Maxillary Molar Teeth Research Articles

Is it possible to extract primary maxillary molars without palatal injection?: a controlled clinical trial

ObjectivesThe absolute necessity of a palatal injection for the extraction of primary maxillary molars has never been explored, despite the fact that it is widely known that children do not tolerate local anesthetic injections into the palatal tissue well. The aim of this study was to compare separately the perception of pain in the absence of palatal injection after anesthesia and maxillary primary molar tooth extraction using different anesthetic solutions and different post-anesthetic waiting times.Materials and methodsA single-blinded randomized controlled study was conducted in 78 participants (26 patients with palatal anesthesia (the control groups), and 26 patients with 5 min and 26 patients with 8 min post-anesthetic waiting time without palatal anesthesia (the study groups)). Subjective experiences of pain were evaluated separately after anesthesia and tooth extraction using the Visual Analog Scale (VAS) and the Wong-Baker Faces Pain Rating Scale (WBS).ResultsIn terms of VAS scores obtained following administration of anesthesia, there was a statistically significant difference between the groups (p<0.05). VAS pain scores were reported to be lower in the groups without palatal anesthesia than in the groups with palatal anesthesia. No statistically significant difference was observed in VAS and Wong-Baker scores after tooth extraction between the groups with and without palatal anesthesia (P>0.05).ConclusionsWhile the pain reported following administration of anesthesia was found to be higher in the groups receiving palatal anesthesia, no difference was found between the groups in the pain reported after tooth extraction.Clinical relevanceExtraction of maxillary primary molars is possible without palatal injection by injecting 4% articaine or 2% lidocaine into the buccal vestibule of the tooth with a waiting time of 5 or 8 min.

Endodontic Retreatment of Maxillary First Molar with Three Roots and Seven Canals: A Case Report

A 25-year-old female existing with mild pain and discomfort during mastication in her right posterior maxillary tooth. On clinical examination, the maxillary first molar tooth was restored with a composite filling. The tooth did not respond to heat or cold test, and it was tender to percussion. Radiograph examination revealed poor obturation of the canals and the periodontal ligament space was broad but there was no definitive periapical radiolucency. Conservative non-surgical root canal treatment was performed; a total of seven root canals were detected and they were obturated by using the calcium-based sealer. Radiograph with RVG and CBCT also confirmed that all seven canals were properly obturated. Twelve months later, there were no clinical or radiographic changes of the treated tooth. These findings suggested that careful examination of the floor of the pulp chamber with RVG and CBCT help to find extra root canals.

Evaluation of Dimensional Changes in Maxillary and Frontal Sinus in Adult Patients With Anterior Open Bite and Normal Overbite: A Retrospective Cone Beam Computed Tomography (CBCT) Study.

An anterior open bite is a form of vertical discrepancy that presents as a lack of contact between maxillary and mandibular segments. The treatment modalities usually involve either intrusion of posterior teeth or extrusion of anterior or a combination of both. The anatomical relationship between the apex of the maxillary molar roots to the inferior wall of the maxillary sinus floor is crucial in planning posterior intrusion. The paranasal sinuses influence the growth of the facial structures that eventually get altered in various malocclusions. Studies have proven that theheight of the sinusgets modified in anterior open bite owing to pneumatization. This study aims to evaluate the distance from the root apex of maxillary first molars (mesiobuccal, distobuccal, and palatal roots) to the maxillary sinus floor to evaluate the significance of the vertical pneumatization of the sinus on planning for true intrusion in anterior open bite and to assess the correlation between frontal and maxillary sinuses in an anterior open bite. This retrospective study evaluated 30 pre-treatment cone beam computed tomographies (CBCTs) of patients out of which 15 were with anterior open bite and 15 with ideal overbite. Linear measurements were carried out using care stream software in CBCTs. There was a significant correlation between the distance of the palatal root and the distobuccal root of the maxillary first molar to the maxillary sinus floor bilaterally in the anterior open bite (p<0.04). A significant moderate positive correlation of the maxillary and frontal sinus height in anterior open bite (p<0.006). A significant moderate negative correlation between the distance from the palatal root to the maxillary sinus floor and maxillary sinus height in anterior open bite (p<0.001). Vertical pneumatisation of the maxillary sinus has caused a significant negative correlation between the apex of the palatal root of the maxillary first molar tooth and the maxillary sinus floor in the anterior open bite. The palatal root being the closest to the sinus floor, and the distobuccal root being second nearest. There is a significant correlation between the height of the sinuses in the anterior open bite.

