Upper Molar Research Articles

Assessment and Identification of Improvement Areas for Facial Symmetry in Hemifacial Microsomia (Type IIB) Using Three-dimensional Measurements.

Surgical planning for hemifacial microsomia (HFM) patients often involves planning the amount of maxillary movement and mandibular bone distraction from three-dimensional (3D) volumetric images constructed from computed tomography scans. By representing anatomical indicators for facial symmetry in X, Y, and Z coordinates, we identified the more challenging areas in correcting facial asymmetry. The study included five HFM patients with a mean age of 22.2 years, all diagnosed with HFM (type IIB). We established measurement points with high reproducible 3D coordinates on the 3D volumetric images obtained from computed tomography scans for before surgery, treatment objectives, and after surgery. We assessed the symmetry of measurement points between the affected side and nonaffected side at each time point. In the before-surgery group, significant differences were observed between the affected side and nonaffected side in X,Y (excluding Palatine foramen, upper molar, canine) and Z coordinates for measurement items. In the treatment objectives group, no differences were observed between the affected side and nonaffected side in X, Y, and Z coordinates, resulting in facial symmetry. In the after-surgery group, significant differences were observed in Y coordinates in the mental foramen area, and significant differences were observed in z axis measurement items in the canine and mental foramen areas. It is evident that relying solely on a front view assessment is insufficient to achieve facial symmetry. Particularly, both anterior-posterior and vertical improvements in the area near the mental foramen on the affected side are necessary.

Effect of mental arithmetic stress on periodontal sensation in the upper molar and tactile sensation in the cheek

AbstractAimThis study examined the absolute threshold of periodontal sensation (ATPS) in the upper molars and the difference threshold of tactile sensation (DTTS) in the cheek skin before and after mental arithmetic stress.MethodsTwenty participants (10 men and 10 women; median age: 24.5 years) and 13 healthy individuals (eight men and five women; median age: 24.0 years) underwent ATPS measurement using the staircase method and DTTS using the method of limits. These tests were conducted before and after 10 min of mental arithmetic task. Psychological state was evaluated by comparing heart rate and blood pressure. Induction of mental stress was confirmed by significant activation of the cardiovascular system after the mental arithmetic task.ResultAlthough ATPS showed a statistically significant increase after mental stress (P = 0.01), DTTS showed no significant change (P > 0.05).ConclusionsThis study revealed that the influence of psychological state tended to appear in the perception of force exerted on the teeth. Therefore, periodontal sensation may be blunted by mental stress, even in healthy individuals. Patients may be exposed to mental stress during dental and oral maxillofacial treatment, and the occlusal sensory threshold may be altered; therefore, caution is essential during prosthetic and other occlusion‐related treatments.

Life-history of Palaeoloxodon antiquus reveals Middle Pleistocene glacial refugium in the Megalopolis basin, Greece

The Balkans are considered a major glacial refugium where flora and fauna survived glacial periods and repopulated the rest of Europe during interglacials. While it is also thought to have harboured Pleistocene human populations, evidence linking human activity, paleoenvironmental indicators and a secure temporal placement to glacial periods is scant. Here, we present the first intra-tooth multi-isotope analysis for the European straight-tusked elephant Palaeoloxodon antiquus, on an adult male individual excavated in association with lithic artefacts at the MIS 12 site Marathousa 1 (Megalopolis basin, Greece). The studied find also exhibits anthropogenic modifications, providing direct evidence of hominin presence. We employed strontium, carbon and oxygen isotope analysis on enamel bioapatite to investigate its foraging and mobility behaviour, using a sequential sampling strategy along the tooth growth axis of the third upper molar, to assess ecological changes during the last decade of life. We found a geographically restricted range, in a C3-dominated open woodland environment, and relatively stable conditions over the examined timeframe. Our results show that, despite the severity of the MIS 12 glacial, the Megalopolis basin sustained a mesic habitat, sufficient plant cover and limited seasonal fluctuations in resource availability, pointing to its role as a glacial refugium for both fauna and hominins.

Molar wear in house mice: insight into diet preferences at an ecological timescale?

