Palatal Aspect Research Articles

Evaluation Of The Effectiveness Of Combined Photobiomodulation And Piezocision On the Rate Of Orthodontic Tooth Movement. A Randomized Control Trial.

Aim: To assess and compare the efficiency of tooth movement in patients subjected to piezocision and photobiomodulation as part of a split-mouth clinical experiment, and to combine their effects in order to derive a synergetic effect if any. Methods: 24 subjects requiring bilateral first premolar extractions were selected for the study. The study had a split mouth design with patients subjected to either piezocision, photobiomodulation or a combination of the two techniques in one quadrant and the opposite quadrant served as the control. Piezocision was carried out by placing vertical interproximal incisions on the mesiobuccal and distobuccal aspect of the maxillary canine, whereas photobiomodulation was carried out at ten sites, five on the buccal aspect and five on the palatal aspect with a total energy of 10J in the period between the three weeks. Results: There was no statistically significant difference observed in terms of accelerated tooth movement between piezocision, photobiomodulation or combination of the two techniques and the conventional technique. Conclusion: Although no statistically significant findings were derived, a synergistic effect was observed with the combined effect of piezocision and photobiomodulation showing an enhanced effect. Increased rate of tooth movements were observed in both piezocision and photobiomodulation group with lowest effect seen in the photobiomodulation group. Bangladesh Journal of Medical Science Vol.22 (Special Issue) 2023 p.138-147

Evaluation of the Occlusal Contact between the Opposing Teeth and the Cusp of Carabelli in Maxillary Permanent First Molars in Patients Visiting Peshawar Dental College

Background: The Cusp of Carabelli is a small additional cusp which is situated on the mesiopalatal surface of first maxillary molars. This nonfunctional cusp comes in many forms including furrows, ridges or pits and is collectively known as the Carabelli trait
 Objective: To evaluate the frequency of the occlusal contacts between the accessory cusp of Carabelli and the opposing arch tooth among both genders in patients attending the out-patients department of Peshawar Dental Hospital, Peshawar
 Methodology: This descriptive cross-sectional study was conducted on 300 subjects visiting the OPD of Peshawar Dental Hospital from October 2022 to December 2022. The sample size was calculated using WHO formula N=p(100-p)z2/d2 (Http://www.fao.orgThe age group selected for the participants was from 13-30 years. Consecutive sampling technique was used.). Articulating paper was used to assess the occlusal contacts caused by the cusp of Carabelli. The data were analyzed using SPSS version 20. Pearson’s chi square test was applied to analyze the data. P value of ≤ 0.05 was considered statistically significant.
 Results: The results of the current study showed that 10.7% of the participants experienced occlusal contacts caused by the presence of their accessory cusp with the opposing arch tooth with no statistically significant difference between genders.
 Conclusion: The cusp of Carabelli is the most prevailing variation found on the palatal aspect of mesiopalatal cusp of permanent maxillary first molars in a hospital-based inhabitants of Peshawar with rare occlusal contacts experienced by the patients.
 Key words: Cusp of Carabelli, Maxillary permanent first molars, Occlusal contact.

Interdisciplinary approach for diagnosis and management of the tooth with type III palatogingival groove

Palatogingival grooves (PGGs) are developmental anomalies well known for causing endodontic and periodontal diseases to the teeth that have no evidence of caries or trauma. It is a rare developmental defect that frequently exhibits the palatal aspect of maxillary anterior teeth. The aim of this case report is to diagnose PGG using cone-beam computed tomography (CBCT) and manage it with an interdisciplinary approach by endodontic and periodontic intervention. A 20-year-old healthy female patient came with a chief complaint of foul smell and discharge of pus from the gum region. During clinical examination, a sinus opening and deep periodontal pocket were noticed with respect to the maxillary left lateral incisor. The tooth showed mild tenderness to percussion and a negative response to thermal and electric pulp testing. The intraoral periapical radiograph showed a vertical radiolucent line with periapical radiolucency, giving suspicion of PGG, which was confirmed by CBCT investigation. The diagnosis of pulp necrosis with chronic periapical abscess was made. After root canal treatment, surgical intervention was done and sealed the groove with Biodentine. This case report shows the successful outcome of a tooth associated with PGG after a 9-month follow-up. The tooth associated with this anomaly can be correctly diagnosed and planned with CBCT, and successfully treated using an interdisciplinary approach with a bioactive restorative material.