Buffered versus Non-buffered Local Anaesthesia in Minor Oral Surgery - A Comparative Study.

Commercially available local anaesthetics are acidic solutions associated with the vasopressor sting on injection, relatively slower onset of action and pain during palatal injections. The above drawbacks can be addressed by anaesthetic buffering. This prospective study was aimed at comparing the efficacy of buffered and non-buffered local anaesthesia in the extraction of grossly decayed maxillary molar teeth in relation to pain on local infiltration, onset and duration of action of local anaesthesia. This is a prospective randomised controlled trial done on 100 patients who required bilateral extraction of maxillary molar teeth. In the study group, patients were given buffered local anaesthesia (which was prepared by mixing 2% lignocaine with 1:80,000 adrenaline and 8.4% sodium bicarbonate) before extraction. In the control group, non-buffered local anaesthesia (2% lignocaine with 1:80,000 adrenaline) was given before extraction. Statistical data confirmed that buffering reduces pain on infiltration, decreases the onset and increases the duration of action of the local anaesthesia compared to non-buffered local anaesthesia. All the parameters measured were statistically significant (P = 0.001). The study concludes that buffered local anaesthesia was more beneficial than non-buffered local anaesthesia in reducing pain on injection, providing a quicker onset of local anaesthesia and increasing the duration of action of the local anaesthesia. Buffering is a safe, easy and efficient process and should be routinely followed to provide a better experience to the patients.

Dental and Alveolar Arch Widths in Normal Occlusion and Class II Division 1 Malocclusion

This study was to evaluate and compare dental arch and alveolar widths of patients with Class II division one malocclusion with group of untreated normal occlusion subjects. This study was performed using measurement on dental casts of 30 normal occlusion and 30 Class II division 1 malocclusion of Iraqi sample aged 15-22 years. T-test was applied for comparing the groups , the finding of this study indicated that maxillary interpremolar width, maxillary canine, maxillary premolar and maxillary first molar and mandibular premolar and molar alveolar widths were found significantly narrower in the Class II division 1 group when compared with the normal occlusion sample (P&lt;.001). The maxillary and mandibular intermolar and mandibular intercanine alveolar widths were statistically significantly larger in the Class II division 1 group ( P&lt;.01) . Maxillary molar teeth in subjects with Class II division 1 malocclusion tend to incline to the buccal to compensate the insufficient alveolar base therefore rapid maxillary expansion rather than slow maxillary expansion should be considered during treat ment of Class II division 1 patients. The results of our study sugg ested that transverse discrepancy in Class II division one maloccl usion originated from upper posterior teeth and maxillary alveolar base.

Morphological and Morphometric Study of Greater Palatine Foramen in Dry Skulls of Eastern Indian Population

Abstract Background: Greater palatine foramen (GPF) transmits important neurovascular structures which may get injured during different operative procedures such as intraoral maxillary nerve block, cleft palate repair, and operative procedures involving maxillary sinus and maxillary molars. Hence, proper knowledge about the GPF is very essential. The aim of this study was to study the shape of GPF and its location in relation to molar tooth, measure the diameters of GPF, and measure the distances of GPF from different landmarks of palate. Methodology: A dry bone-based study was conducted on dry human skulls of Eastern Indian population using digital Vernier caliper. At first location of GPF in relation to maxillary molars was noted, followed by anteroposterior (AP) and transverse diameter of GPF and distance of GPF from incisive fossa, posterior border of hard palate (PBHP) and interpalatine suture was measured. Results: In 69.64% of cases, GPF was present medial to the maxillary molar tooth and most common shape is oval type which is found in 44.64% of cases. AP diameter was almost same in both the sides which is 5.13 mm in average and transverse diameter is 2.91 mm. The mean distance of GPF from incisive fossa, PBHP, and interpalatine suture (IPS) is as follows in sequence, 37.24 mm, 3.21 mm, and 13.68 mm. Conclusion: The findings from the present study can be used as a guide for locating GPF during different operative procedures such as palatal reconstruction in cleft palate, maxillary surgeries, and intraoral maxillary nerve block. GPF is located about 3 mm in front of PBHP, most commonly medial to the third maxillary molar, about 15 mm lateral to IPS in the present study among Eastern Indian population.

