Mandibular Arch Research Articles

Directly printed aligner therapy: A 12-month evaluation of application and effectiveness

Directly printed aligners (DPAs) are gaining in popularity, potentially streamlining manufacturing, decreasing environmental waste, and offering enhanced adaptation and tailoring. This transition has been facilitated by advances in materials, software, and production. Although DPAs may have enhanced versatility and application in the management of more complex malocclusions, there is little research evaluating their effectiveness. A total of 54 patients undergoing treatment with DPAs were evaluated for occlusal improvement, overall treatment duration, and adverse effects. Regression models were fit to evaluate the association between the need for refinement, final peer assessment rating (PAR) score, and independent variables, including the total number of aligners and treatment indications. The mean number of aligners in the initial plan was 7.1 ± 2.9 and 5.1 ± 4.3 in maxillary and mandibular arches. Refinement was required in 40.8% (n= 20). The pretreatment PAR score of 17.01 ± 7.93 showed a significant improvement (86.6%), with a final PAR score of 2.25 ± 1.15. Minor complications were noted in 3 participants. The need for refinement was unrelated to the total number of aligners (odds ratio, 1.05; 95% confidence interval, 0.94-1.18; P= 0.36). There was weak evidence of an association between the final PAR score and the total number of aligners (odds ratio, -0.03; 95% confidence interval, -0.07 to 0.003, P= 0.07). On the basis of this preliminary retrospective evaluation, DPAs may be used to manage mild-moderate malocclusion, producing a significant reduction in PAR score. Nevertheless, additional prospective research is required to confirm these findings and compare the relative merits of DPAs to alternatives.

Evaluation of Treatment Effects of en Masse Mandibular Arch Distalization Using Skeletal Temporary Anchorage Devices: A Systematic Review.

Mandibular arch distalization using temporary anchorage devices (TADs) is effective in correcting borderline Class lll cases without surgery. This review analysed the existing literature evaluating the dental, skeletal, and soft tissue changes after en masse mandibular arch distalization using TADs. We followed PRISMA guidelines and registered this review in PROSPERO database CRD42023450524. PubMed, Google Scholar, Cochrane, Web of Science, and SCOPUS databases were searched. Orthodontic patients requiring en masse mandibular distalization using TADs were compared with different modalities of distalization. Dental changes were evaluated along with skeletal and soft tissue changes and treatment duration. Randomized controlled trials (RCTs), cohort studies, longitudinal studies, and retrospective studies were eligible to be included. The risk of bias was assessed using ROBINS-I tool ("Risk Of Bias In Non-randomized Studies-of Interventions"). Of 1764 identified records, seven studies (one non-RCT, one prospective clinical trial, and five retrospective cohort studies) were included. One study had a low risk of bias, three had moderate bias, two had serious bias, and one had critical bias. All studies showed molar distalization and distal tipping with significant retraction of the lower lip. Miniplates showed greater distalization compared to miniscrews. Interradicular miniscrews exhibited the least distal tipping. Changes in SNB, ANB, occlusal plane angle, and mandibular plane angle were reported. Retromolar screws and ramal plates reported reduced treatment duration. TADs are effective in en masse distalization of mandibular dentition with intrusive or extrusive effects.

Relationship between mandibular arch parameters and third molar impaction

Relationship between mandibular arch parameters and third molar impaction

Evaluation of effect of low-level laser therapy on alleviation of pain in patients with implant-supported mandibular overdenture: A pilot study

