Permanent Teeth Research Articles

Tri-Lineage Differentiation Potential of Stem Cells from Human Exfoliated Deciduous Teeth - An In-Vitro Study

ABSTRACT Background: The use of SHED might bring advantages for tissue engineering over the use of stem cells from adult human teeth as SHEDs were reported to have higher proliferation rate and increase cell population doublings as compared with stem cells from permanent teeth. Objective: The study’s objective was to assess the growth kinetics and tri-lineage differentiation capacity of stem cells derived from human exfoliated deciduous teeth. Material and Method: After being propagated through multiple sequential subcultures, adherent fibroblastic cells in the pulp tissue culture from human exfoliation teeth were evaluated to assess their tripotent differentiation potential into bone, cartilage, and adipose cell lineages. Result: The stem cells derived from dental pulp had a comparatively high ability for proliferation and successfully differentiated into chondrocytes and osteocytes while less significant for adipocytes. Conclusion: Stem cells from Human Exfoliated Deciduous teeth are mesenchymal stem cells which are multipotent and can serve as a promising incentive for therapeutic and future research purposes.

Cost-Effective, Patient-Centric, and Innovative Repurposing of a Broken Lingual Arch Space Maintainer: A Case Report

Abstract Introduction Premature loss of primary teeth due to caries or trauma can cause space discrepancies leading to malocclusion and other dental issues. Space maintainers are essential for preserving the arch space until the eruption of the permanent teeth. This case report presents an innovative modification of an existing space maintainer to address clinical challenges, improve patient outcomes, and reduce costs. Case Report An 8-year-old female presented with a broken lingual arch space maintainer impinging on the lingual mucosa. Clinical examination revealed nonrestorable teeth 84 and 75 that required extraction. Radiographs showed tooth 34 erupting soon and tooth 45 delayed. Owing to financial constraints, the existing appliance was modified by lingually cutting and adapting the wire to the distal surface of the canine. The appliance was cemented using Type I Glass Ionomer Cement in a single visit. After 6 months, tooth 35 erupted normally, without impaction. Conclusion This case demonstrates the effectiveness of modifying existing space maintainers to provide cost-effective patient-centric solutions in pediatric dentistry.

Unequal smiles: consequences of untreated dental caries in citizens living in vulnerable circumstances in the Netherlands: an exploratory pilot study.

The often poor oral health status of socioeconomically vulnerable adults is widely recognised. Nevertheless, research on it is scarce. To address this gap, this exploratory pilot study aimed to report on the prevalence of untreated caries and its clinical odontogenic consequences, as well as the associated Oral Health Related Quality of Life (OHRQoL) in a marginalised adult Dutch population. The Dutch department of Médecins du Monde (Doctors of the World) included socioeconomically vulnerable (low socioeconomic position [SEP]) adults in the Netherlands through community organisations. The validated Deprivation in Primary Care Questionnaire (DiPCare-Q) was translated in Dutch and used to characterise the SEP of the population. To document untreated caries and severe odontogenic consequences, the DMFT (Decayed, Missing, Filled Permanent Teeth) and PUFA (Pulpal, Fistula, Ulceration, Abscess) index were used. The validated Dutch Oral Health Impact Profile questionnaire (OHIP-14) was used to document the impact of these issues on OHRQoL. Data analysis was conducted in SPSS® (Statistical Package for the Social Sciences) statistics (Kruskal-Wallis, Mann-Whitney-U-test) and STATA software. Data from 59 adult participants were analysed. The prevalence of untreated caries (DT ≥ 1) was 65.5%, 57.9% of which experienced severe odontogenic consequences (DT+PUFA). The prevalence of severe odontogenic consequences (PUFA ≥ 1) was 45.5%. The mean OHIP-14 score of 17.7 ± 13.4 (25th-75th percentile: 6-26) illustrated that untreated caries may have impact on OHRQoL. Individuals who experienced any severe odontogenic consequences from untreated caries reported significantly higher OHIP-14 scores (mean ± s.d.: 21.8 ± 14.8 vs.11.1 ± 7.2). The untreated caries and severe odontogenic consequences seen in a large number of the socioeconomically vulnerable adult participants seemed to have an impact on OHRQoL. These findings emphasise the urgency of including these adults in the professional oral health system for treatment and prevention, and may emphasise the necessity of improving the socioeconomic circumstances of this population. Further exploration of the exact barriers and facilitators to oral healthcare access for socioeconomically vulnerable adults is necessary.