Abstract In molars without permanent eruption, wear deeply modifies the geometry of the crown. To test for a signature of diet on wear dynamics, the molar geometry was compared between commensal house mice, relying on an omnivorous-granivorous diet, and Sub-Antarctic relatives, characterized by a switch towards a more ‘predatory’ behaviour. Laboratory-bred offspring of commensal mice served as a reference by providing mice of known age. Molar geometry was quantified using dense 3D semi-landmark based descriptors of the whole molar row and the upper molar only. Laboratory offspring displayed a decreased rate of wear compared to their commensal relatives, due to reduced mastication in mice fed ad libitum. Sub-Antarctic mice displayed a similarly decreased rate of molar wear, in agreement with an optimization towards incisor biting to seize prey. Laboratory offspring and Sub-Antarctic mice were further characterized by straight molar rows, whereas in commensal mice, the erupting third molar deviated away from the longitudinal alignment with the other molars, due to masticatory loadings. Quantifying changes in molar geometry could thus contribute to trace subtle diet variations, and provide a direct insight into the constraints during mastication, shedding light on the functional role of adaptive changes in molar geometry.

Kinematics of lateral tongue-pushing movement in coordination with masticatory jaw movement: An anteroposterior projection videofluorographic study

ObjectiveDuring the mastication of solid food, the tongue pushes the bolus laterally to place it onto occlusal surfaces as the jaw is opened. This movement is referred to as tongue-pushing (TP). TP has an important role in efficient chewing, but its kinematic mechanisms remain unclear. The present study quantified the kinematics of TP and its coordination with masticatory jaw movements. MethodsVideofluorography (VFG) in anteroposterior projection was recorded while 14 healthy young adults ate 6 g each of cookies and meat. Small lead markers were glued to the tongue surface (left, right, and anterior) and buccal tooth surfaces (upper molars and lower canines). The position of the tongue and lower canine markers relative to the upper occlusal plane was quantified with Cartesian coordinates, using the right upper molar as the origin. Jaw motion during chewing was divided into TP and Non-TP cycles, based on the lateral movement of the food and tongue markers. The side of the jaw that compressed food particles was defined as the working side, while the other side was termed the balancing side. Horizontal and vertical displacements of tongue and jaw markers were compared between TP and Non-TP cycles, as well as between food types. ResultsThe mediolateral displacement of all tongue markers was significantly larger in TP than in Non-TP cycles. Vertical displacement was also significantly greater in TP than in Non-TP cycles for the anterior and working side tongue markers. TP cycles occurred more frequently with meat-chewing than with cookie-chewing. ConclusionTP is accomplished by rotation and lateral movements of the tongue surface on the working side and the anterior tongue blade, along with medial movement on the balancing side. These movements produce lateral shift and rotation of the tongue surface toward the working side in concert with jaw opening. Designing exercises to improve the strength of the lateral motion and rotation of the tongue body may be useful for individuals with impaired tongue function for eating and swallowing.

Maxillary sinuses, multiple aspects to consider prior to bone grafting procedure: a retrospective study in a sample of a Palestinian population.

To analyze various anatomical aspects of the maxillary sinuses on CBCT volumes, mainly, the posterior superior alveolar artery (PSAA), and to compare its visibility on CBCT vs. panoramic radiographs. A retrospective radiographic analysis was conducted on 120 patients (240 maxillary sinuses) using their CBCT coronal views (CCV) and panoramic radiographs (CP). On CCV, the PSAA's maximum dimension (MD), vertical distance (PVD) to the alveolar crest, and bone plate thickness (T1 and T2) buccally and inferiorly to the PSAA, respectively, were analyzed. Additionally, on CCV, the ostium vertical distance (OVD) and location were recorded, and the height of the remaining bone height inferior to the maxillary sinuses (MVD) was also measured. The PSAA's visibility was evaluated and compared between CCV and CP. All these variables were studied at the apical region of the second maxillary premolar (P2), first molar (M1), and second molar (M2). Age, gender, and face side (right vs. left) factors affecting the sinus dimensions and visibility were investigated. Several statistical tests were used to analyze these variables. PSAA was detected in 96.53% of the records on CCV, where it was significantly superior to CP in the detection of the PSAA structure (p value 0.000) at all sites analyzed. The PSAA's MD, PVD, T1 and T2 thicknesses, and MVD were on average 1.19mm, 19.54mm, 0.69mm, 1.36mm, and 10.25, respectively. OVD average was 31.04mm where 42.9% of the ostia were within the mesiodistal extent of the second upper molar. No significant relation was found between different age groups, gender, and the visibility level of PSAA. Age, gender, and the side of the face investigated showed no discernible effects on the maxillary sinus's bone thickness, vertical dimensions, or PSAA diameter among the studied Palestinian sample. As CCV was superior to CP in the identification of PSSA, preoperative evaluation of PSSA using CBCT volumes is thus recommended.