Aim: Rehabilitation of edentulous jaws with implant-supported overdenture has achieved a comprehensive acclamation across the globe due to compromised retention and stability in conventional complete dentures. In dentistry, low-level laser therapy (LLLT) has become a viable treatment option for lowering inflammation, easing pain, and speeding up wound healing. This study aimed to evaluate the effect of LLLT on alleviation of pain in patients with two implant-supported mandibular overdentures. Study Setting and Design: This study was carried out in the Department of Prosthodontics at Index Institute of Dental Sciences, Indore, Madhya Pradesh. Completely edentulous patients willing for implant-supported mandibular overdenture and who gave consent, were enrolled. Materials and Methods: A total of ten implants were placed in five patients with completely edentulous mandibular arch willing for implant-supported mandibular overdenture. Individuals from the outpatient division of Department of Prosthodontics, Crown & Bridge, Index Institute of Dental Sciences, Indore were chosen as patients. Bilateral implants were inserted into the mandible at locations B and D. On the experimental side, low-level laser therapy (wavelength 810 nm) was administered immediately following implant insertion and on the third day. Over the course of 72 hours, pain after surgery was assessed using visual analogue scale (VAS) values, beginning at baseline. Statistical Analysis Used: The Mann-Whitney U test was used for statistical analysis of the intergroup pain alleviation scores. Results: The results showed that on intergroup comparison, the experimental side exhibited significantly reduced VAS pain scores relative to the control side (P<0.05). Conclusion: LLLT can be used as a promising adjuvant therapy to lower the degree and duration of pain after undergoing dental implant surgery.

Transverse dentoalveolar development in Chinese children and adolescents: A cross-sectional study using revised Andrews’ Element III analysis

This study investigated the prevalence of maxillary transverse deficiency (MTD) in Chinese children and adolescents using revised Andrews' Element III analysis and studied transverse developmental characteristics of the maxillomandibular complex. Plaster or digital casts of 794 participants aged 7-18 years were evaluated. MTD was diagnosed when the maxilla-mandible width difference, represented by the decompensated maxillary and mandibular first molars, exceeded 4 mm. The average prevalence of MTD among patients aged 7-18 years was 31.1%. Patients with MTD exhibited narrower maxillary and/or wider mandibular arches. Strikingly, 32.3% of participants with posterior crossbite because of local crowding or mandibular deviation were not diagnosed with MTD. Dental compensation, such as a greater buccolingual inclination of the first molars, was common in patients with MTD. Transverse growth of the maxillomandibular complex was completed by 17 years old, with the maxilla undergoing greater transverse growth than the mandible. The physiological buccolingual inclination of first molars was observed in patients without MTD. The 95% reference value of the palatal arch width was 31.9-42.3 mm. The prevalence of MTD is 31.1% among Chinese children and adolescents. However, it is often camouflaged by dental compensation and sagittal discrepancy. The etiology of MTD is uncoordinated width in the maxillomandibular complex, which is not solely attributed to a narrow maxilla but also to an excessively wide mandible. To enhance diagnostic accuracy, individualized measurements of the maxillomandibular complex and a revised dental decompensation formula, rather than posterior crossbite alone, are recommended for transverse diagnosis. A potential presence of MTD is indicated when the palatal arch width is<31.9 mm.

Prevalence and pattern of third molars impaction in a large Yemeni sample: a retrospective study.

The prevalence of teeth impaction varies substantially between different populations, and the impaction of third molars is the most commonly recorded. This study aimed to explore the prevalence and pattern of the third molars impactions among Yemeni population. This was a retrospective radiographic study conducted in Yemen between 2022 and 2023. The digital panoramic radiographs were collected from two major X-ray centers in Yemen. The angular position and depth of the impacted third molars were assessed according to the classifications of Winter and of Pell and Gregory, respectively. All radiographs were evaluated twice by one investigator in a two-week interval, and Kappa test was used for intra-rater reliability. Gender-wise differences, differences between both sides, and differences between maxilla and mandible were analyzed using Chi-squared tes with odds ratio (OR) for the risk of impaction. A P-value < 0.05 was considered significant. Panoramic radiographs of 6338 individuals were included. Their mean age was 35.1 ± 13.3 years andand 63.9% were females. A total of 25,352 sites (quadrants) were screened for the presence of thirds molars. Among which, 14,003 third molars (55.3%) were present in one or more sites. There were 1440 individuals (23%) with a total of 2828 impacted third molars (20% of the existing third molars). Females were less likely to have third molar impaction (OR = 0.46, CI95% = 0.4-0.52). Impaction of the mandibular third molars was significantly more frequent than the maxillary ones (OR = 1.15, CI95% = 1.04-1.26; P = 0.005). Horizontal and mesioangular impactions were statistically more frequent in the lower molars compared to the upper ones (P < 0.001 each). Contrastingly, vertical (P = 0.015), distoangular, and other impactions (P < 0.001 each)were statistically more frequent in the maxilla. Levels A and B were more frequent in the lower third molars, while level C was predominating in the upper molars (P < 0.001 each). The prevalence of third molars impaction is more frequent in males and mandibular arch. The angulation and level of impaction seem to be more complicated in the maxillary arch.