Dental Resorption. From Diagnosis to Management: An Update for the GDP

Dental resorption is a physiological or pathological process that may be initiated and propagated by various mechanisms, including mechanical, surgical, thermal or chemical injury. It refers to non-bacterial destruction of dental tissue resulting from clastic cell activity. It is predominantly asymptomatic in the permanent dentition and may be misdiagnosed and/or poorly understood. This article describes the different types of dental resorption, the features of each and a guide on how to manage them. Some interesting cases are also highlighted. CPD/Clinical Relevance: It is important to understand, identify and diagnose different types of resorption.

Treatment of Dento-alveolar Traumatic Injuries in a Child with Autism Spectrum Disorder (ASD)

This case report details the multidisciplinary management and follow-up of a 9-year-old boy diagnosed with autism spectrum disorder (ASD). He presented with severe intrusion injuries after a fall to his permanent maxillary central and lateral incisor teeth. The patient was initially seen in the emergency department by the maxillofacial team. Owing to the complexity of the dento-alveolar injury, it was felt that a multidisciplinary approach would improve patient outcomes. In theatre, both maxillofacial and paediatric dental teams managed the acute trauma. The paediatric dental team continued to review and follow-up with the child. A multidisciplinary team is ideal for managing paediatric patients with severe dental trauma and complex behavioural needs. This approach ensures the best care for patients and favourable outcomes. CPD/Clinical Relevance: Multidisciplinary management is important in paediatric dento-alveolar trauma.

Electrosurgical Adjunct for Soft Tissue Management of the Paediatric Dental Trauma Patient

The interface between dental restorations and the neighbouring soft tissue is of key significance for restorative success and longevity. Trauma-related enamel–dentine fractures are frequently present with the restorative challenge of subgingival margins and little remaining tooth structure. This report looks at two paediatric dental trauma patients with extensive crown fractures resulting in subgingival margins, which posed a poor long-term tooth survival. Electrosurgery was used before definitive composite restorations to allow for supragingival margins and access. Each patient attended the Child Dental Health Department at the University of Manchester Dental Hospital for assessment and treatment provision. CPD/Clinical Relevance: This article identifies electrosurgery as an increasingly useful adjunct to restorative management of traumatized permanent incisor teeth in paediatric patients.

Fully automated method for three-dimensional segmentation and fine classification of mixed dentition in cone-beam computed tomography using deep learning

ObjectiveTo establish a high-precision, automated model using deep learning for the fine classification and three-dimensional (3D) segmentation of mixed dentition in cone-beam computed tomography (CBCT) images. MethodsA high-precision, automated deep learning model was built based on modified nnU-Net and U-Net networks and was used to classify and segment mixed dentition. It was trained on a series of 336 CBCT scans and tested using 120 mixed dentition CBCT scans from three centers and 143 permanent dentition CBCT scans from a public dataset. The diagnostic performance of the model was assessed and compared with those of two observers with different seniority levels. ResultsThe model achieved accurate classification and segmentation of specific tooth positions in the internal and external mixed dentition datasets (Dice similarity coefficient: 0.964 vs. 0.951; Jaccard coefficient: 0.931 vs. 0.921; precision: 0.963 vs. 0.945; recall: 0.945 vs. 0.941; F-1 score: 0.954 vs. 0.943). These indices consistently exceeded 0.9 across multiple conditions, including fillings, malocclusion, and supernumerary tooth, with an average symmetric surface distance of 0.091 ± 0.029 mm. For permanent dentition, the Dice similarity and Jaccard coefficients exceeded 0.90, the average symmetric surface distance was 0.190 ± 0.092 mm, and precision and recall exceeded 0.94. With the aid of the model, the performance of junior dentists in mixed dentition classification and segmentation improved significantly; in contrast, there was no significant improvement in the performance of senior dentists. The speed of segmentation conducted by the dentists increased by 20.9–22.8 times. ConclusionThe artificial intelligence model has strong clinical applicability, robustness, and generalizability for mixed and permanent dentition. Clinical SignificanceThe precise classification and 3D segmentation of mixed dentition in dentofacial deformities, supernumerary teeth, and metal artifacts present challenges. This study developed a deep learning approach to analyze CBCT scans, enhancing diagnostic accuracy and efficacy. It facilitates detailed measurements of tooth morphology and movement as well as informed orthodontic planning and orthotic design. Additionally, this method supports dental education by assisting doctors in explaining CBCT images to the families of pediatric patients.

