Intrusion of the maxillary posterior teeth with a single buccal mini-implant positioned bilaterally in young adults with a tendency towards hyperdivergence: A clinical study

Background: Skeletal anchorage systems have been used for intrusion of the posterior teeth with satisfactory results. To achieve this, mini-implants are placed at anatomically challenging sites such as the palate or require several mini-implants to produce the desired effect. Objective: To determine the magnitude of intrusion of the maxillary posterior teeth achieved on a continuous arch wire using a single buccal mini-implant placed bilaterally in young patients with a tendency towards hyperdivergence and to evaluate its influence on the skeletal, dental and soft-tissue structures. Methods: A total of 17 patients with proclination of the anterior teeth, tendency towards hyperdivergence and clockwise rotation of the mandible were selected. First premolars were extracted as part of treatment protocol. A 0.022-MBT bracket prescription was used. Mini-implants were placed bilaterally on the buccal aspect at the mucogingival junction or slightly gingival to it between the maxillary second premolar and first permanent molar. A total of 200 g of intrusive force was placed from a continuous 0.019 × 0.025 inch stainless-steel arch wire to the mini-implant by means of an elastomeric thread on both sides. Lateral cephalograms and study models were taken before the start of intrusion and six months later. Parametric and non-parametric tests were done to assess treatment results. Results: Significant intrusion was observed in the maxillary molar and premolar region with tendency towards intrusion in the anterior region. There was significant decrease in lower anterior facial height (LAFH) with anti-clockwise mandibular rotation, decrease in facial proportion index and total facial height. No changes were observed in the transverse plane. Conclusion: Intrusion of the permanent maxillary molar can be achieved on a continuous arch wire with a single buccal mini-implant placed bilaterally with improvement in facial aesthetics, especially in the vertical plane. This method may be beneficial in patients with borderline vertical discrepancy treated with conventional friction mechanics during space closure after first premolar extractions.

Bilateral Symmetry of Number and Size of Dental Caries Lesions among Children

Aim. To determine the bilateral occurrence of caries lesions in 5–12-year-old children, and to assess whether one bitewing photograph can predict caries size and occurrence in the homologous tooth on the other side of the mouth. Study design. The study was carried out on 222 medical files of children 5–12 years old who were first examined in the university dental clinic. The presence and size of the caries lesions in the first and second primary molars and first permanent molars were recorded. Results. No correlation was found when comparing the caries lesion distribution of each tooth’s proximal surface. Seventy-one of the X-rays demonstrated a single caries lesion in a first or second primary molar or in a first permanent molar on one side of the mouth, of which 21.3% demonstrated a single caries lesion in the collateral side, 43.6% demonstrated 2 or more lesions, and 35.21% did not have any caries lesion on the collateral side of the mouth. Conclusion. One bitewing cannot determine the presence and size of a caries lesion on the same site of the homologous tooth.

An unusual case of maxillary permanent 1st molar with two pulp canals with pulp necrosis; diagnosis and endodontic management.

The present case report highlights the need to identify variations in root canal anatomy as a prerequisite for effective nonsurgical root canal therapy planning. As clinicians, we need to develop our observational and clinical abilities as well as amend our understanding of the complexities of the canal anatomy. Reports describing the structure of teeth and pulp canals rarely report the presence of two pulp canals in two permanent upper 1st molars. In this case, it describes the nonsurgical root canal therapy of the upper right 1st permanent molar with two pulp canals, which was confirmed by a cone beam.

Management of pericoronitis for partial eruption of second permanent molar in a pediatric patient

Background: This article discussed the management of pericoronitis for partial eruption of molar on pediatric patients. Purpose: This case report was to discuss how to manage a pediatric patient with a partially erupted second molar by using an electrosurgery method as the last alternative; also, it assessed whether or not the treatment facilitates spontaneous tooth eruption in respect to incomplete treatments. Case: A 9-years-old girl visited the Kuching Armed Forces Dental Clinic with her parents and complained of recurrent swelling on her lower right jaw in the last six months and noticed a tooth-like white lump under it. After a deliberate examination, the dentists came up with a diagnosis of pericoronitis because of a partially erupted second molar. Case Management: In managing a pediatric patient, a systematic desensitization was performed whereby the first visit was more of non-invasive treatment such as oral health instructions, a proper tooth brushing technique, and local scaling and debridement. Operculectomy using the electrosurgery had been carried out in the fourth visit and reviewed after one-week treatment that shows uneventful healing. Conclusion: To prevent and treat oral problems, it is imperative to develop child’s interest and willingness in using dental services. Hence, an early diagnosis is critical, especially as parents seek for the best treatment duration and treatment methods with the least number of consequences. The food impaction and the recurrent swelling because of pericoronitis have a major impact on the patient; therefore, treatment is provided regardless of patient’s age.

