Tooth Extraction Research Articles

Spatial and angular alterations in the dental arch after premature loss of primary molars: Immediate and 9-month computed tomography evaluation.

Contemporary imaging methods and quickly advancing technologies have increased the number of diagnostic tools available in medicine and orthodontics. The current study aimed to determine three-dimensional (3D) space changes that occurred after the extraction of either the maxillary or mandibular primary molars during the mixed dentition period. The present study was a longitudinal split-mouth study with a study group and a control group. The sample consisted of 20 children aged between 6 and 9 years. Clinical examination, radiological analysis, and 3D digital images of the plaster casts were used sequentially to gather all the data. The dental cast measurements recorded were arch width, arch length, hemi-perimeter, dental space at the extraction site, and angulation of the first permanent molar. The children were recalled for follow-up after 9 months, and all dental cast measurements were repeated using nondestructive 3D computed tomography software. For repeated measurements, the test applied was a paired t-test, and for independent samples, the test was a Student's t-test. A significant decrease in arch width (P = 0.001), arch length (P < 0.001), hemi-perimeter (P < 0.001), D-space (P < 0.001), and E-space (P = 0.001) was observed following extraction. A significant increase in angulation measurements was observed (P = 0.001). The study revealed a comparative reduction in mandibular arch width, a reduction in arch length in both the maxilla and the mandible, a reduced hemi-perimeter of dental arches, loss of dental extraction space, and a change in angulation of the erupted first permanent molars following premature loss of the primary molar.

Comparative evaluation of remaining dentin thickness using single file, two file, and multiple rotary file system - An in vitro CBCT study.

Endodontic success hinges on a multifactorial interplay, with meticulous canal shaping, proper disinfection, and three-dimensional obturation being paramount. Among these factors, the amount of dentin remaining after instrumentation directly influences the biomechanical resilience and longevity of the tooth. This study aims to evaluate the impact of various rotary instrumentation systems, including single-file, two-file, and multiple-file configurations, on the remaining dentin thickness (RDT) following canal preparation. This was an in vitro study, original research article. Sixty mandibular premolar human extracted teeth were decoronated at the cementoenamel junction with a diamond disc. Samples were randomly assigned to three groups using a simple random sampling technique (n = 60). Group I - Single-file system (One Curve, MicroMega) (n = 20), Group II - Two-file systems (2Shape, MicroMega) (n = 20), and Group III - Multiple-file system (Hero Gold, MicroMega) (n = 20). Preoperative cone-beam computed tomography (CBCT) scans were obtained after the sample was mounted on a modeling wax sheet. The biomechanical preparation of canals followed the manufacturer's protocols for every system. Postoperative CBCT scans were obtained. Pre- and postoperative scans were compared at standardized depths (4 mm, 7 mm, and 11 mm) within the canals (coronal, middle, and apical thirds), allowing for a comprehensive assessment of RDT throughout the canal. According to one-way ANOVA, the highest mean was seen in Group I, followed by Group II and Group III. Hence, a statistically significant difference was found between all the groups. Post hoc Tukey's test was done for intergroup comparison. A single-file system preserved more dentin with less aggressive cutting compared to two-file and multiple-file systems.

Effect of novel ora-aid intraoral dressing on salivary healing markers in smokers with tooth extraction: A randomized controlled clinical study