Management of Curved Bone Defects in the Anterior Maxilla Using Bone Bending via a Kerfed Khoury Split Bone Block Technique.

The loss of teeth causes inevitable resorption of the alveolar bone. In the anterior arches, the curved anatomy further adds to the challenge of rehabilitation. These areas often require the shaping of membranes and multiple bone blocks through complex surgery to compensate for the curvature. The split bone block technique (SBBT) has been successfully used in complicated cases. However, the inability to create curves from the blocks means that larger quantities of bone or membranes are needed to compensate for this. Bone bending based on an ancient woodbending technique known as kerfing is proposed to shape rigid SBB plates to recreate the natural anatomy of anterior arches. Three patients presenting with bone destruction of the anterior maxilla underwent bone augmentation before implant placement using the SBBT combined with kerfing. The plates were successfully bent to the shape of each maxilla without any deleterious effects. All bone grafts healed uneventfully, and the bone curvature was successfully reconstructed. No complications were reported. Implant placement took place after 4 months and definitive restorations after 7 to 9 months. Clinical and radiographic assessments were performed at 1 year. Full customization of autogenous bone plates was possible through kerfing. This approach resulted in an ideal bone curve and shape in the facial and palatal aspects of the anterior maxilla. In addition, it enabled ideal implant placement with reduced bone harvesting volumes and decreased the need for soft tissue augmentation to recreate the curved shape. This technique promoted close-fitting autologous osseous plates that followed the anatomical curvature of the anterior maxilla, leading to optimal healing and excellent regeneration of the ridge width. This principle can be valuable when dealing with complex anatomical defects. Int J Periodontics Restorative Dent 2023;43:203-210. doi: 10.11607/prd.6469.

Comparison of Maxillary Canine Retraction Using Split-Mouth Design With Dual Force Cuspid Retractor and T-loop Segmental Arch: A Split-Mouth Randomized Clinical Trial.

Introduction This study was designed to explore the differences between two frictionless mechanics for canine retraction i.e., dual force cuspid retractor and T-loop segmental arch. T-loop for canine retraction creates a biomechanical system to deliver a predetermined force and a relatively constant moment-to-force ratio whereas dual force cuspid retractor uses power arms on buccal as well as palatal aspects for canine retraction. Bodily tooth movement can be achieved by both methods, but in this study, our main focus was to reduce the canine retraction timing with better three-dimensional control. Method This split-mouth study was conducted on a total of 20 cuspids of ten patients (five male and five female). Where one side of the arch was selected for T-loop and the other side for dual force cuspid retractor, randomly. Inclusion criteria for this study were; no congenitally missing teeth (excluding third molar), class I or class II molar relationship, no previous history of orthodontic treatment, good oral periodontal status, patients in whom extraction of maxillary first premolar during treatment was indicated. Both groups were compared for the duration of canine retraction, anchorage loss; tipping, and rotation of cuspid and molar, individually, after retraction. Result The result of this study showed that the duration of canine retraction was significantly less in group one, i.e., dual force cuspid retractor 73.8 ± 12.38 days, than in group two, i.e., T-loop 109.4 ± 16.71 days. The anchorage loss in group one was 0.60 ± 0.61 mm and that in group two was 2.40 ± 0.87 mm. Also, the amount of tipping and rotation of the cuspid and molar individually was significantly lesser in group one than in group two. Conclusion In this study, the dual force cuspid retractor shortens the duration of canine retraction with better three-dimensional control and better anchorage preservation when compared to T-loop.

