Search Results (12)

Background: Idiopathic osteosclerosis is a non-expansile bone lesion of unknown etiology, mostly detected incidentally on dental radiographs. It is typically asymptomatic and does not require intervention. Methods: This case report presents a rare clinical presentation in a 30-year-old female patient in whom enlargement of idiopathic osteosclerosis was associated with the progressive migration of an impacted mandibular third molar into close proximity with the inferior alveolar canal. Consequently, this caused paresthesia of the lower lip and chin and required surgical intervention. Results: The diagnosis was confirmed through histopathological examination following surgical removal of the tooth and bone biopsy, which verified the presence of idiopathic osteosclerosis and excluded other possible differential diagnoses. Conclusions: The postsurgical period was uneventful, and the patient reported no neurosensory disturbances after surgical treatment. Full article

Background/Objectives: It is essential to test the accuracy of artificial intelligence-assisted tools that detect dental pathologies from radiographs. This study aimed to evaluate the test characteristics of an artificial intelligence-assisted convolutional neural network-based prototype used for automated radiographic detection. Methods: A total of 300 panoramic and 100 intraoral periapical radiographs were collected between January 2020 and 2024 and then analyzed by two trained, independent specialist evaluators. The diagnostic consensus, “ground truth”, was labeled as follows: BL: bone loss; C: caries; F: filling; I: implants; IT: impacted teeth; P: prosthesis; PC: post-core; PR: periapical radiolucency; RF: root fillings; and RR: retained roots. The radiographs were uploaded to the prototype, and the results were compared. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using Stata version 15.0 (StataCorp). Results: Overall, most of the outcomes demonstrated sensitivity greater than 82%, with values ranging from 66.41% (65.47,67.36) for BL to 100% (100.00,100.00) for I. For all outcomes, specificity was greater than 93%, with values ranging from 93.61% (93.12,94.10) for BL to 100% for I. The overall values for all the test characteristics for the periapical radiographs were above 85%. The key errors identified in the qualitative analysis were errors in tooth identification, failure to detect recurrent caries under fillings and crowns, impacted canines, and inaccurate identification of extensive fillings as crowns. Conclusions: The prototype demonstrated high sensitivity and specificity in identifying dental pathologies. Accuracy in identifying bone loss, teeth that have migrated, including impacted canines, secondary caries, and differentiating extensive fillings from crowns requires further improvement. Full article

Microtubule-actin cross-linking factor 1 (MACF1), also known as actin cross-linking family protein 7 (ACF7), is a giant cytolinker protein with multiple conserved domains that can orchestrate cytoskeletal networks of actin and microtubules. MACF1 is involved in various biological processes, including cell polarity, cell–cell connection, cell proliferation, migration, vesicle transport, signal transduction, and neuronal development. In this review, we updated the physiological and pathological roles of MACF1, highlighting the components and signaling pathways involved. Novel evidence showed that MACF1 is involved in diverse human diseases, including multiple neuronal diseases, congenital myasthenic syndrome, premature ovarian insufficiency, spectraplakinopathy, osteoporosis, proliferative diabetic retinopathy, and various types of cancer. We also reviewed the physiological roles of MACF1, including its involvement in adhesome formation, bone formation, neuronal aging, and tooth development. In addition, MACF1 plays other roles, functioning as a biomarker for the prediction of infections in patients with burns and as a marker for genome selection breeding. These studies reinforce the idea that MACF1 is a bona fide versatile, multifaceted giant protein. Identifying additional MACF1 functions would finally help with the treatment of diseases caused by MACF1 defects. Full article

Background/Objectives: The 2017 Periodontal Classification offers a comprehensive framework for the diagnosis and management of periodontitis based on staging and grading criteria. Orthodontic therapy is increasingly incorporated into the management of periodontitis to rectify malocclusion, pathological tooth migration, and occlusal stability. Nonetheless, few data directly correspond with this revised classification scheme. The objective of this systematic review is to figure out the influence of orthodontic therapy on periodontal outcomes in patients with Stage III and IV periodontitis, as categorized by the 2017 framework. Methods: A systematic review was performed in accordance with the PRISMA 2020 principles. The databases examined were PubMed, Web of Science, Scopus, and Google Scholar. The evaluation focuses on research published from 2012 to 2024. Seventeen studies were assessed after the application of the inclusion criteria. Key outcomes included clinical attachment level (CAL) improvement, probing depth (PD) decrease, and radiographic bone fill. Results: The integration of orthodontic treatment with periodontal therapy markedly enhanced CAL (mean gain: 4.35–5.96 mm), decreased PD (mean reduction: 3.1–6.3 mm), and facilitated radiographic bone regeneration (mean vertical fill: 4.89 mm). Patients with Stage IV Grade C periodontitis had the most significant improvement, especially with early orthodontic intervention subsequent to regenerative treatment. Prolonged follow-ups (up to 10 years) validated consistent results. Conclusions: Orthodontic intervention, as a supplementary measure to periodontal therapy, improves results in severe periodontitis, especially in Stage III and IV patients. These results underscore the need for multidisciplinary teamwork and defined protocols for including orthodontics in periodontitis therapy. Full article