A New Digital Method to Quantify the Effects Produced by Carriere Motion Appliance.

The aim of this study was to analyze a novel digital technique to quantify the distal tooth displacement and derotation angle produced by the Carriere Motion Appliance (CMA). Twenty-one patients with a class II molar and canine relationship underwent orthodontic treatment with CMA. All patients were exposed before (STL1) and after the CMA placement (STL2), submitted to a digital impression, and afterwards, data were uploaded to specific cephalometric software to allow automatic mesh network alignment of the STL digital files. Subsequently, the distal tooth displacement of the upper canines and first upper molars, as well as the derotation angle of the first upper molars were analyzed using the Pearson correlation coefficient (ρ). Repeatability and reproducibility were analyzed using Gage R&R statistical analysis. An increase in canine displacement was correlated with an increase in contralateral canine displacement (ρ = 0.759; p < 0.000). An increase in canine displacement was correlated with an increase in molar displacement (ρ = 0.715; p < 0.001). An increase in upper first molar displacement was correlated with an increase in the contralateral upper first molar displacement (ρ = 0.609; p < 0.003) and the canine displacement (ρ = 0.728; p < 0.001). The distal tooth displacement showed a repeatability of 0.62% and reproducibility of 7.49%, and the derotation angle showed a repeatability of 0.30% and reproducibility of 0.12%. The novel digital measurement technique is a reproducible, repeatable, and accurate method for quantifying the distal tooth displacement of the upper canine and first upper molar, as well as the derotation angle of the first upper molars after using CMA.

A transformation of trigeminal neuralgia into SUNCT/SUNA: A case report and literature review

IntroductionTrigeminal neuralgia and Short-lasting Unilateral Neuralgiform Headache with Conjunctival injection and Tearing (SUNCT)/Short-lasting Unilateral Neuralgiform Headache Attacks with Cranial Autonomic Symptoms (SUNA) are characterized by similar clinical manifestations, which may lead to diagnostic confusion. However, the transformation of trigeminal neuralgia into SUNCT/SUNA is a rare phenomenon. This report describes a case of trigeminal neuralgia transformation into SUNCT/SUNA due to neurovascular compression and reviews all previously published cases of trigeminal neuralgia to SUNCT/SUNA transformation in the literature.Case presentationA 49-year-old Thai male patient presented with progressive right facial pain for a period of three months. One year prior, he developed trigeminal neuralgia along the maxillary branch of the trigeminal nerve, characterized by electrical shock-like pain in the right upper molar, exacerbated by eating. His symptoms were effectively managed with carbamazepine. Nine months later, he began experiencing recurrent electrical shock-like pain along the ophthalmic division of the right trigeminal nerve, accompanied by lacrimation, which failed to respond to continued treatment with carbamazepine. Three months prior to presentation, his symptoms evolved into SUNCT/SUNA, characterized by electrical shock-like pain in the right periorbital area and conjunctival injection, lacrimation. Neuroimaging revealed high-grade neurovascular compression of the right trigeminal nerve by the right superior cerebellar artery. The patient's symptoms resolved following microvascular decompression.ConclusionClinicians should be aware that patients with longer disease duration of trigeminal neuralgia who develop new neuralgic pain in the ophthalmic branch division with mild autonomic symptoms may be at risk for transformation into SUNCT/SUNA.