Posterior superior alveolar nerve block alone in the extraction of upper third molars: a prospective clinical study.

Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

Clinical Outcomes of Surgical Crown Reattachment as Treatment for Complicated Crown-Root Fractures: A Retrospective Study.

This retrospective study evaluated the clinical outcomes of surgical crown reattachment in the treatment of complicated crown-root fractures in permanent teeth in 35 patients. Treatments were defined as follows: surgical crown reattachment combined with internal fixation with a fiberreinforced core post, ostectomy, and reattachment of the original crown fragment. Patients were examined to record the periodontal pocket depth (PD), marginal bone loss, tooth migration, and coronal fragment looseness or loss. In most cases, the fracture lines on the palatal aspect were located below the alveolar crest. About 20% to 30% of teeth had periodontal pockets ≥ 3 mm present at least 1 year after surgery. Significant PD differences were observed between the traumatized teeth and adjacent untraumatized teeth at 6 months. The available evidence suggests that surgical crown reattachment is a feasible and effective technique for managing complicated crown-root fractures in permanent teeth.

Fenestration and dehiscence defects in maxillary anterior teeth using two classification systems.

The primary objective of the study was to assess the buccal bone thickness (BT), evaluate and compare the prevalence of bone fenestration and dehiscence in anterior maxillary teeth using cone-beam computed tomography (CBCT). Images of 300 maxillary anterior teeth were investigated. The BT was measured at the bone crest, 3, 6 and 9 mm from the bone crest, and apical. Fenestration and dehiscence were recorded according to Yang and Pan's classification. Student's t-test and one-way ANOVA were performed for statistical analysis. Fenestration and dehiscence rates were 35.66% and 20%, respectively. Type III fenestration was higher in group 3 (>65 years) (P=0.028). Type I and IV fenestration and CII DII dehiscence were more common in canines (P > 0.05). Fenestration involving two-thirds (46.76%) and one-third (44.84%) of the root length was more common. Fenestrations involving the entire root were 8.4%. Most of the dehiscence (63.3%) involved one-third of the root length. Dehiscence involving two-thirds of the root length and the entire root was 5% and 9.95%, respectively. The coexistence of fenestration and dehiscence was 8.3%. Dehiscence on the palatal aspect was detected in 1.65% of the anterior maxilla. The rate of BT ≤1 mm was 80.08%, and ≥2 mm was 3.66%. Fenestration was most common in canines. Fenestration was mostly located in the apical third, while dehiscence was mostly located in the coronal third. © 2022 Australian Dental Association.

Benign Spindel Cell Neoplasam: A Central Myofibroma of Maxilla in Male Child of Seven Years of Age: A Case Report

Myofibroma is a rare benign spindle cell neoplasm which occurs predominantly in infants and young children. It can occur as a solitary mass or as a multicentric lesion, consisting of myofibroblasts. In oral cavity, the sites most commonly involved are the mandible, tongue, lips and buccal mucosa however, it rarely involves the maxilla. It has aggressive clinical presentation mimicking malignancies. We report a case of a male child seven years of age presented with intraoral swelling on the left palatal aspect of the maxilla that extended from deciduous upper left second molar to the distal of upper permanent left first molar causing the mobility of these teeth. Radiologically, the lesion was osteolytic causing marked resorption of alveolar bone and displacement of permanent maxillary left second molar. A differential diagnosis of peripheral giant cell granuloma, central giant cell granuloma, fibroma, aggressive fibromatosis, nodular fasciitis, peripheral ossifying fibroma and spindle cell neoplasm was made. After the excluding malignant and vascular involvement, the surgical excision of the lesion was planned and was carried out under general anesthesia. Histologically, benign proliferation of spindle cells was seen giving the diagnosis of benign spindle cell neoplasm. Reports also showed positive immunoreactivity with vimentin and αSMA while non-responsive to desmin, validates the diagnosis of myofibroma. KEYWORDS: spindle cell neoplasm; myofibroma; maxilla

