Mid-root Level Research Articles

Angulations of Anterior Teeth With Reference to the Alveolar Bone Measured by CBCT in a Chinese Population.

To analyze angulations of anterior teeth with reference to the alveolar bone. Cone-beam computed tomographic (CBCT) images of 105 participants were taken with the same machine (ProMax 3D Max CBCT), showing the intact anterior teeth. The angulations formed between the long axis of the anterior teeth and the alveolus were measured using cross-sectional images. The thicknesses of alveolar bone on different area of root surfaces were also measured. Maxillary anterior teeth were found to be close to the buccal alveolar surface in apical level with the angulations referred to alveolar bone in center incisor, lateral incisor, and canine were 17.65 ± 6.8, 18.79 ± 7.4, and 23.82 ± 6.96 degrees, respectively. Means of angulations of mandibular anterior teeth were less than 8 degree. The thicknesses of buccal bone at mid-root level in 77% to 90% maxillary anterior teeth were less than 1 mm. The determinations provided high intrarater/interrater reliability. The application of CBCT is reliable for a complete calculation of angulations and thicknesses in a Chinese Han population. As a result, adequate planning combined with image examination preoperatively would contribute to a favorable outcome.

The Influence of Brushing Motion on the Cutting Behavior of 3 Reciprocating Files in Oval-shaped Canals

IntroductionThe purpose of this study was to compare the cutting efficiency of 3 reciprocating single-file systems used with a brushing motion in oval-shaped canals. MethodsSixty premolars with single oval canals were selected and randomly assigned to 3 groups according to the file used in canal instrumentation: R25 Reciproc (VDW, Munich, Germany), Primary WaveOne ((Dentsply Maillefer, Ballaigues, Switzerland), and a novel prototype instrument (UFile; MicoMega, Besancon, France). Instrumentation was performed in 4 consecutive steps; according to manufacturers' instructions, 5 brushing strokes against the buccal wall with a nonworking instrument followed by another 5 and 15 brushing strokes with a working file. Cone-beam computed tomographic scans were taken after each step of preparation. Pre- and postinstrumentation images were superimposed at the apical and midroot levels and then evaluated in terms of changes in the maximum buccolingual (ΔBL) and mesiodistal dimensions (ΔMD). ResultsInstrumentation with a brushing motion resulted in the following findings. At the apical levels, no significant difference was found in ΔBL for the 3 groups (P > .05). However, ΔMD was significantly less for the Reciproc (P = .006) and UFile (P = .03) groups. At the midroot levels, the UFile group showed the highest significance in terms of ΔBL (P < .0001) but the lowest in terms of ΔMD (P = .003). ΔMD was significantly the highest for the WaveOne group at the midroot levels (P = .05). ConclusionsThe prototype file was more efficient than the other files at the midroot levels, whereas all systems acted the same at the apical levels. The increase in the number of brushing strokes resulted in more dentinal cutting in the direction of those strokes.

Effect of EDTA, Sodium Hypochlorite, and Chlorhexidine Gluconate with or without Surface Modifiers on Dentin Microhardness

IntroductionThis study aimed to evaluate the effects of root canal irrigants on the microhardness of root canal dentin in the presence and absence of surface-modifying agents. MethodsForty-eight root halves were prepared by longitudinal splitting of the distal roots of 24 freshly extracted mandibular human third molars and embedded in autopolymerizing acrylic resin, leaving the dentin surface exposed. After polishing, the microhardness values of the untreated dentin surfaces were recorded by using Vickers tester at the mid-root level. The root halves were randomly assigned to 6 groups composed of 8 samples each and treated for 5 minutes with one of the following irrigants: 17% EDTA, REDTA, 2% chlorhexidine gluconate (CHX), 2% CHX with surface modifiers (CHX-Plus), 6% NaOCl, or 6% NaOCl with surface modifiers (Chlor-XTRA). After surface treatment, dentin microhardness values were recorded at close proximity to the initial indentation areas. Experimental data were statistically analyzed by using the t test and one-way analysis of variance, followed by Tukey honestly significant difference test at α = 0.05. ResultsEDTA, REDTA, NaOCl, and Chlor-XTRA significantly decreased the microhardness of root dentin compared with intact controls (P < .05). ConclusionsThe addition of surface modifiers to the irrigants did not affect the microhardness of the samples.

