R2 = 0.176) and the chewing rate (R2 = 0.082) were found to be significant for 60 cycles and swallowing threshold, respectively. Masticatory efficiency was influenced by masticatory performance until 40 and 60 cycles, as well as the radius and total contacts at 2.0 and 3.0 mm (R2 = 0.958). ConclusionA larger radius of Monson’s sphere and a greater number of posterior excursive contacts were found to be related to better masticatory function.

Introduction of Laboratory Endodontics: Evaluating the Perception of the Undergraduate Clinical Dental Students at a Nigerian University

Background: Root canal treatment (RCT) forms a part of the requirements for graduation for dental students. The students are expected to perform the procedure during their clinical training. However, most students are presented to the clinic without formal laboratory practical training.&#x0D; Aim: To introduce laboratory endodontic training and evaluate the perception of Nigerian undergraduate clinical dental students about the program.&#x0D; Methodology: A two-day hands-on training on RCT was done for a set of final-year dental students in the operative technique laboratory of the Department of Restorative Dentistry of the Institution. The training included taking the participants through all the steps involved in RCT. The participants performed all the stages of RCT on extracted lower molar teeth mounted on a phantom head with paraffin wax. Each student performed the two methods of biomechanical preparation taught: manual and rotary instrumentation, and later evaluated the training in terms of confidence and preparation for clinical exposure.&#x0D; Result: Twenty-one (53.9%) students within the age range of 23 to 30 years and a mean age of 25.4±1.7years completed the program. The majority, (81%) of the participants claimed the hands-on demonstration was very helpful in performing the procedure, and all submitted it will help their confidence during clinical exposure to RCT. The participants further suggested the incorporation of training into the regular school program.&#x0D; Conclusion: The laboratory endodontic hands-on training was accepted by all the participants, and it was opined that it will boost their confidence in performing the procedure in the clinic.

The Effects of Calcium Silicate- and Calcium Hydroxide–based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial

IntroductionThis study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide–based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis. MethodsA total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05). ResultsThe statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05). ConclusionsPatients treated with calcium silicate– and calcium hydroxide–based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.

Sublingual floor of Rahmani sheep (Ovis aries): A scanning electron microscopy and histomorphology analysis.

The current study investigated the sublingual floor of Rahmani sheep (Ovis aries). Samples from nine healthy adult sheep have been analysed using morphometrical, scanning electron microscopic (SEM), and histological examination. The sublingual floor of the sheep was formed of a rostral prefrenular part (spatula-shaped) and two lateral sublingual recesses. Right and left sublingual caruncles were asymmetrical in length and each one had a serrated border, divided into three papillae. At higher magnifications, the three papillae of the sublingual caruncle's edge were variable in shape, with other two papillae were demonstrated underneath the caruncle. Each sublingual recess had a sublingual fold (plica sublingualis) extended from the level of frenulum linguae till the glossopalatine arch, bordered with caudolaterally directed papillae till the level of first lower molar cheek teeth. The sublingual salivary glands were mixed (seromucoid) type. The glandular lobule consisted of mucous acini and sporadic serous acini, as well as the presence of some mucous acini capped by acidophilic cells, serous demilunes. The mucous acinus was formed of pyramidal mucous cells with pale stained cytoplasm and basally located nuclei. Two ducts; major sublingual and submandibular ducts were observed within the submucosa of the sublingual caruncle. The sublingual ductal pseudostratified columnar epithelium was interspersed by more goblet cells than that of the submandibular duct. Collagen fibres around the glandular lobules, intralobular and interlobular excretory ducts as well as the connective core of the papillae were noticed. By SEM, two epithelium-lined pits on the surface of the sublingual floor mucosa caudal to the central incisive teeth were termed orobasal organ. As the first study to give a comprehensive analysis of the sheeps' sublingual floor, this one serves as a baseline for future clinical studies.

Comparative Evaluation of the Efficacy of Intraoral Cryotherapy Versus Intracanal Cryotherapy on Postoperative Pain in Lower Molar Teeth with Irreversible Pulpitis and Symptomatic Apical Periodontitis: A Randomized Clinical Trial

Comparative Evaluation of the Efficacy of Intraoral Cryotherapy Versus Intracanal Cryotherapy on Postoperative Pain in Lower Molar Teeth with Irreversible Pulpitis and Symptomatic Apical Periodontitis: A Randomized Clinical Trial

Trends and Outcome of Aggressive Fascial Space Infections.