Assessment of Residual Ridge Morphology among Edentulous Patients at A Tertiary Care Center of Nepal

Background The morphology of the residual ridge is one of the predominant factors influencing denture retention, stability, support and the masticatory function in edentulous patients thereby affecting both the planning and treatment prognosis. This study was aimed to assess the different types of maxillary and mandibular residual ridge in the group of edentulous population in Chitwan, Nepal. MethodsA descriptive cross-sectional study was conducted in total of 107 completely edentulous patients within the age of 55-85 years’ in Prosthodontic department of Chitwan Medical College. The type of maxillary and mandibular residual alveolar ridge in both male and female patients were noted in a predesigned proforma according to American College of Prosthodontists (ACP) classification system. The collected data was entered into Microsoft Excel and later transferred into SPSS version 26 and analyzed for descriptive statistics.ResultsIn this study, 107 completely edentulous patients both male 63 (58.9%) and female 44 (41.1%) participated in the study. In the maxillary arch, Type B was most prevalent residual ridge type 55 (51.4%) whereas Type C in mandibular arch around 35 (32.7%). In male patients, Type B was most common 36 (57.1%) whereas Type A in female 20 (45.5%). Conclusions From this study it can be concluded that there is variation in the residual ridge. In maxillary arch, type B residual ridge was most prevalent followed by type A while in the mandibular arch type C was prevalent followed by type B.

Orthodontic-Orthognathic Management of a Patient With Severe Mandibular Deficiency Due to Bicondylar Fracture: A Case Report

This case report is about a 30-year-old Iranian female. The patient’s chief complaint was the backwardness of the lower jaw. The patient reported a history of condylar fractures in childhood. There was crowding in the maxillary and mandibular arch, and the midline in the mandible was 2 mm deviated to the left. The canine and first premolar on the left side of the maxilla were extracted, and the canine on the left side of the mandible was impacted. Clinical examinations and paraclinical documents revealed that the patient was a skeletal class II case with mandibular deficiency, complicated by a vertical maxillary excess. Virtual surgery planning was used to plan the patient’s treatment. The amount of adhesion of soft tissue to hard tissue was also taken into consideration. According to the measurements of the patient and the class II, vertical maxillary excess of the patient, the shortness of the ramus, and the large angle of the occlusal plane, our chosen orthognathic surgery included bilateral sagittal split osteotomy, advancement genioplasty, and maxillary impaction.

Three-Dimensional Assessment of Collum Angle in Different Sagittal Malocclusions: A Cross-Sectional Study.

