Preservation Of Teeth Research Articles

Retreatment and aesthetic restoration of maxillary incisor with calcified root canal using a dynamic navigation system: a case report

BackgroundPulp canal occlusion (PCO) increases the difficulty of root canal treatment as well as tooth preservation and restoration. This is the first case report of successful localization of a calcified root canal under the guidance of a dynamic navigation system (DNS) for complete root canal retreatment and aesthetic restoration after a failed attempt to locate the calcified root canal with a traditional dental operating microscope (DOM).Case presentationThe patient was scheduled for root canal treatment for a labially inclined maxillary central incisor and post-core crown restoration with resin veneers in another hospital, but the calcified root canal could not be located with a microscope, so the patient was referred to our department. Root canal retreatment was planned for tooth #8, and the calcified root canal of tooth #9 was planned to be located and dredged under the guidance of a DNS. We used a DNS for successful positioning and to complete the root canal retreatment operation in the following 4 steps: preoperative CBCT imaging, preoperative plan design, calibration and registration, and real-time dynamic navigation. Three months later, teeth #8 and #9 presented no clinical symptoms, after which the fiber post-cores and zirconia all-ceramic crown restorations were completed. At the 12-month follow-up visit, the patient continued to be symptom­free, and satisfied with the final aesthetic restoration.ConclusionsThis case report suggests that DNS may be a promising technique with high accuracy and effectiveness to reduce the risk of iatrogenic errors and provide maximal preservation of dentin, when the traditional treatment of calcified root canals approaches failure (lateral perforation).

Three-dimensional finite element analysis of occlusal stress on maxillary first molars with different marginal morphologies restored with occlusal veneers

BackgroundThere are differences in the research results regarding which edge design of occlusal veneers can achieve the best long-term success rate as a relatively new fixed prosthesis restoration method. Further research is needed. The three-dimensional finite element method was used to conduct stress analysis on occlusal veneers of maxillary first permanent molars with different thicknesses and margin preparation designs. The aim of this study was to provide mechanical research evidence and a reference for exploring standardized clinical protocols for the design of occlusal veneer restorations of maxillary first molars.MethodA 3Shape (Intraoral Scanner) was used to scan the maxillary first molar teeth in vitro, after which 3D printing was carried out. Three different edge designs were applied to identical teeth: straight-beveled finishing line(SFL), chamfer finishing line(CFL), and standard cuspal inclination(SCI). Preparation was carried out with a thickness of 0.5 mm. Using the surface deformation feature, the occlusal veneer was thickened to 0.5 mm and 1.0 mm, and periodontal ligaments were added. They were then placed into the upper and lower jaws and dental arches. Finite element analysis was performed after applying bite force dispersion to the loading area on the mandible following dynamic contact.Results(1) As the thickness increased, the maximum Von Mises stress in the occlusal veneers SFL and CFL also increased, while the SCI exhibited the opposite trend. (2). The trend of the maximum Von Mises stress in the adhesive layer decrease gradually with increasing thickness of the occlusal veneer. The stresses of the SFL and CFL is concentrated primarily at the edge position below the functional cusp, resulting in relatively low adhesive stress. However, in the SCI group, the maximum stress at the edge of the adhesive layer exceeds the maximum shear strength of commonly used adhesives.ConclusionsUnder the experimental conditions, the mechanical properties of the maximum Von Mises stress in the SFL, CFL, and SCI occlusal veneers meet clinical needs. Incorporating the minimally invasive concept of tooth preservation, a thickness of 1.0 mm are optimal for glass ceramic occlusal veneers on maxillary first molars.

Biofluorescence imaging system (BIS) Guided surgery for MRONJ: A Case Series on the Preservation of Teeth and Implants: Biofluorescence imaging system guided MRONJ surgery

The decision of surgical margin for Medication-Related Osteonecrosis of the Jaw (MRONJ) surgery is challenging. Recently, a method involving biofluorescence imaging system (BIS) has been reported for its application in MRONJ surgery to live detection of pathologic bone tissue from vital bone, which cannot be distinguished during conventional surgery. This case series aimed to assess the outcomes of adjacent teeth and implants near the lesion site in MRONJ patients who underwent BIS-guided MRONJ surgery. This retrospective study was assessed the radiographic and clinical outcomes of seven patients who underwent MRONJ surgery with BIS guidance but chose not to remove adjacent teeth or implants near the lesion. A total of seven patients (1 male, 6 females, 77.2 ± 4.7 years) were included in the study. Four implants and four teeth adjacent to the lesion were preserved. Over an average duration of 8.7 months, all subjects exhibited normal soft tissue healing and function without any complications. In conclusion, the BIS guided MRONJ surgery can be considered a minimally invasive and effective approach.

