Search Results (70)

Background/Objectives: Hypohidrotic ectodermal dysplasia (HED) is a rare hereditary disorder affecting ectoderm-derived tissues including teeth, hair, and sweat glands. The dental abnormalities associated with HED, such as oligodontia and conical teeth, often result in significant functional, esthetic, and psychosocial challenges, particularly during childhood. Methods: A 10-year-old child presented with psychosocial concerns related to missing and malformed teeth. Clinical examination revealed oligodontia, conical anterior teeth, and a resorbed mandibular ridge. Based on clinical findings and a positive family history, a diagnosis of HED with significant dental involvement was confirmed. Results: A conservative prosthodontic approach was selected. A maxillary overdenture was fabricated over the retained primary teeth to enhance retention and preserve the alveolar bone, and a resin-bonded bridge was placed in the mandible due to poor ridge anatomy. The treatment restored oral function and esthetics and improved the child’s self-esteem. A recall visit after three months confirmed good prosthesis adaptation and a positive response from the patient and parents. Conclusions: This case highlights the importance of early, conservative, and developmentally appropriate prosthetic rehabilitation in pediatric patients with HED. Interim prostheses can significantly improve oral function, appearance, and psychosocial well-being while preserving future treatment options as the child matures. Full article

Aim: Class II Division I malocclusion poses significant challenges in orthodontics. The combination of a Herbst appliance and miniscrew anchorage emerged as a practical solution to improve skeletal and dental outcomes. This study employed finite element analysis to evaluate the biomechanical effects of a miniscrew-supported Herbst appliance on mandibular advancement and dentition movement. Methods: High-definition CBCT scans captured the maxilla and mandible’s detailed dental anatomy. The scans were stored in DICOM format for seamless integration with Mimics software (Mimics Innovation Suite research version 21.0, Materialise NV, Leuven, Belgium) for 3D reconstruction and model refinement. The appliance, designed with a maxillary fixed palatal arch and mandibular acrylic splint connected by telescoping rods, incorporated titanium TADs and elastic chains. STL models were optimized in Geomagic x Design for finite element analysis in Abaqus, assigning validated mechanical properties for materials. Tetrahedral meshing and realistic boundary conditions simulated biomechanical interactions. Tetrahedral C3D4 elements were used for meshing, ensuring a balance between computational efficiency and detailed anatomical representation. Tetrahedral meshing and realistic boundary conditions simulated biomechanical interactions. Dynamic simulations in CATIA evaluated mandibular movement. FEA analyzed displacement across dentoalveolar structures along the X, Y, and Z axes to assess treatment efficacy and biomechanical stability. Results: The Z displacement analysis revealed that the incisal edges of the lower central, lateral, and canines shifted lingually by 0.41, 0.4, and 0.47 mm, respectively. Additionally, the apices of the lower central, lateral, and canines displaced backwards by 0.05 mm, 0.05 mm, and 0.07 mm, respectively. Conclusions: The appliance facilitated mandibular advancement, bodily retracted the lower incisors, well-controlled the upper ones, and mesial-tipped the upper posterior teeth. In contrast with traditional functional appliances, it caused the lower anterior teeth to move backwards, while skeletal anchorage overcame some shortcomings of nonsurgical treatments. This method might be a good treatment option for growing skeletal Class II patients. Full article

Background/Objectives: Delayed tooth eruption (DTE) is a very challenging clinical situation, and the pathogenesis has been associated with local, systemic, and genetic factors. The aim of this presentation is to describe the management of such a case with delayed eruption of mandibular central incisors and canines. Methods: An 11-year-old female patient presented with DTE involving lower incisors (32, 42) and canines, seeking orthodontic treatment. Furthermore, lower permanent central incisors were congenitally missing while lower deciduous incisors were still in place. After a year-and-a-half of just monitoring the case and having suggested the extraction of deciduous first molars and canines, orthodontic treatment started with fixed appliances in the upper and lower jaw. First and second premolars gradually erupted after the precursor’s extraction. Lower canines and the two existing incisors were, after several months, surgically exposed and a gold chain apparatus was bonded on each one, while the closed eruption technique was chosen. A 0.17 × 0.25 stainless steel (SS) lingual wire, leaning on the buccal tubes of the lower molar bands and properly manipulated around them, was fitted in conjunction with the labial brackets and wires in order to facilitate the traction of the impacted teeth, which was carried out for one after the other using either an elastic chain or a second super-elastic wire. Results: All impacted teeth were finally restored to their proper place. The root of 71 did not present resorption, so the tooth was maintained in the lower arch while inter-proximal reduction was performed in the upper arch in the anterior region, in order to anticipate the lower missing incisor. Finally, a stable occlusion with proper contacts was achieved. Conclusions: Proper diagnosis, on-time extractions of deciduous teeth, and a well-designed treatment plan regarding space management and orthodontic traction of impacted teeth contributed to successful treatment outcomes in this DTE case. Full article

