Maxillary Molars Research Articles

Craniofacial and Airway Morphology in Down Syndrome: A Cone Beam Computed Tomography Case Series Evaluation.

Background: Down syndrome (DS) is a genetic condition characterized by an extra copy of chromosome 21, resulting in various physical and cognitive features. This study aimed to comprehensively analyze the dental and craniofacial morphology of individuals with DS using Cone Beam Computed Tomography (CBCT). Methods: Six individuals with DS, comprising five males and one female aged 17 to 35 years, underwent CBCT scanning. Radiographic assessments included dentition, occlusion, paranasal sinuses, airway, skull bones, and suture calcification. Linear and angular cephalometric measurements were performed, and airway analysis was conducted using Dolphin 3D imaging software v.11. Results: The study revealed prognathic maxilla in five patients, prognathic mandible in four, and bimaxillary protrusion in two. Dental findings included microdontia, enamel hypoplasia, and congenitally missing teeth, with maxillary and mandibular third molars most commonly absent. Sinus abnormalities, delayed suture closure, and cervical spine anomalies were also observed. Conclusion: These findings contribute to a deeper understanding of DS-related craniofacial characteristics and emphasize the importance of considering these morphometric features in clinical management strategies for individuals with DS. This study's limited sample size underscores the significance of radiographic assessment in planning interventions such as cosmetic reconstructions, prosthetic rehabilitation, or orthodontic treatment for individuals with DS.

Assessment of Bone Thickness at the Infra Zygomatic Crest Region for Various Orthodontic Miniscrew Implant (OMSI) Insertion Angles: A Cone-Beam Computed Tomographic Study.

To evaluate the infrazygomatic crest (IZC) bone and develop guidelines for the optimum placement of orthodontic miniscrew implants (OMSIs) along the distobuccal root of the permanent maxillary first molar. Bone thickness of the IZC region of 50 young adults (25 males and 25 females) aged 18-30 years were evaluated using cone-beam computed tomography images. The infrazygomatic bone thickness along the distobuccal root of the permanent maxillary first molar was assessed at various insertion angles (40° to 75° i.r.t the maxillary occlusal plane) with an increment of 5°. Student's t-test was used to compare the IZC bone thickness and height at the orthodontic miniscrew insertion site for males and females on the right and left sides. The bone thickness of the IZC region above the distobuccal root of the permanent maxillary first molar was estimated between 4.39±0.25 mm and 9.03±0.45 mm for insertion angles from 40° to 75° to the maxillary occlusal plane. The corresponding OMSI insertion heights were 17.71±0.61 mm to 13.69±0.75 mm, respectively, above the maxillary occlusal plane. There were statistically significant gender and side-wise variations in bone thickness at the IZC area and insertion height. The safe position for OMSI placement at the IZC was 13.69-16 mm from the maxillary occlusal plane with an insertion angle between 55° and 75°. These parameters provide the optimum placement of OMSIs along the distobuccal root of the permanent maxillary first molar.

Relationship of buccolingual inclination between the alveolar bone and first molar in different vertical facial types: A CBCT study

BackgroundThis study aimed to investigate the differences in the buccolingual inclination and transverse width of maxillary and mandibular first molars among different vertical facial types. MethodsIn all, 78 samples were divided into three groups based on the GoGn-SN angle: the low-angle group (n = 26, mean age=24.21±5.11), average-angle group (n = 26, mean age=22.66±3.72), and high-angle group (n = 26, mean age=22.23±2.43). Cone beam computed tomography (CBCT) measurements were used to assess the buccolingual inclination of the axis of the maxillary and mandibular first molars, as well as the buccolingual inclination of the alveolar bone, the dental arch width, and the basal bone width. One-way ANOVA, the LSD test, and Pearson correlation analysis were performed. ResultsThe high-angle group showed significantly greater lingual inclination of the maxillary alveolar bone than the low-angle group and average-angle group (p < 0.001; p < 0.05). The difference in buccolingual inclination of the axis of the maxillary first molar and the alveolar bone was significantly greater in the high-angle group than in the low-angle group (p < 0.05). Both the maxillary and mandibular dental arch were significantly narrower in the high-angle group than in the other two groups. The mandibular basal bone was also significantly narrower in the high-angle group than in the low-angle group and average-angle group (p < 0.001; p < 0.01). ConclusionsThe alveolar bone of maxillary first molar in the high-angle group was more palatal inclined than that the low-angle group and the average-angle group, which suggests that orthodontists should pay more attention to the root-bone relationship in the high-angle group during expansion treatment to prevent bone fenestration and dehiscense.

