Premolar Region Research Articles

Evaluation of force systems generated by Memory Titanol® springs with different preactivation bends.

This study evaluated the force system generated by the Memory Titanol® spring (MTS) with different preactivation bends using an orthodontic force tester (OFT). Three preactivations were tested using a 0.017 × 0.022-in stainless steel (SS) wire and a 0.018 × 0.025-in NiTi segment, with an activation of 30º in the posterior segment (β), with 0º (Group 1 [G1]), 45º (Group 2 [G2]), and 60º (Group 3 [G3]) in the anterior segment (α). The molars showed extrusion values of -1.33 N for G1 and -0.78 N for G2, and an intrusion value of 0.33 N for G3. The force in the premolars was intrusive with a variation of 1.34 N for G1 and 0.77 N for G2; and extrusive with a variation of -0.31 N for G3. Regarding the upright moment (Ty) of the molar, a distal moment was observed with values of 53.45 N.mm for G1 and 19.87 N.mm for G2, while G3 presented a mesial moment of -6.23 N.mm. G1, G2, and G3 all exhibited distal premolar moments (Ty) of 3.58, 2.45, and 0.68 N.mm, respectively. The tested preactivations exerted an extrusive force in G1 and G2 and an intrusive force in G3 during molar vertical movement. The premolar region in G1 and G2 showed intrusive force and distal moment.

Changes in the arch width and buccal corridor after fixed orthodontic treatment with Damon self-ligating system: premolar extraction vs. non-extraction.

Extraction vs. non-extraction is a crucial decision in orthodontic therapy. The aim of the present study was to investigate the changes in the dental arch width and buccal corridor after orthodontic treatment using extraction and non-extraction therapy with Damon self-ligating system. This retrospective study consisted of 35 patients (20 female and 15 male patients with median age of 12.5 years), treated by extracting 4 or 2 premolars, and 37 patients (16 female and 21 male patients with the median age of 12.8 years), treated without premolar extraction. Both groups were treated with Damon self-ligating system. Plaster models before (T0) and after (T1) treatment were measured, and the arch width values were determined at the level of the first molars, second premolars, canines and palatal rugae. Buccal corridor width was measured using the extraoral images at T0 and T1. Paired t-test was used for the analysis of the normally distributed data, and Wilcoxon Mann-Whitney U test was used for the data with non-normal distribution. Values of p<0.05 were set as statistically significant. The upper intercanine width increased significantly in both groups (p<0.01). In the non-extraction group, the arch width increased significantly in the maxillary second premolar and first molar region (p<0.01) as well as in the region of the canines (p=0.04), second premolars (p=0.01) and first molars (p<0.01) of the mandible. The buccal corridor decreased significantly in the non-extraction group (p<0.01). Premolar extraction in combination with Damon self-ligating system did not lead to reduction of the dental arch width in the maxilla, nor did it increase the size of the buccal corridors.

Gingival phenotype role in early peri-implant bone remodeling

According to the literature the preservation of peri-implant bone is multi-factorial process and one of the key factor is the quality and quantity of soft tissues. If necessary, it can be created by different grafting procedures before implant placement, during insertion or even after it. It is necessary to appreciate the influence of gingival phenotype upon periimplant bone loss during healing period. The aim of the study was to evaluate the soft tissue influence upon peri-implant bone remodeling during the healing period. The study was performed by analyzing the bone loss around 109 two-piece dental implants installed in one surgical step in 64 patients in posterior sides of the lower jaw (premolar and molar regions) who presented different thickness of the mucosa. After correlation analysis it was determined that the gingival phenotype have no impact on peri-implant bone loss during the healing period. Thus, gingival grafting can be performed before implant placement, during insertion or even after it.

