Development of a highly accurate machine learning model for the differential diagnosis of ameloblastoma and odontogenic keratocyst on computed tomography images.

Effect of Micro-Osteoperforations on Orthodontic Tooth Movement: A Systematic Review and Meta-Analysis.

Vitamin D as an adjunctive therapy in orthodontics: Impact on alveolar bone and root resorption in male rats.

To investigate the effects of locally applied liquid/gel mixed-phase concentrated growth factor (lgpCGF) on periodontal and pulpal healing following delayed replantation of avulsed immature permanent teeth and explore the potential of lgpCGF in mitigating root resorption. A delayed replantation model in immature permanent teeth was established using eight healthy beagle dogs, with two additional dogs serving as normal controls. From each experimental animal, two mandibular canine teeth (33 and 43) were extracted and left dry for 60 min to simulate delayed replantation. Tooth 43 received freshly prepared lgpCGF in the alveolar socket before replantation (lgpCGF group), while tooth 33 underwent conventional replantation (CR group). Each group initially contained 8 teeth (n = 8); one tooth in the CR group was excluded due to extraction-related damage. Periapical radiographs were obtained immediately after replantation and again at 4 weeks postoperatively, and analysed utilising ImageJ software. Micro-computed tomography (micro-CT) combined with CT-Analyser, ImageJ, and Geomagic Wrap was performed for quantitative assessment of root resorption. Surface resorption (SRR) and/or inflammatory root resorption (IRR) were grouped together and quantified collectively as the proportion of total root surface area affected. Replacement resorption (RRR) was evaluated by measuring the arc length of resorbed areas relative to the total root perimeter on transverse sections. Histological evaluation of periodontal and pulpal tissues was conducted on haematoxylin and eosin-stained sections. Compared with the CR group, the lgpCGF group exhibited improved clinical signs with fewer high-pitched percussion responses and greater tooth stability. Radiographic and micro-CT analyses revealed that the lgpCGF group had a significantly longer root length and smaller apical foramen diameter compared to the CR group (p < 0.05). Additionally, the lgpCGF group showed greater root area and reduced root resorption compared to the CR group (p < 0.05). Histological observations further showed enhanced periodontal regeneration and pulpal tissue organisation in lgpCGF-treated teeth. Local application of lgpCGF to the alveolar socket during delayed replantation of immature permanent teeth effectively reduced root resorption and enhanced periodontal and pulpal healing. These findings support lgpCGF's potential as a regenerative therapeutic strategy to improve the prognosis of delayed tooth replantation.

The periodontal ligament (PDL) and periosteum are mechanosensitive tissues essential for alveolar bone maintenance, remodeling, and regeneration. Their functional interplay, particularly during orthodontic tooth movement, remains underexplored. This review introduces the novel concept of the PDL-periosteum axis as a biologically interactive unit coordinating site-specific alveolar adaptation and periodontal homeostasis. Both tissues share mechanosensitive and osteogenic pathways regulating progenitor recruitment, osteoblastic differentiation, and extracellular matrix remodeling. Through crosstalk with osteocytes, they form a multilevel mechanosensory network integrating internal and external forces across the alveolar complex. Functionally, the PDL transduces forces within the alveolar socket, whereas the periosteum responds to cortical strain by supplying progenitor cells and driving adaptive remodeling. Disruption of either component predisposes to complications, including ankylosis, root resorption, or impaired bone regeneration, whereas preservation of both enables orthodontically induced bone formation even in severe alveolar deficiency. The integrity of the PDL-periosteum axis critically determines clinical outcomes, from favorable healing to maladaptation such as dehiscence, fenestration, or fibrotic adhesions. Recognizing this axis provides a systems biology framework for improved diagnosis, treatment planning, and regenerative strategies, bridging mechanobiology with clinical practice.

Therapeutic approach of simple bone cyst of the jaw: a retrospective study of 72 patients.

This prospective pilot study evaluated the clinical feasibility of autogenous tooth bone graft powder (ATBGP) for surgically assisted labial alveolar augmentation during orthodontic treatment, by assessing radiographic alveolar changes and patient-reported outcomes. Eleven adults with thin labial alveolar bone in the mandibular anterior region underwent surgically assisted alveolar augmentation with ATBGP, involving 52 teeth. Cone-beam computed tomography (CBCT) was performed at baseline and 0, 3, and 6 months postoperatively to assess alveolar bone parameters. Postoperative pain, function, and satisfaction were evaluated using a visual analog scale (VAS). Alveolar bone thickness and area increased at all postoperative time points, while alveolar crest height decreased (p<0.05). Labial bone defects decreased markedly, and sagittal root position improved. Mild root resorption was detected but remained within the physiological range. Most patients reported mild postoperative symptoms and high satisfaction. These findings suggest that ATBGP may represent a feasible, autogenous grafting material for surgically assisted alveolar augmentation in the mandibular anterior region, enabling biological reuse of extracted teeth and potentially reducing reliance on xenografts during orthodontic treatment. Larger randomized studies with longer follow-up are needed to confirm durability and safety.