Age estimation using pulp/tooth area ratio in maxillary canines-A digital image analysis.

Introduction:Determination of age of a subject is one of the most important aspects of medico-legal cases and anthropological research. Radiographs can be used to indirectly measure the rate of secondary dentine deposition which is depicted by reduction in the pulp area.Materials and Methods:In this study, 200 patients of Karnataka aged between 18-72 years were selected for the study. Panoramic radiographs were made and indirectly digitized. Radiographic images of maxillary canines (RIC) were processed using a computer-aided drafting program (ImageJ). The variables pulp/root length (p), pulp/tooth length (r), pulp/root width at enamel-cementum junction (ECJ) level (a), pulp/root width at mid-root level (c), pulp/root width at midpoint level between ECJ level and mid-root level (b) and pulp/tooth area ratio (AR) were recorded. All the morphological variables including gender were statistically analyzed to derive regression equation for estimation of age.Results:It was observed that 2 variables ‘AR’ and ‘b’ contributed significantly to the fit and were included in the regression model, yielding the formula: Age = 87.305−480.455(AR)+48.108(b). Statistical analysis indicated that the regression equation with selected variables explained 96% of total variance with the median of the residuals of 0.1614 years and standard error of estimate of 3.0186 years.Conclusion:There is significant correlation between age and morphological variables ‘AR’ and ‘b’ and the derived population specific regression equation can be potentially used for estimation of chronological age of individuals of Karnataka origin.

Assessment of Corticotomy Facilitated Tooth Movement and Changes in Alveolar Bone Thickness - A CT Scan Study.

Corticotomy is an effective method of accelerating the orthodontic treatment. The aim of this study was to compare the treatment time for the extraction space closure, between corticotomy assisted and conventional orthodontic tooth movement and to check the alveolar bone thickness before and after corticotomy procedure in the corticotomy group. Cross-sectional clinical study. Twenty patients (age>15 y) requiring orthodontic treatment with upper anterior retraction in the extraction space of 1(st) premolar were selected and were randomised into control and corticotomy group each group consisted of 10 subjects. Pre retraction, corticotomy was performed in the maxillary anterior segment. The pre and post retraction CT scans were recorded and the thickness of the alveolar plates were measured at crestal level (S1), mid root level (S2) and apical level (S3) PreTreatment (T1). The same measurements were repeated after incisor retraction was completed PostTreatment (T2). Student's t-test, Pearson correlation coefficient. There was a significant difference in retraction time (days) between control and corticotomy groups (p<0.001). Also, there were significant difference in total alveolar bone thickness at the crest region for all the four incisor teeth (p<0.05). A significant difference was observed in total alveolar bone thickness at the S2 and S3 level for 11, 21 and 11, 12 and 22 (p<0.05) respectively. Alveolar corticotomies not only accelerates the orthodontic treatment but, also provides the advantage of increased alveolar width to support the teeth and overlying structures.

Diagnosis of mandibular premolar tooth with vertical root fracture using by cone-beam computed tomography

Vertical root fracture (VRF) may occur because of root canal treatment or extensive restoration. A 42-year-old woman applied to our clinic with complaint of pain on her left mandibular second premolar tooth. Radiologic examination by panoramic radiograph indicated that the teeth had a root canal treatment and there was a radiolucency through the mesial area of the root. This data was considered that there might be a root fracture, which cannot be detected on panoramic radiograph. Thus, the condition was told to the patient and after her permission, it was decided to take a CBCT image for definite diagnosis. The tooth was scheduled for extraction and socket preservation. A new CBCT image was taken from the extracted teeth with much more dosage to observe the fracture line every aspect. Also, the tooth was sent to the histology department for histologic investigation. The CBCT image demonstrated hardly visible VRF at the coronal, mid-root and apical levels in the axial views. Fracture line that extends through the long axis of the tooth was seen obviously on CBCT image which was taken after extraction and histologically with different zoom in (×25, ×40, ×100, ×200, and ×400). Different stages of endodontic treatment may cause VRFs. Symptoms of VRF are often not obvious, because of this diagnosis may be difficult for dentists. CBCT images could be helpful to evaluate VRFs which cannot diagnose.