Periodontal patients may face orthodontic problems because of bone support loss, such as maxillary incisor proclination, spacing, rotation, extrusion, pathologic tooth migration (PTM) or traumatic occlusion. Orthodontic treatment is therefore an element within the comprehensive treatment of periodontitis after the periodontal condition has stabilized. The presence of fixed appliances (FAs) promotes the accumulation of bacterial biofilm and impedes hygiene procedures. The increasing popularity of clear aligner (CA) treatment is due to the convenience of use, less discomfort, better esthetics, easier hygiene, lower failure rate, and shorter, less frequent visits. Therefore, the question arises whether treatment with aligners is a good solution for periodontal patients. To answer this question, the PubMed/Medline, Cochrane Library and EMBASE databases were searched using the following keywords: periodontitis, orthodontic treatment, clear aligners, multibracket orthodontic appliances, fixed appliance, root resorption, gingival recession and pathologic tooth migration. The search strategy identified 18 relevant studies. A total of 1090 participants took part in the analyzed studies. The available literature was analyzed in terms of the occurrence of root apex resorption, the possibility of treating pathologic tooth migration, the occurrence of gingival recession, periodontal health status and occlusal stability in patients treated with CAs and FAs. Despite statistically significant differences in terms of Plaque Index (PI), probing depth (PD), apical root resorption and gingival recession favor the use of CAs. However, these values are mostly of no clinical significance. It is possible to treat PTM with CAs, but it is limited by the high degree of tooth mobility and incisor inclination. Obtaining perfect occlusion is comparably difficult in both CA and FA treatment. When planning orthodontic treatment in patients with reduced periodontium, the use of both CAs and FAs should be considered. The choice of method would ultimately depend on the patient’s dental condition. Full article

Introduction: Ectopic foreign bodies in the maxillary sinus occur rarely. Ectopic tooth eruption rarely occurs in the orbit, nasal cavity, maxillary sinus, and elsewhere. Ectopic eruption of teeth in the maxillary sinus is most commonly associated with wisdom teeth and is rarely associated with supernumerary teeth. This rare phenomenon may be accompanied by chronic recurrent sinusitis with headaches and facial pain. However, fibro-osseous lesions in the paranasal sinuses are discovered incidentally on X-ray images and are often asymptomatic. Osteoma is the most common fibro-osseous lesion that develops in the paranasal and nasal sinuses. Osteomas rarely cause serious symptoms such as orbital lesions and intracranial invasion. Case Presentation: We report a rare case of exostosis containing supernumerary teeth within the maxillary sinus. A characteristic pedicled bone lesion with a clear border on computed tomography was the undefined orthopantomogram radiopacity in the maxillary sinus, and the lesion contained supernumerary teeth. As the patient had chronic nasal congestion, the tumor was surgically removed. Pathologically, the surgical specimen revealed an osteoma. The patient’s symptoms of chronic sinusitis disappeared. Because the patient had no history of midface trauma or surgery, the supernumerary teeth were speculated to have migrated during a reactive osteogenic process caused by chronic sinusitis. Conclusions: A foreign body in the maxillary sinus can be easily diagnosed by computed tomography. Surgical removal is recommended if the foreign body is symptomatic or occupies more than half of the maxillary sinus. This can help resolve chronic sinusitis symptoms and prevent serious complications in the future. Full article