Effect of temperature and ultrasonic activation on the antibacterial efficacy of sodium hypochlorite alone and combined with etidronic acid in an internal root resorption model.

Interleukin-33 and superoxide dismutase 3 mediates co-achieved tooth movement acceleration and root protection.

Dentigerous cysts (DCs) represent the most common developmental odontogenic cysts and are typically associated with the crown of an unerupted or impacted tooth. These cysts are often asymptomatic but may present with jaw swelling, pain, facial asymmetry, tooth displacement, root resorption of adjacent teeth, and, in severe cases, infection. Radiographically, they appear as welldefined unilocular radiolucencies with sclerotic borders surrounding the crown of the involved tooth. Although enucleation with extraction of the associated tooth has been the conventional treatment, management strategies in pediatric patients should prioritize preservation of developing permanent teeth. Marsupialization has emerged as a conservative treatment modality that facilitates decompression of the lesion and allows spontaneous eruption of the involved tooth. This article reports a case of a large dentigerous cyst in a 9 year-old child managed successfully through marsupialization using a precisely fabricated non functional acrylic obturator. Clinical and radiographic follow-up over a 12-month period demonstrated complete resolution of the lesion with uneventful healing and eruption of the associated permanent tooth.

To overcome the reliance on subjective clinical judgment and the inadequacy of international indices in reflecting Chinese orthodontic expertise and patient characteristics, the Chinese Stomatological Association developed an expert consensus on orthodontic treatment outcome evaluation. This first systematically calibrated framework tailored to Chinese populations was established through an extensive process: comprehensive literature review, analysis of the Peer Assessment Rating (PAR) and the American Board of Orthodontics Objective Grading System (ABO-OGS) indices and a large-scale subjective-objective correlation study involving 65 standing committee members evaluating 216 completed cases. The resulting 3D evaluation system encompasses occlusal relationships, root and bone health and facial profile harmony. Occlusal assessment includes six core indicators: incisor horizontal overlap, vertical overlap, sagittal relationship, alignment, occlusal contact and buccal lingual inclination. Root and bone health evaluation mandates CBCT-based assessment of root resorption, fenestration and dehiscence, the first mandatory inclusion of 3D radiographic evaluation in orthodontic outcome standards. Facial profile analysis comprises five cephalometric measurements (ANB, MP/SN, Sn-GPos, UL-E and Bs-GPos) evaluated using a standardised difference method. Each dimension provides detailed specifications for evaluation materials, objective indicators, measurement methods, scoring criteria and a five-grade classification (excellent, good, fair, poor and worst) based on total deduction scores aligned with expert consensus percentiles. This consensus aims to standardise clinical practice, establish a scientific foundation for treatment quality control and specialist certification, provide morphological evaluation criteria for research and enhance orthodontic care quality in China. Despite being focused on static morphology, the framework is designed to accommodate future integration of functional assessment and long-term stability evaluation.

To summarize time-related biomarker changes in orthodontically-induced root resorption (OIRR), classify biomarkers by function, and examine trajectories across OIRR stages. PubMed/MEDLINE, Embase, Scopus, Web of Science, CENTRAL, CINAHL and grey literature, were searched from inception to October 1, 2025. Reference lists were manually searched. The risk of bias was assessed using the Cochrane RoB 2 for RCTs and ROBINS-I for non-RCTs. The certainty of evidence was evaluated via GRADE. Because of heterogeneity, findings were synthesized narratively. From 11,434 records, 14 studies (225 participants) were included. Gingival crevicular fluid, saliva and serum were analyzed, mainly using enzyme-linked immunosorbent assay. RoB was 'moderate'- 'serious' (non-RCTs) or 'some concerns' (RCTs). Studies reported a rise of pro-inflammatory cytokines right after force application. Subsequent force application phases showed signals of osteoclastic activity and regulation, followed by detection of root hard tissue degradation products that correlated with OIRR volume. Higher baseline salivary secretory IgA and anti-dentin humoral responses and lower baseline mineralized-tissue regulators were associated with greater OIRR severity. Evidence suggests time-related changes involving early inflammatory activation and later matrix degradation, which may be shaped by interaction between orthodontic force and patients' biological responses. Standardized multicenter prospective cohorts are needed for validation. Early cytokines changes and later signals of osteoclast regulation and root hard tissue degradation may help define candidate monitoring method for OIRR during treatment. Baseline immune profiles could inform future risk stratification, while bone turnover biomarkers may reflect tooth movement rather than resorption.

