Correlation Between Face Form and Maxillary Central Incisor Tooth Form in Dentate Patients Visiting Rehman College of Dentistry Peshawar

Aim: To determine the correlation between face form and maxillary central incisor tooth form in dentate patients visiting Rehman College of dentistry Peshawar. Methods: 152 patients fulfilling the inclusion criteria were included in the study through consecutive non probability sampling. Photographs of their face and maxillary central incisor were taken, printed, traced and subjected to classification by William’s method by 4 Prosthodontists. Results: As per descriptive statistics, mean and SD’s for age was 31+5.78, mean and SD’s for face form measurements was recorded as 78+1.67, whereas mean and SD’s for central incisor tooth form measurements was recorded as 25+0.69 Conclusion: It has been concluded that there is no highly defined correlation between the face form and maxillary central incisor tooth form in males and females. These results indicate that the maxillary central incisor tooth shows considerable asymmetry, whereas the face is basically symmetric. Instead, the opinions and desires of the patient should be considered, to ensure optimal dental esthetics for each individual. Keywords: Face form, Tooth form, Central Incisor, Correlation

Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports

Aim: Traumatic dental injuries at the anterior region of the maxilla occur frequently in children and adults. In this case report, we aimed to describe the temporary aesthetic restoration of the upper lateral incisor with a fiber-reinforced bridge by using the original tooth crown, which had avulsed after dental trauma. Methodology: Case 1: A 14-year-old girl with an avulsion in tooth #11 due to trauma visited our clinic. During the examination, it was seen that the wound had healed, and there was no luxation in teeth #21 and #12. Since the patient could not undergo prosthetic procedures, for reasons including implants, and did not want a removable prosthesis, a single crown supported by acrylic tooth fibers was constructed. Case 2: A 17-year-old male patient was referred to our clinic because of an avulsed left lateral incisor tooth, which was traumatized 15 days before visiting the clinic. His medical history revealed that his parents had found the tooth two hours after the trauma. However, the emergency clinic that he had previously visited did reimplant that tooth and repaired it with fiber-reinforced composite. Case 3: In the examination of a 12-year-old male patient who applied to our clinic due to trauma, it was observed that tooth #11 had an avulsion and tooth #12 had a crown fracture. Root canal treatment was performed. A crown was made for the patient by supporting the fiber inside the canals of tooth #11 and tooth #21. It was revised aesthetically with the support of the crown of the other tooth. Conclusion: Avulsion after anterior trauma affects patients’ appearance aesthetically; thus, patients want to be treated as soon as possible. Function, phonation, and aesthetics must be quickly provided for a loose anterior tooth. Fiber-reinforced adhesive bridge techniques may be considered as a temporary treatment for providing an aesthetically appealing appearance until the completion of permanent prosthetic treatment. How to cite this article: Şahin M, Toptancı İR. Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports. Int Dent Res 2021;11(Suppl.1):285-91. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.42 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Fast and cost-effective age estimation in Bengal tiger and Asiatic lion: applicability of cementum analysis method

Age estimation methods, through cementum analysis, for wild animals are rarely developed in Southeast Asian Countries. In the present study, we describe the applicability of the cementum analysis technique for developing a fast (plus minus 1, 19 hours) and cost-effective age estimation method for Bengal tiger (Panthera tigris tigris) and Asiatic lion (Panthera leo persica) using incisor tooth. The I2 and I3 incisor teeth from the right mandible of a tiger and I2 and I3 from the left maxilla of a lion were used in the study. The longitudinal sections of the tooth were made using a low cost hand grinding technique on sand papers followed by decalcification and staining with hematoxylin. The cementum layers were counted under the microscope at 100X or 200X magnifications. Two cementum layers were observed in each of the I2 and I3 incisor tooth of tiger and six cementum layers were observed in each of the I2 and I3 incisor teeth of lion. The permanent incisors in tiger and lion erupt between 12-14 months; hence, we added 1 year to the counted number of cementum layers to estimate the final age of tiger and lion incisors. The absolute age of tiger and lion incisors was estimated to be of 2+1 years and 6+1 years, respectively. The same number of cementum layers in both incisors respective to the tiger and lion were observed. Therefore, we suggest (i) undertake the blind test and (ii) collect incisor teeth from naturally died or killed individuals for strengthening the database on the age of the wild population. This optimized method may be suitable for many carnivore species, applicable in wildlife forensic studies and can be used by researchers with minimum expertise, time, and funds requirements throughout the world.

Accidental avulsion of a recently traumatised maxillary anterior tooth during rubber dam application

Avulsion injuries are usually seen in the anterior maxillary teeth as a result of trauma. Avulsion as an endodontic mishap is extremely rare. This report highlights an unusual instance of exarticulation of a recently traumatised maxillary central incisor tooth when the rubber dam was applied during a routine non-surgical endodontic procedure. The tooth was immediately repositioned and stabilised with wire composite splint. Endodontic treatment was initiated after rubber dam isolation with a modified technique. Calcium hydroxide was used as intracanal medicament dressing, and obturation was done after 2 weeks. The treatment was successful with uneventful periodontal healing at 24-month follow-up. The presence of well-demarcated periodontal ligament space and absence of any resorptive area on the radiograph could be defined as a successful outcome for the present case.