A Semi-Automatic Method on a Small Italian Sample for Estimating Sex Based on the Shape of the Crown of the Maxillary Posterior Teeth

Teeth are known to be reliable substrates for human identification and are endowed with significant sexual dimorphism not only in the size but also in the shape of the crowns. In the preliminary phase of our study (already published in 2021), a novel sex estimation method based on dental morphometric geometric (GMA) analysis combined with the artificial neural network (ANN) was developed and validated on a single dental element (first upper premolar) with an accuracy rate of 80%. This study aims to experiment and validate the combination of GMA-ANN on the upper first and second left premolars and the upper left first molar to obtain a reliable classification model based on the sexual dimorphic traits of multiple maxillary teeth of Caucasian Italian adults (115 males and 115 females). A general procrustes superimposition (GPS) and principal component analysis (PCA) were performed to study the shape variance between the sexes and to reduce the data variations. The "set-aside" approach was used to validate the accuracy of the proposed ANN. As the main findings, the proposed method correctly classified 94% of females and 68% of males from the test sample and the overall accuracy gained was 82%, higher than the odontometric methods that similarly consider multiple teeth. The shape variation between male and female premolars represents the best dimorphic feature compared with the first upper molar. Future research could overcome some limitations by considering a larger sample of subjects and experimenting with the use of computer vision for automatic landmark positioning and should verify the present evidence in samples with different ancestry.

In-vitro pulpal temperature increases when photo-curing bulk-fill resin-based composites using laser or light-emitting diode light curing units.

To evaluate the in vitro pulpal temperature rise (ΔT) within the pulp chamber when low- and high-viscosity bulk-fill resin composites are photo-cured using laser or contemporary light curing units (LCUs). The light output from five LCUs was measured. Non-retentive Class I and V cavities were prepared in one upper molar. Two T-type thermocouples were inserted into the pulp chamber. After the PT values reached 32°C under simulated pulp flow (0.026 mL/min), both cavities were restored with: Filtek One Bulk Fill (3M), Filtek Bulk Fill Flow (3M), Tetric PowerFill (Ivoclar Vivadent), or Tetric PowerFlow (Ivoclar Vivadent). The tooth was exposed as follows: Monet Laser (1 and 3s), PowerCure (3 and 20 s), PinkWave (3 and 20 s), Valo X (5 and 20 s) and SmartLite Pro (20 s). The ΔT data were subjected to one-way ANOVA followed by Scheffe's post hoc test. Monet 1s (1.9J) and PinkWave 20 s (30.1J) delivered the least and the highest amount of energy, respectively. Valo X and PinkWave used for 20 s produced the highest ΔT values (3.4-4.1°C). Monet 1s, PinkWave 3s, PowerCure 3s (except FB-Flow) and Monet 3s for FB-One and TP-Fill produced the lowest ΔT values (0.9-1.7°C). No significant differences were found among composites. Short 1- to 3-s exposures produced acceptable temperature rises, regardless of the composite. The energy delivered to the tooth by the LCUs affects the temperature rise inside the pulp. The short 1-3s exposure times used in this study delivered the least amount of energy and produced a lower temperature rise. However, the RBC may not have received sufficient energy to be adequately photo-cured.

The importance of shape analysis of the first upper molar in the separation of two subspecies of the Hazel dormouse (Muscardinus avellanarius (Linnaeus, 1758)) in Northern Anatolia

Morphological features are important for intraspecific and interspecific variation. Teeth are important taxonomical characteristics because they can differ according to diet. Shape analysis of the first upper molar (M1) was used to determine geographical variations and effects of ecological changes on the population structure of Hazel dormice (Muscardinus avellanarius) living in Turkey. Both outline and landmark analysis, as well as a canonical variates analysis, showed significant differences in teeth shape between populations. With this technique, we separated out two subspecies: M. a. trapezius and M. a. abanticus.

A Case of Chronic Maxillary Sinusitis in a Late Neanderthal Population of the Altai Mountains

We describe a likely case of chronic maxillary sinusitis (CMS) in a Neanderthal skeletal sample from Chagyrskaya Cave, in the Altai Mountains. Signs of CMS were recorded in the Chagyrskaya 57 specimen, which is a fragment of a left maxilla. Alveoli of the upper fi rst molar are partially preserved, and so are the second and third upper molars, with adjacent parts of the walls, and the fl oor of the maxillary sinus. The fragment was found in layer 6b, dating to 53,100–51,100 BP. We analyze the factors that had caused the development of the disease, and assess its etiology. In the 3D-model, generated by computed microtomography, and in the original specimen, porotic changes were registered, situated at the fracture line of the alveoli of M1, lost post-mortem, and near the vestibular roots of both preserved molars. Also, there were isolated bone spicules, 1.0–2.6 mm in size. These signs indicate incipient CMS, evidently caused by chronic periodontal disease combined with a deep alveolar recess of the maxillary sinus. As the periodontal gap expanded, several small nutrient foramina, piercing the bottom of the sinus, merged. As a result, several oro-antral channels formed, whereupon the infection spread into the maxillary sinus. Since the deep alveolar recess is observed in the vast majority of Neanderthal crania with published images or reconstructed maxillary cavities, it can be assumed that Neanderthals were predisposed to odontogenic CMS.