Three-Dimensional Radiographic and Morphological Features of Ameloblastoma and Odontogenic Keratocyst: A Comparative Cone Beam Computed Tomography Study Using Automatic Segmentation.

The two widely used methods for orthodontic tooth movement with sliding mechanics are elastomeric power chains (EPC) and nickel-titanium closed-coil springs (NCCS). To compare the rate of extraction space closure during canine retraction, degree of root resorption, dental plaque accumulation and gingival health using NCCS versus EPC in subjects undergoing first premolar extractions. Single-centered, prospective, split-mouth randomized controlled trial. For canine retraction, NCCS and EPCs were randomly allocated to the right and left quadrants of both maxillary and mandibular arches in 46 subjects. Canine retraction, root resorption, plaque accumulation and gingival health were recorded at four points in time. Within groups, pairwise comparison and between-group comparisons were done using Wilcoxon signed rank test. Generalized Estimating Equation (GEE) analysis was employed to identify the factors significantly influencing the rate of extraction space closure during canine retraction and the extent of root resorption. The study investigators, patients recruited, and assessors were not blinded during the trial due to the visible nature of the orthodontic appliances used. NCCS exhibited faster rates in total canine retraction and during the T0-T1 (p = 0.039) and T2-T3 (p = 0.003) intervals. Root resorption exhibited non-significant differences. Whereas, NCCS demonstrated higher plaque retention at T1 (p = 0.013), T2 (p = 0.016) and T3 (p = 0.033). GI differed significantly between groups, with higher values with NCCS at T1 (p = 0.046) and EPC at T2 (p = 0.039). Extraction space closure rate displayed a significant difference between the T1-T2 and T2-T3 stages with NCCS (p = 0.025). GEE showed a significant positive association of age with root resorption (β = 0.939, CI = 0.312, 1.565, p = 0.003). NCCS demonstrated a significantly higher rate of extraction space closure and plaque accumulation compared to EPC. However, no statistically significant differences were observed between the two groups with respect to root resorption and gingival health. Furthermore, the degree of root resorption was found to increase significantly with the advancing age. Registered at clinicaltrials.gov under the identifier NCT06567730 on 23rd August 2024.

The frontiers of orthodontically induced inflammatory root resorption: mechanism, treatment, and future prospects.

To compare the survival of single-tooth implants placed in sites with previous external cervical root resorption (ECRR) to those placed in unaffected sites. A retrospective matched cohort study was conducted using data from the Swedish National Dental Health Register (2009-2022). Patients receiving a single-tooth implant in a site with previous ECRR were identified and matched 1:1 to controls without such history by age, sex, tooth position, and timing of implant placement (± 2 years). Implant survival, defined as time from placement to removal, was analyzed using Kaplan-Meier curves and stratified Cox proportional hazards models. Restricted mean survival time (RMST) was estimated up to 10 years. Subgroup and sensitivity analyses assessed robustness. The final cohort included 605 matched pairs (n = 1,210). The mean age was 52 years, and 56% of implants were placed in the maxillary anterior region. Implant extraction occurred in 12/571 (2.1%) sites with previous ECRR and 21/564 (3.7%) control sites. Ten-year cumulative survival was 97.3% for sites with previous ECRR and 94.4% for controls. The difference was not statistically significant (HR = 0.58; 95% CI: 0.28-1.22; p = 0.15). RMST analysis showed a negligible absolute survival difference (0.11 years; 95% CI: -0.04 to 0.25; p = 0.15). Within the limitations of registry-based data and a low number of failures, no statistically significant difference in implant survival was detected between sites with and without previous ECRR. These findings suggest comparable survival outcomes but should be interpreted with caution.

External root resorption (ERR) on second molars (M2s) is an undesirable type of pathological damage associated with adjacent impacted third molars (iM3s). Owing to its limited detectability on conventional radiographs, ERR may remain undiagnosed until irreversible damage has occurred. This systematic review aimed to quantitatively evaluate the association between iM3s and ERR on M2s via cone-beam computed tomography (CBCT). Six databases, including PubMed, Scopus, Web of Science, the Cochrane Library, Embase and ProQuest, were searched for relevant articles published prior to June 2025. Only human studies using CBCT to investigate iM3-related ERR on M2s were included. Methodological quality was assessed via the Joanna Briggs Institute Critical Appraisal Checklist. Meta-analyses were performed using random-effects model with heterogeneity assessed via RevMan software. Meta-regression analysis and the evaluation of publication bias were conducted using Stata software. Twenty-six articles were included in this meta-analysis: Twenty-four had a low risk of bias. The quantitative synthesis demonstrated a 31% (95% confidence interval: 26% to 36%) prevalence of iM3-associated ERR on M2s. A higher prevalence of ERR was associated with mesioangular, horizontal or transverse inclination of iM3s and direct contact with the apical third of the M2 roots. Findings indicate that ERR on M2s is related to the contact between iM3s and the apical third of M2 roots. Mesioangular, horizontal, or transverse iM3 inclinations are significantly associated with higher ERR prevalence on adjacent M2s. This study identified key associated factors for ERR on M2s with iM3s, providing evidence-based suggestions for treatment plans of asymptomatic iM3s. PROSPERO: CRD42022332920.