Maximum compressive stress analysis in upper central incisors rehabilitated with fiberglass posts and three types of crowns. A study with the finite element method

To evaluate the maximum compressive stress in maxillary central incisors restored with fiberglass posts and three types of crowns by the FEM finite element method. The study was a virtual, descriptive, and laboratory trial. Three virtual models were made using the SolidWorks 2017 software from upper central incisors rehabilitated with fiberglass posts and a metal-ceramic crown, a monolithic lithium disilicate crown, and a zirconium-ceramic crown. They were then subjected to an oblique occlusal load of 150N with an angulation of 45°, distributed towards the palatal aspect. The stress analysis proceeded by comparing the maximum, minimum, and equivalent von Mises stresses. The maximum compressive stress was found at the cervical level in the vestibular area of each of the crowns. Zirconium-ceramic crown (Design 3) was the one with the highest compressive stress with 73.89 MPa, followed by Lithium Disilicate crown (Design 2) with 63.42 MPa and the metal-ceramic crown (Design 1) with 48.4 MPa. The zirconium-ceramic crown better distributes the stress along the tooth since, due to its rigidity, it absorbs the stresses that are concentrated especially in the cervical area, which could indicate that it is the most appropriate option to rehabilitate endodontically treated teeth.

Lateral Displacement of Maxillary Sinus Palatal Wall: A 1-Year Retrospective Computerized Tomography Study.

To examine the short-term outcomes of maxillary sinus augmentations consisting of laterally and apically displacing the palatal wall through a transcrestal approach. The maxillary sinus floor was fractured in its palatal aspect by allowing a displacement in the buccal and apical direction with a magnetoelectric system. A medial displacement of the alveolar crest in its palatal bony plate was performed at the same time. Crestal bone change was investigated using superimposed preoperative and postsurgical computed tomography scans. Clinical and radiologic outcomes over 1 year were evaluated. A total of 18 implants were selected for retrospective volumetric and linear analyses. Sinus floor and alveolar bone augmentation surgery led to a significant increase in the bone volume (P = .0002) from 0.134 ± 0.060 cm3 to 0.639 ± 0.166 cm3, with an overall gain of +0.504 ± 0.139 cm3. No part of the implant apices appeared to protrude into the maxillary sinus at the 1-year follow-up. The width of the alveolar crest changed from 5.1 ± 0.5 mm to 6.5 ± 0.7 mm, with a significant increase of +1.4 ± 0.6 mm registered at 1 year. However, a marginal bone loss of 1.0 ± 0.8 mm was observed. When tooth positions were investigated, no significant differences between the two groups (premolars versus molars) were found. Significant and effective bone gains allowed proper placement of the dental implants but with a minimal loss of peri-implant bone volume.

Laser assisted periodontal and aesthetic rehabilitation in idiopathically hypertrophied and pigmented gingiva of a young patient- A Case Report

Gingival enlargement/ hyperplasia can occur as an isolated form or part of a syndrome and the treatment of choice is gingivectomy. The harmony of the smile is however not only determined by the shape or position of gingiva, but also by aesthetic appearance of the gingival tissues. Thus, in cases of hyperpigmented gingiva, depigmentation treatment modalities strive to balance the harmonious inter-relationship of the pink with white, for an overall perio-aesthetic achievement. We present a case of idiopathic gingival enlargement on palatal aspect of maxillary anterior region of 15- year-old male patient. High melanin deposition was noticed on the labial surface of maxillary anterior gingiva. Laser gingivectomy was performed on palatal aspect of teeth no. 14 to 24 along with depigmentation of gingiva on the labial aspect using a diode laser 980 nm. The diode laser technique produced desired results, and postoperative inflammation and wound healing were observed to be minimal.