Full Arch Distalisation using Infrazygomatic Crest and Buccal Shelf Implants

This article reports the successful use of Infrazygomatic crest and buccal shelf implants in the maxilla and mandible to treat a female patient of age 13‐years. The patient had a skeletal Class I pattern and Angles class I malocclusion. Temporary anchorage devices (TADs) in the posterior dental region between maxillary and mandibular second premolar and first molar teeth on both sides were used as anchorage for full arch distalization. The patient received a satisfactory occlusion and an attractive smile. This technique requires minimal compliance and is particularly useful for correcting bimaxillary protrusion cases. Keywords: Class I Malocclusion, Distalization, Temporary Anchorage Devices

The prevalence of pulp stones in the Kurdish population as a diagnostic tool in endodontic prognosis using Digital Orthopantomograph

Background:Pulp stones (PSs) are calcified masses, found commonly in dental pulps of healthy, diseased, and even unerupted teeth.Objectives:Our study aims to determine the prevalence of PS in Kurdish adults using an orthopantomograph (OPG) and investigate the relationships between PSs with sex, age, tooth type, and dental arch/side.Patients and Methods:We examined 1,170 digital OPGs from Kurdish patients at the private Maxillofacial Radiology Center in Sulaimaniyah City, Iraq, were taken for various purposes between January and July 2023. A total of 31,598 teeth were examined to identify PSs. We collected patient data and determined correlations between the presence of PSs and various patient variables.Results:About 242 (20.68%) patients and 471 (1.49%) teeth had at least one stone. The prevalence of PS in the Kurdish population was 20.68% based on the total number of patients examined and it was 1.49% based on the total teeth examined. The PS frequently was found in those aged 45 years and more (50%) and the PS prevalence was higher in females (61%) than males (39%). The maxillary dental arches and molar teeth had the highest frequency of PS (p=0.000).Conclusions:In the Kurdish population, the prevalence of PSs was moderately high, particularly among females. PSs were most frequent in the maxillary arch and first molars, with incidence increasing with age.

Prevalence and extent of Alveolar dehiscence and fenestration in Class I hyperdivergent subjects with different buccolingual inclinations of maxillary molar teeth

Buccolingual position of teeth could affect the prevalence of alveolar bone defects. Presence of alveolar defects may have a deleterious effect on orthodontic treatment. The aim was to assess the prevalence and extent of dehiscence and fenestration in Class I hyperdivergent subjects and correlate it with buccolingual inclinations(BL) of maxillary first molar teeth. Methods: This retrospective study involved 80 CBCTs of class I hyperdivergent subjects divided into two groups - group A (n=33) buccolingual inclination &gt;9º and group B (n=47) buccolingual inclination &lt;9º. Prevalence and extent of alveolar bone dehiscence and fenestrations were measured in CBCTs using OSIRIX Lite software. Descriptive statistics, Mann Whitney U test and Spearman correlation were done for evaluating intergroup differences and correlation with Buccolingual inclination. Results: Overall prevalence of dehiscence and fenestration in maxillary first molars was 60.95% and 5% respectively. In the buccal alveolar bone, prevalence of dehiscence was highest in group A (84.6%) for 16 and in the lingual alveolar bone prevalence of dehiscence was highest in group B (71.4%) for 26 . On intergroup comparison, the extent of lingual alveolar bone dehiscence (26) in group B was significantly higher (p value &lt;0.05) than in group A. No significant correlation between the extent of dehiscence and fenestration with buccolingual inclination of molar teeth was noted. Conclusion: Molar teeth with BL inclinations of more than 9º had higher prevalence of dehiscence on the buccal side and molar teeth with BL inclinations less than 9 degrees had more dehiscence on the lingual side. But no significant correlation of BL inclination with prevalence and extent of dehiscence and fenestration was noted.

Evaluation of Canal-centering Ability and Apical Transportation of Hyflex-EDM, OneShape, WaveOne Gold, and Reciproc Files: An Ex Vivo Study.