Investigation of Strain and deformation analysis of Biomaterial in Dental Implant: A 3D FEA Study

In this study, the deformation and strain values in the periimplant bone were assessed in order to examine the impacts of three different dental implant thread pitch settings. In this work, the diameter, length, material, and elastic modulus impacts on the biomechanical behaviour of a new dental implant were predicted using the finite element method. Both a three-dimensional dental implant model and a mandibular segment model that matched the premolar region were acquired. loads that are axially applied. The dental implant models were built using Solidworks 2021, and the simulations were carried out using Ansys / CAE. In this work, FEA was used to analyse how the bioactive material (30% CFR PEEK) and implant thread design influenced strain and distortion in the implantation. According to the study's hypotheses, the 30% CFR PEEK implant system will be made of an isotropic, homogeneous, and linearly elastic material. Using the modelling software tools Solidworks and Ansys Workbench, strain and deformation at the implant and implant-cortical bone contact are examined and evaluated. In the present investigation, FEA was used to analyse how the bioactive material (30% CFR PEEK) and thread design affected strain and distortion in the implantation system. The 30% CFR PEEK implant system will reportedly be built of an isotropic, homogenous, and linearly elastic substance, according to the study's hypothesis. We study and assess strain and distortion at the implant, cortical and cancellous bone using the modelling software tools Solidworks and Ansys Workbench.

A Rare Variant of Ameloblastoma of the Oral Cavity: A Review and Case Report

Abstract Ameloblastoma is a very rare odontogenic tumor of the oral cavity, with different histologic variants. One of the types of ameloblastoma is desmoplastic ameloblastoma (DA) which has 4%–5% of incidence. Here, we review and reported the DA is the least of occurrence of all the variants of ameloblastoma. The uniqueness of this lesion can be further enlightened with respect to its site of occurrence, the radiographic feature and the histological appearance different from the classical type of ameloblastoma. This case report focuses on a DA that occurred in the maxilla of a 35-year-old woman and explains about clinical, radiographic findings, histopathologic findings, and treatment plan. The patient is undergoing routine follow-up and is presently free of disease. From this case, the clinicians should remember to consider the DA as differential diagnosis, if a patient complaints of swelling in and around the premolar region of maxilla.

Immediate implant placement in the premolar maxillary area: a cone-beam computed tomography study.

This research aimed to investigate potential factors associated with the risk of perforation of the labial bone plate, nasal floor, or maxillary sinus floor during immediate implant placement (IIP) in the maxillary premolar area, utilizing a cone-beam computed tomography (CBCT) virtual study. CBCT exams from 179 eligible participants, encompassing 716 teeth, were included. Implants were virtually positioned in 2 orientations: along the long axis of the tooth (the prosthetically-driven position) and in an optimal position relative to adjacent anatomical structures (the bone-driven position). Binary logistic regression analysis was employed to assess potential associations between perforation or invasion and various covariates, including sex, age, tooth region, the distance from the tooth apex to the nasal floor or maxillary sinus floor, the angle between the prosthetically- and bone-driven positions (implant-line A angle [ILAA]), and the labial concavity angle (LCA). The mean ILAA was 18.3°±8.0°, and the angle was significantly larger for the second premolar compared to the first premolar. The mean minimum implant length was 13.0±2.1 mm, with a bone anchorage of 4 mm. The incidence of perforation was 84.1% for the prosthetically-driven position and 40.5% for the bone-driven position. Factors associated with a higher risk of cortical bone wall perforation or invasion of the 2-mm safety margin from surrounding anatomical structures (in the bone-driven position) included female sex, older age, shorter distance from the tooth apex to the nasal cavity/maxillary sinus, and smaller LCA. A high prevalence of cortical bone wall perforation or invasion of the 2-mm safety margin is anticipated when performing IIP in the maxillary premolar region.

Dimensiones tomográficas para la instalación de miniimplantes de expansión rápida maxilar en diferentes grupos de edad