Background and objectives. Socket healing following tooth extraction is considered a big challenge among dentists. However, there is no previous research testing the effects of novel commercial ora-aid dressing on the levels of salivary markers of wounds healing, osteoprotegerin (OPG) and hepatocyte growth factor (HGF) with relation to the smoking status among patients undergone tooth extraction. Material and methods. The current study represents the first randomized, controlled, and clinical research conducted in Iraq from February to May 2022. Forty male outpatients (aged from 20-60 years) who visited the Surgery Clinic of the College of Dentistry, University of Babylon, Iraq, had tooth extraction. The patients were randomly allocated into four groups: smoker patients with ora-aid applied following extraction (N=11), non-smoker patients with ora-aid applied following extraction (N=9), smoker patients without ora-aid applied (gauze only; N=11), and non-smoker patients without ora-aid applied (gauze only; N=9). Levels of preoperative and postoperative (2 weeks after extraction) salivary HGF and OPG were measured. Results. The results indicated that the levels of postoperative HGF were significantly higher in patients with ora-aid dressing compared to those without. Levels of postoperative OPG were significantly lower compared to their preoperative levels in non-smokers without ora-aid dressing. Smoking had significantly negative impacts on the levels of preoperative HGF. Conclusions. The study concludes that commercial ora-aid attachable dressing can be safely applied on the fresh socket after tooth extraction and it can accelerate the healing of intraoral wounds by significantly elevating healing of salivary markers (HGF|) and maintaining the levels of other healing marker (OPG).

Impact of Mucous Adhesive Membrane in Reducing Edema and Pain Post-Surgical Removal of Lower Wisdom Teeth

One of the most prevalent challenges that a specialized oral surgeon might encounter involves extracting impacted lower wisdom teeth, which can lead to post-operative complications like swelling and pain. Various techniques have been developed to mitigate these issues. In this research, we aimed to introduce a novel approach in oral surgery known as adhesive membrane oral aid. This study utilized a split-mouth design to assess the efficacy and impact of the adhesive membrane following the surgical removal of lower wisdom teeth in 10 patients. The split-mouth design enables both the control and study groups to be assigned within the same patient, reducing variability between different patients. The research involved a total of 10 patients who presented bilateral impaction of lower wisdom teeth and were recommended for surgical extraction. In the control group, the patient's ipsilateral side was sutured without the use of a membrane. After one month, the contralateral side of the same patient was sutured with a membrane using figure 8 sutures.

Effect of L-PRF and autogenous bone grafts for immediate implant placement in post tooth extract socket.

The clinical outcomes of bone augmentation substances in immediate dental implant (IDI) placement are of interest to dentists. Hence, we evaluated and compared the effectiveness of L-PRF and autogenous bone grafts in immediate implant placement in tooth extract socket. Hence, assessment of periimplantis pocket depth, assessment of tissue biotype, implant stability and marginal bone loss at one month, three months, and six months follow up was completed. The tissue biotype values at one month, 3 month and 6 month follow up revealed that tissue biotype increased in each category as the time increased in all categories. We found that all three techniques were found to have good clinical outcomes regarding immediate implant placement in fresh tooth extraction socket, however the outcomes were better in the case L-PRF.

Optimizing Multi-Rooted Tooth Extraction: A Comprehensive Study on the Efficacy of Periotome Utilization in Non-Surgical Exodontia

Optimizing Multi-Rooted Tooth Extraction: A Comprehensive Study on the Efficacy of Periotome Utilization in Non-Surgical Exodontia

Effects of Adrenaline Containing Local Anesthesia on Blood Pressure and Blood Glucose Levels Undergoing Tooth Extractions – A Comparative Study

Exodontia, the most common dental procedure for damaged or decayed teeth, often utilizes local anesthesia with vasoconstrictors like adrenaline. Although effective, adrenaline can impact blood glucose levels and hemodynamic parameters, particularly in hypertensive and diabetic patients. Objectives: To compare changes in blood pressure and blood glucose levels among healthy, hypertensive and diabetic patients undergoing tooth extraction with adrenaline-containing local anesthesia. Methods: A total of 177 participants were split equally into three groups: healthy, hypertensive and diabetic. Prior to and twenty minutes’ post-injection, blood pressure, and blood glucose levels were measured while a local anesthetic containing 2% lignocaine HCL with 1: 100,000 adrenaline was administered. Sample paired t test and one-way ANOVA were employed in the analysis. Results: Among hypertensive patients, random blood glucose significantly decreased post-procedure (p=0.001), while systolic blood pressure significantly increased (p&lt;0.001) and diastolic blood pressure significantly decreased (p=0.021). Diabetic patients showed a non-significant decrease in glucose levels (p=0.209) but a significant increase in both systolic (p&lt;0.001) and diastolic blood pressure (p=0.002). Healthy patients experienced a significant increase in systolic blood pressure (p=0.015) but no significant changes in glucose levels (p=0.873) or diastolic pressure (p=0.301). Conclusions: Adrenaline in local anesthesia significantly increases systolic blood pressure in all patient groups, with pronounced effects in hypertensive and diabetic patients. Changes in blood glucose were significant only in hypertensive patients, while changes in diabetic patients were non-significant. These findings highlight the need for careful monitoring and personalized management strategies in dental procedures to minimize potential adverse effects and ensure patient safety.