A Cross sectional study to assess the DMFT, Oral Health related behavior and practice among the selected school of old Dhaka city, Bangladesh

This cross-sectional type of descriptive study was conducted to assess the DMFT, oral health related behavior and practice in Rajer Deuri Government primary school in old Dhaka, Bangladesh.About 158 school children were selected by the purposive type of non-probability sampling technique. Face to face interview with questionnaire followed byChecklist. Out of 158 students, 78 (49.4%) were 12-14 years whereas maximum 80 (50.6%) of them were male and 78 (49.4%) were female. Againmajority students fathers were secondary level 34.2 and mothers were primary level passed 41.1%. Maximum family income belongs to 81 (51.3%) which is ranges from 10000-20000 Tk.Majority 89(56.3%) of the respondents never visited dentist. Again, maximum uses tooth paste with brushes 155(98.1%) and also majority 64(40.5%). use a new tooth brush as long as last Maximum make a visit to the dentist about 62(39.2%) on having toothache. Moreover,though128 (81.0%) agree that consumption of sugar in between meals causes dental caries but 130(82.3%) did not know about fluoride. Again, 64(40.5%) respondents knows not cleaning their teeth may cause tooth decay. In addition, 89(56.3%) students don’t know aboutgum bleeding while 52(32.9%). About 116 (73.4%) of the students didn’t know how to protect their gumMoreover, 118(74.7%) & 135(85.4%) of the respondents don’t know about dental plaque & calculus but 136(86.1%) & 98(62.0%) knows sweet food & soft drinks may affect dental health. Again, maximum 100(63.3%) respondents think that the health of mouth impact on the health of body as well as their treatment is also important. About130 (82.3%) of the respondents thinks that brushing teeth may prevent tooth decay while maximum 134 (84.8%) of the respondents did not know using fluoride strength their teeth. Maximum, 122 (77.2%) & 134(84.8%) did not know using toothbrush& floss help them preventing periodontal disease. Though 79(50.0%) of the respondents mentioned that using toothbrush & flossing is the best method for prevention of tooth decay. About 89(56.3%) of the respondents brush their teeth more than 2 minutes. Maximum 83(52.5%) & 129 (81.6%) of them did not know about the number of their permanent & deciduous tooth. About 136(86.1%) of the students did not know eruption time of 1st permanent molar. Finally, 118 (74.7%) out of 158 get knowledge about oral health from their family.There is a significant association between fathers & mothers education with knowledge which resembles (P value is 0.001). Again, therewas a statistical significant association between cleaning in between teeth and their knowledge (P value is 0.012) and also on having toothache maximum did not visit to the dentist where (P value is <0.001).There is also statistical significant association between DMFT and their knowledge where (P value is 0.004).Finally, a comprehensive oral health educational program for both children and their parents are required to achieve this goal. Update Dent. Coll. j: 2021; 11(2): 20-25

Prevalence of dental caries in the first permanent molar and associated risk factors among sixth-grade students in São Tomé Island

Background Dental caries is one of the most preventable oral diseases among children in developing countries. This study aims to estimate the prevalence and severity of dental caries in the first permanent molar and analyze the related risk factors among sixth-grade students in São Tomé Island. Methods A cross-sectional study with a stratified cluster sampling method was conducted on 1855 sixth-grade school children, mainly aged 11 to 14 years old, from 10 schools in 6 regions of São Tomé Island, from April 17 to June 27, 2021. Dental caries examination was performed by using the CAST criteria (DMFT) index, and the self-administered questionnaires about family background, oral hygiene, and relevant behaviors were collected. Multivariable logistic regression was used to study risk factors related to dental caries of the first permanent molar, and all data analyses were done using SPSS version 25. Results The prevalence of dental caries in the first permanent molar was 68.79%, without significant difference between gender, age, residence, and whether only child or not. The mean Decayed, Missing, and Filled Teeth (DMFT) index and mean Decayed, Missing, and Filled Surface (DMFS) index were 1.751 ± 1.514 and 3.542 ± 3.941, respectively. The rate of filling teeth was 5.50%, and Pit and Fissure Sealant (PFS) rate was 2.21%. The overall prevalence and DMFT index of dental caries of permanent teeth was 76.01% and 2.753 ± 4.569, respectively. The results of logistic regression analysis indicated that the frequency of candy/chocolate consumption (OR = 1.095) and fair self-assessment of dental health (OR = 1.354) were significantly associated with dental caries (P < 0.05). Conclusions The high prevalence of dental caries in the first permanent molar was a public health issue among sixth-grade school children in São Tomé Island. The prevalence of dental caries, mean DMFT and DMFS scores were higher, while the rate of filling and PFS teeth were lower than the average score of other African countries. Thus, oral health education, implement oral health preaching to school children and their parents is crucial to prevent dental caries.