Molecular phylogeny and taxonomy of the genus Nectogale (Mammalia: Eulipotyphla: Soricidae).

The elegant water shrew, Nectogale elegans, is one of the small mammal species most adapted to a semi‐aquatic lifestyle. The taxonomy of the genus Nectogale has received little attention due to difficulties in specimen collection. In this study, we sequenced one mitochondrial and eight nuclear genes to infer the phylogenetic relationship of Nectogale. Phylogenetic analyses revealed two large clades within Nectogale. One clade represented N. elegans, and the other was regarded as N. sikhimensis. The split between N. elegans and N. sikhimensis dated back to the early Pleistocene (2.15 million years ago [Ma]), which might be relevant to the Qinghai‐Tibet Plateau (QTP) uplift. The morphological comparison showed several distinguishing characters within Nectogale: the shape of the mastoids, the first lower unicuspid (a1), and the second upper molar (M2). Overall, the molecular and the morphological evidences supported that the genus Nectogale consists of two valid species: N. elegans and N. sikhimensis.

Complete skull of Bothriogenys fraasi (Mammalia, Artiodactyla, Anthracotheriidae) from the Early Oligocene, Fayum, Egypt

Bothriogenys is an endemic African anthracothere (Mammalia, Artiodactyla), which was first documented at the beginning of the last century by Schmidt in 1913. It is one of the most common genera and species that were unearthed from Early Oligocene deposits of North Africa, like those of the Fayum Depression, Egypt. It has been thought that the genus Bothriogenys probably give rise to the Early Miocene Brachyodus that dispersed to Europe and Asia around 20 million years ago. Here, we describe a complete skull of B. fraasi. The specimen is a nearly complete cranium with right canine, left and right upper first premolar‐upper third molar. The new skull has two mesial cristae on the upper premolars, three cristules on the metaconule and the upper fourth premolar has three roots. The main palatine foramina are located at the level of the mesial border of the upper fourth premolar and the internal choanae open well behind the upper molar. The cranial bones and the dentition indicate that Bothriogenys is located at the basal part of the subfamily Bothriodontinae and very close to early Miocene Brachyodus. If so Bothriogenys was likely among the first anthracotheriids to enter Africa. Continued anthracothere development and evolution ultimately gave rise to Early Miocene Brachyodus.

New allotherian specimens from the Middle Jurassic Woodeaton Quarry (Oxfordshire) and implications for haramiyidan diversity and phylogeny

We report new allotherian tooth specimens from the Middle Jurassic White Limestone Formation at Woodeaton Quarry (Oxfordshire), United Kingdom. Two teeth are assigned to Kermackodon (=Eleutherodon) oxfordensis, a taxon whose original generic name (Eleutherodon) was preoccupied and is here assigned to Kermackodon to form a new binomial combination for the species name. Butlerodon quadratus gen. et sp. nov. (family Kermackodontidae), based on 13 cheek teeth and incisors, shows dental features intermediate between K. oxfordensis and the Late Triassic “haramiyidans” (Haramiyavia and Thomasia). Woodeatonia parva gen. et sp. nov. (family indeterminate), based on three teeth, is characterized by its small size. A second upper molar from a multituberculate is identified as Hahnotherium cf. H. antiquum, which possesses characters typical for multituberculates but distinctive from “haramiyidans”. The allotherian teeth from the Forest Marble Formation, previously assigned to the haramiyidans “Eleutherodon”, “Millsodon” and “Kirtlingtonia”, and the multituberculate Kermackodon, are reinterpreted as teeth from different upper or lower dental loci of the same haramiyidan species K. oxfordensis, which result in significant taxonomical modification of these allotherians (“haramiyidans” and multituberculates). Given that Kermackodon has been regarded as a transitional form between multituberculates and “haramiyidans”, these taxonomical modifications would affect interpretation of early evolution of allotherians. In a comparison of molars in known “haramiyidans”, we delve into their occlusal patterns and cusp homologies that have been controversial but pivotal for understanding evolution of allotherians. We further conduct the first phylogenetic analysis of haramiyidan species. The European Late Triassic species form the stem-ward taxa of “haramiyidans” and the Jurassic species from the United Kingdom are grouped with arboroharamiyids from the Yanliao Biota, China, and nested in “haramiyidans”. http://zoobank.org/urn:lsid:zoobank.org:pub:38F1FB5A-17A2-498F-B1FD-38D975548201 http://zoobank.org/urn:lsid:zoobank.org:act:FF5ADA10-C044-4541-ADA6-54448F17C673 http://zoobank.org/urn:lsid:zoobank.org:act:6E59071A-56DF-43D2-A140-2860465BFECA http://zoobank.org/urn:lsid:zoobank.org:act:CA2EE3CF-951C-450A-879D-2AE438F6BB2A http://zoobank.org/urn:lsid:zoobank.org:act:6B26D9C3-9FC3-4517-A1EF-51822067F970