Assessment of crown-root angulation of the anterior teeth as defined by the collum angle (CA) is crucial for diagnosis and treatment planning. This study was undertaken to evaluate the CA of all anterior teeth within both the maxillary and mandibular arches across various sagittal malocclusions using cone-beam computed tomography (CBCT). Additionally, the secondary aims included investigating sex disparities and side variances in this angular measurement. This cross-sectional study was conducted on 80 pre-orthodontic patients divided into four groups with 20 patients in each group: Group 1, dentoskeletal class I; Group 2, dentoskeletal class II withdivision 1 malocclusion; Group 3, dentoskeletal class II withdivision 2 malocclusion; and Group 4, dentoskeletal class III malocclusion. CA was assessed using CBCT for all anterior teeth in both jaws. The data were then subjected to statistical analysis. There were statistically significant differences in the CA for all anterior teeth in both jaws among all groups (p<0.05). The mean CA was highest in Group 3, followed by Groups 4, 2, and 1 for the maxillary central incisors (CIs). The mean CA was highest in Group 3, followed by Group 2, Group 1, and Group 3 for the maxillary lateral incisors (LI). The mean CA was highest in Group 3, followed by Groups 2, 4, and 1 for the maxillary canines. The mean CA was highest in Group 3, followed by Groups 4, 2, and 1 for the mandibular CI. The mean CA was highest in Group 3, followed by Groups 4, 2, and 1 for the mandibular LI. The mean CA was highest in Group 3, followed by Groups 4, 2, and 1 for the mandibular canines. There were no statistically significant sex or side (right and left) differences between the groups (p>0.05). The highest CA was observed in class II division 2 for all the anterior teeth. The CA of the mandibular teeth was lower than that of the maxillary teeth, and the lowest values of CA were obtained for mandibular teeth in class I malocclusion.

Does enamel deproteinisation with 10% papain affect shear bond strength of orthodontic adhesives: a randomised controlled trial.

To evaluate the effect of 10% papain as an enamel deproteinising agent on the shear bond strength (SBS) of three orthodontic adhesives: Transbond XT, resin-modified glass ionomer cement (RMGIC) and Biofix. Single-centre, double-blinded, split-mouth randomised controlled trial. Department of Orthodontics and Dentofacial Orthopaedics, Nair Hospital Dental College, Mumbai, India. A total of 20 participants requiring bilateral premolar extraction for fixed orthodontic treatment in both the maxillary and mandibular arches were included in this study. In total, 80 premolars from the above-mentioned participants were divided into four groups as follows: group A: Transbond XT deproteinised with 10% papain gel; group B: Biofix deproteinised with 10% papain gel; group C: RMGIC deproteinised with 10% papain gel; and group D: Transbond XT without enamel deproteinisation as a control group-bonded as instructed by the manufacturer. After deproteinisation, brackets were bonded and after a follow-up period of 28 days, the teeth were extracted. The SBS was then measured using the Universal Testing Machine. The force needed to shear the bracket was documented, and bond strengths were subsequently calculated in megapascals (MPa). The obtained results were subjected to statistical analysis and one-way ANOVA was performed to compare the mean SBS between the groups. Subsequently, pairwise comparisons were conducted using Tukey's post hoc test. There was a statistically significant difference in SBS among all groups (P = 0.002). The SBS of TransXT with deproteinisation increased significantly compared with TransXT without deproteinisation (P = 0.03). There was no statistically significant difference between the SBS of TransXT without deproteinisation and RMGIC (P = 0.47) and Biofix (P = 0.39), both with deproteinisation. The use of 10% papain for deproteinising enamel improved the SBS of all materials. Deproteinising improved the SBS of RMGIC and Biofix to the level of TransXT without deproteinisation.

Peritonsillar Abscess: An Update on Diagnosis and Medical-Surgical Management. A Review of the Literature and Case Report

Introduction: Peritonsillar abscess is an acute pharyngeal infection located between the tonsillar capsule and the aponeurosis of the superior constrictor muscle of the pharynx, being an important cause of consultation in emergency services. Its management includes antibiotic treatments and/or emptying of the abscess. Objective: To describe the diagnosis and medical-surgical management of a 47-year-old male patient with peritonsillar abscess; Regarding the case, a review of the updated literature on the topic was carried out. Method: Presentation of the case report: 47-year-old male patient, who attended the Libertador Bernardo O'Higgins Regional Hospital due to increased tonsillar volume. Sudden onset. Clinically, guttural voice, odynophagia, dysphagia, trismus and intermittent fever were notable. Discussion: After the clinical, imaging and laboratory study, a diagnosis of peritonsillar abscess was reached, which underwent medical-surgical management, presenting satisfactory evolution of this case, a review of the literature was carried out in the last 10 years in Spanish. English in the search engines PubMed and Science Direct. Conclusions: Surgical management of peritonsillar abscess continues to be the treatment of choice; however, based on the review of the literature that was carried out, medical management can also be chosen in some cases.