Management of Compromised First Permanent Molar with Triple Antibiotic Paste in a 12-year-old Child: A Case Report

In teeth with pulpal and periapical infection, various group of microorganisms are present. Inhibition of the growth of these microorganisms and suppression of their antimicrobial activity play a crucial role in the success of the endodontic management. Triple antibiotic paste has been reported to have an excellent antimicrobial efficacy and it can be useful in management of teeth with severe infection. A 12-year-old female child reported with pain and swelling in relation with a lower left first permanent molar. Clinical examination of the tooth revealed deep occlusal caries and dentoalveolar abscess. Radiographically, the carious lesion was seen involving the pulp with periodontal ligament widening and inter-radicular bone loss was observed (endo-perio lesion). Considering the position of the tooth and its strategic importance, a conservative approach to salvage the tooth using Triple Antibiotic Paste (TAP) as a medicament was employed with complete radiographic healing by 12 weeks. Subsequent obturation using lateral condensation with gutta percha followed by composite restoration and preformed stainless steel crown was performed. This case report focuses on the endodontic management of perforated first permanent molar with compromised periodontal support and significant bone loss TAP as medicament and Mineral Trioxide Aggregate (MTA) as perforation repair material. Based on the results it can be concluded that Triple Anitibiotic Paste (TAP) can be effective in the disinfection and sterilization of the root canals and repair of complex lesions.

The evaluation of effectiveness of adhesive systems on dental amalgam restorations

Aim: The purpose of this study was to evaluate the effectiveness of different adhesive systems in amalgam restorations and their effects on microleakage. Methodology: In this study, 105 caries-free extracted human permanent molar teeth were used. Teeth were randomly assigned to five groups (n=21), and class I cavities were created on the surface of each tooth. The first was a control group to which no adhesive system was applied. Amalgam Liner (VOCO GmbH, Cuxhaven Germany) was applied to Group II, Clearfil SE-Bond (Kuraray Europe GmbH, Frankfurt Germany) was applied to Group III, Panavia F 2.0 (Kuraray Europe GmbH, Frankfurt Germany) was applied to Group IV, Amalgambond Plus (Parkell Inc.Edgewood, NY USA) was applied to Group V, and then amalgam (Tytin, Kerr, California USA) restorations were placed. After the polishing process, samples were subjected to thermocycling 1,000 times. Teeth were sectioned bucco-palatinally/lingually, and microleakage scores of the occlusal walls were evaluated under a stereomicroscope at 15X magnification by a standardized scale ranging from 0 to 4. One tooth was selected randomly from each group for SEM (Scanning Electron Microscope), and SEM LEO EVO 40 (LEO Ltd., Cambridge UK) photographs of amalgam-tooth hard tissue interfaces were also taken at different magnifications. The results of the microleakage tests were statistically analyzed by both the Kruskal-Wallis Test and the Mann Whitney U Test. Results: In terms of microleakage among groups, the differences that were determined were significant (p<0.05). Microleakage within the control group was determined to be the highest, and statistically important differences were observed between the other groups. Group V (Amalgambond Plus) was determined to have the lowest microleakage scores. Conclusion: In prepared class I cavities, amalgam adhesive systems are effective in preventing occlusal microleakage but do not completely blocked it. How to cite this article: Ünal M, Atakul F. The evaluation of effectiveness of adhesive systems on dental amalgam restorations. Int Dent Res 2021;11(2):83-92. https://doi.org/10.5577/intdentres.2021.vol11.no2.5 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Multiple root canals in the maxillary molar: an unusual case report

Background The objective of this report was to highlight the importance of using a dental operating microscope (DOM) to locate supernumerary canals and diagnose variations in root canals using cone-beam computed tomographic (CBCT) images. Case presentation A 35-year-old Chinese female had repeated swelling in the upper right posterior maxilla for 3 months and was referred to evaluate symptomatic apical periodontitis and mesotaurodonts for upper right first permanent molar and upper right second permanent molar. Root canal therapy was proposed and conducted with the use of DOM and CBCT. Conclusions Proper diagnosis and careful clinicoradiological examination are necessary, and it is essential to reinforce the knowledge of the rare morphology of root canals for clinicians.