Background: Odontogenic infections are common and self-limiting in most cases; however, they can lead to severe consequences, considerable morbidity and can even be fatal despite modern medical therapy. Patients and Methods: This retrospective study included patients with severe deep fascial space infections treated in the Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag Governorate, Egypt, and the Department of Oral and Maxillofacial Surgery, King Fahd Specialist Hospital (tertiary referral center), Burayda City, Qassim Province, Saudi Arabia, from June 2017 to June 2022. Results: This study included 296 patients, 161 (54.4%) males, 135 (45.6%) females. The fifth decade of life was the most common vulnerable age group. Forty-three percent of patients had diabetes mellitus, 26.6% were hypertensive, and 13.3% were on long-term steroid therapy. In 83% of patients, the offending tooth was identified but in 17% of patients no dental cause was identified. The lower third molar tooth was most commonly involved. Sixty-nine (23.3%) patients had submandibular space infections. Fifty-three (17.9%) patients had canine space infections. Thirty (10.1%) patients had submasseteric space infection. Twenty-eight (9.5%) patients had submental space infections. Twenty-three (7.8%) patients had combined infection of the submasseteric, submandibular, and pterygomandibular spaces, whereas 19 (6.4%) patients presented with Ludwig's angina. Conclusions: Odontogenic infections are common. The submandibular space is the most commonly affected single space. These infections could lead to lethal complications in immunocompromised patients, especially patients with diabetes mellitus. These infections require urgent surgical intervention to decrease hospital stays and avoid potentially lethal complications.

Impacted Deciduous Second Mandibular Molar Tooth

A 9-years-old boy presented to the Department of Oral and Maxillofacial Surgery with pain in the posterior region of the left mandible. The child was healthy with an unremarkable medical history. There was no family history of the same condition. Intra-oral clinical examination showed the absence of lower left deciduous molar and multiple carious deciduous teeth at both dental arches. Orthopantogram (OPG) confirmed the complete impaction of the lower-left deciduous 2nd molar with inferior retention of the lower 2nd permanent premolar close to the lower border of the mandible [Panel A]. Under local anesthesia, a two-sided flap was raised, surgical removal of the impacted deciduous 2nd molar and extraction of adjacent 1st deciduous molar, the flap was sutured with 3/0 silk suture [Panel B and C]. Failure of eruption or impaction of deciduous molar was linked to the disturbance of the development of the successor's permanent teeth. Deciduous tooth failure of eruption or impaction is rare in comparison with permanent teeth. Among deciduous dentitions, the 2nd molar was the most commonly affected tooth, followed by central incisors. Impaction can cause many serious problems to underlying tooth buds of the permanent dentition including their delayed eruption or even ectopic eruption. Therefore, proper history and clinical examination, and precise treatment are mandatory. After one month, OPG showed complete healing [Panel D] and the patient was satisfied with the aesthetic and functional outcomes.

Comparison of the Mesiodistal Angulations of Canine and Molar Teeth in Different Types of Orthodontic Malocclusions: A Retrospective Study

(i) Objective: Changes in the mesiodistal axial angulations of teeth with orthodontic treatment have been a topic of interest in orthodontics for many years, although it has not been clarified enough yet. Therefore, this present study aimed to compare mesiodistal axial angulations of canine and first molar teeth by measuring from pre- and post-treatment panoramic radiographs in different types of orthodontic malocclusions. (ii) Materials and Methods: In the study, the mesiodistal axial angulation angles of the lower-upper canines (teeth numbered 13, 23, 33, and 43) and first molars (teeth numbered 16, 26, 36, and 46) were compared on panoramic radiographs taken pre- (T0) and post- (T1) orthodontic treatment of 353 patients: 237 female (mean age 14.74 ± 2.96) and 116 male (mean age 14.44 ± 2.50), who had not received any prior orthodontic treatment. The groups were formed according to pre-/post-treatment, gender, angle classification, skeletal classification, bilaterally first premolar extraction/non-extraction, and the use/non-use of miniscrews in the extraction cases. The mesiodistal angulations between the long axes of both the lower and upper canines and first molars and the interorbital plane were measured separately and recorded. The reliability analysis between the repeated measurements was evaluated using the intraclass correlation coefficient (ICC). For statistical analysis, a paired sample t-test and Wilcoxon test were used for the normally and non-normally distributed data, respectively. For the between-groups comparison, independent sample t-test and one-way ANOVA were used for normally distributed data, while the Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed data. A value of p < 0.05 was considered statistically significant. (iii) Results: ICCs showed excellent reliability, ranging from 0.804 to 0.913 in other teeth, yet were good in tooth 43 (ICC = 0.712). Regardless of the groups, statistically significant differences were found between the T0 and T1 angulations for all teeth, except teeth 13 and 16. In all groups, the increase in the angulations of teeth 33 and 43 and the decrease in the angulations of teeth 36 and 46 (except skeletal class 3) were found to be statistically significant. The T0 and T1 angulation changes in the miniscrews in the used and non-used groups in extraction cases were similar to the differences found in all teeth, regardless of the groups. There was no significant difference between gender, skeletal classes, and angle classes in the amounts of change in the mesiodistal angulations. (iv) Conclusion: It was concluded that orthodontic treatment caused significant changes in the mesiodistal axial angulation of the canine and the first molar teeth. Furthermore, the fact that the angulations tended to increase in the lower canine teeth and decrease in the lower first molar teeth revealed the importance of tooth movement control, especially in orthodontic mechanics in the mandibula.