Suoidea from the lower Miocene of Cetina de Aragón (Spain).

The Suoidea (Mammalia) of the Lower Miocene (Agenian, MN 2a) locality Cetina de Arag&oacute;n (Spain) are Hyotherium meisneri, Hyotherium major (Suidae) and Propalaeochoerus sp. A (Tayassuidae). Most of the fossils belong to Hyotherium meisner i; all permanent teeth are represented. Up to now this species was known by few material. Currently, H. meisneri and H. major were considered to be either regional subspecies or synonyms. H. meisneri from Cetina is compared to H. major from its type locality St.-G&eacute;rand-le-Puy. The morphology does not differ much, but there is an average size difference of 15 %. Size differences of 15 % are common in sympatric species of suoids and tragulids. As the ranges of H. major and H. meisneri overlap in time and space the two taxa are different species, in stead of subspecies. Hyotherium meisneri i s one of the oldest known suids, but shows already the outward fiare in the upper canines of the males, which is typical for the Suidae. Within the Hyotheriinae the genus Hyotherium is characterized by elongated premolars. Propalaeochoerus sp. A from Cetina and Montaigu is similar in size to Propalaeochoerus sp. B from Tomerdingen, but differs in having larger posterior molars and smaller premolars, it might be a direct descendant. These tayassuids and Propalaeochoeruss elaverensis differ from all other Palaeochoerus -like tayassuids, including Palaeochoerus ? pusillus , in the elongated last upper molar.

Odontogenic Keratocyst of the maxilla: Case report

Odontogenic Keratocyst (OKC) is a pathology that presents high proliferative activity and frequent relapses after treatment. The aim of this study was to report a case of OKC with uncommon location in a 22-year-old patient presenting swelling and drainage of purulent secretion in the region of the third right upper molar. In examinations, a radiolucent density unilocular image involving impacted element 18 was observed. After excisional biopsy accompanied by severe bone curettage, the removed specimen was sent for histopathological analysis, where final diagnosis of odontogenic keratocystic was obtained. The patient has been in clinical and radiographic follow-up for more than 6 months and, to date, there are no signs of relapse.

Digital customized abutment planned before implant surgery: merging SS, 1A1T, Surgical stent, Prf an immediate crown on upper molar: A 4-year follow-up study

The goal of the present study was to introduce a new entirely in-house technique, based on digital patient data, used to create customized abutment and temporary crown, according to the anatomical limits and virtual position of the implant. The entire design and production took place before the surgery time and was based on both digital accuracy and biologic healing pattern promoted by Socket Shield (SS). The surgical phase consisted of replicating the digital project by inserting the implant in same position with accuracy. The Dicom file from CBCT and the intraoral scanner.Stl files were combined to collect all specific data and measurements in order to create models of the abutment and crown. A good-quality surgical stent was implemented, centering the osteotomy on the inter-radicular bone septum, in order to allow optimal primary stability and to provide reference points for accuracy during implant insertion. The implant with suitable threads configuration and connection quality was inserted with a manual check, replicating the virtual planning of the implant and allowing the immediate mount of the abutment (one abutment one time (1A1T)) and a provisional crown, made in advance. The post-extraction spaces were filled with Prf. A digital copy of the initial crown, in lithium disilicate, was then cemented after 6 months. The SS, which included both vestibular and palatal laminae prevented the known phenomenon of tissue remodeling in the post-extraction phase. The gingival tissue matured favorably around the abutment, inserted in the surgical phase and never removed (1A1T) with the recovery of the gingival recession on the mesial root, also thanks to the contribution of the Prf. The clinical result was stable initially and over time, with a 4-year follow-up. This is a proof of principle case report: the possibility offered by the digital technology to collect true anatomical data, to be used on a difficult area such as the molar maxillae. Skills are required both on the digital planning side (including the valuation of biological data) and on the surgical sessions, and demanding in terms of the range of accuracy required for correct implant position. The introduction of dynamic guided implantology could simplify tremendously the procedure. Initial diagnosis, correct planning, and surgical approach are the key factors for immediate and long-term results.