The clinical study and multi-factor analysis of temporomandibular joint disorder induced by tooth extraction

BackgroundTemporomandibular joint disorder (TMD) is a common complication of tooth extraction. The pathogenesis of TMD is not clear, and its incidence has not been controlled effectively. Some studies have shown that tooth extraction can induce temporomandibular joint disorder, but the specific factors still need further study. Methods536 patients of tooth extraction were included in our hospital from January 2018 to December 2022. According to whether TMD occurred after tooth extraction, the patients were divided into experimental group and control group.Gender, age, tooth position, tooth type, hammer, tooth extraction time, bruxism, deep overbite and overjet were compared between the two groups. ResultsTMD occurred in 44 patients (8.2%) after tooth extraction. Univariate analysis and logistic regression analysis showed that TMD after tooth extraction was related to the position of tooth extraction (upper or lower jaw), type of tooth extraction (molar or non-molar, deep overbite or overjet (P < 0.05), but not to gender, age, hammer, extraction time and bruxism (P > 0.05). ConclusionMandibular, molar, deep overbite and overjet are the risk factors for TMD after tooth extraction. The corresponding treatment plan should be adopted according to different clinical manifestations and diagnosis. Meanwhile, minimally invasive tooth extraction should be carried out during tooth extraction for minimizing the damage to the temporomandibular joint and preventing the occurrence of TMD.

Macrophages modulate mesenchymal stem cell function via tumor necrosis factor alpha in tooth extraction model.

Mesenchymal stem cells (MSCs) and macrophages collaboratively contribute to bone regeneration after injury. However, detailed mechanisms underlying the interaction between MSCs and inflammatory macrophages (M1) remain unclear. A macrophage-depleted tooth extraction model was generated in 5-wk-old female C57BL/6J mice using clodronate liposome (12.5mg/kg/mouse, intraperitoneally) or saline injection (control) before maxillary first molar extraction. Mice were sacrificed on days 1, 3, 5, 7, and 10 after tooth extraction (n = 4). Regenerated bone volume evaluation of tooth extraction socket (TES) and histochemical analysis of CD80+M1, CD206+M2 (anti-inflammatory macrophages), PDGFRα+MSC, and TNF-α+ cells were performed. In vitro, isolated MSCs with or without TNF-α stimulation (10ng/mL, 24h, n = 3) were bulk RNA-sequenced (RNA-Seq) to identify TNF-α stimulation-specific MSC transcriptomes. Day 7 micro-CT and HE staining revealed significantly lower mean bone volume (clodronate vs control: 0.01mm3 vs 0.02mm3, p<.0001) and mean percentage of regenerated bone area per total TES in clodronate group (41.97% vs 54.03%, p<.0001). Clodronate group showed significant reduction in mean number of CD80+, TNF-α+, PDGFRα+, and CD80+TNF-α+ cells on day 5 (306.5 vs 558.8, p<.0001; 280.5 vs 543.8, p<.0001; 365.0 vs 633.0, p<.0001, 29.0 vs 42.5, p<.0001), while these cells recovered significantly on day 7 (493.3 vs 396.0, p=.0004; 479.3 vs 384.5, p=.0008; 593.0 vs 473.0, p=.0010, 41.0 vs 32.5, p=.0003). RNA-Seq analysis showed that 15 genes (|log2FC| > 5.0, log2TPM > 5) after TNF-α stimulation were candidates for regulating MSC's immunomodulatory capacity. In vivo, Clec4e and Gbp6 are involved in inflammation and bone formation. Clec4e, Gbp6, and Cxcl10 knockdown increased osteogenic differentiation of MSCs in vitro. Temporal reduction followed by apparent recovery of TNF-α-producing M1 macrophages and MSCs after temporal macrophage depletion suggests that TNF-α activated MSCs during TES healing. In vitro mimicking the effect of TNF-α on MSCs indicated that there are 15 candidate MSC genes for regulation of immunomodulatory capacity.