Tooth preservation and "the treatable or hopeless tooth": Re-thinking a concept

The masticatory organ is at the center of dental practice. Tooth loss, regarded as an organ failure, is a core dispute in our profession, as it more often than not does not happen spon-taneously but is influenced by the dentist's treatment plan. Despite the prosthetic possibili-ties of tooth replacement, efforts should be made to preserve as many teeth as possible. Decisions between tooth preservation and extraction are complex and have far-reaching consequences. This article discusses this problem using a clinical case study of a 43-year-old female patient with pronounced localized periodontitis. After a comprehensive diagnosis and treatment planning, a daring regenerative therapy was carried out to try to preserve the tooth. The case shows that even seemingly hopeless teeth can be successfully treated syn-chronously using modern therapeutic approaches. Initial literature data supports the possi-bility of preserving severely compromised teeth in the long term in compliant patients. An integrative treatment approach based on individual patient factors and modern regenerative techniques may well be a viable alternative to tooth extraction and prosthetic restoration, albeit not inexpensive and uncomplicated. This communication emphasizes the need for precise diagnostics, a comprehensive treatment plan, and honest communication with pa-tients about the prospects of success and possible risks, and highlights the strengths of con-sistent tooth preservation.

Apoptotic effects of biodentine, calcium-enriched mixture (CEM) cement, ferric sulfate, and mineral trioxide aggregate (MTA) on human mesenchymal stem cells isolated from the human pulp of exfoliated deciduous teeth.

Preservation of primary teeth in children is highly important. Pulpotomy is a commonly performed treatment procedure for primary teeth with extensive caries. Thus, biocompatibility of pulpotomy agents is highly important. Biodentine, calcium enriched mixture (CEM) cement, ferric sulfate, and mineral trioxide aggregate (MTA) Angelus are commonly used for this purpose. Thus, this study aimed to assess the apoptotic effects of Biodentine, CEM cement, ferric sulfate, and MTA on stem cells isolated from the human pulp of exfoliated deciduous teeth. In this in-vitro, experimental study, stem cells isolated from the human pulp of exfoliated deciduous teeth were exposed to three different concentrations of Biodentine, CEM cement, ferric sulfate, and MTA for different time periods. The cytotoxicity of the materials was evaluated by flow cytometry using the annexin propidium iodide (PI) kit. Data were analyzed by ANOVA and Tukey's test at P<0.05 level of significance. All four tested materials induced significantly greater apoptosis compared with the control group. The difference in cell apoptosis caused by the first concentration of ferric sulfate and MTA was not significant at 24 hours. In other comparisons, the cytotoxicity of ferric sulfate was significantly lower than that of other materials. Biodentine showed higher cytotoxicity than MTA at first; but this difference faded over time. The cytotoxicity of CEM cement was comparable to that of MTA. The highest cell viability was noted at 24 hours in presence of the minimum concentration of ferric sulfate. The lowest cell viability was noted at 72 hours in presence of the maximum concentration of CEM cement. In comparison with other materials, ferric sulfate showed minimum cytotoxicity; the cytotoxicity of the three cements was comparable. It appears that the concentration of ferric sulfate and the composition of cements are responsible for different levels of cytotoxicity.