Prevalence and Pattern of Tooth Impaction: A Radiographic Study in a Trinidadian Population.

The aim of this retrospective study was to determine the prevalence and patterns of impacted third molars in a Trinidadian population. A total of 1500 orthopantomograms (OPG) taken at the School of Dentistry, University of the West Indies, from 2008 to 2019 in patients between 15 and 67 years old were evaluated. From the data collected, the prevalence of third molar impaction, the parameters of gender, angulation, level of impaction, and associated pathologies were evaluated. Other types of impacted teeth were also recorded. Of the 1500 OPG viewed, 408 (27.2%) of the study sample presented with at least one impacted third molar. 161 (39.5%) were males and 247 (60.5%) were females, with a male-to-female ratio of 1:1.5. There was a greater incidence of mandibular third molars versus maxillary third molars, which had a frequency of 77.9% and 22.1%, respectively. The most common type of impaction (Winter's classification) was horizontal in the mandible and distoangular in the maxilla. The most common level of impaction in the mandible (Pell and Gregory classification) was level 1A. The total number of impacted teeth was 775, and of these, 75 (9.7%) showed other impacted teeth besides the third molars. Canines and second premolars were the most prevalent with 7.6% and 1.5%, respectively. Caries on the second molar (49.3%) and third molars (40%) were the most frequently associated pathologies identified. The prevalence of impacted wisdom teeth in this study was 27%. These results raise awareness and provide insight among dental professionals in Trinidad as to the prevalence of impacted third molars, their patterns, as well as commonly associated pathologies, and the need for screening within the population.

Concerns regarding the successful eruption of third molars after extraction of maxillary second molars

Concerns regarding the successful eruption of third molars after extraction of maxillary second molars

Spatial and angular alterations in the dental arch after premature loss of primary molars: Immediate and 9-month computed tomography evaluation.

Contemporary imaging methods and quickly advancing technologies have increased the number of diagnostic tools available in medicine and orthodontics. The current study aimed to determine three-dimensional (3D) space changes that occurred after the extraction of either the maxillary or mandibular primary molars during the mixed dentition period. The present study was a longitudinal split-mouth study with a study group and a control group. The sample consisted of 20 children aged between 6 and 9 years. Clinical examination, radiological analysis, and 3D digital images of the plaster casts were used sequentially to gather all the data. The dental cast measurements recorded were arch width, arch length, hemi-perimeter, dental space at the extraction site, and angulation of the first permanent molar. The children were recalled for follow-up after 9 months, and all dental cast measurements were repeated using nondestructive 3D computed tomography software. For repeated measurements, the test applied was a paired t-test, and for independent samples, the test was a Student's t-test. A significant decrease in arch width (P = 0.001), arch length (P < 0.001), hemi-perimeter (P < 0.001), D-space (P < 0.001), and E-space (P = 0.001) was observed following extraction. A significant increase in angulation measurements was observed (P = 0.001). The study revealed a comparative reduction in mandibular arch width, a reduction in arch length in both the maxilla and the mandible, a reduced hemi-perimeter of dental arches, loss of dental extraction space, and a change in angulation of the erupted first permanent molars following premature loss of the primary molar.