Evaluation Factors Influence the Decision for Simple Tooth Extraction among Dental Students, Interns, and General Practitioners

Objective: This cross-sectional study aimed to assess the knowledge and decision-making processes of dental students, interns, and general practitioners regarding tooth extraction methods. Methods: A questionnaire was distributed online to 113 participants, including fifth and sixth-year dental students, interns, and general practitioners at King Abdulaziz University Hospital.

Alveolar Ridge Preservation Using a Novel Species-Specific Collagen-Enriched Deproteinized Bovine Bone Mineral: Histological Evaluation of a Prospective Case Series.

In recent years, the significance of maintaining the alveolar ridge following tooth extractions has markedly increased. Alveolar ridge preservation (ARP) is a commonly utilized technique and a variety of bone substitute materials and biologics are applied in different combinations. For this purpose, a histological evaluation and the clinical necessity of subsequent guided bone regeneration (GBR) in delayed implantations were investigated in a prospective case series after ARP with a novel deproteinized bovine bone material (95%) in combination with a species-specific collagen (5%) (C-DBBM). Notably, block-form bone substitutes without porcine collagen are limited, and moreover, the availability of histological data on this material remains limited. Ten patients, each scheduled for tooth extraction and desiring future implantation, were included in this study. Following tooth extraction, ARP was performed using a block form of C-DBBM in conjunction with a double-folded bovine cross-linked collagen membrane (xCM). This membrane was openly exposed to the oral cavity and secured using a crisscross suture. After a healing period ranging from 130 to 319 days, guided trephine drilling was performed for implant insertion utilizing static computer-aided implant surgery (s-CAIS). Cores harvested from the area previously treated with ARP were histologically processed and examined. Guided bone regeneration (GBR) was not necessary for any of the implantations. Histological examination revealed the development of a lattice of cancellous bone trabeculae through appositional membranous osteogenesis at various stages surrounding C-DBBM granules as well as larger spongy or compact ossicles with minimal remnants. The clinical follow-up period ranged from 2.5 to 4.5 years, during which no biological or technical complications occurred. Within the limitations of this prospective case series, it can be concluded that ARP using this novel C-DBBM in combination with a bovine xCM could be a treatment option to avoid the need for subsequent GBR in delayed implantations with the opportunity of a bovine species-specific biomaterial chain.

Efficacy of Platelet-Rich Fibrin in Preserving Alveolar Ridge Volume and Reducing Postoperative Pain in Site Preservation of Post-Extracted Sockets.