Treatment Modalities and Rehabilitation Procedures of Dentigerous Cyst Among the Paediatric Population - A Systematic Review of Case Reports

BACKGROUND: The dentigerous cyst which wraps around the impacted teeth is the most prevalent developmental odontogenic cyst among the Paediatric population in India. Various treatment modalities were proposed previously, such as enucleation, marsupialization, fenestration, or a combination technique with or without preservation of the affected dentition. OBJECTIVES: The aim of the Paediatric dentist should rely on the preservation of permanent teeth. Hence, this systematic review aimed to evaluate the prevalence and describe the different treatment methods and rehabilitation techniques conducted following the surgical excision of dentigerous cysts among the Paediatric population in India, which is significant to Paediatric dentists. METHODS: Systematic review registered under PROSPERO following PRISMA guidelines. Thorough search was done in PubMed, EMBASE, ProQuest and Cochrane Library. RESULTS: The results showed that the dentigerous cyst occurred commonly in the age group of children aged 6 – 10 years (72.22%), with a male predilection (80.56%). The complete cyst enucleation with the removal of milk teeth and permanent dentition (52.78%) was preferred more than the preservation of the affected dentition. After complete enucleation of the cyst in only 57.89% of cases, rehabilitation procedures were planned. The results showed that proper rehabilitation was not planned in many cases, which may lead to poor oral hygiene maintenance and early space loss. CONCLUSIONS: It is important for the Paediatric Dentist to know the importance of preserving the permanent teeth or plan a wise rehabilitation procedure to replace missing teeth to maintain the proper oral health of the children. Keywords: Dentigerous Cyst, Paediatric Dentistry, Enucleation, Marsupialization, Oral Rehabilitation.

Clinical and Radiographic Evaluation of Diode and Er,Cr:YSGG Lasers as an Alternative to Formocresol and Sodium Hypochlorite for Pulpotomy Techniques in Primary Molars: A Randomized Controlled Clinical Trial.

Background Pulpotomy treatment is one of the vital pulp therapies that can play a major role in the preservation of primary teeth until their natural exfoliation. The objective of this current clinical trial was to assess the clinical and radiographical success of diode and Er,Cr:YSGG lasers as a viable alternative to formocresol (FC) and sodium hypochlorite in the primary molar pulpotomies. Materials and methods Sixty primary molars were selected and randomly allocated to four groups. All treatment groups followed the same clinical protocol, except for the techniques used for hemostasis of the pulpotomy sites. In group A, hemostasis was achieved by applying a 1:5 dilution of FC solution, whereas in group B, 3% sodium hypochlorite was applied to achieve hemostasis. In group C, exposure to a diode laser of 940 nm was performed, whereas for group D, erbium laser irradiation with Er,Cr:YSGG laser of 2,780 nm was employed to achieve hemostasis. Radicular pulp stamps were covered with a 2 mm layer of mineral trioxide aggregate (MTA) paste. Stainless steel crowns were utilized for the final restorations of the primary teeth. The clinical and radiographic outcomes were evaluated at the six- and 12-month follow-up intervals. The investigation was registered with the ClinicalTrials.gov Protocol and Registration System (ID: NCT06002646). Results The overall clinical and radiographic success rates of pulpotomy were 92.3% for FC, 89% for sodium hypochlorite, 98.3% for a diode laser, and 98.7% for Er,Cr:YSGG lasers. There were no statistically significant differences among the four groups (p > 0.05). Conclusions Both the diode and Er,Cr:YSGG lasers showed outcomes comparable to those of FC and sodium hypochlorite. Therefore, they could be promising alternatives to primary tooth pulpotomies.

Testing the Sample Preparation Method and Oxygen Isotopic Analysis of Tooth Enamel for the Reconstruction of the Birth Seasonality of Ovicaprines (the Case of Teeth from Istykskaya Cave, Eastern Pamir)

Cyclic variations of δ18O along the growth line of M2 and M3 molars provide information about the seasonality of enamel formation and thereby about reproductive seasonality in animals, taking into account the time of tooth eruption and full enamel maturation. Determination of birth seasonality of small ruminants is relevant to the reconstruction of pastoralist strategies. Two peaks of reproductive activity per year are one of the most reliable indicators of human control of the small ruminants. As part of this work, for the first time in Russia, a method of sample preparation and analysis of oxygen isotope ratios in the tooth enamel of small ruminants is proposed. Traditionally, breeding seasonality was evaluated by the isotopic analysis of carbonates, the content of which in dental enamel is only 4 %. According to a new approach, oxygen from a sample is converted to gaseous CO by the interaction of enamel with carbon in a helium flow under 1300 °С, enabling one to measure δ18O in all components of the dental enamel, including phosphates, which make up 90 % of enamel mass and are resistant to diagenesis. In this study, four sample preparation protocols depending on the degree of preservation of teeth and their age were tested: (A) cleaning and sampling of enamel, (B) treatment by H2O2, (C) treatment by NaOCl and CH3COOH, and (D) extraction of Ag3PO4. Results show that for assessing seasonality breeding, it suffices to evaluate the lowest and the highest δ18O along the tooth growth line. If the preservation of sample is good, minimal chemical treatment is enough to observe these extremes.