Objective: The purpose of the research was to com-pare the dimensions of the upper jaw between different age groups for the installation of mini-implants for rapid maxillary expansion. Materials and Methods: The study was descriptive, retroprospective and observational. Cone beam computed tomography was used for the evaluation of 30 patients between 7 and 56 years of age, divided into three groups, ten up to 14 years, ten from 15 to 30 years, and ten from 31 years and older. The premolar and molar regions were selected for the measurement of the maxilla in the coronal plane, both bone and soft tissue. To compare the measurements, the Kruskal Wallis and Mann-Whitney U tests were used. Results: No statistically significant differences were found between the groups. The thicknesses of the bone tissue decreased from the first premolar to the second molar from 9.48 +/-3.71 mm to 5.40 +/-2.80 mm respectively, while the soft tissue thicknesses were more homogeneous with measurements of 0.56 +/-0.74 mm to 2.76 +/- 2.42 mm. Conclusions: The dimensions of the bone and soft tis-sue of the upper jaw, evaluated vertically for the installa-tion of mini-implants, were similar in all the age groups studied, with larger dimensions in men than in women at the premolar level. The dimensions of the maxilla for the palatal miniimplants were close to 9 mm in bone tissue and 3 mm of soft tissue at the level of premolars and 5 mm in hard tissue with 1 mm of soft tissue at the level of molars. Keywords: Palatal expansion technique; Dental im-plants; Mini implants; Maxilla; Cone-beam computed to-mography; Age groups

Evaluation of Biodegradable Fixation Application for Jaw Fracture in Pediatric Patients

Background: The treatment of jaw fractures in pediatric patients need a special concern and different management than adult patients due to their dynamic and structural changes following their growth patterns. Treatment by open reduction and internal fixation (ORIF) using titanium or biodegradable plates as osteosynthesis material is indicated for displaced jaw fracture. Biodegradable fixation could be used as an alternative choice, using plates and screw that will decompose along with bone healing. Case: Two pediatric patients brought to RSUP Dr. Sardjito, Yogyakarta with complaints of jawbone fracture. The first patient was a 7-years-old woman diagnosed with mandibular symphysis fracture and a left mandibular kondilus fracture, while the second patient was a 15-years-old woman diagnosed with malunion of left maxillary fracture. Fracture treatment was performed using biodegradable fixation. The first patient was repositioned according to the anatomical state and the second patient the maxillary refracture was done before repositioning. Patients were evaluated clinically for up to three months postoperatively and radiological imaging was performed. Evaluation results show good jaw bone union, no malocclusion, no tooth mobility and no paresthesia in both patients. Intraoral wound dehiscence with exposed plate was found in the second patient at the vestibule of the left uper canine until premolar region and can be resolved by removal of the plates under local anesthesiaConclusions:. Biodegradable as an ideal osteosynthesis material for jaw fracture in pediatric patients

Analysis of the transverse dental arch dimension stability and risk of gingival recessions associated with orthodontic treatment

Relevance. Orthodontic treatment may adversely affect the periodontal health. Therefore, a comprehensive diagnosis and treatment planning with a periodontist are crucial. Dentoalveolar expansion is one of the ways to provide the space for malocclusion correction. Nevertheless, the stability of the obtained transverse dimensions remains insufficiently studied and requires additional research.Material and methods. The comparative study included the clinical and paraclinical stages. The inclusion and exclusion criteria determined the study sample formation. Each patient had orthodontic treatment with the same standard arch-changing protocol recommended by the manufacturer; the average treatment duration was 18 ± 4 months. All patients underwent a clinical examination specifically focused on the gingival recession diagnosis. During the paraclinical stage, the study investigated medical records and measured study model parameters using Pont’s (1909) and Linder-Hart (1939) indices. Measurements were made four times during orthodontic treatment: before, immediately after, one and six years after treatment. All obtained data were statistically processed using the significance criteria.Results. Study models’ analysis during the active stage of treatment revealed expansion in each segment of the dentition. However, the result is prone to relapse within the first year after the bracket system removal. Clinical examination of the oral cavity revealed gingival recessions, which appeared during the active stage of the orthodontic treatment. Thus, every third case showed marginal tissue displacement. The comparison of the initial transverse dimensions in the study and control groups detected a discrepancy between the measured and reference values, which might be a prerequisite for determining new parameters.Conclusion. A periodontist should monitor orthodontic patients to protect periodontal health. The transverse dimensions appeared to increase to the utmost in the upper and lower premolar regions. However, the achieved result does not always remain stable. Most relapses occur during the first year after the orthodontic treatment; then, the outcome remains stable.