Background and Objectives: In socket preservation, the goal is to minimize bone resorption after tooth extraction to maintain the volume and contour of the alveolar ridge. The use of PRF in post extraction sites may reduce ridge resorption by encouraging the growth of new bone and acting as a scaffold for tissue. In addition, PRF may enhance healing and minimize postoperative pain. The aim of this study was to evaluate the effectiveness of platelet-rich fibrin (PRF) in maintaining the ridges' dimensions at the extraction site, in the maxilla and mandible, as well as its impact on post-extraction discomfort. Methods: The study was conducted on 60 patients presenting for extraction of posterior teeth and was randomly divided into three groups: group I PRF (n = 20), group II PRF + collagen (n = 20), and group III control (n = 20). Sockets were filled with PRF (group I) and PRF + collagen (group II). At baseline and follow-up after 3 months, CBCT was used to assess the bone dimensions. The postoperative pain evaluations were performed at 24 h, 3 days, and 7 days after the tooth extraction. The pain rate was evaluated using a numerical rating scale from the British Pain Society. Results: The study examined the effects of platelet-rich fibrin (PRF) and PRF combined with collagen on the height and width of the ridges, as well as the pain experienced by the patients following alveolar ridge preservation surgery. ANOVA and t-tests were used to evaluate and compare the ridge dimensions. Comparing the results to the control group, there were no significant differences in the height or width of the ridges. However, both the PRF and PRF + Collaplug® treatments effectively reduced the short-term postoperative pain. Conclusions: The study findings suggest that platelet-rich fibrin (PRF) and PRF combined with collagen do not exert significant effects on ridge width and height compared to the standard treatment following alveolar ridge preservation. However, it is noteworthy that both the PRF and PRF + collagen treatments demonstrated efficacy in reducing postoperative pain in the short term, offering a potential advantage over standard treatment protocols.

Comparative assessment of difficulty scales for removal of the third molar of the lower jaw depending on its position

Retention (delayed eruption) of the third molar is one of the most common pathologies in the outpatient practice of a dentist-surgeon. Such a pathology can very often be complicated by inflammatory diseases, such as pericoronitis, periostitis and other more serious diseases. Therefore, early warning and most gentle removal of the causative tooth determines the professionalism of the dental surgeon. A large number of indexes of difficulty of removal of the third molar have been proposed by different authors, but none of them is considered universal and optimal for different clinical cases. The level of complexity is most clearly characterized by a scale that takes into account not only radiological but also clinical and demographic indicators. Such scales exist in modification or in more recent literary sources. Having chosen the most clear and correct scale, it is possible for the surgeon to clearly assess the entire level of complexity and responsibility for surgical intervention on removing the third molar, thereby obtaining the most effective result, minimizing complications both during the operation and after a while. The purpose of the study: justification of the selection of the difficulty rating scale for the removal of the third molar of the lower jaw, depending on its position. The study analyzed and compared 18 basic scales of complexity that are most often used by surgeons before removing the impacted third molar of the lower jaw. Data sources that were used for the search were taken from Medline, PubMed, Google Scholar, Minerva library databases. Each of the difficulty scales was presented and translated into Ukrainian for convenient use in the practice of a dental surgeon. A general table was provided where a comparative analysis of the difficulty scales was made according to thirty parameters. It is shown that the Cosme Gay-Escoda C. scale has the most indicators for preoperative assessment of complexity. There are many difficulty scales for preoperative assessment for the removal of impacted third molars of the lower jaw. Some of them have radiological evaluation criteria, some have clinical criteria, and only the Pernumbuco index (2017), Zhang X. (2019), and Cosme Gay-Escoda C. (2022) scales also have demographic indicators. However, the latter has the largest number of criteria, according to which the difficulty of removing the third molar of the lower jaw is calculated.

Limosilactobacillus reuteri DSM 17938 Inhibition of Biofilm Formation by Prevotella intermedia and Fusobacterium nucleatum Across Salivary pH: An In Vitro Study