Dentine microhardness changes following conventional and alternate irrigation regimens: An in vitro study.

Aim:To compare the changes in microhardness of root dentin caused by two novel irrigation regimens with conventional irrigation.Materials and Methods:Forty extracted human permanent incisor teeth were selected. Decoronated roots were separated longitudinally to get 80 specimens that were embedded in autopolymerizing acrylic resin and grounded flat with silicon carbide abrasive papers. Of these, 60 root segments without any cracks or defects were selected and divided into four groups according to the irrigation regimen used (n = 15). Group I: 5% sodium hypochlorite (NaOCl) + 17% ethylenediaminetetraacetic acid (EDTA) + 0.2% chlorhexidine digluconate (CHX) (conventional). Group II: 6% Morinda Citrifolia Juice + 17% EDTA (MCJ). Group III: 5% NaOCl + Q Mix 2 in 1 (QMix). Group IV: Distilled water (control). Irrigation regimens were performed for 5 minutes. Dentin microhardness was measured with a Vickers indenter under a 200-g load and a 20-s dwell time at the midroot level of root dentin. The data were analyzed using Kruskal Wallis test and Dunn's multiple comparison tests.Results:A significant difference was seen in the median values of the four groups. The control group showed the least reduction in microhardness when comparison with the other groups. Except for Group III (Q Mix), the other groups that were tested (MCJ and conventional regimens) showed statistically significant difference from the control group.Conclusion:Within the limitation of this study, it was concluded that NaOCl + Q Mix were least detrimental to root dentin microhardness when compared with MCJ and conventional irrigation regimens.

Measurement of sagittal root position and the thickness of the facial and palatal alveolar bone of maxillary anterior teeth

To classify the relationship of the sagittal root positions of the maxillary anterior teeth to their respective osseous housings, and to measure the thickness of facial and palatal alveolar bone by cone-beam computed tomography (CBCT). Twenty-three subjects [9 male, 14 female, mean age: (24.5 ± 1.6) years] who fulfilled the inclusion criteria were involved in this study. The CBCT images were evaluated and the relationship of the sagittal root position of the maxillary anterior teeth to its associated osseous housing was recorded as Kan's Class 1, 2, 3, 4. The facial and palatal alveolar bone thickness at three locations:2 mm apical to crest level, mid-root level and apical level, was measured respectively. Ninety seven point one percent(134/138)of the anterior maxillary teeth were classified as Class 1. Only 2.9% (4/138) were Class 4.Occurrences of > 2 mm thickness of maxillary facial alveolar bone were found 2.2% (6/276 sites) at 2 mm apical to crest level and mid-root level in the sample of maxillary anterior teeth. The majority of the anterior maxillary teeth roots were positioned close to the labial cortical plate. Most tooth sites in the anterior maxilla had a thin facial bone wall.

Cone beam computed tomographic analyses of alveolar bone anatomy at the maxillary anterior region in Chinese adults.