Treatment Options For Complicated Crown Fractures In Permanent Teeth

Treatment Options For Complicated Crown Fractures In Permanent Teeth

Effectiveness of conservative treatment of dentigerous cyst in the pediatric patient: A systematic review

The dentigerous cyst is defined as a pathological cavity whose origin is produced by developmental alterations. Most usual treatment is the enucleation of the cyst with the extraction of the tooth. The current approach tends to preserve the tooth. The aim of this study was to determine the total and partial success of the conservative treatment of the dentigerous cyst in terms of eruption of the associated permanent tooth. Pub-Med, Scopus and the Cochrane Central Register of Controlled Trials were searched from January 2012 to December 2023, including patients aged 18 years old or less with a dentigerous cyst associated with a repositionable permanent tooth in the arch. 118 articles were found and 24 were included in full text. 40 cases were reported in the mandible (83 %) and 8 in the maxilla (17 %). 29 cases of marsupialization were included (60 %), 17 of enucleation (36 %) and 2 of decompression (4 %). The percentage of teeth that erupted spontaneously, either completely or partially, after marsupialization, enucleation and decompression was 83 %, 59 % and 100 % respectively. No recurrences have been described in any case. This study highlights that the conservative treatment was a predictable procedure with a total success of 83 % by marsupialization and 100 % after decompression.

A Deep-learning System for Diagnosing Ectopic Eruption

Objectives: To construct a diagnostic model for mixed dentition using a multistage deep-learning network to predict potential ectopic eruption in permanent teeth by integrating dentition segmentation into the process of automatic classification of dental development stages.Methods: A database was established by reviewing 1576 anonymous panoramic radiographs of children aged 6–12 years, collected at the Stomatology Hospital, xxxxxx. These radiographs were categorised as normal or ectopic eruption, with expert diagnoses serving as a benchmark for training and evaluating artificial intelligence (AI) models. Furthermore, tooth boundaries and dental development stages were manually annotated by three pediatric dentistry experts. The dataset was split into training, validation, and test sets at an 8:1:1 ratio.Results: The diagnostic performance of the deep-learning model was rigorously evaluated. The model demonstrated accuracy in tooth segmentation, with Intersection over Union, precision, sensitivity, and F1 scores of 0.959, 0.993, 0.966, and 0.979, respectively. Furthermore, its ability to identify tooth ectopic eruptions on panoramic radiographs, when compared to evaluations by three dentists. Based on McNemar's test, the model's specificity and accuracy in identifying ectopic tooth eruptions on the test dataset surpassed that of Dentist 1 (P < 0.05), while no significant difference was observed compared to the other two dentists. Besides, the deep learning model also showed its potential in classifying dental development stages, as tested against three different standards.Conclusions: The adaptability of the AI-enabled model in this study was demonstrated across multiple scenarios, with clinical validation highlighting its efficacy in diagnosing ectopic eruptions using a multistage deep-learning approach.Clinical Significance: Our findings provide new insights and technical support for the prevention and treatment of abnormal tooth eruption, laying the groundwork for predictive models for other prevalent pediatric dentistry conditions.

Regenerative endodontic treatment of ımmature permanent tooth: Case report

Regenerative endodontic treatment of ımmature permanent tooth: Case report

Evaluating crown materials wear on primary and permanent teeth

Evaluating crown materials wear on primary and permanent teeth

Evaluation of root canal obturation in permanent teeth

Evaluation of root canal obturation in permanent teeth

“The Study Of Eruption Of Teeth In Children From Birth To 12 Years Of Age In Western Maharashtra Region.”