Three-dimensional evaluation of temporomandibular joint and dental asymmetries in angle class II division 1 subdivision malocclusion

Abstract Background Management of class II division 1 subdivision malocclusion has consistently offered an important challenge for orthodontic professionals. This problem arises not only from the complexities associated with its treatment but also from the complex nature of its asymmetric characteristics. Understanding the properties of asymmetry in this particular malocclusion has significant importance. Objectives Evaluate the features of temporomandibular joint and dental asymmetries in angle class II division 1 subdivision malocclusion by using cone-beam computed tomography (CBCT). Patients and methods Forty CBCT scans of adult patients were analyzed and divided into two groups: 20 CBCT for each group skeletal and dental measurements were measured and compared among both groups to evaluate the features temporomandibular joint and dental asymmetries in class II division 1 subdivision malocclusion. Results Dental parameters were significantly different (P &lt; 0.01) between right and left sides in maxillary sagittal position (mandibular first), maxillary and mandibular canine. A comparison of condyle and glenoid fossa concerning right, and left sides showed together significant an differences (P &lt; 0.01) in coronal position of GFI, GlS, Poi, and posterior wall angle of the articular tubercle. Conclusion In class II division 1 subdivision malocclusion the mandibular first molar was distal and lingual in position, while the maxillary first molar was mesial in class II side. In class ii subdivision malocclusion, glenoid fossa position and condylar morphology asymmetries caused skeletal asymmetry.

The treatment effects of maxillary asymmetric mechanics with the use of the mesial-distalslider: A retrospective study

This study had 2 objectives: (1) to evaluate the clinical efficacy of the Mesial-Distalslider (MD) appliance when used for simultaneous maxillary molar mesialization and distalization in patients with a maxillary asymmetrical relationship and (2) to compare the outcomes with those achieved using the unilateral Mesialslider (UM) appliance. The sample included 40 subjects (25 females and 15 males) with a mean age of 22 years (range, 8-55 years). The patients were divided into 2 groups: 20 patients treated with an MD appliance (group 1) and a group of 20 patients treated with a UM appliance (group 2). Superimposition of digital dental models using regions of interest on the palate was performed to evaluate the 3-dimensional molar movements, the proclination or retroclination of the maxillary incisors, and the displacement of the maxillary midline. At the end of the treatment, the MD group's total movements were 4.5 ± 2.2 mm (sagittal), -0.4 ± 2.4 mm (transverse), and 0.3 ± 0.9 mm (vertical) along the mesialization side and -2.4 ± 1.7 mm (sagittal), -0.5 ± 1.5 mm (transverse), and 0.2 ± 1.4 (vertical) along the distalization side. UM group total movements were 5.5 ± 3.6 mm (sagittal), -0.4 ± 2.7 mm (transverse), and 0.1 ± 2.0 mm (vertical). Incisor displacements were minimal. No statistically significant differences were found between the MD and UM groups for all the parameters. The use of the MD enables controlled movements in the sagittal direction with negligible dental side effects in the other planes (transverse and vertical). Furthermore, it facilitates asymmetrical movements simultaneously in the desired direction without the patient's compliance and provides good anchorage control.

Multimethod Analysis of a Novel Multi-coloured Heat-treated Nickel-Titanium Rotary System: Design, Metallurgy, Mechanical Properties, and Shaping Ability