Background/Objectives: Eccentric bruxism is a complex parafunctional activity that involves grinding of teeth and occurs more frequently during sleep. This study aimed to assess differences in condylar parameters (sagittal condylar inclination -SCI and Bennett angle -BA) and mandibular and condylar kinematics during functional and parafunctional movements in bruxers and non-bruxers and to assess a digital method for quantifying eccentric bruxism using an optical jaw tracking system (Modjaw^®). Methods: The study group included subjects diagnosed with eccentric bruxism according to validated clinical diagnostic criteria. A control group of non-bruxer subjects with demographic characteristics similar to the study group was considered. Each participant underwent Modjaw^® examination twice to assess the recordings’ repeatability. The anterior guidance, mastication, and simulated eccentric bruxism were recorded. The SCI and BA were computed. The trajectories of interincisal inferior point (IIP), left condyle (LC), and right condyle (RC) in the frontal (F), sagittal (S), and horizontal (H) planes were outlined in rectangles to calculate areas of mastication and areas of eccentric bruxism (mm²). Intraclass correlation coefficient (ICC) was used to assess the recordings’ repeatability. Comparisons between groups were performed using Student’s t- and Mann–Whitney tests. The receiver–operator characteristic (ROC) curve was used to assess the diagnostic quality of the digital method. Results: Twenty bruxers (10 F and 10 M) and 20 non-bruxers (10 F and 10 M) were included. The ICC had values higher than 0.85. SCI, BA, and area of mastication for IIP, LC, and RC were similar between the groups (p > 0.05). The area of eccentric bruxism was significantly wider in the bruxers (p < 0.001). According to the ROC curve, the following cut-off areas (mm²) for eccentric bruxism were found in F, S, and H planes: IIP (18.05, 13.43, 16.28); LC (3.74, 10.83, 3.35); and RC (4.21, 10.63, 2.9), corresponding to sensitivity > 0.8, specificity > 0.75 and area under the curve (AUC) > 0.85. Conclusions: Mandibular and condylar kinematics during functional movements were similar in bruxers and non-bruxers. A novel digital method for quantifying eccentric bruxism was found using Modjaw^®, which could serve as a tool for early detection of eccentric bruxism before the onset of clinical consequences. Full article

Background/Objectives: The purpose of this study was to measure the bone thickness and angulation of the maxillary and mandibular anterior teeth on the buccal and palatal/lingual sides and also to analyze the sagittal root position (SRP) in the alveolar bone in relation to age and gender using cone-beam computed tomography (CBCT) in an Iraqi subpopulation. Methods: CBCT images of 1200 maxillary and mandibular central and lateral incisors and canines from 100 patients (48 males and 52 females) were retrospectively analyzed. These patients were categorized by age into group I ≤ 25, group II 26–40, and group III ≥ 41 years old. The SRP in the alveolar bone was classified as class I, class II, class III, and class IV, and the buccal type was further classified into subtypes I, II, and III. In addition, the buccolingual inclination of the tooth and buccal/palatal/lingual bone thickness at the coronal, middle, and apical thirds were evaluated and then compared based on age and gender. The data were analyzed using the Pearson chi-square test. Descriptive statistics, Kruskal–Wallis and Mann–Whitney U test were used to compare the thickness and angulation according to the SRP classes. Results: The mean frequency distribution of SRP of maxillary anterior teeth indicated that most of them were located buccally and were classified as (Class I) and subtype (III). Moreover, for mandibular anterior teeth, the majority were classified as (Class IV) and subtype (II). The mean sagittal angulation of maxillary anterior teeth approximately ranged from 5.9 for tooth 12# to 8.2 for teeth 13# and 23#, while for mandibular anterior teeth it ranged from 7.4 for tooth 33# to 10.3 for tooth 41#. The thickness of bone in the apical third of the buccal side of all maxillary and mandibular teeth was significantly related to age (p < 0.05). In the middle third, the thickness of bone in the buccal and palatal side of all maxillary anterior teeth and in the apical third of most mandibular teeth in the lingual side was significantly higher in males (p < 0.05). Conclusions: A majority of the maxillary anterior tooth roots were positioned close to the buccal cortical plate, while most of the mandibular anterior teeth were engaging both the buccal and lingual cortical plates. Males had more alveolar bone thickness for both maxillary and mandibular anterior teeth, and only the apical portion significantly changed with age. CBCT of the buccal and palatal/lingual bone and SRP is recommended for the selection of the appropriate treatment approach and implant placement. Full article

