Vital Teeth Research Articles

Maintaining Tooth Vitality With Super Minimally Invasive Pulp Therapy.

In aging humans, tooth loss is a predictor of decreased longevity. Tooth loss is mainly caused by dental caries and periodontal disease. Pulpitis refers to inflammation of the dental pulp caused by bacterial infection secondary to dental caries. It is accompanied by severe toothache and has infectious disease-associated pathophysiology. Pulpitis is mainly treated by pulpectomy, which is aimed at removing the infected dental pulp and controlling pain by removing nociceptive nerve fibers. However, teeth without dental pulp have a poor prognosis. In this report, we proposed a novel "super minimally invasive pulp" therapy for treating pulpitis without pulpectomy, which combines antibiotics, steroids, and ultrasound-guided trigeminal nerve block (UGTNB) to protect the dental pulp. UGTNB is used as an analgesic for severe pain, antibiotics for pulp infections, and steroids as antiinflammatory drugs. This novel therapy could improve the longevity of the tooth and therebyoral health.

The Four Pillars for Successful Regenerative Therapy in Endodontics: Stem Cells, Biomaterials, Growth Factors, and Their Synergistic Interactions.

Endodontics has made significant progress in regenerative approaches in recent years, thanks to advances in biologically based procedures or regenerative endodontic therapy (RET). In recent years, our profession has witnessed a clear conceptual shift in this therapy. RET was initially based on a blood clot induced by apical bleeding without harvesting the patient's cells or cell-free RET. Later, the RET encompassed the three principles of tissue engineering, stromal/stem cells, scaffolds, and growth factors, aiming for the regeneration of a functional dentin pulp complex. The regenerated dental pulp will recover the protective mechanisms including innate immunity, tertiary dentin formation, and pain sensitivity. This comprehensive review covers the basic knowledge and practical information for translational applications of stem cell-based RET and tissue engineering procedures for the regeneration of dental pulp. It will also provide overall information on the emerging technologies in biological and synthetic matrices, biomaterials, and signaling molecules, recent advances in stem cell therapy, and updated experimental results. This review brings useful and timely clinical evidence for practitioners to understand the challenges faced for a successful cell-based RET and the importance of preserving or reestablishing tooth vitality. The clinical translation of these current bioengineering approaches will undoubtedly be beneficial to the future practice of endodontics.

Incidence of endodontic therapy after complete or partial coverage glass-ceramic restorations with a follow-up time of over 30 years: A prospective clinical study

Statement of problemLong-term clinical data are lacking on the comparison of the incidence of endodontic therapy in adhesively luted complete and partial coverage glass-ceramic restorations, as well as on the effect of technique and clinical variables. PurposeThe purpose of this prospective clinical study was to assess the long-term incidence of teeth requiring endodontic therapy after receiving either complete or partial coverage glass-ceramic restorations. Material and methodsParticipants requiring single anterior complete, posterior complete, or posterior partial (inlay or onlay) coverage restoration, or a combination of these on a vital tooth were recruited from a clinical private practice. Only the participants who chose glass-ceramic partial and complete coverage restorations without the need of endodontic therapy were included in the study. The overall clinical performance of these glass-ceramic restorations was assessed by clinical factors determined at recall. The effect of various clinical parameters (type of restoration, dental arch, tooth position in the dental arch, age and sex of participant, and ceramic thickness) was evaluated by using Kaplan–Meier survival curves to account for attrition bias and other reasons for failure. The statistical significance of differences between parameters was determined by using the log rank test (α=.05). ResultsA total of 1800 participants requiring 4511 glass-ceramic anterior and posterior restorations were evaluated. The mean age of the participants at the time of restoration placement was 62 (range 20 to 99 years, 710 men and 1090 women). Of 4511 restorations, 1476 were anterior complete coverage, 2119 posterior complete coverage, and 916 posterior partial coverage. Endodontic therapy after restoration placement was needed for 76 restorations (10 anterior complete, 50 posterior complete, and 16 posterior partial). The total time at risk was 50 436 years providing an estimated need for endodontic therapy risk of 0.15% per year. The estimated 35-year cumulative survival was 97.36%. The majority of endodontic treatments (67%, 52/76) occurred in the first 5 years.The estimated cumulative survival of anterior complete coverage, posterior complete coverage, posterior partial inlay, and posterior partial onlay restorations was 98.89% (n=1476, 10 endodontic treatments), 96.38% (n=2119, 50 endodontic treatments), 96.78% (n=553, 11 endodontic treatments), and 98.53% (n=363, 5 endodontic treatments), respectively. Statistically significant differences occurred between anterior complete coverage, posterior complete coverage, and posterior partial coverage inlay restorations, with a higher incidence in posterior complete coverage and posterior partial inlay restorations (P<.05). First molars had the highest rate of endodontic therapy after restoration in both arches. Age and restoration thickness were significant factors, recording statistically higher number of endodontic treatments in participants >52 years and restorations with all surfaces ≥1 mm (P<.05). Other clinical variables, dental arch and sex of the participants, were not significantly related to endodontic treatments (P>.05). ConclusionsThe clinical performance of 4511 units over 30 years in service was excellent, with the estimated cumulative survival of 97.36%. Posterior complete coverage and posterior partial inlay restorations had a significantly higher need for endodontic therapy than anterior complete coverage restorations. Their overall clinical performance relative to endodontic treatment was excellent with a cumulative survival of 96.38% and 96.78% over 30 years. There was no difference in the endodontic treatment rate between posterior complete and partial coverage restorations. Thickness of the restoration affected the endodontic treatment rate, with ≥1 mm resulting in higher incidence. The age of the participants influenced the endodontic treatment rate, with higher incidence in the >52-year age group. Other confounding clinical variables did not have a significant effect on the endodontic treatment rate.