Investigating Factors Affecting Compliance of Patients Who are Candidates for Non-Surgical Periodontal Treatment Referred to Yazd Faculty of Dentistry in 2023

Introduction: Considering the importance of periodontal supportive treatment in long-term preservation of teeth and prevention of recurrence of periodontitis, it was aimed to identify the factors affecting patients' compliance in continuing periodontal treatment. Methods: This cross-sectional study conducted on 233 patients referred to the periodontics and oral health and community dentistry departments and were candidate for non-surgical periodontal treatment. Data were collected by researcher-made questionnaires and the association between demographic characteristics and some possible external and internal influencing factors with the patients' attendance in first follow-up was investigated. Results: Only 39% of patients participated in the first follow-up. The patients' previous internal desire to participate in follow-up sessions had a statistically significant relationship with their compliance (P=0.001). Age, gender, education level, economic status, type of employment of patients and smoking did not show any significant relationship with following up the treatment. None of the investigated factors such as lack of time, the quality of mutual communication between the dentist and the patient, satisfaction with the treatment, providing health instructions by the dentist and explaining the consequences of not continuing the treatment to the patient did not affect the probability of the patient's adherence to continuing the treatment. Conclusion: There is no definite factor to increase the compliance rate of patients and it is necessary to increase the patients' motivation with different intervention methods, in a way that the importance of participating in the follow-up sessions is clarified for the patients.

Patterns and Determinants of Primary Tooth Extraction in Children: A Study in an Indian Tertiary Care Dental Setting.

Preservation of primary teeth is essential for optimal oral health in children; however, there is limited research on primary tooth extraction patterns in India. This study aimed to investigate the reasons for and patterns of primary tooth extraction in children in an Indian tertiary care dental setting. This retrospective cross-sectional study analyzed dental records of children aged up to 14 years who underwent tooth extraction under local anesthesia from January to December 2023. Demographic data, reasons for extraction, and tooth types extracted were collected and analyzed using descriptive statistics and the Chi-square test. Among the 261 subjects studied, there were 132 males and 129 females. Dental caries was the leading cause of extraction (42.6%), followed by mobility (20.8%) and over-retention (17.3%). Maxillary teeth were extracted more frequently than mandibular teeth, with central incisors being the most commonly extracted. This study highlights the prevalence of dental caries as the primary reason for primary tooth extraction in Indian children. Gender-specific differences were observed in extraction reasons, and maxillary teeth were more frequently extracted than mandibular teeth. These findings emphasize the importance of targeted preventive strategies to address dental caries and promote optimal oral health in children in India.

Decompression-first or direct enucleation: The choice of treatment for medium-sized odontogenic jaw cysts

BackgroundThe treatment of medium-sized odontogenic jaw cysts is inconsistent at present. Two main treatments, namely decompression and enucleation, are used overlappingly. This retrospective analysis aims to provide useful references for technique selection for future management of medium-sized odontogenic jaw cysts. MethodsOdontogenic cysts with lesion sizes ranging 2–4 cm were included. The clinical and radiological data of the patients were reviewed. Decompression-first and direct enucleation treatments were the two main surgical techniques. The preoperative parameters and postoperative outcomes were compared between the two groups. ResultsOut of 69 patients included, 40 (58 %) were in the decompression group and 29 (42 %) in direct enucleation group. The logistic regression analysis of preoperative parameters demonstrated that the maximum lesion size and the chief surgeon's preference could affect the selection of surgical techniques for medium-sized cysts (P < 0.05). Receiver operating characteristic curve analyses demonstrated that a lesion size >2.5 cm was the best cutoff value for predicting a decompression selection. Most postoperative outcomes differed significantly between the two groups (P < 0.05). Lower-risk anesthesia, shorter hospitalization, tooth function protection, and fewer neurosensory impairments were decompression-favoring outcomes. However, more follow-up visits, more postoperative X-rays, and longer postoperative care were outcomes against decompression. The recurrence rate was low and did not differ significantly between the two groups (P > 0.05). ConclusionsThere is no apparent preference for treating medium-sized jaw cysts. The maximum lesion size is a moderate-impact factor for treatment selection. A tendency to prefer decompression-first with larger lesion size was found in medium-sized jaw cysts. The advantages of teeth preservation and low neurosensory impairment of decompression were verified in the medium-size jaw cysts. The burden of postoperative care should be considered when selecting decompression.

