Permanent Anterior Teeth Research Articles

Clinical application of CAD/CAM technology in 3D printed dental model used for removable splints fabrication in the treatment of traumatized anterior permanent teeth in children

ObjectivesTo evaluate the effectiveness of computer-aided design (CAD)/computer-aided manufacturing (CAM) in designing and manufacturing 3D-printed dental models used to make thermoplastic removable splints for children with traumatized anterior permanent teeth. MethodsA total of 28 patients with dental trauma (subluxation, extrusive luxation, and lateral luxation) were divided into experimental (14 patients) and control groups (14 patients). The experimental group was treated with the removable splint made using a new 3D printed dental model designed with CAD/CAM technology, while the control group received a wire-composite splint. Follow-up was performed at week 2 and 1, 2, 3, 6, 12, 18, and 24 months post-treatment, and every year after that. The traumatized teeth were evaluated according to clinical symptoms, tooth color, mobility, position, percussion pain, abnormal percussion sounds indicating ankylosis or other pathosis, swelling, fistula of gums, vitality test, and radiographic examination. ResultsNo significant difference was found in gender and age between the two groups. The experimental group had 23 traumatic teeth, and the control group had 24 traumatic teeth. Traumatic teeth in the two groups most commonly involved open apex teeth (>90 %). The average follow-up time for the experimental and control group was 35.47±14.23 and 32.92±14.79 months (P > 0.05), respectively. The pulp survival rate and periodontal healing rate in the experimental group (86.96 %, 91.30 %) were higher compared to the control group (62.50 %, 75.00 %) (all P > 0.05). ConclusionA removable splint made by a 3D printed dental model designed with CAD/CAM technology achieved an equivalent treatment effect to a wire-composite splint. Clinical significanceA 3D-printed dental model designed with CAD/CAM technology can be used to fabricate removable splints, which in turn can decrease iatrogenic injuries frequently encountered during the traditional model production process. For example, taking the impression directly from the patient's mouth can cause displacement of a traumatized tooth or even exfoliation. The removable splints produced using a new 3D-printed dental model can meet clinical treatment requirements of traumatized teeth, especially for children and adolescents with occlusal trauma in mixed dentition.

Single- versus multi-visit approach for fragment reattachment in complicated crown-root fractures: a cohort study

BackgroundComplicated crown-root fractures are a type of tooth fracture that involves the enamel, dentin, and cementum and accompanied by pulp exposure. The treatment of a complicated crown-root fracture is always challenging due to the difficulties in achieving a hermetic seal and a stable restoration with a fracture level close to the crestale bone level. This study aimed to evaluate and compare the efficacy of single-visit and multi-visit approaches for fragment reattachment in complicated crown-root fractures of anterior teeth.MethodsTwo cohort consist of 10 adolescent patients in each group at both genders, who suffered from permanent anterior tooth complicated crown-root fracture were included. Fragment reattachment with root canal treatment was performed with either single or multiple-visit approach. Single visit fragment attachement combined with root cannel therapy was conducted in single-visit approach group immediately after injury. Fragment attachment, root cananel therapy and post resoration were performed during three times ‘ clinical visit in multi-visit approach group.ResultsAll the patients in both groups achieved satisfactory aesthetic results one year after fragment reattachment. Patients who underwent a multi-visit approach had a significantly shorter operative duration, less intra-operative pain and fatigue, slightly better periodontal health at an early stage, and a decreased incidence of temporomandibular joint disorders compared to those who underwent a single-visit approach. However, multiple visits approach may increase the risk of fragment detachment postoperatively.ConclusionFragment reattachment a reliable but temporary technique for adolescent patients who have suffered from complicated crown-root fractures. Multi-visit approach showed similar effecacy to single-visit approach but with slightly less complications. The choose of these two merhos should depend on the specific patient situation and patient compliance.Trial registrationThis prospective cohort study was retrospectively registered in Chinese Clinical Trial Registry (ChiCTR2300076811) on 19/10/2023.