Evaluation of Alveolar Bones in the Context of Orthodontic Single-Tooth Space Closure: A Retrospective Cone Beam Computed Tomography-Based Analysis

In the literature, there are no studies evaluating alveolar bone width in areas with a single missing tooth in terms of orthodontic tooth movement. This study was meant to determine whether residual alveolar bone width in edentulous crests is a risk factor for orthodontic tooth movement. The aim of this study was to evaluate the change in the residual alveolar bone width in the edentulous region compared to the alveolar bone width on the symmetrical toothed side using CBCT in individuals with a single missing tooth in whom orthodontic tooth movement was planned. This retrospective radiographic study was performed using CBCT images that were taken before orthodontic treatment for the evaluation of the edentulous area between January 2010 and January 2022. Individuals without any systemic disease aged 18 years or older whose edentulous area was restricted to one tooth were included in this study. Bone measurements were made on cross-sectional CBCT images. Of the 265 individuals participating in this study, 129 were male and 136 were female, with a mean age of 32.67 ± 6.50 years. The distribution of 265 edentulous regions (caused by 265 tooth extractions) was as follows: 23 were in the incisor region, 54 were in the premolar region, and 188 were in the molar region. The molar region had the highest bone width among the edentulous regions (p &lt; 0.01). Bone widths were smaller in the edentulous crests for all regions (p &lt; 0.01). In this study, it was determined that the bone width in the areas with a single missing tooth was insufficient, and this is a risk factor for orthodontic treatment.

Evaluation of two treatment concepts of four implants supporting fixed prosthesis in an atrophic maxilla: finite element analysis

BackgroundCurrently, oblique placement of long implants or the use of short implants to circumvent the maxillary sinus area and provide support for fixed prostheses are viable alternatives. The purpose of this study was to compare these two treatment concepts and ascertain which one exhibits superior biomechanical characteristics.MethodsTwo different treatment concept models were constructed. The first one, LT4I, consisting of two mesial vertical implants positioned in lateral incisor regions and two distal tilted implants (45°) situated in second premolar regions of the maxilla. The second model, VS4I, includes two mesial vertical implants in lateral incisor regions and two vertically positioned short implants in second premolar regions. Numerical simulations were conducted under three loading types: firstly, oblique forces upon the molars; secondly, vertical forces upon the molars; thirdly, oblique forces upon the incisors. The maximum principal stress (σmax) and minimum principal stress (σmin) of the bone, as well as von Mises stress of the implants, were calcuated.ResultsUnder oblique loading on the molar, higher stress values in the bone were observed in LT4I group. Under vertical loading on molar, higher stress values in the bone were also observed in LT4I group. Furthermore, little difference was found between the two groups under oblique loading on the incisor.ConclusionBoth treatment concepts can be applicable for edentulous individuals with moderate atrophic maxilla. Compared to tilted implants, short implants can transmit less occlusal force to the supporting tissues.

A comparative study to evaluate microstrain of low-profile attachment associated with and without bar connection in implant assisted mandibular overdenture (in vitro study)

BackgroundThe aim of this study was to compare the microstrain transmitted to peri-implant tissues of implant-assisted mandibular overdentures using two different low-profile attachment designs; OT- Equator attachment with and without bar attachment.Materials and methodsA completely edentulous epoxy resin mandibular model was used, in which two parallel dental implants were inserted at the canine region bilaterally and one in the middle. Sixteen identical complete edentulous mandibular overdentures were fabricated following conventional, standardized techniques and were divided equally between two groups according to the design and placement of the OT-Equator. Group A implants were kept solitary with an OT-Equator attachment, while group B implants were kept splinted with a bar associated with two mini-OT-Equator attachments in between. Sixteen identical mandibular complete overdentures were constructed, to which attachments were picked up. The difference in stress distribution was measured using strain gauges and compared between the two studied groups. A vertical load of 100 N using the universal testing machine was applied unilaterally on the left mesial fossae of the mandibular first molar and bilaterally on the bar attached to the mandibular premolar molar region of the overdentures. Statistical analysis was conducted using IBM SPSS version 28. Normality was checked by using the Shapiro-Wilk test and normality plots. The Mann-Whitney U test was then used to analogize the groups.ResultsThere was a statistically significant difference between groups A and B upon application of vertical unilateral and bilateral loadings of 100 N, with mean microstrain values of P 0.05. Group A (OT-Equator attachment) showed lower strain values than Group B (OT-Equator bar attachment) upon application of vertical, unilateral, and bilateral loadings of 100 N.ConclusionsImplant-assisted mandibular overdenture with a solitary attachment is associated with lower microstrain values around the implants after application of unilateral and bilateral vertical loadings of 100 N.