Recent developments in bioactive pulp capping materials (direct and indirect)

The field of dentistry is rapidly shifting its focus toward biologically active restorative materials. Bioactive materials are those capable of inducing and promoting the regeneration of the damaged tissue and remineralizing demineralized dentinal structure as a vital dental pulp is necessary for the long-term healthy survival of a tooth. Vital pulp therapy intends to protect and prevail the vitality of pulp tissue which gets compromised when subjected to mutilating factors like dental caries, trauma, and operative or restorative procedures. During the therapy, the said bioactive material initially forms a non-irritant protective bridge over the vital pulp and later stimulates the pulpal odontoblasts to produce a reparative dentinal barrier which later forms a barrier and protects the underlying pulp’s vitality. The vitality of a tooth needs to be intact protected because the consensus reports that endodontically treated teeth, particularly molars, reportedly have a reduced survival probability than the vital teeth. [1] These factual arguments lead to the development of biologically active restorative materials. This review article intends to provide a review of the modern products introduced in the category of bioactive restorative materials.

Effect of laser radiation and sodium fluoride on the reactivity of prepared teeth

BACKGROUND: The use of esthetic restorations (metalceramic and metal-free) provides for the preparation of teeth within the enamel and surface or middle layers of the dentin, which entails an increase in the reactivity of teeth. One of the promising directions for increasing the resistance of the prepared teeth in the orthopedic treatment of patients using esthetic dental restorations is the combined and consistent use of fluorides and low-intensity laser radiation.&#x0D; AIM: To examine the effect of low-intensity laser radiation and sodium fluoride on the reactivity of dissected vital teeth.&#x0D; MATERIAL AND METHODS: A 2% aqueous solution of sodium fluoride was administered by electrophoresis with a portable device Desensitron-II. For laser exposure, a dental laser device Optodan was used in the first (anti-inflammatory) mode of operation. The research material was the results of orthopedic treatment of 120 patients aged 2039 years (57 men and 63 women). To assess the initial state of teeth reactivity and the effect of the therapeutic measures, the sensitivity of the teeth to temperature (thermoreactivity of the teeth), mechanical (sliding tangent test), and electrical (electrodontometry) influences was investigated.&#x0D; RESULTS: In the third group, the studied indicators before fixation demonstrated the maximum improvement in indicators relative to the data obtained in other groups.&#x0D; CONCLUSIONS: The combined sequential effect of low-intensity laser radiation and sodium fluoride reduces the reactivity of the prepared teeth while significantly improving the indicators of electrical excitability of the pulp and increasing the pain threshold in relation to temperature and mechanical stimuli.

Risk Factor Assessment for Survival of Removable Partial Dentures and Their Abutment Teeth: A Retrospective Analysis.

