[Advances in risk factors and early imaging assessment of canine impaction].

The canines play an important role in both the esthetics and function of the human body. The maxillary canines has the highest prevalence of impaction in the entire dentition, except for the third molars. Once canine impaction occurs, it can lead to the conditions such as root resorption of adjacent teeth, occlusal function interference and esthetic problems. Moreover, the treatment of canine impaction is time consuming and difficult, and it often requires multi-disciplinary involvement. Therefore, the early diagnosis and treatment of canine impaction is an urgent problem in orthodontic treatment. The etiology of canine impaction is complex and its early development is highly insidious. To assist orthodontists in the early diagnosis and treatment of canine impaction, this review summarizes and discusses the relevant risk factors associated with maxillary and mandibular canine impaction, and the commonly used radiographic assessment methods.

Radiographic assessment of unerupted permanent maxillary canines and their relationship to the phases of dentition in mixed dentition Spanish children: a retrospective cross-sectional study.

PURPOSE: Evaluate if there is a significant association between the position and inclination of the unerupted maxillary canine measured on a panoramic radiograph, and their relationship to gender, age of the patient and stage of dentition. METHODS: 138 panoramic radiographs were examined for this retrospective cross-sectional investigation. Only patients living in Madrid, Spain with mixed dentition were included. These measurements were performed on radiographs, considering the inclination and position of the maxillary canines with regards to the midline, and height with respect to the occlusal plane. Spearman's correlation coefficient was used to analyze the relation among the canine angle and height. p < 0.05 was considered to be significant. RESULTS: The prevalence of patients with an altered canine angle was 10%, while 43.5% had an apparently abnormal position (overlapping at least half of the adjacent lateral incisor root). No statistically significant association was found between these two variables. In 5% of the patients, the maxillary canine was with an anomalous angle and position. Significant differences were obtained when comparing canine height between children with ectopic canines and normal canines (p = 0.032). CONCLUSION: No significant association was found between the position and inclination of the unerupted maxillary canine in our sample. Ectopic maxillary canines had a higher incidence in girls, although we did not find statistically significant differences between genders. We observed a higher prevalence of abnormal position and inclination of the permanent maxillary canine in early mixed dentition. Maxillary canines were significantly elevated, further from the occlusal plane, in children with ectopic canines.

The diagnostic accuracy of cone-beam computed tomography and two-dimensional imaging methods in the 3D localization and assessment of maxillary impacted canines compared to the gold standard in-vivo readings: A cross-sectional study.

BACKGROUND: Although the widespread cone-beam computed tomography (CBCT) is a diagnosing tool for impacted canines, the surgical exposure-based diagnostic accuracy of this 3D imaging modality has not been established yet. Therefore this study aimed to (1) compare the accuracy of CBCT- and 2D-based interpretations of impacted canine and its relationships with the neighbouring structures with the gold standard (GS) readings, (2) and calculate the diagnostic accuracy, sensitivity, and specificity values of the variables assessed using CBCT and 2D methods. MATERIAL AND METHODS: Patients with unilateral impacted maxillary canines (IMCs) planned for surgical extraction between 2016-2018 were checked in-depth to include in this cross-sectional study. For each patient, 2D and 3D radiographic records were obtained and assessed by eight postgraduate orthodontic students. These assessments were compared with the GS readings based on surgical exposure and direct vision of the IMCs. To compare 2D- and CBCT-based assessments with the GS values, Cochran's Q tests, Friedman's tests, McNemar's, McNemar-Bowker's, and Wilcoxon tests were applied. RESULTS: A total of 17 patients (6 males, 11 females; mean age: 20.52±3.98 years) were randomly selected and included in this study. Significant differences were found between the CBCT-based assessments and the GS only concerning shape and bony coverage of the IMC (P=0.001 and P<0.001, respectively). On the contrary, there were significant differences between the 2D-based assessments and the GS regarding all the assessed variables except for the ankylosis and the proximity to the adjacent teeth (P=0.424, and P=0.080, respectively). CBCT-based assessments had remarkably higher values of diagnostic accuracy, sensitivity, and specificity compared to 2D-based ones. CONCLUSIONS: The diagnostic accuracy of CBCT outperformed 2D radiography in localizing the IMC (labiopalatal, mesiodistal, and vertical location), detecting root apex development of the IMCs, and the resorption of the adjacent incisors. Although both 2D and 3D techniques showed the same ability in the diagnosis of IMCs ankylosis, the diagnostic accuracy of CBCT was superior. However, both techniques inaccurately determined the shape of the impacted canine and the bony coverage.