Evaluation of the Relationship between Crown Preparation Techniques and Zirconia Restoration Thickness

Bu in vitro çalışmanın amacı, diş destekli sabit protezlerde kullanılan monolitik Zirkonya Kuronların ideal kalınlığı ile iki farklı kuron preparasyonunun (Rehber Oluklu Diş Kesimi ve Konvansiyonel Diş Kesim yöntemleri) ilişkisini araştırmaktır. Çalışmamız için Frasaco fantom mandibulasına yerleştirilmiş 39 adet prefabrike sağ alt azı dişi kullanıldı. Bu dişlerin 16'sı Konvansiyonel Diş Kesim yöntemi ile diğer 23 diş ise Rehber Oluklu Diş Kesim Tekniği ile hazırlandı. Çalışma için sagittalde 4, frontalde 5 ölçüm noktası olmak üzere iki farklı kesitten ölçüm yapılmıştır. Bu prefabrike dişler Sirona Cerec görüntüleme sistemi ile tarandı. Hazırlanan kuronlar ile orijinalleri arasındaki saggital ve frontal kesitleri ile görselleştirilen malzeme kaldırma kalınlıkları Sirona Cerec görüntüleme sistemi ile belirlendi. Her bir kesilmiş prefabrik dişin 3 boyutlu taramaları rehber alınan 9 bölgeden standardize edilmiştir. CAD-CAM ile yapılan 3 boyutlu taramalarda yapılan ölçümler, her bir uygulayıcının iki farklı kuron hazırlığı (AK, Ufuk, Alev, NK) ve referans ortalamalarını gösterecek hale getirildi. Sayısal değerler, Rehber Oluklu diş kesimi ve Konvansiyonel diş kesimi sistemleri olarak gruplandırılarak istatistiksel olarak analiz edildi ve ölçümler karşılaştırıldı. Rehber Oluklu diş kesimi için (AK, Ufuk, Ref) ölçümlerinin ortalamaları ve Konvansiyonel diş kesimi grubu için NK ve Alev ölçümlerinin ortalaması hesaplanmıştır. Çalışmamızda Konvansiyonel diş kesimi sonuçları tüm bölümlerde daha yüksek bulunmuştur. Rehber Oluklu diş kesimi sonuçları, sagital kesitlerden Kesit 13 hariç tüm ölçümlerde anlamlı olarak daha düşük bulundu (P

AN UNUSUAL SOCIAL HABIT LEADING TO A FOREIGN BODY IN TEETH

In children, discovery of a foreign body in teeth is often diagnosed accidently which may be lodged due to a traumatic injury or it may be a self-inflicted injury. However, in adults, it may be due to a social habit and the patient usually reports only when he/she experiences pain and then the foreign object is discovered in radiographic examination. In this article, we present a case report of a 23-year-old male with a ball pen nib lodged into the lower molar teeth due to an unusual social habit, which the patient himself was unaware about and the subsequent removal of the foreign body.

Impacted Lower Third Molar Profile at Dental Hospital of Padjadjaran University

&#x0D; Introduction: Impacted teeth are teeth that erupt incompletely in the normal eruption period. This situation can be caused by hard or soft tissue obstructions or a lack of arch jaw. Objectives: This study aimed to determine the impacted lower third molar teeth profile by age, sex, class, angulation, treatment, and anesthesia at RSGM UNPAD in 2017-2019. Methods: The study was conducted from February 8, 2020, to March 8, 2020. The study represents the impacted lower third molar teeth profile of patients referred to Outpatient Installation, Central Surgical Installation, and the Radiology Installation. Classification of tooth impaction was based on Pell &amp; Gregory and Winter classifications using ImageJ application, while Intraclass Correlation Coefficient (ICC) was used to confirm data validity. Results: There were 146 impacted dental cases, with a total case of 62 (42.5%) for males and 84 (57.5%) for females. Most impacted teeth occurred in the 12-25 years age group up to 72 (49.3%). A total of 177 impacted teeth mostly occurred in 48 teeth, as many as 91 (51.4%). Impaction class Pell &amp; Gregory class B with 110 (62.1%) cases were found the most. Based on the anterior border of ramus, class II with 164 (91.1%) cases was found the most. Horizontal (79 cases, 44.6%) became the most frequent angulation. The procedures taken were all odontectomy 177 (100%) with more use of local anesthesia 136 (93.2%) compared to general anesthesia 10 (6.8%). Conclusion: Cases of impacted lower third molar teeth at RSGM UNPAD in 2017-2019, were most common in females and mostly in the 12-25 years age group, with Pell &amp; Gregory class IIB classification and Winter horizontal angulation classification, all procedures performed were odontectomy, majority using local anesthesia.