To evaluate and compare canal-centering ability (CCA), canal transportation (CT), and dentinal crack formation by using Hyflex-electrical discharge machining (EDM), OneShape, WaveOne Gold, and Reciproc single file system in the mesiobuccal root of maxillary first molar at coronal, middle, and apical third using cone-beam computed tomography (CBCT) and scanning electron microscopy (SEM). Mesiobuccal roots of 120 freshly extracted maxillary molar teeth were divided into four experimental groups; Hyflex-EDM, OneShape, WaveOne Gold, and Reciproc (n = 30/group). Preinstrumentation scanning was done using CBCT for all samples at coronal one-third (4 mm), middle one-third (8 mm), and apical one-third (12 mm). After cleaning and shaping with standard irrigation protocol, the specimens were again scanned. Canal-centering ability and CT were calculated using pre- and postinstrumentation CBCT values. A scanning electron microscope was used to identify dentinal crack formation. No significant difference was found for CCA by any of the systems at coronal, middle, and apical third, respectively. However, OneShape was found to have better CCA at the coronal third and WaveOne Gold at the middle and apical third. There was a significant difference in canal transportation at the apical third (p = 0.004) with WaveOne Gold having the least CT followed by Reciproc at the apical third. OneShape resulted in more dentinal cracks in the coronal and middle thirds. Also, Hyflex-EDM was better in the apical third. No difference in CCA was observed between the groups. The lowest values for CT were obtained for WaveOne Gold (similar to Reciproc) whereas both rotary files showed higher values for CT. Also, OneShape showed the most dentinal at all levels. Furthermore, Hyflex-EDM and WaveOne Gold produced the least dentinal cracks at all levels. Given that the Reciprocating file system had the least CT and least dentinal cracks, the clinical success rate of root canal treatment (RCT) with the Reciprocating file system can be a better choice to improve the longevity of root canal-treated teeth.

Effect of XP-Endo Finisher Rotary File on Removal of Smear Layer on the Root Canal Wall Using Different Rotary Files and Different Irrigants (An Ex- vivo Study)

Objective: To evaluate the efficacy of XP- endo finisher (XPF) in removing the residual smear layer as a final step following the useof the One Curve and 2Shape files. Methods: Sixty extracted maxillary first molar teeth with (MB) root curvature within (10-25°) were selected, and only (MB) rootswere used in this study. After that, the teeth were divided randomly according to the type of file used for canal preparation into twomain groups (1 and 2). Then the main groups were divided into three subgroups (A, B, and C). In subgroups A1, B1, and C1, the2Shape file was used for canal preparation; in subgroups A2, B2, and C2, the One Curve file was used. In subgroups A1 and A2,NaOCl was used during instrumentation and XPF to improve the residual smear layer removal with EDTA. In subgroups B1 and B2,NaOCl was used during instrumentation, and EDTA was used for 1 min to remove the residual smear layer. In subgroups C1 and C2,normal saline was used during instrumentation and with XPF. Then the roots were linearly sectioned into two parts. The coronal,middle, and apical thirds were quantified for the remaining smear layer under the scanning electron microscope (SEM). The Kruskal– Wallis- test and Mann- Whitney U test were used to measure the subgroups' differences. All tests were performed at the significant (p &lt; 0.05) level. Results: The subgroup C1 had the highest mean score and lowest efficiency in removing the residual smear layer. The result showed that the subgroup A2 exhibited the best residual smear layer removal effectiveness. Significant differences were observed between subgroups A1 and A2 (p &lt; 0.05). At the same time, there were significant differences between subgroups B1 and B2 (p &lt; 0.05), and subgroups A2 and B2 exhibited significant differences from C2 (p &lt; 0.05). Furthermore, significant differences were observed when subgroups C1 and C2 were compared to all the other subgroups (p &lt; 0.05). Conclusions: Using the One Curve file with NaOCl during instrumentation and using XPF to improve the residual smear layer removal with EDTA exhibited the best efficacy for removing the residual smear layer.

Effect of different intraoral scanning strategies on the marginal and internal fit of CAD-CAM inlay restorations: An in vitro study