Can deep learning-designed anterior tooth-borne crown fulfill morphologic, aesthetic, and functional criteria in clinical practice?

ObjectivesThis study aimed to compare the design outcomes of anterior crowns generated using deep learning (DL)-based software with those fabricated by a technician using conventional dental computer-assisted design (CAD) software without DL support, with a focus on the evaluation of crown morphology, function, and aesthetics. MethodsTwenty-five in vivo datasets comprising maxillary and mandibular arch scans of prepared maxillary central incisors were utilized to design anterior crowns by using three methods: 1) a DL-based method resulting in as-generated outcome (DB), 2) a DL-based method further optimized by a technician (DM), and 3) a conventional CAD-based method (NC, control). Evaluations were conducted for crown morphology (total discrepancy volume (TDV), root mean square (RMS), positive average (PA) and negative average (NA) deviations), functional aspects (incisal path: deviations, length, and mean inclination), and aesthetics (crown width, height, width-to-height ratio, angular radius of mesioincisal line angle, proximal contact length, and tooth axis angle). ResultsSignificant differences in TDV ratio were noted between the DB–NC (32.3 ± 8.5 %) and DM–NC (26.5 ± 5.4 %) pairs (P = 0.006). No significant differences were observed in TDV between the DB–NC (65.3 ± 24.4 mm3) and DM–NC (54.3 ± 21.0 mm3) pairs (P = 0.095). For the entire palatal surface, significant differences in RMS and PA values were observed between the DB–NC and DM–NC pairs (P < 0.037). Significant differences in RMS values for the incisal half (P = 0.021) and in PA values for the cervical half (P = 0.047) of the palatal surface were also noted between these pairs. Significant differences in the deviation of the incisal path were observed between the DB–NC (290.4 ± 212.4 μm) and DM–NC (132.0 ± 122.3 μm) pairs (P < 0.001). However, no significant differences were found among the groups (DB, DM, and NC) in terms of the length and mean inclination of incisal paths or in aesthetic outcomes. ConclusionsA DL-based method can result in promising outcomes with clinically acceptable morphology and aesthetics for anterior crowns. Minor deviations in incisal path of the crowns may lead to anterior guidance discrepancies, which can be corrected by the dental technician at the design stage. Clinical significanceWith the potential of DL-based design methods in dental applications, integrating AI technology into dental CAD workflow can enhance the clinical efficiency and consistency of anterior crown design, although human intervention may be required to refine functional aspect.

Wearing the mandibular advancement orthosis and dental movements: Contribution of a digital monitoring protocol

AbstractObjectivesOral appliance (OA) has been increasingly used for the treatment of obstructive sleep apnoea hypopnea syndrome (OSAHS). OAs work by propelling the mandible, increasing the upper airway calibre and reducing collapsibility. While they have shown efficacy in reducing OSAHS, long‐term use can lead to adverse effects, such as dental displacement. The present study focuses on the impact on dental displacements of the NARVAL® computer‐aided design and manufacturing OA from the ResMed laboratory.Materials and MethodsThe study included 39 patients aged 18 or older who were treated for OSAHS using OAs initiated between 2019 and 2021 and had initial digital dental impressions. A new digital print was taken for each patient using the TRIOS 4 Wireless intra‐oral scanner from 3SHAPE. Dental displacement was measured using a 3D system's GEOMAGIC design X 3D reverse engineering software. The study analysed different blocks of teeth in both the maxillary and mandibular arches. Statistical analysis was conducted to determine the significance of dental displacements.ResultsPatients had been wearing the OA for an average of 2.5 years. The study found dental displacements in both the maxillary and mandibular arches. However, these displacements were not statistically significant. Qualitative analysis revealed palatoversion and vestibuloversion, while quantitative analysis showed minor dental displacements.ConclusionThis study on patients wearing the NARVAL® OA for an average of 2.5 years found dental displacements in both the maxillary and mandibular arches. However, these displacements were not statistically significant. The results suggest that the OA, designed using a complete digital workflow, did not significantly impact dental positions. To confirm the impact, further investigations with larger sample sizes, an exclusively digital protocol and a control group are required.