To investigate the risk factors related to failure of removable partial dentures (RPDs) and to compare the survival of RPDs when abutment teeth have good vs reduced bone support. In this longitudinal patient record-based cohort study with a mean follow-up of 44.9 months, Cox regression models were used to evaluate the associations between clinical covariates and abutment tooth failure, as well as prosthesis failure. A total of 142 patients and 172 RPDs were included. Of the 172 prostheses, 64 (nearly 40%) failed after a mean time of about 4 years. Loss of abutment teeth was the main reason leading to RPD failure, followed closely by poor fit and adaptation. No factor was shown to be statistically significant at the prosthesis level. Women (Hazard Ratio [HR] = 0.542), endodontic treatment (HR = 3.460), presence of post and core (HR = 0.302), presence of a prosthetic crown (HR = 3.403), and abutment tooth type (in relation to incisor: canine HR = 0.196, premolar HR = 0.449) were the risk factors statistically significantly associated with the loss of abutment teeth. The pre-prosthesis amount of bone support of the teeth did not affect their prognosis as abutments for RPDs. RPD treatment modality presented a high failure rate after a mean follow-up of 4 years. Vital abutment teeth had a better survival rate than the ones treated endodontically (whether restored with or without a post and core); nevertheless, the amount of bone support did not affect their survival.

A retrospective analysis of the complications associated with miniscrew-assisted rapid palatal expansion

Miniscrew-assisted rapid palatal expansion (MARPE) has recently been advocated as a treatment option for older adolescents and adult patients with maxillary transverse deficiencies. This study aimed to identify the complications associated with MARPE and the frequency of their occurrences. A retrospective analysis was conducted on 256 patients (mean age, 18.8 ± 8.6; 126 females and 130 males) who underwent MARPE at a private practice and a graduate orthodontic clinic. Specific complications and their severity were identified by reviewing clinical notes and photographs. Asymmetric expansion was measured for patients who had cone-beam computed tomography scans taken before MARPE and immediately after expansion. The midpalatal suture was separated in 87.8% of patients. The most common complication was gingival inflammation around the appliance, found in 83.9% of patients. 45% of patients reported some form of pain during and after expansion. Appliance breakage occurred in 10% of patients. 47.8% of patients showed >1 mm of asymmetric expansion. Rare complications included tooth discoloration (potentially indicative of tooth vitality loss), temporary hearing loss, numbness, swelling, severe gag reflex, and sinus infection. The most common complication was gingival inflammation followed by pain; major and long-term complications were rare with MARPE. Overall, patients should be informed that gingival inflammation and pain are common side effects of MARPE and that rare complications can occur. Although asymmetric expansion was common after the palatal split, most patients were managed with orthodontic treatment.

CONTEMPORARY TECHNOLOGIES FOR THE MEASUREMENT OF PULPAL BLOOD PERFUSION IN TEETH

Pulse oximetry (PO) and laser-Doppler fluxmetry (LDF) can be used for a determination of tooth vitality by measuring the pulpal blood perfusion. They offer an alternative to conventional pulpal sensibility tests, which evaluate only the pulpal sensory function. The aim of the study was to conduct vitality and sensibility tests on permanent caries-free and carious teeth with different degrees of caries progression and compare the results. In the clinical study, 230 permanent teeth from 25 adult subjects were tested with two conventional pulpal sensibility tests (electric, cold) and two novel pulpal vitality tests (PO, LDF). Carious lesions were detected and assessed using the criteria of the International Caries Detection and Assessment System (ICDAS). In the further statistical analyses, pulpal oxygenation levels and LD flux values were compared between the carious and caries-free teeth. The degree of agreement between the sensibility and vitality tests was also evaluated. Both methods proved reliable for a determination of pulpal vitality with their consistent readings on the teeth. Carious teeth had significantly lower PO values than non-carious teeth (p &lt; 0.05). The degree of agreement between the tests of vitality and sensibility was fair to poor (κk &lt; 0.40), which confirmed the thesis that further clarification of their relations is needed. PO and LDF proved useful in the evaluation of the pulpal tissue function by enabling the assessment of pulpal blood supply.