Orthodontic treatment of periodontally compromised patients presents unique challenges, including controlling periodontal inflammation, applying appropriate force, designing an effective dental anchorage, and maintaining treatment results. Deteriorated periodontal support leads to alterations in the biological responses of teeth to mechanical forces, and thus orthodontists must take greater care when treating patients with periodontal conditions than when treating those with a good periodontal status. In this article, we report the case of a 59-year-old woman with stabilised Stage IV grade C generalised periodontitis characterised by pathological tooth migration (PTM). The assessment, planning, and treatment of this patient with orthodontic fixed appliances is described. Moreover, the anchorage planning and biomechanical considerations are detailed. Specific orthodontic appliances were employed in this case to produce force systems for achieving precise tooth movement, which included a cantilever, mini-screws, and a box loop. Careful application of those appliances resulted in satisfactory aesthetic and functional orthodontic outcomes in the patient. This case highlights the importance of multidisciplinary collaboration in the treatment of patients with severe periodontitis and the potential for tailored biomechanical approaches in orthodontic treatment to furnish good outcomes. Full article

Pathologic tooth migration (PTM) is a complication of Stage III and IV periodontitis. This pilot study aims to analyze the periodontal response to orthodontic aligner therapy in stage IV periodontitis patients, by perio charting and digital orthodontic data obtained from intraoral scans. Following periodontal treatment of 21 recruited patients, 11 underwent clear aligner treatment. Periodontal data (Probing Pocket Depth—PPD, Recession Index—REC, Clinical Attachment Loss—CAL) were collected at baseline (T0), after periodontal treatment (T1), and at the end of the orthodontic treatment (T2). Digital data obtained at T1 and T2 were processed with the 3D software Geomagic^® Control X™. Occlusograms obtained by the proximity sensors of the scans were converted into differently colored pixelated areas. These results were compared to highlight changes in clinical crown length or occlusal contact areas. The results showed a slight increase in the REC index and a statistically significant reduction of PPD and CAL at T1 and T2. Digital data showed a statistically significant decrease in terms of gingival recessions and clinical crowns at the end of orthodontic treatment. Hard occlusal contacts showed a statistically significant decrease by the end of the orthodontic treatment. The results are comparable to those reported in the scientific literature for fixed orthodontic treatment. Clear aligner treatment could be considered an option in patients with severe periodontitis, promoting final light occlusal contacts. Full article

The early diverging, dolphin-sized, cetacean clade Xenorophidae are a short-lived radiation of toothed whales (Odontoceti) that independently evolved two features long thought to be odontocete synapomorphies: the craniofacial and cochlear morphology underlying echolocation and retrograde cranial telescoping (i.e., posterior migration of the viscerocranium). This family was based on Xenorophus sloanii, which, for the past century, has been known only by a partial skull lacking a braincase and tympanoperiotics, collected around 1900 from the Ashley Formation (28–29 Ma, Rupelian) near Ladson, South Carolina. A large collection of new skulls and skeletons (ChM PV 5022, 7677; CCNHM 104, 168, 1077, 5995) from the Ashley Formation considerably expands the hypodigm for this species, now the best known of any stem odontocete and permitting evaluation of intraspecific variation and ontogenetic changes. This collection reveals that the holotype (USNM 11049) is a juvenile. Xenorophus sloanii is a relatively large odontocete (70–74 cm CBL; BZW = 29–31 cm; estimated body length 2.6–3 m) with a moderately long rostrum (RPI = 2.5), marked heterodonty, limited polydonty (13–14 teeth), prominent sagittal crest and intertemporal constriction, and drastically larger brain size than basilosaurid archaeocetes (EQ = 2.9). Dental morphology, thickened cementum, a dorsoventrally robust rostrum, and thick rugose enamel suggest raptorial feeding; oral pathology indicates traumatic tooth loss associated with mechanically risky predation attempts. Ontogenetic changes include increased palatal vomer exposure; fusion of the nasofrontal, occipito-parietal, and median frontal sutures; anterior lengthening of the nasals; elaboration of the nuchal crests; and blunting and thickening of the antorbital process. The consistent deviation of the rostrum 2–5° to the left and asymmetry of the palate, dentition, neurocranium, mandibles, and vertebrae in multiple specimens of Xenorophus sloanii suggest novel adaptations for directional hearing driven by the asymmetrically oriented pan bones of the mandibles. A second collection consisting of a skeleton and several skulls from the overlying Chandler Bridge Formation (24–23 Ma, Chattian) represents a new species, Xenorophus simplicidens n. sp., differing from Xenorophus sloanii in possessing shorter nasals, anteroposteriorly shorter supraorbital processes of the frontal, and teeth with fewer accessory cusps and less rugose enamel. Phylogenetic analysis supports monophyly of Xenorophus, with specimens of Xenorophus simplicidens nested within paraphyletic X. sloanii; in concert with stratigraphic data, these results support the interpretation of these species as part of an anagenetic lineage. New clade names are provided for the sister taxon to Xenorophidae (Ambyloccipita), and the odontocete clade excluding Xenorophidae, Ashleycetus, Mirocetus, and Simocetidae (Stegoceti). Analyses of tooth size, body size, temporal fossa length, orbit morphology, and the rostral proportion index, prompted by well-preserved remains of Xenorophus, provide insight into the early evolution of Odontoceti. Full article