Evaluation of the reliability and accuracy of YouTube™ and TikTok™ contents about storage media for avulsed teeth: A cross-sectional study.

The preservation of avulsed teeth is critical in dental trauma management, necessitating effective storage media to ensure viable tooth reimplantation. The urgent need for accurate information has led both professional and non-professional individuals to increasingly seek guidance from video-sharing platforms such as YouTube™ and TikTok™. These platforms have become key resources for advice on such dental emergencies, but the reliability and accuracy of this information have not yet been systematically evaluated. This study aimed to assess the quality, accuracy, and reliability YouTube™ and TikTok™ of videos regarding storage solutions for avulsion injuries. A search was conducted on YouTube™ and TikTok™ on February 4th, 2023, using terms related to traumatic dental injuries, and 53 videos were included. Video demographics such as platform, duration, type, upload date, likes, and comments were recorded. Video content quality, reliability, and accuracy were measured using the Global Quality Scale (GQS), Journal of the American Medical Association (JAMA) benchmarks, and Video Information and Quality Index (VIQI). Research data were analyzed using SPSS IBM 24.0 at a 95% confidence interval. In total, 53 videos were examined. The average scores were JAMA: 1.70/4.00, modified DISCERN: 54.3/80.00, GQS: 3.88/5.00, and VIQI: 13.8/20.00. According to the modified DISCERN index, there were no "very poor" or "poor" quality videos, 49.05% were "moderate," 22.6% were "good," and 28.3% were "very good." No difference was found between YouTube™ and TikTok™ videos in terms of the modified DISCERN index, JAMA scores, GQS, and VIQI scoring (p > .05). Traumatic dental injuries are a common problem among children, and evaluating the reliability of available contents is becoming crucial for appropriate intervention. The study reveals that despite being sourced mainly from dental professionals, the overall quality of videos on avulsed tooth management was mediocre, underscoring the risks associated with misleading or incomplete information in such critical situations.

Patients' Perceptions Regarding Acceptance of Dental Implants as an Option for the Replacement of Missing Teeth: An Observational Study.

Dental implants enhance the self-assurance and overall well-being of individuals by providing oral comfort during mastication and a notable degree of contentment. The objectives of the present study were to assess patients' perception of opting or non-opting for dental implants as a replacement for missing teeth and to determine the correlation between various factors and perceived demand for dental implant treatment. A cross-sectional observational study was conducted on 214 partially edentulous individuals aged between 21 and 50 years. These patients sought treatment to replace their missing teeth. The participants were provided with detailed information regarding various options for replacing their missing teeth, including removable prostheses, fixed partial dentures, and dental implants. The researchers recorded and evaluated the reasons behind the patients' decision to opt for or decline dental implant treatment using the chi-squared test. Categorical variables were summarized as percentages (n %). The association between variables and binary data was examined using point biserial correlation, whereas, for continuous data, the Pearson correlation coefficient was employed. About 65 (30.4%) patients opted for dental implant treatment and 149 (69.6%) patients did not opt for dental implant treatment. Missing teeth were found in 120 women (56.08%) and 94 men (43.92%). The main reason for seeking dental implant treatment was the need for improvement in functions such as chewing in 65 (100%) patients, followed by the need for improvement in oral health in 57 (88%), aesthetics in 54 (83%), need for bone and adjacent teeth preservation in 52 (80%), and durability of dental implants in 46 (71%) patients. The main reasons for not seeking dental implant treatment and opting for fixed prostheses other than dental implantsor removable prostheses cost 149 (100%), fear of surgery 132 (91%), underlying health issues 121 (81%), lack of knowledge about dental implants 120 (80.5%), and time management issues 92 (62%). Gender, age, and number of missing teeth showed a negative correlation, whereas level of education, social status, and oral health awareness showed a positive correlation with the perceived need for dental implant treatment. Dental implant treatment was preferred by 30.4% of patients, which was influenced by gender, sex, level of education, social status, awareness of oral health, and number of missing teeth. Cost, fear of surgery, underlying medical conditions, lack of knowledge, and time management are some reasons for not opting for dental implant treatment.