IntroductionThis study aimed to compare a new multicolored rotary system with four heat-treated rotary instruments using the multimethod approach. MethodsThree-hundred instruments of RCS Rainbow, Rotate, RaCe EVO, OneCurve, and ProTaper Ultimate systems were evaluated regarding their design (stereomicroscopy, scanning electron microscopy, and 3D surface scanning), metallurgy, and mechanical performance (cyclic fatigue, torsional resistance, bending and buckling resistance, and cutting ability). Unprepared surfaces after canal preparation of maxillary molars were evaluated using micro-computed tomography. Kruskal-Wallis and one-way analysis of variance post hoc Tukey tests were used for statistical comparisons (α = 5%). ResultsInstruments exhibited variations in active blade length, number of spirals, and cross-sectional designs. RCS Rainbow showed specific phase transformation temperatures, highest bending (400.5gf) and buckling (286gf) resistance values, and lowest mean angle of rotation (529°) (P < .05). OneCurve exhibited superior cutting ability (8.4 mm) and longer time to fracture (112s). RaCe EVO displayed the lowest time to fracture (51s), maximum torque (1.2 N.cm), buckling (174gf), and bending resistance (261gf) values (P < .05). ProTaper Ultimate showed the highest torque (1.6 N.cm) and angle of rotation (611°) (P < .05), while its bending load (262gf) was comparable to RaCe EVO (P > .05). Rotate instrument showed intermediate values in the mechanical tests. No difference was observed regarding the unprepared canal surfaces (P > .05) ConclusionsRCS Rainbow demonstrates a trade-off between flexibility and other mechanical properties. Its dimensions exceeded those of other instruments, affording it higher torque resistance, yet concurrently reducing its flexibility, angle of rotation, and cutting ability. OneCurve stands out as a well-balanced choice by integrating geometric design and mechanical performance.

Comparative analysis of incidence of dentinal defect with different taper of rotary instrument use stereomicroscope

Aims: Study the effect of canal preparation with different Niti rotary system (Edge x7 file and F-one file) with different taper (0.04 and 0.06) on the incidence of dentinal defect. Methods and Material: 75 straight palatal root of maxillary first molar were collected, the instrumentation was done to 11 mm root length for all sample except control group, the sample were divided randomly into five group (n=15), Group (A) was a control, Group (B) with Edge x7 taper (0.04), Group (C) with Edge x7 taper (0.06), Group (D) with F-ONE taper (0.04), and Group (E) with F-ONE taper (0.06) Every sample had a horizontal section from the apex at 2 mm, 4.5 mm, and 7 mm, dentinal defect was evaluated with 25x stereomicroscope. Statistical analysis used: The data were statistically evaluated at significance levels of 5% or more using Fisher's exact test. Results: Ther is no significant difference between different taper and between different file, in general taper 0.04 showed less dentinal defect than taper 0.06, and Edge x7 showed less defect than F-ONE. Conclusions: Dentinal defects were present in all experimental groups, but not in control group. Key-words: Edge x7, AF Fanta, dentinal defect, stereomicroscope

Pulpitis pain relief by modulating sodium channels in trigeminal ganglia

Objectives: The pulp is the center of the tooth containing nerves and blood vessels. The condition in which the pulp becomes inflamed due to caries or periodontitis is called pulpitis. Pulpitis is a difficult-to-treat disease and causes peripheral nerve tissue changes and severe pain; however, the relationship between neuronal activity and voltage-gated sodium channel 1.7 (Nav1.7) expression in the trigeminal ganglion (TG) during pulpitis has not been well studied. In this study, we found that experimentally induced pulpitis activates Nav1.7 expression in the periphery, leading to neuronal overexpression in the TG. Thus, we sought to identify ways to regulate this process. Methods: Acute pulpitis was induced in rat maxillary molars by treating the pulp with allyl isothiocyanate (AITC). Three days later, in vivo optical imaging was used to record and compare neural activities in the TG. Western blotting was used to identify molecular changes in terms of the expression of extracellular signal-regulated kinase (ERK), c-Fos, transient receptor potential ankyrin 1 (TRPA1), and collapsin response mediator protein-2 (CRMP2) in the brain stem. Results: The results confirmed the neurological changes in the TGs of the pulpitis model, and histological and molecular biological evidence confirmed that increased Nav1.7 expression induced by pulpitis leads to pain. Furthermore, selective inhibition of Nav1.7 resulted in changes in neural activity, suggesting that pulpitis induces increased Nav1.7 expression, and that effective control of Nav1.7 could potentially reduce pain. Conclusions: The inhibition of overexpressed Nav1.7 channels may modulate nociceptive signal processing in the brain and effectively control pain associated with pulpitis.

Macrophages modulate mesenchymal stem cell function via tumor necrosis factor alpha in tooth extraction model.