The present study aims to examine and classify the localization of canine teeth impacted in the maxilla for various reasons, their relationship with adjacent structures, and the developing pathologies by using cone beam computed tomography (CBCT). CBCT images taken for various reasons from 175 patients with maxillary impacted canine teeth that met the research criteria were examined. Demographic characteristics of the patients such as age and gender were recorded. The maxillary impacted canine teeth were examined by using CBCT in terms of their locations, relationship with the maxillary sinus, nasal floor and nasopalatine canal (NPC), relationship with adjacent teeth and the associated pathologies. A total of 209 maxillary impacted canine teeth of 175 patients were examined. Of the patients included in the study, 37.3% were male, while 62.7% were female. The mean age was found as 35 (age range 18-70). The rate of unilateral impacted canine teeth was 67.5% and 52.6% of the canine teeth were found to be located on the right side of the maxilla. Canine teeth were palatally impacted in 79% and 89% were found to be in a mesioangular position. The rate of canine teeth associated with the nasal cavity floor was found to be 7%, the rate of canine teeth with roots extending into the maxillary sinus was 6%, and the rate of canine teeth associated with NPC was found to be 15%. When the relationship of maxillary impacted canine teeth with the surrounding anatomical structures was examined, maxillary impacted canine teeth of male were found to have a higher relationship with the nasal cavity floor. The rate of pathologies associated with maxillary impacted canine teeth was found to be 22.5%. The most common pathologies were intracoronal resorption in maxillary canine teeth (8%) and root resorption in lateral incisors (7%). The results of the present study show that maxillary impacted canine teeth can remain for many years without causing pathology. However, it is crucial to evaluate them comprehensively by using CBCT when orthodontic or surgical intervention is planned.

Primary Hyperoxaluria Type 1 (PH1) is a rare metabolic disorder characterized by systemic oxalate deposition, which may influence bone metabolism through mechanisms such as oxalate accumulation in alveolar bone, renal osteodystrophy, and the long‑term effects of immunosuppressive therapy following transplantation. In the present case, conventional prosthetic options were unsuitable due to external root resorption and the poor prognosis of the remaining dentition. This report describes implant‑supported oral rehabilitation in a medically complex patient with PH1 and a history of combined liver-kidney transplantation and multiple systemic comorbidities. Dental implant therapy was selected following comprehensive clinical and radiographic assessment. At six months, resonance frequency analysis demonstrated secondary stability with ISQ values of 75 (right) and 74 (left). Clinical and radiographic evaluation at 14 months showed stable peri‑implant conditions without detectable complications. This case suggests that implant therapy may be feasible in selected patients with PH1 when thorough risk assessment, individualized planning, and close postoperative monitoring are ensured. However, the findings are limited by the single‑case design and relatively short follow‑up period, and should be interpreted as hypothesis‑generating rather than conclusive evidence regarding long‑term implant outcomes in this population.

Orthodontically induced external apical root resorption is a common iatrogenic effect of tooth movement. With the increasing use of clear aligner therapy, it is important to evaluate whether its biomechanics reduce root resorption compared with fixed orthodontic appliances. To compare apical root resorption in patients treated with clear aligners and fixed appliances using cone-beam computed tomography (CBCT). A retrospective comparative CBCT-based analysis was conducted on 120 orthodontic patients. Root volumes and lengths were measured from the cementoenamel junction to the apex using pre- and post-treatment CBCT scans. Apical root resorption was quantified as percentage volume loss and absolute root length reduction. Primary analyses employed linear mixed-effects models adjusted for clustering of teeth within patients and for tooth type, arch, extraction status, and treatment duration. Clear aligner therapy was associated with significantly lower apical root resorption than fixed appliances. Mean percentage root volume loss was lower in the aligner group (6.1 ± 4.8%) than in the fixed appliance group (8.4 ± 6.1%) (p = 0.004). Mean root length reduction was also smaller with aligners (p = 0.001). Clinically significant root resorption occurred less frequently in the aligner group (p = 0.048). Longer treatment duration increased resorption risk. Clear aligner therapy is associated with less apical root resorption than fixed orthodontic treatment, while treatment duration remains an independent risk factor.