Background/Objectives: The aim of this study was to evaluate incidental findings in the mandible after the placement of dental implants using a new cone–beam computed tomography (CBCT) software. Methods: The initial sample consisted of 2872 CBCT scans of patients of both sexes. The parameters evaluated in this study were the location of the implants in the mandible, implant length, anatomical relationship of the implant with the mandibular canal, presence or absence of damage to the adjacent teeth, presence or absence of implant fractures, and presence or absence of bone support. Fisher’s exact test was performed to compare the variables. The significance level was set at p = 0.05. Results: Out of 2872 CBCT scans, 214 images of patients with an average age of 44.5 years were included. The most frequent location of the implants was the posterior region (93.5%), with 54% of the implants having a length between 9 and 14 mm. It was found that 92% of the implants were positioned above the mandibular canal. Damage to adjacent teeth was observed, with no correlation with the implant positioning (p = 1.000). In 100% of cases of implants in the anterior region, there was bone support. Fracture was observed in 1.7% of implants with a length between 9 and 14 mm. Conclusions: The installation of implants in the mandible occurs more frequently in the posterior region, with a high presence of bone support and a low incidence of damage to adjacent teeth, anatomical structures, and fractures. Full article

Aims: This study was conducted to systematically evaluate the biomechanical impact of varying degrees of root and bone resorption resulting from periodontitis and orthodontic tooth movement (OTM) on the mandibular anterior teeth. The objective was to determine whether these distinct resorption patterns exert a specific influence on tooth displacement and strain patterns. Methods: A finite element (FE) model of an idealized anterior mandible from the first premolar in the third to the fourth quadrant was developed without bone or root resorption and a constant periodontal ligament (PDL) thickness of 0.2 mm. Variations included three root resorption levels (0%, 20%, 50%) and three bone resorption types (circular 50%, circular 80%, vestibular 80%). Models ranged from 200,000 to 440,000 elements and 55,000 to 130,000 nodes. Orthodontic forces, namely root torque (5 Nmm), intrusion (0.2 N), and distalization (0.5 N) were applied for subsequent crown displacement and PDL strain analysis. Results: A total of 180 simulations were performed. Simulations showed that displacement was similar across different bone resorption conditions, irrespective of modeled root resorptions. Circumferential bone resorption increased tooth displacement, regardless of root resorption status. Vestibular bone resorption exhibited less increase in tooth displacement. However, when accompanied by root resorption, the combination exacerbated tooth displacement. Strains in the PDL clearly increased with a circumferential bone resorption of 80%. Conclusions: This study highlights the critical role of bone resorption in tooth displacement during OTM, particularly the challenges associated with circumferential resorption. Clinicians must consider both bone and root resorption for personalized medicine treatment of patients with severe periodontitis, in favor of low-force application strategies to optimize outcomes and minimize complications linked to excessive tooth displacement. Full article

Combined Kelly syndrome, also known as anterior hyperfunction syndrome, is a complex pathological condition of the stomatognathic system, originally established by five characteristics but primarily triggered by edentulism, specifically, the absence of the upper and posterior mandibular teeth. This condition is characterized by a series of clinical features, such as bone loss, tuberosity growth, enamel wear, periodontal damage, muscle fatigue, pain, and temporomandibular joint issues. However, these features are not unique and rather reflect an oral hyperfunction state. There is a lack of consensus on the best way to assess and diagnose this condition, which is proposed to be understood as an “oral hyperfunction state” rather than a syndrome. This study aims to conduct a literature review to analyze the available information on anterior hyperfunction syndrome in dentistry, with the goal of proposing a conceptual model of the etiological risk factors that contribute to early diagnosis and the prevention of complications. This approach has important clinical implications, as it would allow for the early identification and management of risk factors, thus improving the quality of life of patients and preventing malpractice that could compromise their oral health. Full article