Mesenchymal stem cells (MSCs) and macrophages collaboratively contribute to bone regeneration after injury. However, detailed mechanisms underlying the interaction between MSCs and inflammatory macrophages (M1) remain unclear. A macrophage-depleted tooth extraction model was generated in 5-wk-old female C57BL/6J mice using clodronate liposome (12.5mg/kg/mouse, intraperitoneally) or saline injection (control) before maxillary first molar extraction. Mice were sacrificed on days 1, 3, 5, 7, and 10 after tooth extraction (n = 4). Regenerated bone volume evaluation of tooth extraction socket (TES) and histochemical analysis of CD80+M1, CD206+M2 (anti-inflammatory macrophages), PDGFRα+MSC, and TNF-α+ cells were performed. In vitro, isolated MSCs with or without TNF-α stimulation (10ng/mL, 24h, n = 3) were bulk RNA-sequenced (RNA-Seq) to identify TNF-α stimulation-specific MSC transcriptomes. Day 7 micro-CT and HE staining revealed significantly lower mean bone volume (clodronate vs control: 0.01mm3 vs 0.02mm3, p<.0001) and mean percentage of regenerated bone area per total TES in clodronate group (41.97% vs 54.03%, p<.0001). Clodronate group showed significant reduction in mean number of CD80+, TNF-α+, PDGFRα+, and CD80+TNF-α+ cells on day 5 (306.5 vs 558.8, p<.0001; 280.5 vs 543.8, p<.0001; 365.0 vs 633.0, p<.0001, 29.0 vs 42.5, p<.0001), while these cells recovered significantly on day 7 (493.3 vs 396.0, p=.0004; 479.3 vs 384.5, p=.0008; 593.0 vs 473.0, p=.0010, 41.0 vs 32.5, p=.0003). RNA-Seq analysis showed that 15 genes (|log2FC| > 5.0, log2TPM > 5) after TNF-α stimulation were candidates for regulating MSC's immunomodulatory capacity. In vivo, Clec4e and Gbp6 are involved in inflammation and bone formation. Clec4e, Gbp6, and Cxcl10 knockdown increased osteogenic differentiation of MSCs in vitro. Temporal reduction followed by apparent recovery of TNF-α-producing M1 macrophages and MSCs after temporal macrophage depletion suggests that TNF-α activated MSCs during TES healing. In vitro mimicking the effect of TNF-α on MSCs indicated that there are 15 candidate MSC genes for regulation of immunomodulatory capacity.

Comparison of the Accuracy and Efficiency of Two Dynamic Navigation System Workflow for Fiber-post Removal: Small versus Large Field-of-view Registration Workflows

IntroductionThis study investigates the feasibility of a dynamic navigation system (DNS) small field of view workflow (DNS-SFOVw) for fiber-post removal and compares its accuracy and efficiency to the conventional large field of view workflow (DNS-LFOVw). MethodsFifty-six extracted human maxillary molars were divided into DNS-SFOVw (n = 28) and DNS-LFOVw (n = 28). The palatal canal was restored with an intraradicular RelyX fiber post and luted with RelyX Unicem; a core buildup was used. Teeth were mounted in a 3D-printed surgical jaw. A preoperative cone-beam computed tomography (CBCT) scan was taken with a 40 × 40 mm FOV for the DNS-SFOVw and a single arch CBCT scan for the DNS-LFOVw. The drilling entry point, trajectory, angle, and depth were planned in the X-guide software. The DNS registration method for the DNS-SFOVw was virtual-based registration on teeth, and the marker point-based method was used for the DNS-LFOVw. The fiber posts were drilled out under DNS guidance. A postoperative CBCT scan was taken. Three-dimensional deviations, angular deflection, number of mishaps, registration, and total operation time were calculated. ResultsThe DNS-SFOVw was as accurate as DNS-LFOVw (P > .05). The DNS-LFOVw registration time was less than DNS-SFOVw (P < .05). There was no difference in the number of mishaps (P > .05). Both DNS-SFOVw and DNS-LFOVw were time-efficient, with DNS-LFOVw taking less total operational time (P < .05). ConclusionWithin the limitations of this in-vitro study, the DNS-SFOVw was as accurate as the DNS-LFOVw for fiberpost removal. Both DNS-LFOVw and DNS-SFOVw were time-efficient in removing fiber-posts.