Comparison between platelet rich fibrin as space filling material versus xenograft and alloplastic bone grafting materials in immediate implant placement: a randomized clinical trial

BackgroundThis study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla.Materials and methodsThirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test.ResultsThis study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness.ConclusionPRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness.Trial registrationThe study was listed on www.clinicaltrials.gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).

Effect of rh-BMP-2 in the Initiation of Neovascularization in Human Gingival Tissue: A Split-Mouth Clinical Study.

The randomized controlled clinical trial included twenty patients with bilateral partial edentulous of the mandibular premolar and molar region. Each patient received one implants on each side. Only one side received a 0.25 µg injection of rhBMP-2 into the gingival flap and grafted material during guided bone regeneration (GBR) for dental implantation. And the other side received GBR without injection. Three samples were collected from each patient as follows: one from the anterior area of the mandible (control group #1) collected at the time of all implant surgeries, and the two other samples during the placement of healing abutments at 4 months of follow-up, from treated side with rh-BMP-2 (test group) and untreated ones (control group #2). A total of 60 gingival samples were collected. Samples were stained with hematoxylin-eosin, and immunohistochemistry was performed with a vascular endothelial growth factor marker. The number of new vessels in each sample was counted. Statistical analyses showed a significantly higher number of new vessels in the gingival tissue of the test group. Rh-BMP-2 injections into the gingival flap significantly improved new blood vessel formation.

Topic: All-on-Four Concept Literature Review

In patients with total edentulism, dental implant treatment is a treatment model which has been accepted scientifically, and with long-term outcomes [1,2]. Dental implants with immediate function by making implant-supported fixed full-arch restorations are becoming the gold standard in dental implantology [3-5]. Normally in literature successful prostheses are made using [6-8] implants in the maxilla and 6 implants in the mandible and applying posterior cantilever extension where it is necessary, in these treatments, hygiene controls can be easily performed especially in full arch screw-retained fixed prostheses [7-9]. In some cases maxillary sinuses for maxilla restricts the implant placement in the posterior region. The posterior implant treatment is also difficult in patients with resorbed mandible with a mandibular nerve located at the top of the alveolar crest. The all-on-four implant concept has been developed to prevent these disadvantages presented by Malo for the first time in 2003 and the all-on-four concept that began to be used in atrophic full arch mandibular and in the maxilla in 2005. In this technique implants are positioned in the pre-maxillary region in the maxilla and in the inter-foraminal region in the mandible.Anterior implants are placed to the lateral incisor sites or canine/first premolar region, posterior implants are placed to the second premolar or first molar region [12-16].

Alveolar antral artery: cone beam computed tomography study and clinical context.

Anastomosis between posterior superior alveolar artery and infraorbital artery can go through bony canal in the lateral wall of the maxilla. This artery is called alveolar antral artery. It can complicate lateral sinus lift procedure by bleeding and hemosinus formation or bone graft wash out. The artery can also go in soft tissues where is not visible on cone beam computed tomography. In previous studies, the relation of this artery to sinus floor or alveolar process was measured. These structures are highly unstable during lifetime and after tooth loss. The aim of this study is to study presence and relations of bony canal in the lateral maxillary wall, to characterize the group of patients which is more likely to have bone canal in the lateral maxilla. The aim and the novelty of this study is the describing of the relationship of the bony canal to the more stable structure of hard palate and describing the relation of presence of bony canal on width of maxillary sinus, and to facilitate the prediction of presence of the alveolar antral artery. The cone beam computed tomography scans of the patients (251 in number) of the university hospital were examined for presence of alveolar antral artery (148 was fulfilled inclusion criteria), patient were characterized by gender, age, and sinus type (wide, average, narrow). The diameter of the bony canal and its relation to the level of sinus floor and hard palate were measured. The cone beam computed tomography scans of 148 patients, out of it 55 man (37,2%) and 93 women (62,8%). Bony canal containing alveolar anastomosis was found in 69 cases (57,0%). Presence of the bony canal in the lateral wall of maxillae showed statistical probability depending on age with p=0,064 according to Mann-Whitney test. The older patients have more likely the bony canal. The presence of the alveolar antral artery was found more likely in the wide sinuses. The hard palate level can serve as a prediction point of alveolar antral artery only in first molar and second premolar region. In accordance with previous studies the width of bony canal is significantly higher in group of man (p=0,015). There was found a correlation between smaller distance of bony canal from sinus floor in the presence of teeth (p=0,067). After tooth loss the distance between sinus floor and bony canal increases, but the distance of bony canal to hard palate level stays constant. This can be explained hypothetically so that periodontal ligaments and root surface acts as a barrier for sinus pneumatization. Lateral sinus lifting in some cases can be unenviable, the knowledge about alveolar antral artery anatomy can reduce the risk of arterial bleeding. The cone-beam computed tomography is a routine examination prior to augmentation surgery and therefore the data obtained from it has an impact on clinical practice.