Periodontal Management of Palatogingival Groove – Case Report

Periodontal and endodontic infections are interrelated and most common during routine dental practice. Palatogingival groove, a morphological anomaly usually reported on the palatal aspect of maxillary incisors, cause periodontal attachment loss and alveolar bone destruction and finally tooth loss. Unknown etiology was reported for the developmental defect, develops in to pathological condition only when the there is a discontinuity in the epithelial attachment. Early diagnosis and proper selection of therapeutic modalities helps in preservation of involved tooth. Milder cases were treated by saucerization, odontoplasty and strict oral hygiene maintenance protocol. Moderate case was treated by open flap debridement, regenerative applications such as bone graft and membrane placement. PGG restored using various restorative material and seal the morphology. Clinical diagnosis become unnoticed in most cases, hence proper diagnosis and therapeutic interventions are of prime importance in PGG management.

Effect of the buccal gap width following immediate implant placement on the buccal bone wall: A retrospective cone-beam computed tomography analysis.

The effect of the buccal gap width on the clinical outcome of socket graft and immediate implant placement (IIP) at maxillary central incisor sites has not been investigated. Thus, the aim of the present study was to evaluate the effect of the width of the buccal gap on the thickness of the newly formed buccal wall. Forty-two patients and 51 maxillary central incisor sites treated with IIP and ridge preservation by means of graft of the buccal gap at the maxillary central incisor region were included in the study. The width of the buccal gap was measured and filled with deproteinized bovine bone mineral. Implant sites were divided into two groups: wide gap (WG, >2 mm; n=34) and narrow gap (NG, ≤2 mm; n=17). After at least 1year in function (5 ± 4), CBCT scans were obtained and assessed by a calibrated examiner. The thickness of the buccal and palatal bone walls, the percentage of the implant height covered by bone in the buccal and palatal aspects and the position of the buccal and palatal crests were compared between the two groups. A linear regression model was performed to assess predictors of the thickness of the buccal bone. The buccal bone was significantly thicker in the WG group than the NG group at all levels observed (overall 1.9 ± 0.9 mm and 0.5 ± 0.6 mm, respectively). The thickness of the palatal bone was similar between both groups (>2 mm). The percentage of the implant height covered by bone at the buccal aspect was significantly higher in the WG group (95 ± 16.6%) than in the NG group (59.4 ± 42.3%). The position of the buccal crest in relation to the implant shoulder was significantly more coronal (0.3 ± 2.2 mm) in the WG group than in the NG group (-4.7 ± 5.6 mm). The regression analysis model indicated that the width of the buccal gap was the only predictor of the thickness of the newly formed buccal bone wall (p < 0.001). Grafting of >2 mm-wide buccal gaps following IIP promoted a thicker buccal bone wall.

Evaluation of the success rate of single- and dual-thread orthodontic miniscrews inserted in the palatal side of the maxillary tuberosity

Recent studies have reported that the placement of miniscrews for orthodontic anchorage in maxillary tuberosity is anatomically safe and can aid in achieving efficient tooth movement mechanically. However, the success rate of miniscrews placed on the palatal aspect of the maxillary tuberosity has not yet been elucidated. This study aimed to evaluate the success rate of single- and dual-thread miniscrews inserted in the palatal aspect of the maxillary tuberosity. A total of 101 miniscrews (17 single-thread miniscrews: diameter 2.0 mm, length 10 mm; 84 dual-thread miniscrews: diameter 2.0 mm, length 12 mm) placed in 61 patients (6 males, 55 females; mean age = 30.9 ± 8.66 years) were retrospectively examined. Miniscrews that could be maintained for orthodontic anchorage for more than 6 months were considered successful. The direction of placement, bone-miniscrew contact (BMSC) rate, and survival of miniscrews were measured using cone-beam computed tomography. The overall success rate of single-thread miniscrews was 82.4% and that of dual-thread miniscrews was 94.0%. There was no significant difference in the overall clinical success rate between the two designs. Sex, mandibular plane angle, and malocclusion type did not significantly affect the success rate in both groups. Both single- and dual-thread miniscrews placed on the palatal aspect of the maxillary tuberosity showed high success and BMSC rates. However, there were no significant differences in the overall success rate and BMSC rate between the two miniscrew designs.