Whether the scanning strategy of intraoral scanners (IOSs) affects the accuracy of the digital recording for an indirect ceramic inlay restoration is unclear. Furthermore, which strategy would be optimal and most effective is uncertain. The purpose of this in vitro study was to evaluate the impact of 3 different scanning strategies using the Carestream CS 3700 IOS on the marginal and internal fit of a mesio-occluso-distal (MOD) ceramic inlay restoration. A typodont master model (ANA-4 VCER; Frasaco) was used with a standardized preprepared MOD inlay maxillary first molar typodont tooth (ANA-4 ZP16 CER99-008; Frasaco) (N=30). These inlay preparations were scanned with the CS 3700 IOS using 3 different scanning strategies: linear, wave, and S-figure scanning strategies. Each scan strategy group was scanned 10 times for all groups to obtain 30 standard tessellation language (STL) files. Thirty restorations were milled from lithium disilicate CAD blocks (IPS e.max; Ivoclar AG) and cemented into their typodont-prepared inlay cavities. A single examiner used a stereomicroscope to measure the marginal and internal gaps at the predetermined points. A 1-way ANOVA was used for the statistical analysis, followed by the Tukey post hoc test with Bonferroni adjustment. All tests were 2-tailed (α=.05). All scanning strategy groups demonstrated statistically significant differences for the marginal and internal fit of the inlay restorations (P<.001). Overall, the linear scanning strategy showed the lowest mean marginal and internal gap values (29.2 ±3.6µm and 39.0 ±6.4µm), followed by the wave scanning strategy, which had comparable mean marginal and internal gap values: 49.1 ±3.6µm and 48.2 ±6.0µm, respectively. The S-figure scan strategy had the highest mean marginal and internal gap values: 50.2 ±12.6µm and 71.3 ±7.7µm, respectively. Inlay restorations scanned by the linear scan strategy had the best marginal and internal fit when scanned with the CS 3700 IOS.

Prevalence of root fusion in canine maxillary second molar teeth using cone-beam computed tomography

This study evaluated the prevalence of root fusion in the right and left maxillary second molar teeth in dogs using cone-beam computed tomography (CBCT). A total of 180 dog CBCT scans, or a total of 360 maxillary second molar teeth, were analyzed in this study. Dogs were divided into weight categories of small (&amp;lt;10 kg), medium (10–25 kg), and large (&amp;gt;25 kg). Skull type (brachycephalic, mesocephalic, dolichocephalic) and sex were also recorded for each dog. Overall, 65% of maxillary second molar teeth had some type of root fusion. Of the teeth that had fusion, the only configuration represented was fusion of the distobuccal root with the palatal root. The most common root morphology overall (all dogs and both right and left maxillary second molar teeth included) was partial fusion (177/360, 49%). With the high prevalence of fused roots in maxillary second molar teeth in dogs found in this study, CBCT will help clinicians to more accurately assess a dog's anatomy and implications for treatment.

The Effect of Thermo Cycling on Fracture Resistance Of Temporary Prosthesis Fabricated By CAD/CAM With Composite- Based Material

Aim: The objective of this study was to evaluate the effect of thermo cycling on fracture resistance of temporary prosthesis constriction by computer-aided design/ computer-aided manufacturing (CAD/CAM) with those of composite materials. Material and Methods: A dentoform maxillary molar tooth was prepared for full coverage crown, temporary prosthesis was constriction and divided into the following groups: CAD/CAM poly (methyl methacrylate) (PMMA) blocks, and auto- polymerizing temporary material. All specimens were subjected to thermo cycling and then fracture strength was measured by a universal testing machine. Results: The mean ± Stander deviation values for CAD CAM group before thermo cycling (560.50 ±83.581 Newton) and after thermo cycling (901.00± 311.598 Newton) were recorded statistically significant higher fracture resistance mean compared with composite fabricated interim restorations. Conclusion: Interim prosthesis constructed using CAD CAM technique showed higher fracture

Enhancing the mechanical stability of restored teeth with interfacial cracks: Finite element analysis