Osteomyelitis is the leading cause of total carcass condemnation in finishing pigs in Portugal, causing significant economic losses in swine production. The present study sought to determine a possible link between osteomyelitis in pig carcasses, pre-slaughter factors, and concomitant post-mortem inspection findings. For this purpose, meat inspection data were collected from 100,489 finishing pigs slaughtered in a northern Portuguese abattoir. Information regarding total carcass condemnation, slaughter season, origin, sex, tail-biting lesions, and husbandry invasive procedures (tail docking and teeth resection) was collected. The main cause of total carcass condemnation was osteomyelitis (61.03%). A total of 36.16% of osteomyelitis cases were present in the anterior region and 52.20% in the posterior region. In the anterior region, 94.78% of osteomyelitis cases were in the mandibular bone. Pigs with clipped teeth and carcasses with pleurisies were associated with a higher occurrence of osteomyelitis (p = 0.00262 and p < 0.0001, respectively). Second- and third-grade tail-biting lesions were also linked to a higher occurrence of osteomyelitis (p = 0.00128 and p < 0.0001, respectively). Slaughter inspection and monitoring procedures should be revised to better assess welfare factors and correlate management practices with the occurrence of osteomyelitis in pig carcasses. Full article

A thick periodontal phenotype with thick gingiva and alveolar bone volume is required for safe orthodontic tooth movement and long-term stability. A high incidence of dehiscence and fenestration in the labial aspect of mandibular anterior teeth may limit the correction of deformity and orthodontic treatment, especially when the lower anterior teeth are needed to have a large range of movement. This study reports a combination of periodontal therapy and orthodontic therapy with periodontal corticotomy regenerative surgery (PCRS) in a 25-year-old patient suffering from skeletal Class II malocclusion and periodontitis. The patient received periodontal therapy 5 years ago and commenced orthodontic treatment 4.5 years ago. During the 4 years of follow-up for PCRS, the clinical and radiographic evaluations revealed significant improvements in the periodontal phenotype of the mandibular anterior region. The periodontal phenotypes in the mandibular incisors region were all modified from thin to thick. Supplementing orthodontic treatment with labial PCRS could be a promising treatment strategy to maintain long-term periodontal health in adult patients with alveolar deficiency and thin gingiva tissue. Full article

Background/Objectives: Anterior open bite (AOB) is characterized by the absence of occlusal contact between the maxillary and mandibular anterior teeth, while the posterior teeth are in contact when occluded. Here, we aimed to clarify the difference in maxillary alveolar bone morphology in adult patients with and without AOB. Methods: This cross-sectional study was conducted on 50 adults aged 18–39 years: 25 patients without AOB (control group; 13 males and 12 females; age: mean ± standard deviation [SD], 22.2 ± 4.5 years) and 25 patients with AOB (9 males and 16 females; age: 24.2 ± 6.4 years). Using cone-beam computed tomography images, the height of the maxillary alveolar bone crest in the anterior and posterior teeth and thickness of the alveolar cortical bone on the labial and palatal sides were measured and compared between the two groups. An independent t-test and Pearson’s correlation analysis were used to examine statistical significance (p < 0.05). Results: The AOB group showed a significantly longer (p = 0.016) posterior alveolar crest and thinner cortical bone on the buccal (p < 0.001) and lingual (p = 0.009) sides of the anterior region and the buccal (p = 0.006) sides of the posterior region than the control group did. Moreover, a significant negative correlation (p = 0.046; r = −0.403) was observed between bite force and cortical bone thickness on the buccal side of the posterior region in the AOB group. Conclusions: It is suggested that the absence of occlusal contact in the anterior area influences the alveolar bone morphology of the maxilla. Full article