Permanent tooth avulsions: A retrospective analysis of the demographics and aetiology of cases at a tertiary hospital in Sydney, Australia

AbstractThis retrospective analysis reviewed the demographics of patients sustaining dental avulsion injuries at a tertiary dental hospital in Sydney, Australia. Data were extracted from dental records of patients who presented with avulsed permanent anterior teeth and were treated between 1 January 2001 and 30 June 2021. Demographic, clinical and radiographic data from 91 patients with 117 avulsed permanent anterior teeth were available for analysis. The median age of the patients was 12 years (IQR 9.0–17.0). Males accounted for 68.4% of avulsion injuries. Non‐organised sports were the most common cause of injury (42.7%). Maxillary central incisors were the most frequently avulsed tooth (83.3%). Peak prevalence of injuries occurred on the weekend. The findings from this study may reflect regional factors such as climate and participation in sport. Anticipatory guidance should be provided to patients at elevated risk of dental avulsion.

Root canal morphology of mandibular anterior permanent teeth in Turkish sub-population using two classification systems: a cone-beam computed tomography study.

This study examined the root and canal morphology of mandibular anterior teeth (MA) in the Turkish sub-population using cone-beam computed tomography (CBCT), comparing the findings based on Vertucci's and Ahmed et al. classification systems. The CBCT images were acquired using the 3D Accuitomo CBCT device. Images that were deemed suitable for visualizing the roots, canals, and the complete pulp chamber and apex were included in the study. Vertucci and Ahmed et al. classification systems were employed to determine the root canal morphology. 500 CBCT images and 3000 teeth were analyzed. Type I (1MA1) was the most frequent, followed by Type III (1MA1-2-1). 3.8% of teeth could not be classified with Vertucci system. In canine teeth, Vertucci type III (1MA1-2-1) was significantly more prevalent in males than females (p = 0.038) and Type I (1MA1) was less frequent in individuals aged 41-50 (p < 0.05). Canal divergence/merging was the most common at the middle/apical level for central (15.5%) and lateral (10.3%) teeth, and at the coronal/middle level for canine teeth (1.9%). Bilateral similarity was high for all tooth groups (> 78%). One-third of mandibular incisor teeth have two canals, with a significant number exhibiting canal divergence/merging that was separated in the middle region and merged in the apical region. The Vertucci classification was found to be inadequate in some cases, while Ahmed et al. classification was able to classify all mandibular incisors with a single code. Ahmed et al. classification is a more useful system for classifying all MA.

Quantitative Analysis of Tooth-Whitening Efficiency Using Natural Bleaching Agents: An In Vitro Spectrophotometric Evaluation

Abstract Aim: While conventional whitening agents provide effective color change, concerns linger regarding enamel health. This study explored the potential of natural alternatives for coffee stain removal on extracted teeth, aiming to identify safe and efficacious options for patients seeking noninvasive bleaching solutions. Materials and Methods: This study employed 50 extracted permanent anterior teeth divided into five groups (negative control, positive control, strawberry, pineapple, and honey). Standardized coffee staining was applied to all teeth followed by 3 weeks of twice-daily treatment with their respective solutions. Shade changes were measured objectively using a Konica Minolta Spectrophotometer CM-5 at baseline and after 1, 7, 14, and 21 days post-treatment. Statistical analysis was conducted with Kruskal–Wallis and Tukey post hoc tests (IBM® SPSS®). Results: Strawberry juice exhibited equivalent ΔE (color change) compared with 35% hydrogen peroxide (P &gt; 0.99), indicating similar stain removal efficacy. Both pineapple juice and honey solution displayed significantly lower ΔE values compared with the control and strawberry juice groups (P = 0.002 and &lt;0.001, respectively), suggesting limited bleaching capability. Conclusion: This study demonstrates the potential of strawberry juice as a viable alternative to conventional bleaching agents, offering comparable stain removal efficacy on coffee-stained teeth and further highlighting the need for further research on their effectiveness in clinical settings. Meanwhile, pineapple juice and honey solution exhibited limited bleaching potential. These findings contribute to the expansion of safe and potentially noninvasive teeth-whitening options.