A CBCT Based Assessment of Canine Eruption and Development Following Alveolar Bone Grafting in Patients Born With Unilateral Cleft lip and/or Palate.

To three-dimensionally assess and visualize the eruption path and development of the maxillary canine following alveolar bone grafting in patients born with cleft lip and palate. A further objective of this analysis was to assess how the presence of the lateral incisor impacts the eruption path of the canine.Observational follow-up study.Stockholm Craniofacial Team, Karolinska University Hospital, Sweden.Thirty children born with non-syndromic unilateral cleft lip with or without palate were consecutively included.CBCT scans of the maxilla were taken six months before and six months after the alveolar bone-grafting surgery for each patient.Canine eruption (angulation and vertical movement) and canine development (length and volume).There was a significant difference pre- and post-operatively of the canine angulation between the cleft and non-cleft sides. The mean angulation on the cleft side was 14.7° (SD = 11.1°) while on the non-cleft side, it was 4.9° (SD = 9.2°). No significant differences were noted between cleft-side and non-cleft side canines in terms of amount of vertical eruption and volumetric development. Absence of the lateral incisor did not significantly contribute to either canine angulation or its vertical eruption on the cleft-side.Higher angulation of the canine on the cleft side indicates a higher risk of future canine impaction. Presence or absence of the lateral incisor did not significantly affect canine angulation or its vertical eruption. Increased age and children born with total cleft lip and palate imply a higher risk of angulated canines on the cleft side.

Age estimation in young dogs by radiographic assessment of the canine pulp cavity/tooth width ratio.

Age estimation in adult dogs can be performed by the radiographic measurement of the tooth pulp cavity, but the technique has hardly been described. In this study, the application of measuring pulp/tooth width ratios (P/T ratios) of the maxillary canine teeth was investigated. Pulp and tooth widths were measured at two locations on 166 maxillary canine teeth of the heads of 84 dog cadavers, using digital extraoral lateral oblique open mouth radiographs. The dogs belonged to different breeds and sexes and had a known age between 194 and 1907 days (approximately 6 months - 5 years). Both at the cemento-enamel junction (CE) and the half-height of the tooth, a comparable non-linear regression with age was demonstrated. Measuring at the CE location was less hindered by wear or superimposition. No statistically significant difference according to sex and breed size and no clinically significant difference according to skull type was found. The highest predictable capacity was found in the youngest dogs until the age of 448 days, of which 84.4% of the canine teeth had a P/T ratio above 0.39. Our results demonstrate that measuring P/T ratios of canine teeth can be used in practice to assign dogs to age categories, with the highest accuracy in young adult dogs.

An assessment of root stage of canine and premolar teeth at alveolar eruption.

OBJECTIVE: The primary aim was to evaluate the degree of root development of permanent canines at the time of alveolar eruption. We also aimed to assess whether differences in the degree of root development at alveolar eruption exist between permanent canines and premolars and between maxilla and mandible. DESIGN: A cross-sectional study. SETTING: Barts and The London School of Medicine and Dentistry, Queen Mary University of London. PARTICIPANTS: Two hundred dental panoramic radiographs taken as part of routine dental care. METHODS: Radiographs were assessed for canine and premolar root development stage and eruption level with calibration and repeat measurements undertaken. RESULTS: Two hundred and sixty teeth were identified as being at the level of alveolar eruption. The majority of maxillary canines reached alveolar eruption when root formation was complete. Most premolars and mandibular canines reached alveolar eruption when roots were three-quarters developed. At alveolar eruption, canines were statistically more mature than premolars (p<0.001) and maxillary teeth were more mature than mandibular teeth (p<0.05). CONCLUSIONS: Root development appears to be particularly advanced for maxillary permanent canines, being essentially root-complete at alveolar eruption, while premolars and mandibular permanent canines appear to have three-quarters root development at this stage. This information may be used to inform whether and when to extract primary teeth for orthodontic reasons.