Aesthetic rehabilitation with immediate implant placement in anterior maxilla after traumatic avulsive injury. A case report

Traumatic oral injuries present their own unique restorative challenges to the clinician due to their variable clinical presentation. In such cases, achieving optimum aesthetics and function in the maxillary aesthetic zone is challenging. This case report describes the rehabilitation of a patient with immediate implant placement after suffering trauma to the oral cavity resulting in a complete loss (avulsion) of a permanent central incisor tooth. In order to preserve the existing soft and hard tissue and to achieve predictable and aesthetically pleasing results, we decided to place an immediate implant as opposed to replantation of the avulsed tooth. Flapless implant surgery was planned and a dental implant (Bio horizons Implant Systems, Inc.) was placed following non-submerged protocol. At six month’s follow-up, the clinical and radiographic examination revealed a well osseo-integrated implant with an intact buccal cortical plate. Continuous...

Non-Surgical Endodontic Management of External Root Resorption in a Permanent Maxillary Central Incisor Tooth - A 3 Year Follow-Up of a Rare Case Scenario

Resorption of the tooth represents a multifactorial and a perplexing problem for all clinicians resulting in complete or partial loss of tooth structure. The present clinical demonstration describes management of the permanent maxillary left central incisor (tooth number #21) affected by external root resorption involving the mesial and distal surface of middle one-third of the root. Conventional nonsurgical endodontic treatment followed by MTA (Mineral trioxide aggregate) obturation (PRoRoot MTA, Dentsply, Tulsa Dental Specialties) was planned. The root canal of the affected teeth was debrided with Dual Rinse HEDP (Medcem Weinfelden, Switzerland) containing etidronate powder and chemomechanical preparation of the root canal was performed with XP endo shaper file system (FKG Dentaire, SA, Switzerland). Thirtysix months’ post-operative follow-up revealed complete healing of the external root resorption defect with no clinical and radiological signs and symptoms. In the present case simple non-surgical endodontic management of severe external root resorption was done in a permanent maxillary tooth by using a continuous chelation irrigation technique, intracanal medicament followed by obturation with bio-ceramic material produced satisfactory results in contrast to the recommended surgical management. Resorption of the tooth being a multifactorial and a perplexing problem for all clinicians results in complete or partial loss of tooth structure. According to the Glossary of Endodontic terms, Resorption is defined as a condition associated with either a physiologic or a pathologic process resulting in the loss of dentine, cementum, and/or bone.1 Traditionally resorption can present either as internal or as external resorption.2 External root resorption occurs on the outer surface of the root and are of dissimilar nature such as external surface resorption, external inflammatory root resorption, ankylosis, and external replacement resorption, the most common being external inflammatory root resorption.3 According to the Glossary of Endodontics, “Inflammatory resorption is defined as an internal or external pathologic loss of tooth structure and possibly bone, resulting in a defect; occurs as the result of microbial infection; characterized radiographically by radiolucent areas along the root”.1 It may result due to dental trauma, forceful orthodontic tooth movement, long standing infection of the pulp or periodontal tissues. External resorption presents as a major resorptive condition of the root without any clinical signs and symptoms.2 The non-surgical management of external inflammatory root resorption is based on its aetiology, which needs to be eliminated

Repopulation of a 3D-simulated periapical lesion cavity with triggered osteoblastic-differentiated dental pulp stem cell spheroids.

We established a proof of concept model system for the biological repair of periapical lesions using stem cell spheroids. A mesenchymal stem cell line isolated from the dental pulp of deciduous teeth (shed cells) was cultured in a 2D monolayer and then in 3D multicellular spheroids. An image of a periapical lesion of an upper lateral incisor tooth was obtained by computed micro tomography, which was used as a model for photopolymer resin 3D printing to generate a negative frame of the lesion. The negative model served to prepare a positive model of the periapical lesion cavity in an agarose gel. Shed cells cultured in monolayers or as spheroids were seeded in the positive lesion mold before or after osteoblastic differentiation. The results showed that compared to cells cultured in monolayers, the spheroids featured uniform cellularity and had a greater viability within the lesion cavity, accompanied by a temporal reduction in the expression of mRNAs typically expressed by stem cells (Cd13, Cd29, Cd44, Cd73, and Cd90). Concomitantly, there was an increase in the expression of protein markers that characterize osteoblastic differentiation (RUNX2, ALP, and BGLAP). These results provide a new perspective for regenerative endodontics with the use of spheroids prepared with shed cells to repair periapical lesions.