Case Report: Managing Odontoma and Molar-Incisor-Hypomineralization Challenges in Orthodontics: A Case Report

This report presents the successful orthodontic management of a case of odontoma associated with impaction of the mandibular right permanent canine and Molar-incisor-hypomineralization (MIH). Although case studies have reported the management of odontomas and MIH as separate entities, there is a lack of evidence regarding the comprehensive management of patients presenting with a combination of odontoma, dental impaction, and MIH. A 15-year, 7-month-old female patient complained of the appearance of her smile and the delayed eruption of her mandibular right permanent canine. She was diagnosed with Angle’s Class I molar relationship and Class II canine relationship with the maxillary permanent right lateral incisor in a lingual crossbite. Furthermore, she had mandibular right permanent canine impaction, retained mandibular right primary canine, and MIH in the permanent anterior teeth and first molars. The management involved the removal of the odontoma to allow for orthodontic traction of the lower permanent right canine. After that, the esthetic appearance of the teeth was improved through restorative treatment.

Root canal configuration of human permanent anterior teeth: A cross-sectional study using cone-beam computed tomography in the Pakistani population.

To analyse and document internal root morphological variations in permanent anterior teeth using conebeam computed tomography. The cross-sectional, retrospective study was conducted from January 21 to June 19, 2021, at Jinnah Magnetic Resonance Imaging and Body Scan, and comprised data from July to December 2020 related to all the patients who had been referred to the centre for dental cone-beam computed tomography scan. The scans were evaluated at the Radiology Department of the School of Dentistry at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. The morphology of the roots and root canals in all permanent anterior teeth was examined. Root canal configuration was categorised using Vertucci's classification. Data was analysed using SPSS 20. Of the 211 patients, 116(55%) were females and 95(45%) were males. The overall mean age was 39.9±1.02 years (range: 15-65 years). All the permanent anterior teeth exhibited a single root, with the exception 2(0.9%) mandibular right and 4(1.9%) left canines which had double roots. Type I root canals were observed in all 211 (100%) maxillary right central incisors, maxillary left central incisors and maxillary left canines. Among maxillary right canines, 208(98.6%) had type-I root canals, and the corresponding value for maxillary right lateral incisors was 209(99.1%), and for maxillary left lateral incisors, the value was 210(99.5%). Root canal polymorphism had no significant association with gender (p>0.05). The presence of type-I root canal was common in permanent anterior teeth, and there was significant association of root canal polymorphism with gender.

Prevalence of different types of interproximal contacts in the permanent dentition – a study cast evaluation

Background A new classification called OXIS was proposed for categorizing the interproximal contacts of primary molars, modified for the primary canines and its prevalence was established. No such information is available for the permanent dentition. Hence, the aim was to establish the variations in interproximal contacts of the permanent dentition and thereby modify the OXIS classification of primary molars and primary canines to the permanent dentition. Methods We propose a study-cast-based classification of interproximal contacts of the permanent dentition. Three hundred and forty-three pretreatment casts of patients based on an inclusion and exclusion criteria were selected. Contacts of posterior teeth were classified based on OXIS classification of interproximal contacts, and its modification was used for anterior teeth. Results Among the posterior contacts, the ‘O’ type of contact was least prevalent, while most prevalent was the ‘S’ type for second molar-first molar contact, ‘I’ type for the first molar-second premolar contact, and ‘X’ type for the second premolar-first premolar contact. Among the anterior contacts, least prevalent was ‘S1’ type for the first premolar-canine contact, and I type for the canine-lateral incisor and the lateral incisor-central incisor contacts. There was no statistical significance between right- and left-side contacts (P &gt; 0.05) while significance was seen between maxillary and mandibular contacts (P &lt; 0.05). Similarity of contacts ranged from 5.17% to 10.05%. Conclusion The OXIS classification is applicable to posterior permanent teeth, and its modification is representative of anterior permanent teeth.