To provide an anatomical basis for clinical implant esthetics, we evaluated the morphology of the nasopalatine canal (NPC) and analyzed labial and interproximal bone anatomy at the maxillary anterior region. We sought to investigate the effect of maxillary protrusion and tooth labiolingual inclination on labial bone anatomy in Chinese adults. Three dimensional (3D) images were reconstructed using cone-beam computed tomography (CBCT) images from 80 Chinese subjects and by SimPlant 11.04. The dimensions of the NPC, the thickness and profile of the labial bone, the width and height of the interproximal bone, angle sella-nasion-subspinale (SNA) and angle upper central incisor-nasion,subspinale (U1-NA) were measured. The incisive foramen of the NPC was markedly wider than its nasal foramen. The dimension of its labial bone wall demonstrated an increasing width from the crestal to apical measurements. The labial bone at the maxillary anterior region was rather thin, especially at 3 mm below the cemento-enamel junction (CEJ) and the mid-root level; the profile of the labial bone was more curved at the central incisor, and the interproximal bone became wider and shorter posteriorly. There were significant relationships between maxillary protrusion and labial bone profile, tooth labiolingual inclination and labial bone thickness (P < 0.02). To achieve optimal esthetic outcome of implant, bone augmentation is necessary at the maxillary anterior region. For immediate or early placement at the maxillary anterior region, the implant should be located palatally to reduce labial bone resorption and marginal recession; its apex should be angulated palatally to avoid labial perforation at the apical region. To protect the NPC, implants at the central incisor region should be placed away from NPC.

Changes in alveolar bone thickness due to retraction of anterior teeth during orthodontic treatment: A cephalometric and computed tomography comparative study

Evaluate the changes in alveolar bone as a result of maxillary and mandibular incisor retraction in patients with bimaxillary protrusion by means of using lateral cephalograms and computed tomography (CT) scans and to investigate any occurrence of bony defects like dehiscence and fenestration. Ten patients (age 15 ± 3 years) with bimaxillary protrusion treated by extraction of four first premolars were investigated by lateral cephalograms and CT scans during pre-treatment (T1) and after 3 months of completion of incisor retraction (T2). The labial and lingual cortex of all the incisors were assessed on the CT scan with measurements taken at site adjacent to widest point of the labiolingual root in three slices separated by 3 mm at crest level (S1), mid root level (S2), and apical level (S3). In the mandibular arch, after lingual movement of the incisors, the bone labial to the anterior teeth decreased in thickness at the coronal level of the left lateral and left central incisors. Left lateral incisor showed significant changes in all the three levels. In the maxilla the change in the labial bone thickness was not statistically significant. Lingual bone of all the incisors showed significant changes in S1 level and S3 levels. Few patients demonstrated bone dehiscence that was not visible macroscopically or cephalometrically. When incisors are retracted, the risk of adverse effect is present. This must be carefully monitored to avoid negative iatrogenic effects. This study needs follow up after 6 months or 1 year after completion of the orthodontic treatment to assess the long-term consequences.

A comparison of four nickel titanium rotary systems, quantec series, k3 endo, race and hero 642 for canal cleaning ability - An in vitro study

Background And Objectives : To compare in-vitro, the cleaning effectiveness of pulp space preparation under Scanning electron microscope (SEM) using four different NiTi rotary instrumentation systems – Quantec SC, K3 Endo, RaCe and HERO 642. Materials and Method : Forty-eight freshly extracted palatal roots of human maxillary first molar teeth were procured, stored and surfaced adhering to infection control protocols in the laboratory as prescribed by Centre for Disease Control Global. Random sampling of specimens into four groups of ten teeth each and one group of eight teeth was done. Groups I, II, III & IV served as experimental with Group V as control. Access cavities were prepared in all groups and working length was determined only in experimental groups. Control group remained non-instrumented. Cleaning and shaping was done for experimental groups only. Teeth were prepared to # 40 master apical file using crown down technique. The experimental groups: I. Teeth with Pulp space instrumented with Quantec SC. II. Teeth with Pulp space instrumented with K3 Endo. III. Teeth with Pulp space instrumented with RaCe. IV. Teeth with Pulp space instrumented with HERO 642. V. Control group: Teeth with pulp space not instrumented. Thereafter all teeth were longitudinally sectioned buccolingually and examined under SEM at 20.0 kV and 500 X magnifications in the middle third of the canal. Debris was defined as dentin chips, pulp remnants, and particles loosely attached to the root canal wall. Analysis of SEM images was performed using following five score index:-Numerical Evaluation (Scoring System): Score 1 – Clean root canal walls, only few small debris particles. Score 2 - Few small agglomeration of debris. Score 3- Many agglomerations of debris covering less than 50% of the root canal wall. Score 4- More than 50% of the root canal wall covered with debris. Score 5- Complete or nearly complete root canal walls covered with debris. Statistical Analysis : Kruskal Wallis test was used to determine whether a statistical difference existed amongst the four group of instruments, with P < 0.001, considered to be statistically very highly significant. Whitney Mann -U test for individual intergroup comparison and “CHI-square” test was used to detect frequency of individual debris score in each tested groups followed by Kendell’s tau-b test to measure observer agreement. Results : Teeth with pulp space instrumented with RaCe system exhibited maximum canal cleanliness compared to the other experimental groups. The differences observed within the groups were statistically very highly significant (p<0.001). Conclusion : Post pulp space preparation with four different NiTi rotary systems, statistically very highly significant differences in canal wall cleanliness at the midroot level was achieved. Under the conditions of this study, best canal cleaning efficacy was achieved by RaCe, followed by HERO 642, K3 Endo and Quantec SC.