Association of dietary inflammation with tooth loss and cognitive decline in older adults from cross-sectional data: The moderated role of albumin

ObjectiveGrowing evidence suggests a potential connection between tooth loss and cognitive function in recent years. Increasing studies have focused on their inter-relationship, however, the underlying mechanism has yet to be fully elucidated. Few studies have considered the role of dietary inflammation and serum albumin in the association between tooth loss and cognitive function. Therefore, the aim of this study was to explore the role of dietary inflammation and serum albumin in the association between tooth loss and cognitive impairment. MethodsA sample of 1,009 US adults from the National Health and Nutrition Examination Survey (NHANES) provided data on oral condition, cognitive function, dietary intake, and serum tests. The association between tooth loss (exposure variable) and cognitive function (outcome variable) was assessed by linear regression. Furthermore, a moderated mediation model was established to examine the influence of dietary inflammation on the association between tooth loss and cognitive tests, and the visualization of the moderating effect of serum albumin concentration was displayed through the Johnson-Neyman curve. ResultsParticipants with impaired dentition had worse cognitive function and a higher Dietary Inflammation Index (DII). DII was highly correlated with Immediate Recall Test (IR), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), which mediated 16.46 %, 14.41 % and 11.28 % of the effect between tooth loss and cognitive functions. Additionally, the relationship between DII and DSST was moderated by serum albumin concentration. ConclusionTooth loss was associated with cognitive function which was affected by pro-inflammatory dietary patterns and serum albumin level. Clinical significanceThis study presents evidence for dentists that dietary pattern change due to tooth loss plays a role in cognitive deterioration, which can also be moderated by serum albumin level. Therefore, the preservation of natural teeth is important for cognitive function, especially in an immunocompromised population with decreased serum albumin concentrations.

Impact of the Removable Partial Denture Components on the Prognosis of the Abutment Teeth: An Exploratory Clinical Study

Introduction Partial edentulism is considered one of the challenging topics in dentistry. The main objectives of the patient are to restore function and esthetics. However, the dentist’s main goals are preserving the remaining teeth supporting structures and restoring the patient’s quality of life. A Removable Partial Denture (RPD) design should be considered carefully for each case, as there are clinical and personal variables for each patient that will impact the prognosis of the denture. With the growing need for RPD, design principles require more research to improve the preservation of abutment teeth. This study aims to clinically evaluate the abutment teeth and supporting tissues before and after RPD placement and to correlate these clinical findings with the RPD components. Methods: Patients were recruited from the dental clinic at Schulich Dentistry, Western University in London, Ontario, Canada. Abutment teeth were evaluated for the following clinical parameters: Tooth Mobility (TM), caries, defective restorations, tooth fracture, Probing Depth (PD), Gingival Recession (GR), bleeding on probing (BOP) and Plaque Index (PI). These clinical measurements were collected at the time of RPD insertion and at least two years after. Clinical parameters were analyzed using Kruskal Wallis H, Mann-Whitney U and Chi-Squared tests. Results: 34 participants were recruited, and 40 cast metal RPDs were evaluated. The mean age of participants was 73.8 years, and the mean duration of denture use was 37.6 months. Most frameworks assessed were Kennedy Class III RPDs. Caries were significantly associated with rest type, wherein occlusal rests showed an increased incidence of caries compared to cingulum rests. The retentive clasp arm type was associated with a mean difference in PD, wherein cast circumferential and wrought wire clasp arms had deeper PD after RPD insertion than Infra gingival clasps (I-bars). Conclusion: The results of this study suggest clasp arms and occlusal rests influence dental disease. Larger samples and more clinical studies are needed to confirm the role of specific RPD components on the abutment teeth prognosis.