Comparative evaluation of open tray impression technique: investigating the precision of four splinting materials in multiple implants

BackgroundThis study aimed to determine the relative positioning accuracy of multiple implants utilizing four distinct types of splinting materials.MethodsThe purpose of this in-vitro study was to compare the precision of four splinting materials in an open tray impression technique in multiple implant situations. Based on the material used for splinting, four groups were made (n = 40)- Group A: Conventional Method, Group B: Prefabricated Pattern Resin Framework, Group C: Prefabricated Metal Framework, Group D: Light Cured Pattern Resin, these groups were compared with the master model. A heat-cured clear acrylic resin and a master model were constructed. A pilot milling machine drill was used to drill four parallel holes in the anterior and premolar regions, which were later labeled as A, B, C, and D positions from right to left. Then, sequential drilling was carried out, and four 3.75‑mm diameter and 13-mm long ADIN implant analogs with internal hex were placed in the acrylic model using a surveyor for proper orientation. The impression posts were then manually screwed to the implant analogs using an open tray, and they were secured to the implants using 10 mm flat head guide pins with a 15 N.cm torque. 10 Open tray polyether impressions were made, and casts were poured. Each splinting method’s distortion values were measured using a coordinate measuring machine capable of recordings in the X-, Y-, and Z-axes. Comparison of mean distances for X1, X2, and X3 was made using the Kruskal-Wallis test, and Pairwise comparison was done using Post Hoc Tukey’s Test.ResultsThe differences between the groups were significant when assessing the distances X1, X2, and X3 (p < 0.05). The comparison of deviations between the groups revealed a statistically significant difference (p < 0.05) for the deviation distance X3 but not for the deviation distances X1 and X2. For distance Y1, the difference between the groups was statistically significant (p0.05), but it was not significant for distances Y2 and Y3. A statistically significant difference was seen in the comparison between the groups (p < 0.05) for the deviation distances Y1, Y2, and Y3. The results were statistically significant for the distance Z1 comparisons, namely, control vs. Group A (p = 0.012), control vs. Group B (p = 0.049), control vs. Group C (p = 0.048), and control vs. Group D (p = 0.021), and for distance Z3 comparison for control vs. Group A (p = 0.033). The results were statistically insignificant for the distance Z2 comparisons (p > 0.05).ConclusionsAll splinting materials produced master casts with measurements in close proximity to the reference model. However, prefabricated pattern resin bars splinting showed the highest accuracy among the studied techniques. The most recent splinting techniques using prefabricated metal framework and light-cure pattern resin showed similar accuracy.

Preserving periodontal tissue in the treatment of a large peripheral ossifying fibroma: a case study.