Atomoxetine and spironolactone combine to reduce obstructive sleep apnea severity and blood pressure in hypertensive patients.

Norepinephrine reuptake inhibitors such as atomoxetine (ato) can improve OSA by increasing pharyngeal muscle activity. Mineralocorticoid antagonists such as spironolactone, may potentiate the reduction of OSA severity and reduce blood pressure. We evaluated whether adding spironolactone to atomoxetine (ato-spiro) improved responses in hypertensive OSA patients. Twenty-one patients with an apnea-hypopnea index (AHI) between 10 and 50 events/h and a history of hypertension were recruited and crossed-over in random order to ato 80mg and ato-spiro 80/50mg for 1 week after a 3-day low dose run-in period. Two dropped out due to drug related side effects. Polysomnography and 24-hour blood pressure (BP) monitoring were performed at baseline and after each treatment period. AHI decreased on both ato and ato-spiro from a baseline median(IQR) of 20.3(18.8 to 28.5) to 8.2(7 to 13.1) and 6.2(5.7 to 14.1), respectively (p < 0.001 for both). Systolic BP (mmHg) fell by mean(95%CI) -4.5(-13.8 to 4.8, p = 0.33) on ato and - 10.3(-19.2 to -1.5, p = 0.02) on ato-spiro, and diastolic BP dropped by -3.0(-8.0 to 2.0, p = 0.23) on ato and - 5.0(-9.1 to -0.9; p = 0.02) on ato-spiro. Both ato and ato-spiro led to a significant shift from apnea to hypopnea predominance (p < 0.001), and significant reductions in hypoxic burden (p ≤ 0.001) and REM sleep (p ≤ 0.001). Both ato-spiro and ato alone decreased OSA severity similarly, but ato-spiro led to even greater, statistically significant and clinically meaningful falls in systolic and diastolic BP. BP reductions were likely due to ato-related improvements in upper airway patency and hypoxemia, and to spiro-related reduced fluid retention. These findings show promise for ato-spiro as an oral treatment for hypertensive OSA patients. REGISTERED AT CLINICALTRIALS.GOV: NCT04905979.

Trifold origin of the reptilian ear ossicle and its relation to the evolutionary modification of the temporal skull region.

Whereas mammals are characterized by the presence of three middle ear ossicles, reptiles have only one, the columella (stapes). Nevertheless, there is a great diversity of columellar anatomy among sauropsids, especially in the unique and cartilaginous "extracolumella"-portion. Molecular studies revealed the "columella" of chicken and quails to be formed within the second pharyngeal arch, although conflicting evidence exists for the columellar footplate and distal parts of the columella in these birds. We studied columellar development in four turtles, one lizard, and one caiman species and argue, using early blastematous stages, that, distally, the so-called "extracolumella" in turtles is mainly of quadrate, that is, first pharyngeal arch origin. Differently, the dorsal aspect of the "extracolumella" of the lizard and a part of the "dorsal columella process" of the caiman are likely quadrate-derived. This indicates only a partial homology of the distal columellar compartments among reptiles. Moreover, we observed in most species that, at early stages, the footplate differentiates from the otic capsule, which confirms widespread experimental findings of mesodermal cells contributing to the proximal part of the columella. We provide a hypothetical framework for the changes in the columella and quadrate morphology in reptilian evolution. Originally, as evidenced by the fossil record, the columella served as a stabilizing brace between the quadrate and braincase. Associated with changes in the feeding mode of late Permian taxa, the quadrate was integrated along the stress flows from biting, and in early development part of the quadrate differentiated to differently contribute to the distal part of the "columella-complex," which now contacts the tympanic membrane. In addition, part of the original otic capsule contributes to the footplate of the mobile columella, providing a connection with the inner ear.