Three-dimensional assessment of two different canine retraction techniques: a randomized split-mouth clinical trial.

INTRODUCTION: The aim of this split-mouth trial was to compare power-arm sliding (PAS) and direct sliding (DS) canine retraction mechanics in terms of speed, rotation, angulation, and anchorage loss. METHODS: Thirty-six class II division 1 patients (20 females, 16 males; mean age, 16.94 ± 3.23) requiring upper first premolar extraction were included in the study. Miniscrews were used as anchorage units, and a retraction force of 150 gr was applied from the power arm on one side and from the bracket on the opposite side by using elastomeric chains. Randomization was achieved by block randomization with a 1:1 allocation ratio either to the right or the left with allocations concealed in opaque, sealed envelopes. Digital models were acquired using an intraoral scanner at the beginning of the retraction (T0), the first month (T1), the second month (T2), and the third month (T3). Before the scans, the archwire was removed, and custom metal jigs were inserted into the vertical slot of the canine brackets to evaluate the canine angulation. The digital models of each patient were separately superimposed with the local best-fit algorithm, and the retraction rate, angulation, rotation, and anchorage loss were measured. The digital measurements were performed using the Geomagic Control X software. RESULTS: The DS technique's total retraction rate was higher than that of the PAS technique (2.09 and 1.57, respectively, p = .002). There was, however, no significant difference between the two techniques in terms of angulation, rotation, and anchorage loss. A negative correlation was observed between the retraction rate and age, but it was not statistically significant. No significant difference was observed between the retraction rates of female and male participants in either retraction technique. CONCLUSIONS: For both orthodontists and patients, the DS technique is simpler and more convenient; thus, it is the preferred method for canine retraction. TRIAL REGISTRATION: The trial was not registered. PROTOCOL: The protocol was not published before the trial commencement.

Volumetric assessment of the dental crown for sex estimation by means of cone-beam computed tomography.

Sex estimation has a vital role in the solution of forensic cases when the identification of a large number of victims is needed. Considering the sexual dimorphism of the human teeth, the objective of this study was to estimate human sex by means of cone beam computed tomography (CBCT)-based volumetric assessment of the dental crown. A total of 78 CBCT images of the upper central incisors, upper and lower canines, and lower lateral incisors were equally selected from a Brazilian population aged between 8 and 36 years old. The dental crowns were subjected to image-based volumetric assessment by manual segmentation using the 3D slicer software, and the outcomes were compared by the Mann-Whitney test, unpaired t-test, Pearson correlation test, conditional backward stepwise logistic regression and intraclass correlation coefficient (α=0.05). The volumetric accuracy of the upper central incisor, upper canine and lower canine for sex estimation were 64.1%, 74.4% and 79.5%, respectively. The combined analysis of the upper and lower canines allowed an average accuracy of 83.7%. In conclusion, the combined volumetric analysis of the crown of the upper and lower canines can be applied for sex estimation in the studied population.

3D CBCT morphometric assessment of mental foramen in Arabic population and global comparison: imperative for invasive and non-invasive procedures in mandible.

BACKGROUND: Recent advancements in clinical dentistry have increased the possibilities of surgical procedures in the mental region. A detailed knowledge of mental foramen (MF) morphometry is significant to preserve integrity of the mental nerve trunk in surgical interventions such as orthognathic surgery, implant placement and anaesthetic block. OBJECTIVE: The aim of this study was to determine the most accurate position of the mental foramen by using new assessment approach in a sample of dental patients presenting to the specialist dental clinic, College of Dentistry, Al Jouf University, Saudi Arabia. STUDY DESIGN: A retrospective study was performed using cone beam computed tomography (CBCT) of 600 patients (40.1 ± 11.78 years old). Following inclusion and exclusion criteria, 395 CBCT were finally obtained and analyzed for the most accurate position of the mental foramen (MF) by OnDemand 3D software (Seoul, Korea). Prevalence of shape of MF and accessory MF were also assessed. Pearson chi-square test was employed to test significant differences between genders and races. RESULTS: The most common horizontal and vertical position of the mental foramen was in line with the long axis of 2nd premolar (41.3%) and below the root apex level (93.2%), respectively. The most common shape of MF was round type (72.66%). The prevalence of accessory 2MF and 3MF was 2.28% and 0.25%, respectively. CONCLUSION: New information about MF presented in this article can help anatomists, prosthodontists, orthodontists, surgeons, forensic odontologists and paleoanthropologists to predict the position of the MF and perform safer surgeries.