Peripheral ossifying fibroma (POF) is a reactive, benign gingival enlargement. Its etiology is not fully known. It can be seen in many different sizes in the mouth. The histopathological appearance of POF is mineralized tissue and fibrous proliferation. All relevant soft and hard tissues must be removed to prevent recurrence. Periodontal tissue remaining after excision is important for tooth preservation. With large lesions, the loss of healthy periodontal tissue is also large. Periodontal surgical approaches are important to preserve the remaining periodontal tissue. The positive effects of autogenously obtained titanium-prepared platelet-rich fibrin (T-PRF) and connective tissue graft (CTG) on soft tissue are well known. A 34-year-old woman presented with a fibrous and pedunculated gingival mass in the upper left canine premolar region. The operation was performed with complete excision of the lesion down to the bone along with the surrounding healthy tissue. Periodontal treatment of the large defect created after excision of a large POF lesion was performed with laterally positioned flap, CTG and T-PRF. The periodontal tissue and defect were noted to heal in a healthy manner at the 6-month follow-up. POF is a benign lesion; however, it has a high recurrence rate. Complete elimination of the lesion is crucial to prevent recurrence. Periodontal surgical methods and biomaterials applied after surgical excision are significant to maintain the periodontal health of the remaining teeth and tissues.

An innovative approach for treatment of anterior open bite in Class II Division 1 patient with VF appliance (Zygomatic Implant and Spur Assisted) - A case report

Controlling anchorage is one of the foremost necessary aspects of treatment. Moderate anchorage is comparatively simple to manage with the use of some intraoral appliances and biomechanical procedures. On the opposite hand, cases that need the most anchorage need extraoral support to strengthen the anchorage. In some instances, 100 percent anchorage has got to be maintained, such an anchorage may be termed as absolute anchorage. It's tough and not possible to get absolute anchorage by using typical ways like extraoral force application. In this case report, we describe the treatment of Open bite by using the support of Zygomatic plates and Spurs anteriorly placed with the combination of posterior bite blocks. A 20-year-old female reported to our department of orthodontics with the chief complaint of anteriorly placed upper front teeth. There was no relevant medical history; she was having tongue thrusting habit, acute nasolabial angle and incompetent lips. Overjet of 12mm and anterior skeletal open bite from canine to canine of 5mm was present associated with anterior tongue thrusting habit, and constricted upper arch. The molar relation was end-on on the right side and class II on left side. Canine relation is end-on, on both the side. Growth pattern is vertical. Upper arch is well aligned with constriction in premolar region; lower arch has crowding of 6 mm. The treatment plan was selected as alignment of the teeth with fixed mechanotherapy and impaction of the maxillary posteriors using zygomatic anchorage with posterior bite block and spurs soldered to the anterior part of the appliance. The sutures were removed after 7 days, the appliance was inserted into the patient’s mouth and secured with a power chain to the hooks of the appliance and the hook of zygomatic implant, 400gms of force was applied on both the sides.

Evaluation of Cortical Thicknesses and Bone Density Values of Mandibular Canal Borders and Coronal Site of Alveolar Crest.

The objectives of this retrospective study are to measure the amount of the alveolar crest cortication and cortication around the mandibular canal, and to evaluate bone density values of alveolar crest, cortication around mandibular canal, and possible implant placement area for edentulous sites. Six hundred forty-two cone-beam computed tomography scans from 642 subjects were evaluated in four centers. Cortical thicknesses of alveolar crest and mandibular canal cortical borders (buccal, lingual, apical, and coronal) in each mandibular posterior teeth region were measured. Bone density of alveolar crest and mandibular canal cortical borders (buccal, lingual, apical, and coronal) in each mandibular posterior teeth region were recorded. The correlations between numeric variables were investigated using Pearson's correlation test. The largest cortical border of the canal was measured 1.1 (SD 0.71) mm at the left second molar area and in coronal side of the mandibular canal (MC). Left and right first premolar regions showed higher bone density values compared to the other sites in all bone density values evaluations. The buccal side of the canal at the right first premolar region showed the highest bone density values (832.32 [SD 350.01]) while the coronal side of the canal at the left second molar region showed the lowest (508.75 [SD 225.47]). The bone density of possible implant placement area at the both left (692.25 [SD 238.25]) and right (604.43 [SD 240.92]) edentulous first premolar showed the highest values. Positive correlations between the bone density values of alveolar crest and the coronal side of MC were found in molar and left second premolar regions (P < 0.05). Results may provide information about the amount of cortication and bone densities tooth by tooth for posterior mandible to surgeons for planning the treatment precisely.