Abstract Objectives This study aims to investigate Limosilactobacillus reuteri DSM 17938's antibiofilm effects on Prevotella intermedia and Fusobacterium nucleatum, common causes of alveolar osteitis. It seeks topical alternatives to prevent this condition posttooth extraction. The secondary objective is to assess these effects under different pH conditions (pH 4.5 and pH 7), mimicking oral cavity saliva pH dynamics. Materials and Methods Ethical approval was secured for the saliva collection process involving five healthy adult participants who had undergone wisdom tooth extraction. Saliva samples were diligently collected on the 7th day post-surgery. The unstimulated saliva underwent a series of treatments, including the addition of phenylmethylsulfonyl fluoride (PMSF), pH adjustments, centrifugation, and filtration. The pH levels were re-measured, and subsequent adjustments were made to achieve pH values of 4.5 or 7. Limosilactobacillus reuteri DSM 17938, with a concentration of 1×108 colony-forming units (CFU) per 5 drops, was utilized in the study. Biofilm testing involved incubating saliva samples with varying pH (4.5 or 7) alongside bacterial suspensions (Prevotella intermedia, Fusobacterium nucleatum, or a mixed species). The Interlac suspension was introduced, and plates were anaerobically incubated for 24 hours. Biofilm results were obtained using a spectrometer. The test is conducted in triplicate. Statistical Analysis To scrutinize the impact of pH on biofilm development, the acquired data underwent a two-way ANOVA test in SPSS as part of the statistical analysis. A significance level of p&lt;0.05 was used to determine statistical significance. Results Limosilactobacillus reuteri DSM 17938 significantly reduced biofilm formation across bacterial strains (p = 0.000). Statistical analysis indicated a significant impact of pH on biofilm development (p = 0.000) compared to no saliva samples, with higher formation observed under acidic conditions (pH 4.5). However, the pH levels of 4.5 and 7 did not result in significantly different bacterial biofilm formation (p = 0.529). Conclusion This research highlights Limosilactobacillus reuteri DSM 17938's potency in inhibiting biofilm formation of Prevotella intermedia and Fusobacterium nucleatum. Salivary pH variations significantly influence biofilm development, emphasizing the need to consider pH when assessing probiotic effectiveness. Despite limitations in saliva sample sterilization, this study provides valuable insights into alternative approaches for preventing alveolar osteitis. Further research should explore clinical applications and refine sterilization methods for more accurate results.

Thermal implant removal in a pig jaw: a proof of concept study

ObjectivesThe aim of this study was to evaluate whether thermal implant removal of osseointegrated implants is possible using a diode laser with an specific temperature–time interval.Materials and methodsFirst, tooth extraction of the first three premolars was performed in the maxilla and mandible on both sides of 10 pig. After 3 months, implants were inserted into the upper and lower jaws of 10 pigs. After 3 more months, osseointegrated implants were heated with a laser device to a temperature of 50 °C for 1 min. After 14 days, the implant stability quotient (ISQ), torque-out values, and bone-to-implant contact (BIC) ratio were assessed using resonance frequency analysis.ResultsISQ values showed no significant differences within each group or between the control and test groups. Furthermore, torque-out and BIC value measurements presented no significant differences between the groups.ConclusionsAt 50°C, changes in the BIC values were noticeably smaller; however, these differences were not significant. Future studies should evaluate the same procedures at either a higher temperature or longer intervals.Clinical relevanceWith only 50 °C for 1 min, a dental implant will not de-integrate predictably.

Ameloblastic fibrosarcoma of the maxilla arising in an old woman, a rare case report and literature review

BackgroundAmeloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumor, commonly occurring in young adults and typically affecting the mandibular region. We report an exceptionally rare and highly atypical case of AFS in an elderly female patient originating from the maxillary bone.Case presentationA 66-year-old woman was admitted with a two-week history of a lump in her left upper molar. CT scans suggested a cyst in the maxillary bone. An incisional biopsy revealed a spindle cell neoplasm. MRI showed abnormalities in the left maxilla, indicating a possible tumorous lesion. The patient underwent a subtotal maxillectomy, wide tumor excision, intraoral epithelial flap transplantation, and dental extraction. Histology identified atypical tumor cells with visible mitotic figures. Immunohistochemistry showed negative for PCK and CD34 expression, but positive for Vimentin and SMA expression. The Ki-67 proliferation index ranged from 30 to 50%. These findings suggested a potentially malignant soft tissue tumor in the left maxilla, leaning towards a diagnosis of AFS. The patient received postoperative radiotherapy. There was no recurrence during the six-month follow-up.ConclusionBased on repeated pathological evidence, we report a rare case of an elderly female with AFS originating from the maxillary bone. Surgery and postoperative radiotherapy resulted in a favorable outcome.