An evaluation of insertion sites for mini-implants

(1) To report the thickness of the cortical bone in insertion sites commonly used for orthodontic mini-implants, (2) to assess the impact of a change in insertion angle on primary cortical bone-to-implant contact, and (3) to evaluate the risk of maxillary sinus perforation. At autopsy, 27 human samples containing three to five adjacent teeth were excised and scanned using a table-top micro-computed tomography system. Bone thickness measurements were taken at 45° and 90° to the long the axis of the adjacent teeth, simulating a mini-implant insertion at the mid-root level. In the maxilla, the overall mean cortical thickness at 90° was 0.7 mm buccally in the lateral region, 1.0 mm buccally in the anterior region, and 1.3 mm palatally. In the mandible, the mean cortical thickness was 0.7 mm buccally and 1.8 mm lingually in the anterior region; 1.9 mm buccally and 2.6 mm lingually in the lateral region. Changing the insertion angle from 90° to 45° increased the cortical bone-to-implant contact by an average of 47%. Perpendicular insertion at the mid-root level only rarely interfered with the sinus, whereas apically inclined insertion increased the risk of sinus perforation. Buccally and palatally in the maxilla and buccally in the anterior mandible, the thickness of the alveolar cortical bone is often less than 1 mm. In contrast, the alveolar cortical bone is frequently thicker than 2 mm laterally in the mandible. Changing the insertion angle to 45° will generally enhance implant stability but increase the risk of perforation to the maxillary sinus.

The Effect of Surfactant Addition to EDTA on Microhardness of Root Dentin

IntroductionThe aim of this study was to investigate the effect of different concentrations of cetrimide with or without 5% EDTA solution on the microhardness of human root dentin in vitro. MethodsTwenty-five recently extracted single-rooted human teeth were selected. The roots were split longitudinally into 2 parts. The specimens were randomly divided into the following 5 groups and were treated with 5% EDTA, 5% EDTA + 0.25% cetrimide, 5% EDTA + 0.50% cetrimide, 0.25% cetrimide, and 0.50% cetrimide immediately after the initial baseline microhardness measurements. A standardized volume of 50 mL of each solution was used for 1 minute. The reference microhardness values of untreated specimens were initially measured with a Vickers indenter under a 50-g load and a 10-second dwell time at the midroot level of the root dentin. Post-treatment microhardness values were obtained in the same manner as the initial ones. The decrease in microhardness was calculated as a percentage. Data were analyzed statistically by 1-way analysis of variance (P = .05) and the post hoc Tukey test for multiple comparisons at the same level of significance. ResultsAll solutions significantly decreased the microhardness of root dentin (P < .05). Although there was no significant difference among the solutions (P > .05), the specimens in the EDTA + 0.50% cetrimide solution group showed the highest change in microhardness. The plain EDTA and plain 0.50% cetrimide groups had similar values. ConclusionsThe use of surfactants higher than 0.25% in concentration is questionable for clinical conditions.