ObjectivesThis study aims to enhance the mechanical stability of restored molar teeth with class II occlusal-distal (OD) cavities. We seek to achieve this goal through a comprehensive investigation of three primary factors: (1) the choice of restoration material properties, (2) internal cavity geometries, and (3) the impact of double-layered restoration configurations. MethodsTo achieve our objectives, we initiated by creating two-dimensional (2D) models of restored teeth featuring class II OD cavities, utilizing scanned and segmented images of maxillary molar teeth. We drew 2D profiles of dentine and enamel, which were then imported into finite element analysis (FEA) software. To explore various cavity geometries, we implemented a total of thirteen different designs, encompassing straight, oblique, grooved, curved, and double-layered configurations. We utilized a semi-circular stone to simulate the application of contact load on the restored tooth. We applied identical boundary conditions and contact loading across all models. To assign material properties, we developed a Python code, enabling the automatic assignment of seven elastic moduli ranging from 2 GPa to 26 GPa to the restoration materials. Meanwhile, constant material properties were assigned to the enamel and dentine. In total, we conducted 133 FEA simulations to comprehensively analyse the effects of the aforementioned factors on the strength and performance of restored molar teeth. ResultsOur analysis revealed two key factors significantly influencing the mechanical resistance of treated teeth, particularly in the presence of a crack or debonding: (1) the marginal geometry of the OD cavity and (2) the elastic modulus of the restorative material. However, altering the internal cavity angle and implementing a double-layered restoration did not significantly influence the restored tooth's overall strength and performance in the face of crack or debonding situations. SignificanceThe findings of this study have substantial implications for designing and restoring class II OD cavities to enhance resistance to cracks or debonding. The use of curved marginal geometries in restoration design can significantly improve fracture resistance, with double-curved geometries reducing stress concentrations by approximately 43% compared to straight cavities. These results offer valuable guidance for strengthening the structural integrity of restored teeth, calling for further experimental investigations to explore practical applications and benefits.

Interdental Bone Level around Immediately Placed Implants at Maxillary and Mandibular Molar Sites: A Retrospective Radiographic Analysis.

Background and Objectives: The current study aimed to compare the amount of interdental bone loss between early and immediate implant placements. Materials and Methods: A total of 16 immediate implants and 16 early implants radiographs were included in the current research. The bone level was assessed at two different stages: at the extraction appointment (T1) and after three to six months of implant placement (T2). A line was drawn from the cemento-enamel junction connecting adjacent teeth to the interdental line connecting the interdental alveolar crest at both stages. The difference between measurements in the T1 and T2 stages is the bone loss measurement for the early implant group. For the immediate implant placement sites, the measurements were taken from the interdental bone crest to the implant platform level. Results: A Mann-Whitney U test was performed to evaluate the differences between both groups. The descriptive statistics of the T1 and T2 stages for both groups suggest that the bone loss in the T2 stage was generally higher than T1 stage. The immediate implant group showed higher bone loss compared to the early implant group. Moreover, there was significantly higher bone loss (p = 0.039) in the immediate implant group compared to the early implant group. Conclusions: The results of this study indicate that immediate implant might have disadvantages over early implant in terms of bone loss after the extraction of maxillary and mandibular molar teeth.

Procedure time and filling quality for bulk-fill base and conventional incremental composite techniques—A randomised controlled in vitro trial

ObjectivesThe aims of this randomised controlled laboratory trial were to determine the procedure time and immediate quality (surface porosity and marginal gaps) of fillings placed using the bulk-fill base technique and the conventional incremental technique in simulated clinical settings. MethodsForty-two dentists and dental students were randomly allocated to use either the bulk-fill base technique or the conventional incremental technique to fill an identical class II disto-occlusal cavity in a maxillary left first molar typodont tooth. We recorded the time the participants used to fill the cavity and evaluated the surface porosity and marginal gaps on the approximal surfaces of the fillings using a stereomicroscope and specific probes according to the FDI criteria for restoration evaluation. Data were analysed using the Mann–Whitney U, Kruskal–Wallis, and chi-square tests. ResultsThe median time ± interquartile range was 186 ± 80 s for the bulk-fill base technique and 463 ± 156 s for the conventional incremental technique (p < 0.001). The quality of the fillings was better for the bulk-fill base technique than for the conventional incremental technique (X2 = 9.5, p = 0.002). Neither operator experience nor the usual technique of choice were associated with the procedure time or the quality of the fillings. ConclusionsCompared to the conventional incremental technique, the use of the bulk-fill base technique shortened the time to fill a cavity by 59.8 % or 4 min and 36 s, and it improved the immediate surface and marginal quality of the fillings, regardless of the operator's experience or technique preference. Clinical significanceThe use of the bulk-fill base technique instead of the conventional incremental technique leads to significant time-savings when placing large class II composite fillings. Additionally, the use of the bulk-fill base technique instead of the conventional incremental technique improves the immediate quality of large class II composite fillings.