Onco-Ontogeny of Squamous Cell Cancer of the First Pharyngeal Arch Derivatives.

Head and neck squamous cell carcinoma (H&NSCC) is an anatomic, biological, and genetic complex disease. It involves more than 1000 genes implied in its oncogenesis; for this review, we limit our search and description to the genes implied in the onco-ontogeny of the derivates from the first pharyngeal arch during embryo development. They can be grouped as transcription factors and signaling molecules (that act as growth factors that bind to receptors). Finally, we propose the term embryo-oncogenesis to refer to the activation, reactivation, and use of the genes involved in the embryo's development during the oncogenesis or malignant tumor invasion and metastasis events as part of an onco-ontogenic inverse process.

Molar Incisor Hypomineralization: Prevalence and Treatment Needs in 7- to 9-year-old Children of Lucknow City.

Molar incisor hypomineralization (MIH) is one of the most common developmental disturbances that dental practitioners encounter, which may influence the child's quality of life and can impact their future dental health. To determine prevalence and treatment needs of MIH in children of Lucknow. A total of 800 children aged 7 to 9 years were clinically screened for the presence of MIH. All demographic details were filled in by the examiner in communication with the parents, and examination was performed using the Würzburg MIH concept. The overall prevalence of MIH in the children examined was 5.12%. A higher prevalence was found in males (7%) than in females (3.25%). The distribution of MIH was higher in the mandibular arch than in the maxillary arch. Mandibular molars were the most affected teeth, followed by maxillary incisors, and the least affected teeth were maxillary molars. On the basis of severity, 55.14% of teeth with MIH had no breakdown or hypersensitivity followed by 30.14% of teeth with hypersensitivity but no breakdown, and 7.35% of teeth had both hypersensitivity and breakdown. Based on severity, in 39.70% of teeth, the intervention suggested was fluoridated toothpaste, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) remineralizing agent, and varnish application. This was followed by the application of sealants and low-viscosity glass ionomer cement (GIC) in 38.97% of teeth, and in 7.35% of teeth, short- and long-term restorations, including stainless steel crown (SSC), were recommended. Prevalence of 5.12% was observed in children of Lucknow city. The characteristics of MIH defects were predictive of the treatment of the affected first permanent molars and incisors and can guide their management. Chowdhury AR, Singh N, Rathore M. Molar Incisor Hypomineralization: Prevalence and Treatment Needs in 7- to 9-year-old Children of Lucknow City. Int J Clin Pediatr Dent 2024;17(7):790-795.

Ecotoxicological risk assessment of the novel psychoactive substance Esketamine: Emphasis on fish skeletal, behavioral, and vascular development

Novel psychoactive substances (NPS), such as Esketamine (Esket), often contaminate the aquatic ecosystems following human consumption, raising concerns about the residues and potential ecological hazards to non-target organisms. The study used zebrafish as a model organism to investigate the developmental toxicity and ecotoxicological effects of acute Esket exposure. Our findings demonstrate that exposure to Esket significantly affected the early development and angiogenesis of zebrafish embryos/larvae. The mandible length was significantly decreased, and the angles between the pharyngeal arch cartilages were narrowed compared to the control group (all P < 0.05). Additionally, Esket resulted in a decrease of 47.6–89.8 % in the number of neural crest cells (NCC). Transcriptome analysis indicated altered expression of genes associated with cartilage and osteoblast growth. Moreover, Esket significantly inhibited swimming ability in zebrafish larvae and was accompanied by behavioral abnormalities and molecular alterations in the brain. Potential mechanisms underlying Esket-induced behavioral disorders involve neurotransmitter system impairment, abnormal cartilage development and function, aberrant vascular development, as well as perturbations in oxidative stress and apoptosis signaling pathways. Notably, the dysregulation of skeleton development through the bone morphogenetic protein (BMP) signaling pathway is identified as the primary mechanistic behind Esket-induced behavioral disorder. This study enhances our understanding of Esket's ecotoxicology profile and provides a comprehensive assessment of the environmental risks associated with NPS.