MiR-20a: a key regulator of orthodontic tooth movement via BMP2 signaling pathway modulation

ABSTRACT Aim In this study, we aimed to establish a rat tooth movement model to assess miR-20’s ability in enhancing the BMP2 signaling pathway and facilitate alveolar bone remodeling. Method 60 male SD rats had nickel titanium spring devices placed between their left upper first molars and incisors, with the right side serving as the control. Forces were applied at varying durations (18h, 24h, 30h, 36h, 42h, 1d, 3d, 5d, 7d, 14d), and their bilateral maxillary molars and surrounding alveolar bones were retrieved for analysis. Fluorescent quantitative PCR was conducted to assess miR-20a, BMP2, Runx2, Bambi and Smad6 gene expression in alveolar bone, and western blot was performed to determine the protein levels of BMP2, Runx2, Bambi, and Smad6 after mechanical loading. Result We successfully established an orthodontic tooth movement model in SD rats and revealed upregulated miR-20a expression and significantly increased BMP2 and Runx2 gene expression and protein synthesis in alveolar bone during molar tooth movement. Although Bambi and Smad6 gene expression did not significantly increase, their protein synthesis was found to decrease significantly. Conclusion MiR-20a was found to be involved in rat tooth movement model alveolar bone remodeling, wherein it promoted remodeling by reducing Bambi and Smad6 protein synthesis through the BMP2 signaling pathway.

Comparative Study of Mesiodistal Crown Dimensions and Tooth Size Discrepancies of Thalassemia and Control Iraqi Patients

Aims: To find differences in mesiodistal tooth width in Iraqi B thalassemia compared with normal individuals. Setting and design: 44 subjects, 22 thalassemia (11 males, 11 females) (12.5–22) years, and 22 control (11 males, 11 females) 14–23 years. Methods and Material: Registrations of MD for maxillary and mandibular teeth from the first molar on one side to analogous tooth on the other side were done. Statistical analysis: Mean, standard deviation and 2-sampled t-test were used. Results: In both groups, males’ crown size was greater than females. In the study group largest gender variances appear in the maxillary molars, mandibular molar, maxillary central and maxillary canine respectively. In control, the greatest sexual difference is present in the maxillary first premolar followed by the mandibular second premolar. The means of mesiodistal in both sexes in thalassemia were smaller than in control except in male maxillary central and lateral and female maxillary lateral incisor. In the maxilla, a significant decrease in mesiodistal thalassemia is present in canine and second premolar in both sexes. In the mandible, a significant decrease in thalassemia was present in all comparisons in both genders in comparison with the control. The greatest mesiodistal difference in the mandibular male is present in the first molar, first premolar, second premolar, canine, lateral and central incisor respectively. In female mandibular teeth, the greatest difference is present in the first molar followed by the first premolar, second premolar, canine, lateral incisor and central incisor. Conclusions: Means mesiodistal dimensions in thalassemia show a significant reduction in mandibular teeth and maxillary canine and second premolar in both genders.

The use of laser photobiomodulation as pre-anesthetic tissue management technique in reducing injection pain in children