LATERAL PERIODONTAL CYST: A CASE REPORT

Lateral periodontal cyst (LPC) is an uncommon developmental cyst. The lesion often presents as a unilocular mandibular radiolucency adjacent to a vital tooth. About one-third of LPCs can be associated with tooth displacement. A 16-year-old male patient was referred to the clinic presenting an asymptomatic intraosseous lesion in the edentulous left premolar region. Periapical radiography revealed a radiolucent area delimited by a radiopaque halo in the alveolar bone. The clinical diagnosis was residual cyst, and it was treated by enucleation. Histological examination showed a cystic capsule lined by thin, nonkeratinized stratified epithelium with thickening areas containing clear cells. Those findings are compatible with LPC. After the final diagnosis, the patient did not return. Unilocular LPCs have a good prognosis, with recurrence rates of approximately 2%. Lateral periodontal cyst (LPC) is an uncommon developmental cyst. The lesion often presents as a unilocular mandibular radiolucency adjacent to a vital tooth. About one-third of LPCs can be associated with tooth displacement. A 16-year-old male patient was referred to the clinic presenting an asymptomatic intraosseous lesion in the edentulous left premolar region. Periapical radiography revealed a radiolucent area delimited by a radiopaque halo in the alveolar bone. The clinical diagnosis was residual cyst, and it was treated by enucleation. Histological examination showed a cystic capsule lined by thin, nonkeratinized stratified epithelium with thickening areas containing clear cells. Those findings are compatible with LPC. After the final diagnosis, the patient did not return. Unilocular LPCs have a good prognosis, with recurrence rates of approximately 2%.

Review of guidance for the selection of regenerative endodontics, apexogenesis, apexification, pulpotomy, and other endodontic treatments for immature permanent teeth.

This review guidance is a work in progress because the limitations of regenerative endodontics are still being discovered. The endodontic treatments for immature permanent teeth with a necrotic pulp can vary considerably among endodontic practitioners. Whereas, regenerative endodontic treatments are growing in popularity and are creating ever more complex treatment protocols, involving revascularization and/or autologous platelet-rich plasma and scaffolds to elicit host stem cell de novo tissue formation to reestablish the vitality of immature teeth for the purpose of continuing root maturation. Despite much evolving controversy about their potential benefits, risks, prognosis, and contraindications, this review is aimed to discuss how to ensure that regenerative endodontic treatments are successful, by strictly adhering to case selection criteria, and following precise steps to accomplish and monitor the success of the treatment. A review of the endodontic literature was performed, together with practical observations of the problems and outcomes of performing regenerative endodontic treatments. Traditionally, apexification has long been the treatment of choice provided to immature teeth with a necrotic pulp. Regenerative endodontics may be provided as an alternative to apexification, if the tooth and patient meet all the case selection criteria, and if there are no contraindications. Regenerative endodontics has the unique potential advantage of being able to continue the root development in immature permanent teeth, thereby potentially saving the teeth for the lifetime of the patient. Whereas, conventional endodontic root canal treatment, Cvek partial pulpotomy, apexogenesis, and apexification, should always be provided when these treatments are more likely to benefit the patient because they can be more successful than regenerative endodontics.

Influence of geometric dimensions on early failures of adhesively retained composite resin core build-ups.

To determine the influence of the geometric dimensions of core build-ups on early core build-up failure, that is, loss before definitive prosthesis cementation. Adhesive core build-ups of exclusively vital teeth in 114 participants were evaluated (n materials: 40 Rebilda DC, 38 Multicore Flow, 36 Clearfil DC Core; n teeth: 8 incisors, 54 premolars, 52 molars). Impressions of the abutment teeth were made (1) after removal of insufficient restorations/caries and (2) after core build-up and preparation for a fixed prosthesis. Digitized model surfaces of both situations were aligned (Geomagic Design X) and core build-up volume (VCBU ), remaining hard tissue volume (VAbut ), and size of the adhesive surface (Aadh ) were assessed. The derived measure dCBU =VCBU /Aadh can be interpreted as mean arithmetic core build-up thickness. Associations between participant or core build-up design characteristics and the occurrence of early failures were statistically evaluated (SPSS v27, α=0.05). A total of six (5.3%) core build-up failures were registered. Higher participant age, greater core build-up volume VCBU and greater arithmetic uniform thickness dCBU were associated with a greater incidence of failure in bivariate and univariate, however, not in multivariate statistics. Core build-up volume and thickness were associated with early success or failure. In the case of voluminous/thick core build-ups in relation to the adhesive surface, additional measures, such as the preparation of retentive elements to increase the bonding area, might be considered to reduce the risk of early core build-up failure.

Optimal timing of endoscopic sinus surgery for the retention cyst of maxillary sinus.