The impact of Cone Beam CT on financial costs and orthodontists' treatment decisions in the management of maxillary canines with eruption disturbance.

Background: Examination with Cone Beam CT (CBCT) is common for localizing maxillary canines with eruption disturbance. The benefits and costs of these examinations are unclear. Objectives: To measure: 1. the proportion of orthodontists' treatment decisions that were different based on intraoral and panoramic radiography (M1) compared with CBCT and panoramic radiography (M2); and 2. the costs of producing different treatment plans, regarding patients with maxillary canines with eruption disturbance. Subjects and methods: Orthodontists participated in a web-based survey and were randomly assigned to denote treatment decisions and the level of confidence in this decision for four patient cases presented with M1 or M2 at two occasions for the same patient case. Results: One hundred and twelve orthodontists made 445 assessments based on M1 and M2, respectively. Twenty-four per cent of the treatment decisions were different depending on which method the raters had access to, whereof one case differed significantly from all other cases. The mean total cost per examination was €99.84 using M1 and €134.37 using M2, resulting in an incremental cost per examination of €34.53 for M2. Limitations: Benefits in terms of number of different treatment decisions must be considered as an intermediate outcome for the effectiveness of a diagnostic method and should be interpreted with caution. Conclusions: For the patient cases presented in this study, most treatment decisions were the same irrespective of radiological method. Accordingly, this study does not support routine use of CBCT regarding patients with maxillary canine with eruption disturbance.

Treatment decision analysis for palatally-displaced canines based on orthodontists' opinion and CBCT.

OBJECTIVES: The aim of this study was to assess difficulty of treatment of palatally-displaced canines (PDC) according to experts' opinion using CBCT data and to determine a cut-off point for extraction versus forced eruption. SUBJECTS AND METHODS: Seven CBCT variables of thirty PDC cases were measured with Dolphin 3D software. In addition to measurements of each case, nine 3D and 2D views were prepared on one page and uploaded on the website (canineimpaction.com). Thirty-four orthodontists were asked to judge the difficulty of bringing the impacted canine into occlusal plane. Then, they scored from 1 to 5 the effect of each variable on treatment difficulty and also decided whether to force-erupt or extract the impacted tooth. RESULTS: Overlap in frontal view, angulation of the canine to the occlusal plan, vertical distance to the occlusal plane, age, dilaceration and rotation had significant relationship with the level of treatment difficulty. The treatment plan decision for PDC with treatment difficulty>7.5 was extraction rather than forced eruption. CONCLUSION: We can predict treatment difficulty of PDC by measuring CBCT variables and decide to extract or force-erupt with a reasonable level of agreement among a panel of orthodontists.

Assessment of the root apex position of impacted maxillary canines on panoramic films.

INTRODUCTION: In this study, we aimed to analyze the root apex positions of impacted maxillary canines on panoramic radiographs according to their labiopalatal positions and to propose a new panoramic radiographic predictor of impacted maxillary canines. METHODS: Paired panoramic films and cone-beam computed tomography images of 104 patients with unilateral impacted maxillary canines were selected. The sector locations of the impacted canine root apices on the panoramic radiographs were compared with the labiopalatal positions of impacted maxillary canines on cone-beam computed tomography. Statistical correlations between panoramic and cone-beam computed tomography findings were examined with the chi-square test. RESULTS: A statistically significant association was observed between the sector locations of impacted canine root apices and the labiopalatal positions of the canines (P <0.001). The root apices of labially impacted canines were more frequently located in sector 2 (corresponding to the lateral incisor position), those of palatally impacted canines were more frequently located in sector 4 (corresponding to the first premolar), and those of midalveolus impacted canines were more frequently located in sector 3 (corresponding to the canine). CONCLUSIONS: On panoramic films, the root apices of palatally impacted canines tended toward the root apices of the maxillary first premolars, whereas those of labially impacted canines tended toward the root apices of the maxillary lateral incisors. Therefore, the sector locations of impacted canine root apices on panoramic radiographs could be used for the early prediction of maxillary canine impactions and determination of the labiopalatal positions of impacted canines.