Comparative Evaluation of Resin Infiltration and Bifluoride Varnish in White Spots in Children between the Ages of 8 and 15 Years

The aim of this study was to compare the efficacy of resin infiltration and bifluoride varnish in white spot lesions (WSLs) in children between the ages of 8 and 15. Methods and Results: This study was conducted at Alma Mater Europaea Campus College "Rezonanca" (Pristina, Kosovo) and enrolled 60 participants (34 females and 26 males) between the ages of 8 and 15 years with WSLs in the vestibular surface on permanent anterior teeth. The participants were randomly assigned to the resin infiltration (Icon®) group (Group 1, n=30) and the bifluoride varnish (F&amp;A Biflu) group (Group 2, n=30). Both materials were applied on permanent anterior teeth with WSLs in enamel. WSLs were assessed using ICDAS-II (International Caries Detection and Assessment System) criteria by visual inspection, which were coded as 1 and 2. Lesions were evaluated before the material was applied (T0), just after application (T1), and at a 6-month follow-up (T2). A total of 173 teeth from 60 participants were included in our study. Group 1 showed a significant decrease in ICDAS-II scores throughout time intervals T0-T1 (P=0.001), T0-T2 (P=0.001), and T1-T2 (P=0.041). In Group 2, there was no visible difference between T0-T1 (P=1.00) but a significant decrease between T0-T2 (P=0.001) and T1-T2 (P=0.001). Comparisons between the two groups in relation to T0, T1, and T2 were analyzed using the independent samples t-test. Significant differences have been presented in two cases at T1 (P=0.001) and T2 (P=0.003). ICDAS-II scores decreased significantly in Group 1. Conclusion: The application of RI in WSLs was found to be more effective than the application of BFV. While the effects of BFV in WSLs persisted over time, the effect of RI was evident as soon as WSLs were treated. Moving forward, we recommend considering RI as a favorable option for WSL treatment. Future studies with long-term follow-ups are necessary to corroborate these results.

Are sleep disorders associated with traumatic dental injuries in school children? A cross-sectional study.

To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and disorders. A cross-sectional study was carried out with a representative sample of schoolchildren aged 8 to 10 years (n = 1402) from Florianopolis, Brazil. Clinical examinations for TDIs were performed according to the classification proposed by Andreasen. Parents/caregivers completed a questionnaire addressing sociodemographic characteristics and sleep behaviours/disorders (sleep duration, insomnia, sleep rhythmic movement, snoring, and signs of sleep apnoea). Descriptive analysis and Poisson regression were performed. The prevalence of TDIs was 10.9%. Insomnia was observed in 3.0% of the children, snoring in 42.8%, sleep rhythmic movement in 27.9%, and signs of obstructive sleep apnoea in 33.6% of the schoolchildren. Most children (75.2%) slept less than eight hours a day. The prevalence of TDIs was higher among schoolchildren with an increased overjet (PR: 1.65; 95% CI: 1.15-2.35; P < 0.01), after adjusting for monthly family income, caregiver's schooling, and sleep behaviours. The prevalence of TDIs was not associated with sleep behaviours/disorders. Parent-reported sleep disorders such as insomnia, sleep rhythmic movement, snoring and signs of sleep apnoea were not associated with the prevalence of TDIs in schoolchildren. © 2024 Australian Dental Association.

Comparative Evaluation of Fracture Resistance of Carbon Fiber Posts and Glass Fiber Posts in Permanent Anterior Teeth: An In Vitro Study.