The optimal timing of functional endoscopic sinus surgery for odontogenic infections precipitated by retention cysts of the maxillary sinus was investigated. Five adults who underwent functional endoscopic sinus surgery were examined. The root apexes of all teeth that had odontogenic infection protruded into the maxillary sinus. All teeth with odontogenic infections precipitated by the retention cysts had percussion pain, indicating they had periodontitis and pulpitis around the root apex. They were vital teeth, indicating they did not have pulp necrosis. The small area of cyst wall attached to the floor of the maxillary sinus and root apex were left intact. The teeth that had odontogenic infections precipitated by retention cysts continued to be vital with no symptoms. Functional endoscopic sinus surgery should be performed before periodontitis and pulpitis of the root apex progress to ascending pulpitis and pulp necrosis. In other words, functional endoscopic sinus surgery should be performed while the affected tooth is still vital.

Proximal contact loss between implant prostheses and adjacent natural teeth: A qualitative systematic review of prevalence, influencing factors and implications

ObjectivesTo evaluate the prevalence of proximal contact loss (PCL) between implant prostheses and natural teeth, and identify the risk factors and implications associated with PCL. Data/sourcesPubMed (MEDLINE), Google Scholar, Cochrane Library Database, Scopus, EMBASE, Open Grey, ScienceDirect, and Web of Science were electronically searched to retrieve clinical studies on PCL around implant prostheses up to September 2021. Study selectionA total of 19 studies were eligible. The short-term studies (less than 2 years) revealed a PCL prevalence of 11–30%, the medium-term studies (2–5 years) indicated a PCL prevalence of 13–65%, and the long-term studies (more than 5 years) showed a PCL prevalence of 29–83.3%. The likely influencing factors were the duration of service and the mesial location of proximal contacts. Other factors, such as occlusion, vitality of adjacent teeth, implant location, patient age and splinting had a less obvious relation to PCL. The reported implications of PCL were food impaction and patient dissatisfaction. Bone loss, peri-implant inflammation, bleeding on probing and pocket depth had a less clear association with PCL. ConclusionsPCL development between implant prostheses and natural teeth is frequent, inevitable and progressive. While the review identified several influencing factors and implications of PCL, future research is needed to outline the influence of prosthesis design on PCL and food impaction. Clinical significancePatients with implant prostheses should be informed about PCL likelihood and the risk of food impaction around implant prostheses. The proximal contact quality and its implications should be monitored during the review visits.

Carboxymethyl cellulose hydroxyapatite hybrid hydrogel used to evaluate the osteogenic and odontogenic differentiation potential of dental pulp and periodontal ligament stem cells

In order to maintain optimal function, the aim of pulp treatment is to maintain the tooth structure intact. Retaining the vitality of teeth damaged due to caries or trauma is also one of the purpose of pulp treatment. In particular, the preservation of pulp vitality is essential for continuous root development and apical closure in the case of immature permanent teeth. In recent years, regenerative endodontic treatment procedures have been suggested in order to replace the damaged pulp tissue with viable tissue. The idea of regeneration of the dentin-pulp complex was introduced into endodontics to restore the vitality of young permanent teeth that have been non-vitalized due to trauma/dental caries. The concept of success in regenerative endodontic procedures is relied on three basic elements that are; stem cells, growth factors, and scaffolds. Each of these play their own important role in the regeneration of pulp-dentin complex. This invitro comparative study had intended to deal with the new experimental custom prepared semi-synthetic hybrid scaffold (CMC-HA), its acceptance for the cells (DPSCs and PDLSCs) seeded on it and osteogenic and odontogenic differentiation of both the dental pulp and periodontal ligament stem cells.

CPP-ACP in the Treatment of Hyper Sensitivity Associated with Vital Tooth Bleaching: A Systematic Review

CPP-ACP in the Treatment of Hyper Sensitivity Associated with Vital Tooth Bleaching: A Systematic Review

Partial Pulpotomy as an Applicable Treatment Option for Cariously Exposed Posterior Permanent Teeth: A Systematic Review of Randomized Clinical Trials.

The major focus of this systematic review is to assess how effective partial pulpotomy is in managing carious vital pulp exposures in permanent posterior teeth. An electronic search for studies published between January 2011 and December 2021 was conducted using the following databases: PubMed, Scopus, Google Scholar, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were followed during the search process. We selected human randomized clinical trials (RCTs) that investigated the success rate of partial pulpotomy for the treatment of cariously exposed vital permanent posterior teeth and the success rate of decayed exposed vital human permanent posterior dentition managed with a partial pulpotomy. Exclusively, randomized clinical trial papers were considered for assessment. The Cochrane Collaboration’s tool was applied to assess the risk of bias. Four papers were selected for the final analysis from the 321 identified during the initial search. Our results showed that after six, 12, and 24 months of follow-up, the success rate was 94%, 93%, and 90%, respectively. The preoperative pulp state was the only significant predictive factor. Teeth with the presumptive diagnosis of irreversible pulpitis had the worse outcome. The treatment outcome was not influenced by the final restoration, pulp capping agent, apex closure, or patient age. Finally, the available data indicated that partial pulpotomy showed a high success rate in treating cariously exposed permanent posterior teeth for up to 24 months. When assessing the effectiveness of a partial pulpotomy, six months of maintenance is deemed adequate. To enhance treatment success, additional clinical and radiological measures are needed.