Evaluation of Bolton’s Class II Patients Treated with EXT Premolars with Appropriate Finishes in Orthodontic Treatment

Background and aim: One of the requirements for orthodontic treatment is, making appropriate final occlusion and Finishing correctly. More frequently in Class II patients with maxillary pre molar extraction, to make the final occlusion is impossible, This is due to the disruption of Bolton rate by Extraction maxillary premolars, because the mean mesiodistal width of the premolar tooth is greater than the migration rate of the maxillary first molar tooth from the buccal groove mandibular first molar to the embrasure between the fifth and sixth teeth. For these reasons, to make an appropriate final occlusion, more frequently we need the TIPR (total inter proximal reduction) in mandible. in this study, we examined patients with Class II who were treated with extraction of maxillary first pre molars and its treatment with selective TIPR reached to the appropriate final occlusion, to we’ve got the ultimate good of Bolton is calculated.

Effect of photobiomodulation on the efficacy of anesthesia in maxillary permanent molar teeth with molar incisor hypomineralization: A randomized clinical trial.

Difficulty in anesthetizing teeth that have been diagnosed with molar incisor hypomineralization (MIH) is a frequently reported clinical problem. The effects of low-level laser application (photobiomodulation) on the efficacy of anesthesia during the dental treatment of patients with MIH have not yet been studied. To assess the effects of photobiomodulation therapy (PBMT) on the efficacy of anesthesia in maxillary permanent molar teeth with MIH. This prospective, parallel-arm control, randomized, triple-blind clinical trial included children aged 7-12 years. Maxillary permanent first molar teeth with MIH that required pulpotomy treatment were included. Seventy participants were randomly divided into two groups: experimental (with PBMT) and control (placebo). In the experimental group, before the administration of local infiltration anesthesia, PBMT (diode laser: 940 nm; continuous mode; 0.5 W; 78 J/cm2) was applied to the oral mucosa for 60 s each. In the control group, the laser probe was channeled toward the mucosa but was not activated. Pain scores were evaluated during the access cavity preparation of the pulpotomy treatment (when using the dentin cutting handpiece and while entering into the pulp) using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Additional anesthesia requirements were assessed in both groups. The data obtained were analyzed for statistical significance (p < .05). The chi-squared test was used to determine the effect of PBMT on categorical outcomes. The no-pain scores of the experimental group were higher than those of the control group (29% vs. 20%). Moderate-to-high pain was more frequent in the control group than in the experimental group (43% vs. 20%). While 31% of the experimental group required supplemental anesthesia, 49% of the control group required supplemental anesthesia during pulpotomy of the tooth with MIH. No statistical difference, however, was found between the two groups in terms of pain scores and the need for supplemental anesthesia (p = .235, p = .143). Anesthesia with and without PBMT caused no difference in pain during the treatment of maxillary molar teeth with MIH.

Evaluation of The Accuracy of Two Apex Locators For Determining The Working Length of Endodontically Retreated Curved Mesial Roots of Maxillary Molar Teeth : An Ex Vivo Study

Objective: To evaluate the accuracy of PROPEX PİXİ (Dentsply Sirona, Ballaigues, Switzerland) and Apex ID (Sybron Endo, Orange, CA, USA) in determining the working lengths of curved mesial roots of upper molars during the retreatment procedure. Method: Twenty curved mesial roots of upper molar teeth were selected. Canals were shaped with ProTaper Next instruments (Dentsply Sirona) up to X3. The canal lengths were determined with a microscope (Carl Zeiss GmbH, Oberkochen, Germany) at 2,5X magnification (DM) and then also detected electronically (EM1P and EM1A) with PROPEX PİXİ (Dentsply Sirona) and Apex ID (Sybron Endo) in an alginate model. Specimens were then obturated using a size X3 master gutta-percha cone and an epoxy resin-based root canal sealer. Seven days later, the coronal part of the filling was removed with a Gates Glidden drill size 3 and for the middle part Protaper Universal Retreatment File D2 used. Working lengths electronically were detected again by two different apex locaters (EM2P and EM2A). Data were analysed by using the Wilcoxon Signed Rank and Mann Whitney u test. The analyses were carried out with MedCalc Statistical Software. Results: No significant difference was found between direct measurements (DM) and electronic measurements before and during retreatment for PROPEX PİXİ (P=0.135) and Apex ID (P=0.232). Also there was no significant difference between two apex locaters before (P=0.108) and during retreatment (P=0.242) Conclusion: PROPEX PİXİ and Apex ID were considered accurate for the root canal length determination during retreatment procedure. Keywords: Apex locator, curved molar, retreatment, working lenght