BackgroundOne of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease injection pain. So, this study aimed to assess the impact of laser photobiomodulation on local anesthesia (LA) injection pain in children and its effect on the efficacy of LA during pulpotomy and SSC procedures.MethodsThe research was carried out as a randomized controlled clinical trial with two parallel group design. It involved 64 cooperative healthy children, age range from 5 to 7 years, each having at least one maxillary molar indicated for pulpotomy. Children were randomly allocated to one of the two groups based on the pre-anesthetic tissue management technique used: test group received laser photobiomodulation, while control group received topical anesthetic gel. Pain during injection, pulpotomy, and SSC procedures was assessed using physiological measures (Heart Rate (HR)), subjective evaluation (modified Face-Pain‐Scale (FPS), and objective analysis (Sound‐Eye‐Motor scale (SEM)).ResultsA total of 64 children with mean age 6.23 ± 0.78 participated in this research. The mean HR scores were significantly lower in the laser PBM group during buccal and palatal infiltration injections. The SEM mean scores were significantly lower in the laser PBM group during both injections. For the FPS scale, the number of children who recorded satisfaction during injection was significantly higher in laser PBM group. There was no statistically significant difference in mean HR as well as in SEM and FPS scores between the two groups during pulpotomy and SSC procedures. Comparisons between the two study groups were performed using independent samples t- and Mann-Whitney U tests. Significance was set at p value < 0.05.ConclusionLaser photobiomodulation is a promising non-pharmacological pre-anesthetic tissue management technique in children that offered less painful injection compared to topical anesthetic gel without compromising the effectiveness of LA.Trial RegistrationClinicalTrials.gov Identifier: NCT05861154. Registered on 16/5/2023.Graphical

Tooth movement analysis of maxillary dentition distalization using clear aligners with buccal and palatal mini-screw anchorages: A finite element study.

To assess the tooth movement trends during the three stages of maxillary dentition distalization with clear aligners (CA) and to compare the efficacy of different mini-screw anchorage systems. Three-dimensional (3D) finite element models of three anchorage systems (A, control group; B, buccal mini-screw anchorage group; C, palatal mini-screw anchorage group) were established. Three stages of simulating maxillary dentition distalization with CA included maxillary molar distalization (stage 1), maxillary premolar distalization (stage 2) and maxillary anterior teeth retraction (stage 3). Therefore, a total of nine models were constructed to analyse the 3D displacement of maxillary teeth during the distalization process. The displacement pattern of maxillary dentition during distalization was similar across the three groups, but with varying magnitudes. During stage 1, groups B and C exhibited greater amounts of molar distalization compared to group A. Group C also demonstrated the least amount of labial movement of the maxillary central incisor compared to the other two groups. During stage 2, the mesial displacement of the maxillary first molar was less significant in groups B and C than in group A. In the final stage, group C exhibited a greater amount of maxillary anterior retraction compared to groups A and B. The palatal mini-screw anchorage system was effective in reducing anchorage loss and improving the efficacy of maxillary dentition distalization with CA.

Root anatomy and canal configuration of human permanent maxillary third molar - systematic review.

Knowledge of the root canals configuration is essential for the success of endodontic treatment. The main aim of the systematic review is to determine the number of roots and the number of root canals in maxillary third molars, in addition, where possible, to determine the Vertucci classification. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines. The study protocol was registered and approved on the International Prospective Register of Systematic Reviews PROSPERO (Reg. No: CRD42022366444) before the start of the study. Twelve studies were included in the analysis, differing in sample origin and methodology. The combined studies were analyzed based on the number of roots, number of canals, and root canal configurations, and the findings were compared with those of other international studies. Analyzing the available research results regarding the root anatomy and canal configuration of the third maxillary molar, the most commonly maxillary third molars had 3 roots (59.00%). Single-rooted teeth (24.20%) or double-rooted teeth (13.80%) were less common. In addition, it was observed that maxillary third molars typically possessed three root canals (47.28%) and the MB (mesiobuccal), DB (distobuccal), and P (palatal) canals most often showed Vertucci Type I (59.53%, 95.83% and 98.61%, respectively) in three-rooted form. Due to the small number of available studies, it is necessary to conduct further analyses taking into account demographic and ethnic differences that may affect the anatomical and morphological structure of the teeth.

Effects of the DL76 Antagonist/Inverse Agonist of Histamine H3 Receptors on Experimental Periodontitis in Rats: Morphological Studies.