Human beings show 2 sets of dentition- deciduous and permanent2. Variation of tooth has been an enduring interest to clinical practitioner as well as from anthropological and forensic point of view7 . These variations in the form of teeth are characteristics of race, are of anthropological, genetic and forensic interest.2,7hence studies have been done using teeth for age, sex determination1,8 . As existing eruption schedule of dentition is based on western population this study is done in western Maharashtra region to find out variation in time number, form and pattern of eruption in deciduos and permanent teeth as well as in males and females.

Regenerative Endodontic Procedures With Minced Pulp Tissue Graft in Mature Permanent Teeth: A Clinical Study

IntroductionRegenerative endodontic procedures (REPs) using cell-based approaches have emerged as novel treatment modalities. This clinical study aimed to present the outcomes and explore factors influencing REPs with minced pulp tissue (MP) grafts in a mature tooth. MethodsSix healthy male patients aged 20–27 requiring nonsurgical root canal treatment were enrolled in this study. MP tissue obtained from third molars was introduced into the instrumented, disinfected, and blood-filled root canal. The canal was sealed with bioceramic cement, and the coronal access cavity was restored. ResultsFollow-ups for 6 cases ranged from 19 to 42 months. Radiographically, all the teeth showed favorable outcomes. Among the 6 teeth, 2 showed neither intracanal calcification nor recovery in sensibility tests, and one had no intracanal calcification with an inapplicable sensibility test evaluation. In 2 teeth, intracanal calcification was observed in the apical third; however, there was no recovery in the sensibility tests. One tooth exhibited intracanal calcification in the apical third and showed recovery in the sensibility tests. Considering these outcomes and clinical variables, the size of the apical foramen and the composition of the transplanted pulp tissue were identified as tentative influencing factors. ConclusionsThis study on simplified cell-based therapy using autologous MP for pulp/dentin regeneration in adult teeth not only enhances our understanding of REPs but also suggests its potential as an alternative treatment option to conventional endodontic treatment.

Impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults : Across-sectional study.

The aim of this study was to investigate the impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults. Across-sectional study was conducted with asample of 213 young adults aged 18-30years. Dental occlusion data were assessed through clinical examination. Aquestionnaire was used to collect data on oral habits. Outcomes were collected using the Oral Health Impact Profile (OHIP-14) and Mini Sleep Questionnaire. Anterior open bite (adjusted odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.02-5.67, p = 0.044), swallowing disorders (adjusted OR = 2.39, 95% CI = 1.13-5.05, p = 0.022), and sleeping on hands were associated with anegative impact on oral health-related quality of life. Females (adjusted OR = 2.61, 95% CI = 1.10-6.17, p = 0.029), teeth grinding (adjusted OR = 2.78, 95% CI = 1.08-7.14, p = 0.034), biting lips or cheeks (adjusted OR = 4.28, 95% CI = 1.49-12.29, p = 0.007), and self-perception of need for orthodontic treatment (adjusted OR = 7.88, 95% CI = 2.12-29.30, p = 0.002) were associated as arisk for sleep disturbances. The findings suggest that oral habits and some types of malocclusions can impact oral health-related quality of life. In addition, sleep disturbances were associated with agreater need for orthodontic treatment and ahabit of grinding teeth in young adults.