Bonding Efficiency between Artificial Teeth and Denture Base in CAD/CAM and Conventional Complete Removable Dentures.

A common challenge encountered with both traditional and digitally produced dentures involves the extraction of artificial teeth from the denture base. This narrative review seeks to present an updated perspective on the adherence of synthetic teeth for denture base materials, employing diverse methods. Dental technicians often employ chemical approaches and mechanical techniques (including abrasion, laser treatment, and abrasive blasting) to augment the retention of denture teeth. However, the efficacy of these treatments remains uncertain. In certain instances, specific combinations of Denture Base Resin (DBR) materials and artificial teeth exhibit improved performance in conventional heat-cured dentures following these treatments. The primary reasons for failure are attributed to material incompatibility and inadequate copolymerization. As new denture fabrication techniques and materials continue to emerge, further research is imperative to identify optimal tooth-DBR combinations. Notably, 3D-printed tooth-DBR combinations have demonstrated reduced bond strength and less favorable failure patterns, while utilizing milled and traditional combinations appears to be a more prudent choice until advancements in additive manufacturing enhance the reliability of 3D-printing methods.

Dysphagia and Trismus After Tooth Extraction : Clinical Conondrum.

Clinicians should consider disorders of masticatory muscle including lateral pterygoid muscle as a differential diagnosis in patients presenting with dysphagia and trismus after tooth extraction.

Dental treatments in patients with special needs provided by university medical center in Southern Taiwan: a retrospective study.

We perform special-need dental treatment at outpatient department (OPD), under general anesthesia (GA) when necessary, and provide domiciliary dental care. We aim to evaluate the profile and the characteristics of special needs patients (SNPs). We consecutively enrolled 3117 SNPs from January 1, 2019 to December 31, 2022. Eighty patients with rare or genetic diseases were excluded. Demographic data were retrospectively collected. There were totally 3037 SNPs (mean age: 48.2 years; range, 1-100; male-to-female ratio, 1.5); 89.1% (n = 2705) SNPs received dental care at the OPD (OPD-SNPs), 7.9% (n = 239) received dental treatment under GA, and 3.0% (n = 93) received domiciliary dental care. Among those SNPs who received dental treatment under GA (n = 239), 91.2% (n = 218) were mental/intellectual disabled, and most underwent cavity filling (69.5%) and dental extractions (56.5%). OPD-SNPs with mental/intellectual disabilities (n = 1340) received significantly more items of dental treatment than those without (n = 1365). SNPs with more severe disabilities received more fluoride application and ultrasonic scaling (both p < 0.001, trend tests). Interestingly, among OPD-SNPs with mental/intellectual disabilities (n = 1340), more severe patients received more fluoride application (p < 0.001) and ultrasonic scaling (p < 0.001) but fewer root canal treatment (p = 0.007, trend test). GA benefited SNPs with more dental procedures, including invasive items. SNPs with mental/intellectual disabilities can tolerate more measures and SNPs with more severe mental/intellectual disabilities received more preventive measures but less invasive measures. Similarly, more severe SNPs with other disabilities received more preventive measures but not invasive measures. Our findings may provide useful information for special needs dentists and for doctor-patient communication.

Overview of Diagnosis, Management of Mesiodens and Its Impact on Children – A Series of Case Report

Supernumerary teeth are a developmental anomaly having extra teeth in addition to the normal dentition. Mesiodens is a supernumerary tooth present in the midline between the two central incisors. It usually results in oral problems such as malocclusion, food impaction, poor aesthetics, and cyst formation. Malocclusion due to mesiodens has also physical, psychological, and social effects on Quality of Life (QoL). The present overview and series of case reports describes cases of surgical removal of supernumerary teeth (mesiodens) which were detected on clinical or radiographic examination. The article highlights the psychological and social impact of supernumerary tooth on the oral health-related quality of life and need for regular follow-up of permanent teeth eruption in young children.