RADICULAR GROOVE OF MAXILLARY PREMOLAR: IS A “DANGER ZONE"?

Objectives: To evaluate the presence of radicular groove and dentin thickness on the palatal aspect of the buccal root of maxillary first premolars using cone-beam computed tomography (CBCT). Materials and methods: Images of 312 maxillary first premolars belonging to 187 patients (between 18-69 years, 94 females and 93 males) who were referred to the clinic were retrospectively reviewed. Root canal treatment, periapical lesion, and post-core were excluded. One and three-rooted premolars were also excluded. CBCT images were viewed on the axial plane to detect grooves. The concave area on the palatal aspect of the buccal root was recorded as a groove. Buccal and palatal dentin thicknesses were measured by two observers at the level of 3 mm below furcation. Statistical analyses were performed. Results: Buccal and palatal thicknesses were 1.28(±0.25) and 0.87(±0.13) mm, respectively. According to Student’s t-test, buccal dentin thickness was statistically higher than palatal dentin (p=0.016). The prevalence of groove was 82.05%. While palatal thickness without groove was 0.93(±0.14) mm, palatal thickness corresponding to groove was 0.82(±0.12) mm. One-way ANOVA showed palatal and buccal thickness in group 1 (18-35 years) was statistically lower than group 3 (&amp;gt;65 years) (p=0.012 and p=0.003). No statistical difference in thickness was observed between sex and left or right side (p&amp;gt;0.05). Conclusions: Palatal thickness related to groove can be considered a “danger zone” for post-core and endodontic treatment. Considering the high prevalence (82.05%) and thin dentin of the groove, more conservative canal and post space preparation and CBCT examination are recommended to avoid perforation.

Quantitative analysis of maxillary palatal masticatory mucosa thickness and anatomical morphology of palatal vault in Zhejiang province.

To quantitatively analyze the maxillary palatal masticatory mucosa thickness and anatomical morphology of palatal vault in Zhejiang province. Cone beam computed tomography (CBCT) images of 146 adult patients were collected from outpatients in Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine. The images were reconstructed by adjusting the reference line and analyzed on the sagittal plane of the measured teeth. The thickness of masticatory mucosa from maxillary canine to second molar area was measured at the level of 3, 6, 9, 12 mm from the gingival margin. At the same time, the height and width of the palatal vault were measured, the position of the greater palatal foramen relative to the second molar, and the distance from the greater palatal foramen to the mid-palatal suture and the alveolar crest were determined. Spearman correlation analysis and multiple regression analysis were used to explore the influencing factors of the maxillary masticatory mucosa thickness. One-way analysis of variance and LSD multiple comparisons were used to analyze the difference in palatal mucosal thickness of each tooth position in different age groups. The sample t-test was used to analyze the differences in the mucosal thickness of each tooth position and the distance from the greater palatal foramen to the mid-palatal suture and the alveolar crest in different anatomical forms of the palatal vault. The mean palatal masticatory mucosa thickness from maxillary canines, first premolars, second premolars, first molar and second molar areas were (2.94±0.48), (3.28±0.49), (3.43±0.53), (3.01±0.55), (3.49±0.70) mm, respectively. The mucosa thickness of canines, first premolars and second premolars areas showed increasing at first and then decreasing trend. The mucosal thickness of the canines area was greatest at 6 mm from the gingival margin, and the thickness of the first and second premolars areas was greatest at 9 mm from the gingival margin. Premolars are thickest at 9 mm from the gingival margin. The thickness of the mucosa of the first molars area increased with the increase of the distance from the gingival margin, and the thickness of the mucosa of the second molars area was the thinnest at 6 mm, and then increased with the increase of the distance from the gingival margin. The main influencing factors of the mucosal thickness of canines, first premolars and first molars areas were age and palatal vault aspect ratio, the main influencing factor of the mucosal thickness of second premolars area was age, and the main influencing factor of the mucosal thickness of second molars area was palatal vault aspect ratio. There was no significant colinearity among the variables ( VIF<10). The results of the further stratified analysis showed that the mucosal thickness of the maxillary canine to the first molar area was positively correlated with age, and mucosal thickening is more pronounced in people aged 45 years old and above. The thickness of the canine mucosa in the high palate vault group was greater than that in the low palate vault group ( P<0.05), and the thickness of the second molar mucosa was smaller than that in the low palate vault group ( P<0.05). The greater palatal foramen was mostly located in the distal region of the second molar crown. The distance from the greater palatal foramen to the alveolar crest in the high palatal vault group was greater than that in the low palatal vault group ( P<0.05), while there was no significant difference between the two groups in the distance from the foramen magnum to the mid-palatal suture ( P>0.05). The most suitable donor site for autologous soft tissue graft may be 3-9 mm from the gingival margin of the first and second premolars area.