Calcium Carbonate of Blood Cockle (Anadara granosa) Shells induced VEGF-A Expression in Dentin Pulp Complex An In Vivo Study

Introduction: Mild or moderate-intensity injury will respond with a brief inflammatory response followed by reactionary dentinogenesis. Calcium hydroxide has been considered the gold standard for pulp capping materials for decades to stimulate the formation of tertiary dentin. Blood clamshells (Anadara granosa) contained a high content of calcium carbonate (CaCO3) in the blood clamshells. It is a source of calcium and it has good biocompatibility to be used as a bone repair material. This study is aimed to reveal the expression VEGF-A in odontoblast pulp cells on days 1, 3, and 7 after administration of blood clam shells derived calcium carbonate in dentin pulp complex. Methods: Thirty Wistar rats (Rattus norvegicus) were divided into 6 groups consist of 5 random samples each. The experimental group’s cavity was prepared on the occlusal side of the right upper molar, and they were treated with blood clamshell calcium carbonate suspension and sealed with RMGIC. For decalcification, the solution was replaced with ethylene-diamine tetra acetic acid (EDTA) after 24 hours and was refreshed every day. Anti-VEGF-A monoclonal antibodies were used for HE and immunohistochemical staining. Result: In this study, the results were obtained consecutively on the 1st, 3rd, and 7th day with p&gt; 0.05 for VEGF-A in all groups. Conclusion: The application of calcium carbonate is expected to be an innovative treatment in opening up new pathways for the regenerative dentin process through upregulation of VEGF-A

The Efficacy and Predictability of Maxillary First Molar Derotation with Invisalign: A Prospective Clinical Study in Growing Subjects

To analyze the derotation of maxillary mesio-rotated first permanent molars in subjects with Class II edge-to-edge dental malocclusion in mixed dentition treated with Invisalign Clear Aligners (CA). In total, 36 patients (16 males, 20 females, 9.9 ± 1.9 years) treated with CA are enrolled from the Department of Orthodontics. Inclusion criteria are the following: Caucasian ancestry, mixed dentition, molar Class II edge-to-edge, no tooth/craniofacial anomalies, no caries/periodontal diseases. Pre-treatment (T1) and post-treatment (T2) digital casts, and final ClinCheck representations (T2ClinCheck) are acquired. The Henry’s angle (HA) is used to assess maxillary first molars rotation. The molars with an HA &gt; 11° are taken (53 teeth). Five measurements are performed at T1, T2, and T2ClinCheck: Henry’s angle (HA), mesiobuccal-expansion (MBE), distobuccal-expansion (DBE), mesiobuccal-sagittal (MBS), and distobuccal-sagittal (DBS). A paired t-test was used to compare T2-T1 and T2ClinCheck-T2. The T2-T1 shows a distal-rotation (difference −6.3°) with an expansion of 2.2 mm for MBE and 1.5 mm for DBE. At T2, the mesiobuccal cusps show a distal movement of 1.0 mm and the distobuccal cusps of 0.9 mm. The HA’s T2ClinCheck-T2 difference is −4.2°. In the sagittal plane, the difference is 0.9 mm for the MBS and 0.7 mm for the DBS. The expansion showed the highest predictability (60% HA, 52.6% MBS, and 56.25% DBS). The CA effectively produces an arch expansion and upper molars’ distal rotation. Upper molar derotation provides a 1 mm of gain in arch perimeter and occlusal improvement.