Introduction Dental caries and traumatic injuries often lead to tooth loss in adolescents and adults, necessitating endodontic treatment and subsequent restoration. Restoring such teeth presents a challenge due to varying degrees of substance loss. After endodontic treatment, the choice of an appropriate post is crucial for long-term stability. While metal posts are sturdy, they lack aesthetics and may cause root fractures. Fiber posts, such as carbon and glass fiber, offer improved aesthetics and mechanical properties, but their comparative performance warrants investigation. Materials and methods A total of 30 extracted anterior single-rooted teeth were divided into two groups to receive either carbon fiber or glass fiber posts. After endodontic treatment and post-space preparation, the posts were cemented using a dual polymerizing adhesive resin composite. Fracture resistance was assessed using a universal testing machine. Results The mean fracture resistance of the carbon fiber post group was recorded at 271.2 N, whereas the glass fiber post group exhibited a significantly higher mean fracture resistance of 416.133 N. This difference in fracture resistance between the two groups was found to be statistically significant (p < 0.05). Conclusion Glass fiber post systems demonstrated superior fracture resistance compared to carbon fiber post systems in anterior single-rooted teeth. These findings support the clinical preference for glass fiber posts in restoring endodontically treated anterior teeth, offering both mechanical reliability and aesthetic advantages. However, further research, including long-term clinical trials, is warranted to validate these findings and assess the overall clinical performance and longevity of fiber post systems in real-world settings.

Traumatic dental injuries among children attending the public after-hours emergency dental clinic in Bergen, Norway.

To investigate traumatic dental injuries (TDIs) among children who for 1 year attended a Norwegian public after-hours emergency public dental (EPD) clinic. The study included 7-18-year-olds (n = 312) who presented at the EPD clinic, underwent a clinical dental examination, and consented to the disclosure of clinical information. Recording of TDIs was restricted to anterior permanent teeth. Potential TDI predictors were also analysed. Almost half (n = 148) of the children were assessed with TDIs in permanent teeth, showing a mean age of 11.0 (standard deviation [SD]: 3.5) years. Males constituted 54.7%. The children experienced TDIs often outside school hours (43.9%), and the majority (58.1%) were caused by falls/accidents. Sixty of them experienced only one TDI. The most common location was the maxillary central incisors. Assessment of TDIs according to severity, could only be done in 131 individuals, involving 253 TDIs. Of these, 81.8% were mild. The odds of visiting the emergency clinic for a TDI were higher (odds ratio [OR] = 2.64, confidence interval [CI]: 1.61-4.31) among children with previous TDIs and lower (OR = 0.28, CI: 0.12-0.68) among those with poor dental attendance. Traumatic dental injuries were a common reason for seeking emergency care. Milder injuries dominated and involved mostly one maxillary central incisor. Previous episodes of TDIs and attendance patterns seemed to be associated with seeking care for TDIs.

Effectiveness of H-files and Pro-Taper universal systems in removing Gutta-percha during endodontic retreatment: A comparative study

ObjectiveThis research was aimed at assessing the effectiveness of manual H-files versus a combination of a Pro-Taper universal rotary canal preparation system and retreatment system in removing gutta-percha (GP) during endodontic retreatment, by using a digital radiography technique. MethodsThis ex vivo study used a non-probability consecutive sampling technique. The study sample comprised 60 extracted anterior permanent teeth, each with one root with a straight root canal (RC). After preparation, RCs were obturated with GP and sealer. Subsequently, teeth were stored for 2 weeks in a humid environment at 37 °C. Thirty teeth each were randomly assigned to the control (group I), and experimental (group II) groups. GP removal was performed with H-files {group I) or a combination of a Pro-Taper universal rotary canal preparation system and retreatment system (group 2). Digital radiographs were acquired with Carestream digital radiovisiography software (Kodak; version-VER.6.10.8.3-A), and the presence of residual GP was analyzed. AutoCAD (2006) software was used to demarcate the RC and residual root filling. The residual GP in both groups was compared with independent sample t-tests. ResultsThe remaining root filling did not significantly differ when GP was removed with conventional Hedstrom files versus a combination of Pro-Taper Universal preparation and retreatment file systems. The residual GP was confined to the apical third of the canals in both groups. ConclusionsPro-Taper Universal preparation and retreatment file systems have similar effectiveness to manual H-files in GP removal in straight canals.

Risk of pulp necrosis and related complications in the permanent anterior teeth with lateral luxation: A systematic review and meta-analysis.