Age estimation of indian adults from orthopantomographs

The aim of this study was to develop a method for estimating the chronological age of Indian adults based on the relationship between age and various morphological variables of canine teeth, obtained using orthopantomographs. Orthopantomographs of 120 selected patients were digitized, and radiographic images of the right maxillary canine in each case were processed using a computer aided drafting program. Pulp/tooth area ratio, pulp/root length ratio, pulp/tooth length ratio, pulp/root width ratio at the cemento-enamel junction level, pulp/root width ratio at midroot level, and pulp/root width ratio at the midpoint between the cemento-enamel junction and the midroot of the canine were calculated by measuring various features on the images. Pearson's correlation, multiple linear regression, one way analysis of variance (ANOVA), and Student's t-test were used for statistical analysis. Regression equations were developed to estimate age from morphological variables. The observed minus the estimated age in the total study sample ranged from -2.2 to +1.5 years, in males from -0.9 to +0.8 years, while in females it was from -1 to +0.8 years. Differences between observed and estimated ages of subjects were not statistically significant. In conclusion there is a linear relationship of pulp/root width ratio at mid-root level and pulp/tooth area ratio of the right maxillary canine with chronological age in the Indian population. Age of subjects can therefore be estimated with a good degree of accuracy using regression equations.

Classification of Maxillary Central Incisors—Implications for Immediate Implant in the Esthetic Zone

This is the first study to analyze the positions and angulations of the central maxillary incisors with reference to the alveolus, providing data for clinicians to achieve good esthetic results for immediate implant placement in the esthetic zone. A total of 300 cone beam images were selected randomly. Five aspects were measured: the thickness of the palatal and buccal bone at their mid-root and apical level and the apical bone height. A classification was established according to the positions and angulations of the tooth. The data from 170 cone beam images were included in the present study. The mean thickness of the buccal bone at the mid-root level was 0.9 ± 0.4 mm and at the apical level was 2.04 ± 1.01 mm. The mean thickness of the palatal bone at the mid-root level was 3.76 ± 1.37 mm and at the apical level was 8.51 ± 2.54 mm. The mean apical bone height was 9.53 ± 2.76 mm. The proportion of incisors positioned more buccally (type B) was 78.8%, 19.4%, and 1.8% positioned midway (type M) and more palatally (type P), respectively. Regarding the angulation, 49.9% were classified as type 2 (toward buccal), 34.7% as type 3 (toward buccal, with the long axis anterior to the A point), and 15.4% were categorized as type 1 (toward palatal or parallel to the alveolus). We recommend that clinicians appreciate the socket in 3 dimensions to achieve a good outcome. According to the difficulty of achieving good results, the cases were categorized as levels I to III and recommendations were given.

Nasopalatine Canal Position Relative to the Maxillary Central Incisors: A Cone Beam Computed Tomography Assessment

The aim of this study was to determine the proximity of the nasopalatine canal (NPC) to the maxillary central incisor root (MCIR). The study included 120 cone beam computed tomography scans obtained from the Center for Implant Dentistry, Loma Linda University, between June 2006 and September 2009. They were equally distributed into six groups: (1) 21- to 40-year-old men, (2) 21- to 40-year-old women, (3) 41- to 60-year-old men, (4) 41- to 60-year-old women, (5) 61- to 80-year-old men, and (6) 61- to 80-year-old women. The closest distances between the NPC and the MCIR (NPC-to-MCIR) were measured at the midroot (bisecting palatal cementoenamel junction to root apex) and the apex levels. Differences between the groups were analyzed using a t test and 1-way analysis of variance at a significance level of α = .05. The overall mean NPC-to-MCIR distances at the midroot and apex levels were 3.05 ± 1.64 and 5.22 ± 1.56 mm, respectively. The modes of the NPC-to-MCIR distances at the midroot and apex levels were in the range of 1.01-2.00 mm and 4.01-5.00 mm, respectively. The mean NPC-to-MCIR distance was significantly greater in men than in women at the midroot level (P < .05) but not at the apex level (P > .05). The mean NPC-to-MCIR distance was significantly shorter for the youngest age group than the other two age groups at the midroot level (P < .05). However, at the apex level, the youngest age group had a significantly shorter distance compared with the oldest age group (P < .05) but not the middle age group (P > .05). The results of this study suggest that, to avoid NPC penetration, more care must be exercised during immediate implant placement at the midroot level of a maxillary central incisor in women and younger patients because of the root proximity to the NPC. Tapered implants may also be beneficial in such situations.