Attitude and Management Preferences of Deep Carious Lesion in Vital Permanent Teeth : Observational Cross‑Sectional Study among Dentists in Tunisia

Attitude and Management Preferences of Deep Carious Lesion in Vital Permanent Teeth : Observational Cross‑Sectional Study among Dentists in Tunisia

Clinical, Radiographical and Histological Assessment of Pulpotec pulptomy in vital Primary Teeth

Clinical, Radiographical and Histological Assessment of Pulpotec pulptomy in vital Primary Teeth

Micro-CT Study of the In Vivo Accuracy of a Wireless Electronic Apex Locator

IntroductionThis study aimed to compare the in vivo accuracy of Wirele-X and RootZX II electronic apex locators (EALs) in determining the position of the major foramen using micro–computed tomography (micro-CT) as the analytical tool. MethodsEleven vital teeth planned for extraction from 5 patients were used. After conventional access cavity preparation, root canals were flared and negotiated up to the apical third with sizes 08 and 10 K-files followed by irrigation with 2.5% NaOCl. K-type files were used to determine the working length of the selected canals using Root ZX II and Wirele-X apex locators until their numeric displays read “0.0.” After fixing the silicon stop to the file, teeth were extracted and imaged in a micro-CT device using a double-scan protocol. Image stacks, with and without the file in the root canal, were then co-registered and the measurement error calculated as the absolute difference between the tip of the file and the major foramen. Positive and negative values were recorded when the file tip was detected beyond or short of the major foramen, respectively. Accuracy was determined on stable measurements within ± 0.5 mm when the file tip did not extend beyond the major foramen. The χ2 test was applied to compare the ability of the EALs to detect the position of the major foramen, and the t test for dependent variables was used to verify differences in the 2 measurements obtained in each tooth. Significance level was set at 5%. ResultsWithin a tolerance level of ± 0.5 mm, no significant differences were observed between the tested EALs regarding the absolute distance values (P = .82) or in their ability to detect the position of the major foramen (χ2 = 0.2588; P = .6109). The accuracy of the Root ZX II and the Wirele-X apex locators within ± 0.5 mm were 81.8% and 90.9%, respectively. ConclusionsRoot ZX II and Wirele-X performed similarly regarding the in vivo detection of the major foramen. Using strict criteria, the accuracy of the Root ZX II and the Wirele-X apex locators were 81.8% and 90.9%, respectively.

Can bite-force measurement play a role in dental treatment planning, clinical trials, and survival outcomes? A literature review and clinical recommendations.

Bite force (occlusal force) may play a significant role in patient treatment outcomes. However, as a diagnostic risk assessment tool, it has been examined in the literature but is not commonly utilized by practicing clinicians and in academic studies. This diagnostic evaluation may assist the dental clinician in planning tooth- and implant-supported restorations, as damage to the tooth, implant, or restoration may be dependent upon a restoration's resistance to loading conditions. The overall bite force has been estimated to be up to 2,000 N, with a clear sexual dimorphism and age dependence. The magnitude of these forces along the dental arch have been shown to be elevated in the posterior compared to the anterior region. The bite force magnitude has been inversely related to the proprioception, as a significant increase in bite force is seen in patients with endodontically treated teeth as compared to their vital teeth. Bite force has been linked to chewing efficiency, quality of life, and implicated in the life expectancy of the restorations. Restoration life expectancies have been associated with the material selection and preparation design parameters, both of which may be affected by masticatory bite force. Treatment planning criteria for preparation strategies affected by bite force include tooth location, material selection, occlusion pathways, and subsequent occlusal reduction amounts. When implants are used in patients with elevated magnitude of bite force, an increase in the number and diameter of the implants as well as occlusions with reduced occlusal tables buccolingually and lighter contacts may be recommended. An understanding of the magnitude and load of a patient's bite force can assist the dental clinician in the design of dental treatments along with other standard risk assessment criteria.