In stage IV periodontitis patients with pathologic tooth migration (PTM), interdisciplinary treatment includes regenerative periodontal surgery (RPS) with an application of biomaterials and orthodontic therapy (OT) to restore function, esthetics and thereby quality of life (QoL). In a 24-month randomized trial we explored the synergy between regenerative medicine and biomechanical force application. The following methods were used: Forty-three patients had been randomized to a combined treatment comprising RPS and subsequent OT starting either 4 weeks (early OT) or 6 months (late OT) post-operatively. Clinical periodontal parameters and oral health-related QoL (GOHAI) were recorded up to 24 months. We obtained the following results: Mean clinical attachment gain (∆CAL ± SD) was significantly higher with early OT (5.96 ± 2.1 mm) versus late OT (4.65 ± 1.76 mm) (p = 0.034). Pocket closure (PPD ≤ 4 mm) was obtained in 91% of defects with early OT compared to 90% with late OT. GOHAI-scores decreased significantly from 26.1 ± 7.5 to 9.6 ± 4.7 (early OT) and 25.1 ± 7.1 to 12.7 ± 5.6 (late OT). Inconclusion, teeth severely compromised by intrabony defects and PTM can be treated successfully by RPS followed by early OT with the advantage of an overall reduced treatment time. As a result of the combined periodontal-orthodontic therapy, the oral health-related QoL of patients was significantly improved. Early stimulation of wound healing with orthodontic forces had a favorable impact on the outcomes of regenerative periodontal surgery. Full article

This retrospective study described the clinical and radiographic long-term outcomes of combined periodontal and orthodontic treatment (OT) with fixed appliances in patients with Stage IV periodontitis and pathologic tooth migration (PTM) in the anterior sextants. OT was performed in either one or both arches, using tooth-supported or skeletal anchorage, following completion of active periodontal treatment and accurate planning of tooth movement biomechanics. Twenty-nine patients were identified and retrospectively examined when presenting for a supportive periodontal care (SPC) appointment. The mean SPC duration was 8.9 years (range 5 to 12 years). All anterior-migrated teeth showed statistically significant periodontal improvement compared to baseline values and stable radiographic bone levels at the final follow-up. Residual probing depths were 2.9 ± 0.5 mm at the end of active periodontal treatment, and they remained stable at the completion of OT (2.9 ± 0.6 mm) and at the last follow-up visit (2.8 ± 0.5 mm). These findings suggest that OT is a safe and effective treatment in improving the long-term prognosis of teeth with PTM in Stage IV periodontitis provided that periodontal health has been re-established and maintained with individualized SPC sessions. Full article

Due to the high prevalence of periodontitis, dentists have to face a larger group of patients with periodontally compromised dentitions (PCDs) characterized by pathologic tooth migration and malocclusion. Impression taking in these patients is challenging due to several undercuts and extensive interdental areas (IAs). The aim of this clinical trial was to analyze the ability of analog and digital impression techniques to display the IAs in PCDs. The upper and the lower jaws of 30 patients (n = 60, age: 48–87 years) were investigated with one conventional impression (CVI) using polyvinyl siloxane and four digital impressions with intraoral scanners (IOSs), namely True Definition (TRU), Primescan (PRI), CS 3600 (CAR), and TRIOS 3 (TIO). The gypsum models of the CVIs were digitalized using a laboratory scanner. Subsequently, the percentage of the displayed IAs in relation to the absolute IAs was calculated for the five impression techniques in a three-dimensional measuring software. Significant differences were observed among the impression techniques (except between PRI and CAR, p-value < 0.05). TRU displayed the highest percentage of IAs, followed by PRI, CAR, TIO, and CVI. The results indicated that the IOSs are superior to CVI regarding the ability to display the IAs in PCDs. Full article