Caries experience in permanent dentition of schoolchildren in Azerbaijan

Caries experience in permanent dentition of schoolchildren in Azerbaijan

Dental Caries and Erosive Tooth Wear Among 12-Year-Old Hong Kong Children

ObjectiveThis study is to investigate the dental caries, erosive tooth wear status, and oral health-related habits of 12-year-old Hong Kong children. MethodsThis cross-sectional survey recruited 12-year-old children using clustered random sampling from three main districts. The trained examiner examined the children's caries status using the criteria recommended by the World Health Organization and recorded their caries experience using the decayed, missing, and filled tooth (DMFT) index. The children's tooth wear status was determined using the Basic Erosive Wear Examination (BEWE) index. Their oral hygiene practice was collected using a self-administered questionnaire. ResultsWe recruited 445 children and 396 children participated (response rate: 89%). Their mean DMFT was 0.29 ± 0.73. Seventy children (18%, 70/396) had caries experience (DMFT > 0) and they had 116 teeth suffered from caries. Among these 116 carious teeth, 75 teeth (65%, 75/116) were filled (FT), one tooth (1%, 1/116) was extracted (MT), and 40 teeth (34%, 40/116) were carious (DT). Five children had more than one decayed tooth (DT > 1), and one child had the highest number of decayed teeth (DT) at 4. BEWE results showed 284 (72%, 284/396) children had no erosive tooth wear (BEWE = 0). No child had severe erosive tooth wear (BEWE = 3). However, children consuming lemon tea or lemonade and vitamin C drinks 3 times a week or more showed significantly higher BEWE scores. Additionally, 380 (96%, 380/396) children brushed their teeth daily and 116 children (29%, 116/396) flossed their teeth. ConclusionMost 12-year-old Hong Kong children had neither caries experience nor tooth wear, and their oral health-related habits were satisfactory. SignificanceThis study updated the caries status of the permanent dentition of 12-year-old Hong Kong children. The information offers updated oral health data for the local, regional, and global authorities for planning effective public health programmes to improve the oral health of children.

Comparative evaluation of various biomaterials as pulpotomy agents in molars with symptomatic irreversible pulpitis: A randomized single-blinded single-center control trial

Abstract Introduction: Untreated tooth decay in mature permanent dentition is a prevalent global issue, affecting 34.1% of people with 2.5 billion cases annually. Extensive decay often leads to irreversible pulpitis, characterized by pulp inflammation and pain. Pulpectomy, the standard treatment, involves complex procedures with potential complications. Modern endodontics favors minimally invasive treatment such as pulpotomy, which preserves pulp vitality. This study aims to compare the clinical as well as radiographic outcomes of different pulpotomy agents: Biodentine, mineral trioxide aggregate (MTA), Bio-C repair, and Endosequence Bio-ceramic root repair material (BCRRM) in mature permanent molars. Methodology: This single-blind, single-center study involved 80 participants randomly assigned to four groups, each receiving one of the biomaterials. Ethical approval was obtained. Participants aged 14–60 years with symptomatic irreversible pulpitis were selected. Pulpotomy procedures were performed, and follow-up evaluations occurred at 24 h, 1 week, 4 weeks, 3, 6, and 12 months. Clinical success was measured by the absence of pain, sensitivity, and tenderness. Radiographic evaluation used the periapical index (PAI) scoring system. Results: Pulpotomy significantly reduced postoperative pain in all groups. Endosequence BCRRM showed the maximum pain reduction at 24 h with a statistically significant difference from all the groups (at 1% probability level), followed by Bio-C repair, Biodentine, and MTA. At 1 week, Bio-C repair led in pain reduction with statistically nonsignificant results. All groups reported no pain at 3, 6, and 12 months. Endosequence BCRRM had the highest improvement in periapical findings at 1 year. Sensitivity to hot and cold improved significantly in all groups, with Endosequence BCRRM performing best. Conclusion: Endosequence BCRRM provided the best overall outcomes, emphasizing the importance of material choice in pulpotomy treatments. Further research on biomaterials’ long-term clinical and radiographic outcomes is needed to enhance treatment efficacy.

Management Of Radicular Cyst Of Mandible In Pediatric Patients: A Case Series

Radicular cyst is a pathologic cavity partially or completely lined by epithelium in an area of apical periodontitis that is the result of root canal infection of a tooth. The radicular cysts are most likely caused by the inflammatory proliferation of Malassez's epithelial cell resting in the periapical tissues that are irritated. It rarely occurs in conjunction with deciduous teeth and is typically linked to permanent dentition. This article describes a case series of two male children, ages five and seven, who had an apical periodontal cyst in the mandibular posterior region of the jaw, which was connected to their deciduous teeth. Conservative treatment might have been the outcome of an early diagnosis of the lesion. The goal of this paper is to highlight the pedodontist's contribution in the early analysis of such lesions