Assessment of Root Resorption and Root Shape by Periapical and Panoramic Radiographs: A Comparative Study.

INTRODUCTION: One of the common findings encountered by the clinician at the end of orthodontic treatment is the apical root resorption. Root resorption occurs to various degrees. A severe form of root resorption is characterized by shortening of root for more than 4 mm or more than one-third of the total tooth length. A low incidence rate of resorption is observed based on radiographic findings for the diagnosis of root resorption, panoramic radiography, and periapical radiography. Hence, we evaluated the accuracy of panoramic radiographic films for assessing the root resorption in comparison with the periapical films. MATERIALS AND METHODS: This study included the assessment of all the cases in which pre- and post-treatment radiographs were available for analysis of the assessment of the amount of root resorption. Complete records of 80 patients were analyzed. Examination of a total of 900 teeth was done. Mean age of the patients in this study was 21 years ranging from 11 to 38 years. The majority of the patients in the present study were females. All the treatments were carried out by registered experienced orthodontists having minimum experience of more than 10 years. All the cases were divided into two study groups. Group I comprised panoramic radiographic findings, while group II consisted of periapical radiographic findings. For the measurement of crown portion, root portion, and the complete root length, magnification loops of over 100 powers with parallax correction with inbuilt grids were used. Assessment of the tooth length and the crown length was done by the same observers. All the results were analyzed by Statistical Package for the Social Sciences software version 6.0. RESULTS: Maximum amount of root resorption was observed in case of maxillary central incisors and canines among group I and II cases respectively. However, nonsignificant difference was obtained while comparing the mean root resorption in relation to maxillary incisors and canines among the two study groups. While comparing the overall value of root resorption among the two study groups, a significant difference was obtained. The maximum value of tooth length in both the groups was observed in cases of maxillary canines. Significant differences were observed while comparing the tooth length of various teeth among the two study groups. Among the deviated forms of root shape, dilacera-tion was the most common form of root shape detected in both the study groups. CONCLUSION: Periapical radiographs are more efficient in the assessment of the shape and resorption of the root. CLINICAL SIGNIFICANCE: Thorough evaluation of periapical radiographs is necessary for detection of even minute levels of root resorption.

Periodontal surgery of the maxillary impacted canine for orthodontic purposes: Proposal for a surgical decision tree.

In a private practice, between January 2010 and December 2015, 621 impacted teeth were exposed for orthodontic purposes. The majority were maxillary canines (464=74.71%), followed by maxillary central incisors (36=5.80%), mandibular canines (32=5.15%) and, finally, second premolars (30=4.83%). The 464 maxillary canines were present in 356 patients with a mean age, at the time of the intervention, of 15 years and 3 months (7 years and 10 months to 45 years and one month). The gender distribution was 60.7% (F) to 39.3% (M); 32.8% of maxillary canines were buccal and 67.2% were palatal. Only 6 canines did not move, with a success rate of 98.7%. At the pretreatment interview, the orthodontists explained that orthodontic-surgical placement of an impacted canine lengthened treatment time by an average 6 months, but in some cases by 12 months or more. The purpose of this surgery is to help the orthodontist to position the impacted tooth in the dental arch with all the periodontal structures and with the best possible integration esthetics. The objective of this article is to illustrate the periodontal orthodontic surgery of the maxillary canine and to propose a surgical decision tree.

Assessment of gingival biotype and facial hard/soft tissue dimensions in the maxillary anterior teeth region using cone beam computed tomography.