Periodontitis preceded by gingivitis is the most common form of periodontal disease and occurs due to the interaction of microorganisms present in the complex bacterial aggregates of dental plaque biofilm and their metabolism products with periodontal tissues. Histamine is a heterocyclic biogenic amine acting via four types of receptors. Histamine H3 receptors act as presynaptic auto/heteroreceptors to regulate the release of histamine and other neurotransmitters. Since the nervous system is able to regulate the progression of the inflammatory process and bone metabolism, the aim of this study was to investigate the effects of DL76, which acts as an antagonist/inverse agonist of H3 receptors, on the course of experimental periodontitis. This study was conducted in 24 mature male Wistar rats weighing 245-360 g, aged 6-8 weeks. A silk ligature was placed on the second maxillary molar of the right maxilla under general anesthesia. From the day of ligating, DL76 and 0.9% NaCl solutions were administered subcutaneously for 28 days in the experimental and control groups, respectively. After the experiment, histopathological, immunohistochemical and radiological examinations were performed. Ligation led to the development of the inflammatory process with lymphocytic infiltration, increased epithelial RANKL and OPG expression as well as bone resorption. DL76 evoked a reduction in (1) lymphocytic infiltration, (2) RANKL and OPG expression as well as (3) bone resorption since the medians of the mesial and distal interdental spaces in the molars with induced periodontitis were 3.56-fold and 10-fold lower compared to the corresponding values in saline-treated animals with periodontitis. DL76 is able to inhibit the progression of experimental periodontitis in rats, as demonstrated by a reduction in the inflammatory cell infiltration, a decrease in the RANKL/RANK OPG pathway expression and a reduction in the alveolar bone resorption.

Mitochondrial biogenesis disorder and oxidative damage promote refractory apical periodontitis in rat and human.

To elucidate whether mitochondrial biogenesis disorder and damage from oxidative stress promote refractory apical periodontitis (RAP) in rat and human. Twenty Enterococcus faecalis-induced RAPs were established in the maxillary first molars of male Wistar rats. Concurrently, 12 periapical lesion specimens from patients presenting with RAP were obtained by apicoectomy. Radiographic examination and histologic analysis were conducted to evaluate periapical bone tissue destruction and morphological changes. The expression of key regulators of mitochondrial biogenesis, PGC-1α and Nrf2, were detected by immunohistochemistry and double immunofluorescence staining, Western blot and real-time PCR were also assayed. Mitochondrial ROS (mtROS) was identified by MitoSOX staining. Mitochondrial function was detected by the quantification of ATP production, mitochondrial DNA (mtDNA) copy number and activities of mitochondrial respiratory chain complexes. Furthermore, mitochondrial oxidative stress was evaluated by the determination of 3-nitrotyrosine (3-NT), 4-hydroxy-2-nonenal (4-HNE) and 8-hydroxy-deoxyguanosine (8-OHdG) expression levels, as well as malondialdehyde (MDA) expression and antioxidant capacity. Student's t-test was performed to determine significance between the groups; p < .05 was considered significant. In the maxilla, significantly more bone resorption, greater number of periapical apoptotic cells and Tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells were observed in the RAP group compared with the control group (p < .01). PGC-1α and Nrf2 were significantly reduced in rat and human RAP lesions compared to the control group (p < .01) at both the mRNA and protein levels. Double immunofluorescence analysis of PGC-1α or Nrf2 with TOMM20 also indicated that mitochondrial biogenesis was impaired in RAP group (p < .01). Additionally, mitochondrial dysfunction was observed in RAP group, as reflected by increased mtROS, decreased ATP production, reduced mtDNA copy number and complexes of the mitochondrial respiratory chain. Finally, the expression levels of mitochondrial oxidative stress markers, 3-NT, 4-HNE and 8-OHdG, were significantly increased in the RAP group (p < .01). Consistent with this, systemic oxidative damage was also present in the progression of RAP, including increased MDA expression and decreased antioxidant activity (p < .01). Mitochondrial biogenesis disorder and damage from oxidative stress contribute to the development of RAP.