This systematic review aimed to evaluate the evidence related to the occurrence of pulp necrosis and related complications in permanent anterior teeth with lateral luxation. It was envisaged to address the ambiguity related to the recommendation for pulp extirpation in teeth with mature root apex. An a priori protocol was formulated as per the best practices of evidence-based medicine and registered in PROSPERO. A comprehensive search was performed electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane on July 10,2023 without any restriction of language or year of publication. The screening of titles and abstracts and later the full-text articles were performed. Later, the data extraction was performed by using a self-designed sheet, risk of bias (ROB) assessment was done, meta-analysis was performed, and the GRADE approach was used to assess the quality of evidence. The qualitative synthesis was performed on 13 studies done from 1985 to 2020 in hospital settings. There was variability in the minimum and total observation periods, sample sizes, and characteristics of the sample population. The overall pooled prevalence of pulp necrosis was found to be 57% (95% CI: 42, 72%). It was 12% (95% CI: 8%, 18%, I2 = 0%) in immature teeth, and 58% (95% CI: 42, 73%, I2 = 86%) in mature teeth. The pooled prevalence of EIRR was found to be 11% (95% CI: 4, 27%, I2 = 95%) with greater risk in teeth with mature root apex (RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%). The ROB was moderate or high in nine studies and the GRADE of evidence was very low in 14 of 15 outcomes. There are greater chances of pulp necrosis in teeth with lateral luxation, especially with mature apex. However, it can still be less than 60% in most cases with the prevalence of EIRR less than 20%. Hence, an absolute recommendation for endodontic intervention in mature teeth with lateral luxation must be interpreted with slight caution.

Pattern of Traumatic Dental Injuries and Treatment Receipt among Children Attending the University Dental Hospital in Saudi Arabia

ABSTRACT Objective: The aim of this study was to investigate the pattern and distribution of traumatic injuries to primary and permanent anterior teeth in 2–14-year-old pediatric dental patients in AlHassa region of Saudi Arabia. Methods: The study sample consisted of pediatric dental patients visiting the university dental complex seeking treatment for traumatic dental injuries (TDIs) during the period from February 2022 to April 2023. Data were collected by means of interviewing the children and/or parents regarding the history of trauma and clinical examination for evidence of dental trauma to primary and permanent teeth. Results: A total of 122 children (184 teeth) including 78 (63.9%) boys and 44 (36.1%) girls sustained traumatic injuries to their teeth. The most common reason for dental trauma was falls, and maxillary right central incisor was the most frequently affected permanent teeth. Enamel-dentine fractures in permanent teeth and luxation injuries among primary teeth were predominantly noted. Majority of the injuries (47.5%) have been found to have not received timely attention for treatment. Conclusions: Early treatment of dental trauma should be emphasized, and preventive strategies targeted at parents and teachers at the community level are needed to promote and reduce the burden of TDIs.

Remineralizing effect of the association of nano-hydroxyapatite and fluoride in the treatment of initial lesions of the enamel: A systematic review

ObjectiveAssessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ. MethodsSeven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies’ methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study. ResultsThe included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings. ConclusionEven with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found. Clinical significanceDue to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.

Analyzing the Impact of Different Bonding Protocol Strategies to Improve the Fracture Resistance of Uncomplicated Crown Fractures on Tooth Fracture Reattachment in Permanent Anterior Teeth: An In-vitro Study.

Objective This study aims to analyze three different bonding protocol strategies in determining the fracture resistance on the reattachment of fragments in permanent anterior teeth. Methodology This study evaluated the ability of three bonding methods (Group A, total-etch technique; Group B, selective-etch technique; and Group C, self-etch technique) to enhance the fracture resistance of reattached tooth fragments. Sixty permanent maxillary central incisors were chosen, segmented at 3 mm from the incisal edge, and randomly distributed among the three groups. Tooth fragments were stored for 24 hours in GC Tooth Mousse (GC Corporation, Tokyo, Japan), and then reattachment was done using respective bonding techniques. Fracture resistance was gauged using a universal testing machine. Results The mean fracture resistance values were as follows: total-etch (419.5995 N), selective-etch (359.1448 N), and self-etch (192.0887 N). One-way analysis of variance (ANOVA) and post hoc Tukey tests revealed a statistically significant difference between the groups. It was inferred that the total-etch technique exhibited the highest fracture resistance, while the self-etch technique resulted in the lowest fracture resistance (P < 0.05). Conclusions The choice of bonding technique for reattaching tooth fragments should be made based on clinical context and patient needs. Total-etch provided the highest fracture resistance, but selective etch can be preferred for anterior teeth with lower occlusal loads to prevent sensitivity.The self-etch technique may not provide sufficient strength and should be used cautiously. More clinical studies are required to validate these findings and guide clinical decision-making in traumatic dental injury management.