Influence of shaft design on the shaping ability of 3 nickel-titanium rotary systems by means of spiral computerized tomography

To evaluate the influence of shaft design on the shaping ability of 3 rotary nickel-titanium (NiTi) systems. Sixty curved mesial canals of mandibular molars were used. Specimens were scanned by spiral tomography before and after canal preparation using ProTaper, ProFile, and ProSystem GT rotary instruments. One-millimeter-thick slices were scanned from the apical end point to the pulp chamber. The cross-sectional images from the slices taken earlier and after canal preparation at the apical, coronal, and midroot levels were compared. The mean working time was 137.22 +/- 5.15 s. Mean transportation, mean centering ratio, and percentage of area increase were 0.022 +/- 0.131 mm, 0.21 +/- 0.11, and 76.90 +/- 42.27%, respectively, with no statistical differences (P> .05). All instruments were able to shape curved mesial canals in mandibular molars to size 30 without significant errors. The differences in shaft designs seemed not to affect their shaping capabilities.

Cephalometric Evaluation of Alveolar Bone Remodeling following Anterior Teeth Retraction

ABSTRACT Aim To evaluate the extent of the alveolar bone remodeling after incisor retraction using lateral cephalograms. Materials and methods Lateral cephalograms of 30 patients with age of 16 years and above requiring therapeutic extraction of both maxillary and mandibular first premolars, mainly for the purpose of retraction of anterior teeth, had been taken at the start of treatment and after retraction of anterior teeth. Various hard tissue anatomical landmarks were traced, and linear parameters of pretreatment (T1) and postretraction (T2) lateral cephalometric radiographs were measured. The mean and standard deviation were calculated, the data were tabulated, and comparison of T1 and T2 readings was made utilizing paired Student’s t-test. Results When maxillary incisors are retracted, the labial bone thickness at the midroot level (MxL2) and at apical level (MxL3) increased during upper incisor retraction. There was a significant reduction in alveolar bone thickness on the lingual/palatal side after maxillary and mandibular incisor retraction. Conclusion When tooth movement is limited, forcing the tooth against the cortical bone may cause adverse sequelae. This type of approach must be carefully monitored to avoid negative iatrogenic effects. How to cite this article Dhanani D, Shivaprakash G. Cephalometric Evaluation of Alveolar Bone Remodeling following Anterior Teeth Retraction. CODS J Dent 2016;8(1):21-24.

Newly-designed Artificial Maxillary First Premolars with the Presence of Radiolucency to Bifurcated Canals at Mid-root Level and a Single Apical Foramen for Pre-clinical Endodontics : Tooth Morphology and Microfocus X-ray Computed Tomography

Newly-designed Artificial Maxillary First Premolars with the Presence of Radiolucency to Bifurcated Canals at Mid-root Level and a Single Apical Foramen for Pre-clinical Endodontics : Tooth Morphology and Microfocus X-ray Computed Tomography

Multiple pulp stones and shortened roots of unknown etiology

An unusual case of generalised pulpal calcifications (pulp stones) with normal clinical crowns is reported in a 13-year-old boy. Radiographic examination revealed pulp stones in the single rooted and premolar teeth, situated at the midroot level, with the roots bulging around them. The apical portion of the roots, periodontal ligament space, and surrounding bone had a normal radiographic appearance, apart from the upper premolars, and no periapical pathology was discernible. The upper premolars exhibited considerably shortened roots. No medical, dental, or family history was found to be contributory. Reviewing the literature revealed similar cases, but with differing diagnoses including dentine dysplasia (DD) or idiopathic cases. This report suggests either a variation of DD or possibly a new nonsyndromic dentine defect, and highlights the difficulties in establishing a definitive diagnosis by traditional methods. The recent discovery that mutation of the bicistronic dentine sialophosphoprotein gene (DSPP) is involved in DD may provide solutions to this problem.