A novel pre-formed distal shoe eruption guidance appliance in chairside management of early loss of primary second molar: a case report

Preservation of the primary teeth until exfoliation is one of the most important aspects of preventive and interceptive dentistry. Premature loss of the second primary molar before the eruption of the permanent first molar may lead to space loss that results in tooth size/arch length discrepancy. Early loss of a second primary molar is a challenge to paediatric dentists if the first permanent molar has not erupted. A space maintainer of the intra-alveolar type assists in controlling the eruption of the permanent first molar in these circumstances. This report describes the case of space maintenance in a 3-year-old girl for whom the primary second molar was extracted owing to a poor prognosis. A pre-formed intra-alveolar space maintainer, which in this case was a Roche's distal shoe type, was given and followed up for 12 months. CPD/Clinical Relevance: This pre-formed distal shoe space maintainer gives the advantage of reduced chairside time, more stability and strength, and is better accepted by the child.

Root resection: tooth preservation by targeting the root of the problem

When problems occur in multirooted teeth, such as persistent endodontic problems following endodontic treatment, problems involving fracture or furcation, extraction may be decided on. However, removal of the tooth will result in loss of occlusal units and the alveolar process. By removing the compromised root and preserving the healthy part, the tooth can remain functional, but only after restorative treatment. A correct indication or diagnosis, a properly performed endodontic, restorative and surgical treatment and proper follow-up are mandatory for a successful treatment outcome.

SURFACE MATTERS THAN THE IMPLANT ITSELF-A REVIEW

Nowadays dental implants are a predictable and popular treatment option for tooth replacement in completely or partially edentulous patients. Implants are preferred over conventional treatment due to certain advantages it offers like preservation of bone; preservation of adjacent teeth, durability, better mastication and speech etc.Implant comes in direct bone contact and anchors through osseointegration. Successful osseointegration revolves around many factors such as biocompatibility of the implant material, quality and quantity of the available bone, surface treatment of the implant, loading and surgical protocol and various other systemic and local factors. Predictability of clinical success of dental implants can be enhanced by using newer materials or alterations in designs, surgical or loading protocols on the basis of available literature. Various studies have suggested that rough surface of implant enhances its integration with bone than a smooth implant surface. Several approaches are used to attain a rough surface and to improve the process of osseointegration of titanium dental implants. The present paper reviews different methods of treating implant surfaces to enhance bone implant interaction starting from the basic material used in dental implant manufacture.

Application of intentional replantation in advanced periodontitis involving teeth preservation.

With the development of periodontal regenerative technology, an increasing number of scholars reported that advanced periodontitis involving teeth can be preserved through intentional replantation. Intentional replantation has become the last possible method to preserve natural teeth for advance periodontitis with signs of tooth extraction. However, the indications of intentional replantation are strict, and the success of the operation is closely related to the condition of cases and the operation skills of doctors. In this article, the operation steps and criteria of intentional replantation were summarized by introducing three success cases of advanced periodontitis involving teeth preserved by intentional replantation. The relevant factors that affect the prognosis of intentional replantation in advanced periodontitis involving teeth preservation were analyzed to help clinicians preserve natural teeth.

Clinical Application of Quantitative Light-Induced fluorescent(QLF) device in the Diagnosis of cracked teeth

As social interest in health increases, interest in oral health and preservation of natural teeth are also increasing. The hard tissues in the oral cavity undergo physical changes as age increases. One of the changes is the progress of tooth cracks in natural or restored teeth. These cracks are commonly encountered in daily clinicalpractice but often confuse the operator due to its difficulties in diagnosis and therapeutic access. Diagnosing acracked tooth has been a chanllenge to dental clinicians. For the diagnosis of a cracked tooth, the quantitative light-induced fluorescent (QLF) device, which is capable of detecting fluorescent reactions of the tooth with visible light (405nm), has been introduced as one of the methods for observing tooth cracks. Specific metabolites of microorganisms that penetrate through the crack’s line react with specific autofluorescence to 405nm visible light emitted from the QLF device. These fluorescent image provided by the QLF helps to observe the location of the crack during the diagnosis of a cracked tooth and helps the patient’s dental record. The QLF images provided a magnified image as well as a fluorescent im-age that could identify the location of the crack existing outside the tooth, around the restoration, and inside the cavity after removal of the restoration by a simple process of capturing images. This report shows the process of diagnosis of a cracked tooth using a QLF device by observing three separate cases which can help clinicians to understand this process.