Augmented reality assisted intraoral scanning of mandibular arch: A proof-of-concept pilot clinical study

ObjectivesTo investigate whether the scanning time, trueness and number of photos are influenced when augmented reality (AR) heads-up display (HUD) is utilized during the intraoral scan of fully dentate mandibular arches. MethodsA total of 10 patients (6 females and 4 males) were included. The mandibular arch of each patient was scanned twice using an intraoral scanner (Trios4 Pod IOS: 3Shape): one with and one without AR-HUD (ML2; Magic Leap). Further, alginate impression was taken, and the cast was digitized to acquire the reference model for trueness comparison (T310, Medit). The scan time and number of photos were recorded. Trueness was evaluated qualitatively and quantitatively using colored heat maps and RMSE values respectively. t-test was used to evaluate the difference in scan time, trueness, and number of photos between the two groups (α = .05). ResultsAR-assisted IOS resulted in significantly faster scan time (44 s) compared to the time consumed following conventional scan method without AR-HUD (63 s) (P = <0.001). The number of photos was also significantly less with AR-assisted IOS (836) compared to IOS using conventional technique without AR-HUD (1209) P = <0.001. No statistical difference was detected in RMSE between the test groups. ConclusionsIntegration of AR technology with IOS process represents a promising potential to acquire digital impressions with reduced scan acquisition time and reduced images count while simultaneously maintaining the trueness of the acquired scans. Clinical SignificanceAugmented Reality presents an emerging potential in Prosthodontics to acquire digital impressions with decreased number of images and acquisition time.

Oral health-related quality of life and patient satisfaction using three-dimensional printed dentures: A crossover randomized controlled trial

ObjectivesThis crossover randomized controlled clinical trial (RCT) aimed to evaluate the clinical applicability of three-dimensional printed dentures (CAD-3DPs) by comparing two fabricated complete dentures, CAD-3DPs and conventional complete dentures (CCDs), and assess the non-inferiority of CAD-3DPs. The hypothesis was that CAD-3DPs would be inferior to CCDs in terms of the oral health-related quality of life (OHRQoL) and patient satisfaction. MethodsThis single-blind RCT was conducted at two university hospitals. The participants included adult patients with edentulous maxillary and mandibular arches, who had existing complete dentures and were willing to use new complete dentures. Eighteen participants were assigned to two groups: CCD-CAD-3DP and CAD-3DP-CCD, based on the order of denture delivery. Both sets of maxillary and mandibular CCDs and CAD-3DPs were delivered to all the participants. The OHRQoL using Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) was considered the primary outcome. General satisfaction using a 100-mm visual analog scale was also evaluated as a suboutcome. ResultsBased on the non-inferior test on the total score of the OHIP-EDENT and each score of the seven conceptual subdomains, the lower limit of the 95 % confidence interval was < 2.65 in seven domains. Therefore, CAD-3DP was judged to be non-inferior to CCD. Patient satisfaction was not significantly different between the CCD and CAD-3DP groups (p > 0.05). ConclusionsThis RCT revealed that CAD-3DP is comparable to CCD based on the OHIP-JDENT scores and patient satisfaction. Clinical SignificanceCAD-3DP is clinically applicable and comparable to CCD in terms of patient-reported outcomes.