Background: We investigated treatment outcomes and post-treatment stability in 10 patients with an anterior open bite and nonsurgical orthodontics. Methods: The patients underwent maxillary molar intrusion using temporary anchorage devices (TADs) to deepen the overbite due to mandibular autorotation. Lateral cephalograms and dental cast models were obtained before treatment (T0), immediately after it (T1), and >1 year after it (T2). Skeletal and dental cephalometric changes and three-dimensional movements of the maxillary dentitions were evaluated. Results: At T0, cephalometric analysis indicated that patients had skeletal class I with tendencies for a class II jaw relationship and a skeletal open bite. During active treatment (T0 to T1), the maxillary first molar intruded by 1.6 mm, the mandibular first molar extruded by 0.3 mm, the Frankfort-mandibular plane angle decreased by 1.1°, and the overbite increased by 4.1 mm. Statistically significant changes were observed in the amount of vertical movement of the maxillary first molar, Frankfort-mandibular plane angle, and overbite. Three-dimensional (3D) dental cast analysis revealed that the maxillary first and second molars intruded, whereas the anterior teeth extruded, with the second premolar as an infection point. In addition, the maxillary molar was tipped distally by 2.9° and rotated distally by 0.91°. Statistically significant changes were observed in the amount of vertical movement of the central incisor, lateral incisor, canine and first molar, and molar angulation. From T1 to T2, no significant changes in cephalometric measurements or the 3D position of the maxillary dentition were observed. The maxillary and mandibular dentitions did not significantly change during post-treatment follow-up. Conclusions: Maxillary molar intrusion using mini-screws is an effective treatment for open bite correction, with the achieved occlusion demonstrating 3D stability at least 1 year after treatment. Full article

Background: Fragile gingival tissue is a risk factor for the development of gingival recessions. Despite the fact that gingival recessions are more commonly seen around anterior mandibular teeth, previous research has predominantly concentrated on the gingival dimensions in the anterior maxilla. The objective was to systematically compare buccal gingival thicknesses between the upper and lower jaws in individuals with healthy gingival conditions in the aesthetic zone. Methods: A comprehensive search of three databases was carried out until October 2023. Gingival thickness differences between the maxilla and mandible were evaluated by calculating the mean differences along with the corresponding 95% confidence interval (CI). Subgroup analysis was conducted based on the measurement area, measurement method, and tooth category. Results: A total of seventeen studies were included in this systematic review. Eleven studies were included in the quantitative analysis. Quantitative analysis comparing gingival thickness around 2100 teeth in the anterior mandible to 2056 teeth in the anterior maxilla revealed a statistically significant thinner buccal gingiva in the mandible (mean difference: 0.16 mm; 95% CI [−0.24, −0.07]; p = 0.0003). Conclusions: The present systematic review revealed a more delicate buccal gingiva in the anterior mandible. However, further scientific validation is required due to the considerable heterogeneity in study design and the potential presence of confounding variables. Full article

Oral mucosa inflammation can cause severe pain and interfere with eating, reducing quality of life. However, few options for self-care are available. An oral liquid bandage forms a protective film over the affected area. We aimed to assess the acid erosion risk when a newly developed oral liquid bandage (ORAPLA) is accidentally deposited on teeth and to examine the relative acid erosion risk at multiple time points of the maximum recommended duration of continuous use. ORAPLA was applied to both enamel and dentin blocks from 45 bovine anterior mandibular teeth, and an acid challenge was performed in a simulated oral cavity with artificial saliva, with one exposure cycle lasting 6 h. The enamel showed substantial defects and a decrease in Vickers hardness after nine cycles, with no change in surface roughness. Dentin showed an increase in parenchymal defects and surface roughness and a trend toward decreased Vickers hardness with increasing exposure time. We found no significant acid corrosion in enamel after up to nine times the upper limit of normal use time or in dentin after up to six times the upper limit. We conclude that the acid erosion risk due to accidental attachment to teeth is low, and in the human oral cavity with salivary buffering and remineralization, likely even lower. Full article

Periodontal disease is a site-specific disease affecting the supporting tissues of the teeth. It is useful for the clinician to have information about the prevalence and severity of alveolar bone loss (ABL) according to the site, location, and position of the teeth for a better treatment plan and expected prognosis. This study aimed to assess the prevalence and severity of ABL at mesial, distal, buccal and lingual sites of teeth in different locations, positions and sides of the dentition. The ABL of 20,620 sites of 5155 teeth in 212 patients was assessed using cone-beam computed tomography from the cemento-enamel junction to the crest of the alveolar bone. The prevalence of ABL was higher in the interproximal sites as well as anterior and mandibular teeth compared to their counterparts. Buccal sites and anterior teeth revealed higher ABL levels than the other tooth sites and posterior teeth, respectively. Furthermore, associations in the severity of ABL were observed between distal and mesial sites, buccal and lingual sites, maxillary and mandibular teeth, anterior and posterior teeth, and right and left sides. This study showed that the prevalence and severity of ABL differ from one tooth site to another and according to the tooth’s location in the dentition. Higher prevalences were found in the interproximal sites, anterior teeth and mandibular teeth; higher ABL was found in buccal and distal sites, with the strongest associations between distal and mesial sites, buccal and lingual sites, and right and left sides. Full article