The Role of Morphometric Characteristics of Anterior Maxilla in Planning the Interventions Accompanied by Orthodontic Teeth Movement – An Overview

Abstract The anterior maxilla or premaxilla is part of the upper jaw and the most significant content of this region, from the aspect of orthodontic therapy, are the incisor teeth. The frequency of complications during orthodontic movement of the upper incisors refers to a more detailed evaluation of the anatomical structures of the premaxilla. The aim of this study was to investigate morphological and morphometric characteristics of the anterior maxilla by cone beam computed tomography, which could be of interest for planning orthodontic teeth movement. By reviewing the available literature, we compared the values of the alveolar bone height, the distance between the alveolar crest and enamel – cement boundary, total alveolar bone width, the thickness of the buccal, and palatal plate, nasopalatine canal, and accessory canals of the anterior maxilla. The results of our study show changes in the labial and palatal aspects of the alveolar bone height during orthodontic interventions. Different results of the alveolar bone width are in correlation with gender, age, and type of orthodontic tooth movement. Distance between the nasopalatine canal and maxillary central incisors was estimated at the value from 4 to 6 mm, which is below the recommended value for maximum incisal retraction by Proffit. Research results show variations in shape, length, and diameter of the nasopalatine canal, which indicates individual varieties detected on cone beam computed tomography. Other anatomical structures and measures show an insignificant correlation with orthodontic teeth movement. According to the contradictory results of the available articles, it is required to achieve an individual approach to orthodontic interventions in the area of the anterior maxilla.

Morphological characteristics of the mesiobuccal root in the presence of a second mesiobuccal canal: a micro-CT study.

ObjectivesThis study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal.Materials and MethodsForty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student’s t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05).ResultsIn maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001).ConclusionsThe internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.

Trio talonovih kvržica na spojenom maksilarnom centralnom sekutiću - jedinstvena prezentacija

Introduction: Odontogenic malformations of teeth can be frequently encountered affecting both the primary and permanent dentition. The co-occurrence of talon cusp in a fused tooth, however, is an uncommon developmental dental aberration that necessitates a variety of prophylactic procedures to minimize potential consequences. Often, the presence of talon's cusp can result in pulpal necrosis due to its deep extension, which increases functional complexity. Methods: The present case describes the fusion of a supplemental tooth to a maxillary permanent tooth in conjunction with multiple talon's cusps on labial and palatal aspects which is an extremely rare entity and first of its kind. Results: Endodontic management followed by esthetic reconstruction of the affected tooth is considered as the standard treatment in cases of pulpal involvement of any odontogenically malformed tooth. Our case also demonstrates the establishment of an accurate diagnosis using a three-dimensional imaging modality by overcoming the challenges of periapical radiographs. Conclusion: In addition to diagnosis, practitioners should also have an in-depth understanding of the origin, prevalence, clinical and radiographic characteristics of odontogenic malformations, which AIDS in an effective treatment strategy.