Shear Bond Strength of Four Types of Orthodontic Retainers after Thermocycling and Cyclic Loading

Objectives. This study assessed the shear bond strength (SBS) of four types of orthodontic retainers after thermocycling and cyclic loading. Materials and Methods. This in vitro, experimental study evaluated 120 extracted mandibular central and lateral incisors. The teeth were mounted in acrylic resin blocks in sets of three, such that the interdental contacts and positioning of the teeth resembled the dental arch. The acrylic blocks were divided into four groups (n = 10) for the use of 0.016 × 0.022-inch Bond-A-Braid® wire, 0.0195-inch twisted wire, 0.0175-inch coaxial wire, and 0.038 × 0.016-inch Ortho-Flex Tech® wire, as retainers. The retainers were bonded to the lingual surface of the teeth with Transbond XT adhesive in all groups, and the specimens underwent thermocycling and cyclic loading (125,000 load cycles applied to the incisal edge of the incisor tooth in the middle, simulating 6 months of clinical service). Any fracture in the process of aging was recorded. The teeth were then subjected to vertical loads applied along their occlusoapical axis in a universal testing machine to determine the SBS in Newtons. The adhesive remnant index (ARI) scores were also determined. Data were analyzed using ANOVA, the Monte Carlo chi-square test, and the Kruskal–Wallis test. Results. Thermocycling and cyclic loading did not cause degradation or fracture of the retainers. The SBS and ARI scores of the four groups were not significantly different ( P > 0.05 ). Conclusion. The SBS of retainers with flat rectangular-shaped cross-section was similar to that of retainers with a round cross-section; thus, they have no superiority over each other in this respect.

Number of Osteoblasts and Osteoclasts in Combination Carbonate Hydroxyapatite, Platelet Rich Fibrin (PRF) and Antioxidant in Socket Rats Wistar After Tooth Extraction

Background: Bone graft materials have been used extensively to support bone healing after tooth extraction. Bone healing could be increased reactive oxygen species (ROS) that prolong the phase of the inflammatory and delay reparative phase. Antioxidants are substances that can improve and reduce the number and the damage produced by ROS. Hence, the utilization of antioxidant which is utilized in conjunction to Carbonate hydroxyapatite is expected to increase the success of bone healing. Purpose: The aim of this study is to compare the number of osteoblasts and osteoclast in the process of bone healing after employing Carbonate Hydroxyapatite and antioxidant in the Wistar rats’ incisor tooth extraction socket. Methods: Twenty-seven male Rattus norvegicus strain Wistar rats were divided into 3 treatment groups. This study uses a post-test only control design. Sample of 27 rats were divided into 3 groups. Mandibular incisive is extraction. Group 1, socket is lefted to fill with blood (control). Group 2, socket is filled bonegraft and antioxidants and group III, socket is filled antioxidants, bonegraft and platelet rich fibrin (PRF). After that, the wound is sutured. On day 14, the mice are terminated then viewed in microscopy of osteoblasts. The preparation of the bone tissues was given the staining by hematoxylin-eosin and then the numbers of the osteoblasts and osteoclast were calculated. Results: Statistical testing by using one-way ANOVA has proved that there are significant differences in the number of osteoblasts in all 3 groups (p = 0.000). The highest numbers of osteoblasts were found in the group that was given Carbonate Hydroxyapatite combined with antioxidant and PRF and the lowest numbers of osteoblasts were found in the control group. Conclusion: Combination bonegraft, antioxidants and PRF could be increased the highest number of osteoblasts and could be decreased the lowest number of osteoclasts compared with control group and the group bonegraft and antioxidants.

Multifactorial Contributions to Central Incisor Tooth Morphology and the Presence of Black Triangles: A Case Study

Dentists are often faced with patient concerns of smile esthetics in addition to oral health and should be equipped to help patients manage both. Black triangle disease, or a lack of interdental papilla, is esthetically displeasing particularly in the central incisor region and has a hoard of etiologies ranging from gum disease to inherited tooth morphologic features. Addressing patients’ esthetic concerns must first be met with understanding the causation of the black triangles before treatment can be rendered. Genetic contributions are multifactorial, and this case report provides evidence for a case of a central incisor black triangles without other affected family members.Background: Black triangles are a prominent feature for those experiencing a lack of interdental papilla between central incisors and may dramatically affect the presentation of a person’s smile. The aim of this case report is to convey the importance of managing patients’ esthetic chief complaints while addressing the etiology of the esthetic concern.Case Description: A 24-year-old man presented to his dental colleague with concern of his black triangle spaces. The patient does not have gingival recession in the area of interest, and his biological mother and brother do not have black triangle spaces. Pathology is not an issue, but instead inadequate length of the central incisor mesial contact area prevents the interdental papilla from reaching the contact. Esthetics are a concern, but the patient is not interested in irreversible treatment for his healthy tissue.Practical Implications: Dentists should be aware of the multifactorial contributions to patients’ esthetic concerns. Dentists should also be aware that meeting a patient’s expectations may require a more complex treatment plan than the patient expected.