Discoloration after revascularization using calcium phosphosilicate-based bioceramic versus mineral trioxide aggregate in necrotic immature permanent anterior teeth: A Randomized clinical trial.

The aim of the current study is to evaluate the effect of calcium phophosilicate-based bioceramic "Totalfill bioceramic putty" and white mineral trioxide aggregate (WMTA) as the coronal plug on discoloration after revascularization of necrotic immature permanent anterior teeth. This study was conducted on (48) necrotic young permanent central incisors in children ranging from 8 to 14 years old, that were randomly allocated to either Totalfill bioceramic (Group I = 24) or WMTA (Group II = 24) as the coronal plug. Two visits revascularization protocol was adopted in this study using 1.5% sodium hypochlorite, followed by 17% ethylenediaminetetraacetic acid, and ending with a saline flush as irrigation solution. The double antibiotic paste was used as intracanal medication. The blood clot was used as scaffold followed by the application of collagen membrane followed by coronal plud malterial. Finally, the access was sealed using resin composite restoration and composite restoration. Clinical assessment was conducted at 1, 3, 6, 9, and 12 months, while radiographic assessment was conducted at 6 and 12 months. Data were statistically analyzed using the Chi-squared test for intergroup comparisons and Cochran's Q test for intragroup comparison. Clinically, Group I exhibited a success rate of 100%, whereas Group II exhibited a success rate of 85.7%. Radiographically, both materials showed a 90.5% success rate. There was no statistically significant difference between both materials for all assessed clinical and radiographic parameters at different follow-up periods. Both Totalfill bioceramic putty and WMTA can be used successfully as coronal plug in esthetic areas.

Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study

BackgroundAdequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems.Methods3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal’s morphology were described according to Vertucci and Ahmed classifications.ResultsFrequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots (2MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root.ConclusionsOne fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology.Clinical relevanceThe prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.

Анкетування як важливий інструмент для виявлення факторів впливу на затримку прорізування зубів

Aim. To identify risk factors for delayed eruption of permanent anterior teeth in children aged 7 to 14 years, based on clinical examination, radiological examination, parental/caregiver questioning. Materials and Methods. The study included Ukrainian children aged 7-14 years who had delayed eruption of permanent teeth. They were divided into two groups. Group I was composed of 56 (40.0%) children aged 7-9 years with early mixed dentition; Group II was made of 84 (60.0%) individuals aged 10-14 years who had the final stage of mixed dentition. After careful history taking and physical examination, a clinical examination was performed to identify abnormal positions of incisors or canines and to determine the condition of the oral cavity and the bite; a radiological examination included CBCT; and the children’s parents /caregivers were surveyed with the use of the questionnaire we had developed. Results. It has been established that the main risk factors for delayed eruption of permanent teeth are arch-length deficiency, recurrent colds, respiratory disorders, delay in chewing food, pathology in the first trimester of pregnancy, premature extraction of primary teeth, use of a pacifier, delayed loss of deciduous teeth, bad habits, allergies, formula and mixed feeding, orthodontic treatment in the parents’ history, ectopic teething, and injuries to the maxillofacial area in children. Conclusions. A comprehensive history taking, an appropriate determination of the stages of dental development and an assessment of the potential risks of delayed teething are of paramount importance in the diagnosis of pathology, as they allow for the prediction of future orthodontic complications. Key words: delayed eruption of permanent teeth, questionnaire, X-ray examination, dental trauma, ENT pathology, bad habits, CBCT, early loss of primary teeth, allergy, burdened family history, stressor.