OBJECTIVE: This study sought to assess the relationship between facial gingival and bone dimensions in maxillary anterior teeth region using cone beam computed tomography (CBCT). DESIGN: This study assessed 621 maxillary anterior teeth in 144 patients. In the sagittal plane, facial bone thickness (BT) and gingival thickness (GT) were measured at the crestal level and at 2, 4 and 6mm apical to the cementoenamel junction (CEJ). The dentogingival complex (DGC) dimensions and the distance from the CEJ to bone crest were also measured on CBCT scans. To determine the gingival biotype, GT at 2mm apical to the gingival margin was measured and GT <1.5mm was categorized as thin while GT ≥1.5mm was categorized as thick. The data were analyzed using SPSS version 21 via repeated measures ANOVA and the Cochrane's Q, chi-square and independent samples t-tests. RESULTS: The BT around the maxillary central and lateral incisors and canine teeth at 4 and 6mm apical to the CEJ was significantly different in thick and thin gingival biotypes (P<0.05). The mean GT at 2 and 4mm apical to the CEJ was significantly different around central and lateral incisors (P<0.05). Thickness of crestal bone was significantly different between the two gingival biotypes around central and lateral incisors (P<0.05). CONCLUSION: The two gingival biotypes had significantly different mean BT; different biotypes and their relationship to BT varied around anterior maxillary teeth.

Assessment of the Pubertal Growth Period using the Open Apices of the Lower Teeth.

AIM: The purpose of this study was to evaluate whether the open apex measurements of the lower teeth can be used for prediction of the pubertal growth spurt. MATERIALS AND METHODS: The study group consisted of 150 males and 142 females ranging in age from 10 to 16 years. A total of 292 panoramic and 292 hand-wrist radiographs were obtained and analyzed. The skeletal maturity was determined according to the skeletal maturity indicators (SMIs) developed by Fishman. The open apices measurements of the left lower teeth were made according to the method described by Cameriere. RESULTS: The Spearman rank order correlation coefficient revealed a relationship between the skeletal maturity stages and the open apex measurements. These correlations ranged from 0.577 for the lower second premolar to 0.830 for the lower canine. The measurement of the left lower canine showed the highest correlation, so its relationship with the SMIs was further investigated. The measurements of 6.07 (or greater) indicated to SMI4, and 2.485 (or lesser) indicated to SMI7. CONCLUSION: The skeletal maturity well related to the measurements of the open apices of the lower teeth. Lower canine open apex measurements could be used as an indicator of the SMI4 and SMI7. CLINICAL SIGNIFICANCE: The measurements of the open apices of the left lower canines from panoramic radiographs may be clinically useful as an indicator of the beginning and the ending of the pubertal growth period.

Skeletal maturity assessment using mandibular canine calcification stages.

OBJECTIVE: The aims of this study were: to investigate the relationship between mandibular canine calcification stages and skeletal maturity; and to evaluate whether the mandibular canine calcification stages may be used as a reliable diagnostic tool for skeletal maturity assessment. MATERIALS AND METHODS: This study included 151 subjects: 81 females and 70 males, with ages ranging from 9 to 16 years (mean age: 12.29±1.86 years). The inclusion criteria for subjects were as follows: age between 9 and 16 years; good general health without any hormonal, nutritional, growth or dental development problems. Subjects who were undergoing or had previously received orthodontic treatment were not included in this study. The calcification stages of the left permanent mandibular canine were assessed according to the method of Demirjian, on panoramic radiographs. Assessment of skeletal maturity was carried out using the cervical vertebral maturation index (CVMI), as proposed by the Hassel-Farman method, on lateral cephalograms. The correlation between the calcification stages of mandibular canine and skeletal maturity was estimated separately for male and female subjects. RESULTS: Correlation coefficients between calcification stages of mandibular canine and skeletal maturity were 0.895 for male and 0.701 for female subjects. CONCLUSIONS: A significant correlation was found between the calcification stages of the mandibular canine and skeletal maturity. The calcification stages of the mandibular canine show a satisfactory diagnostic performance only for assessment of pre-pubertal growth phase.

Clinical and radiographic assessment of maxillary canine eruption status in a group of 11- to 14-year-old Irish children.

OBJECTIVE: The aim of this study was to investigate the prevalence of potentially ectopic maxillary canines and associated dental features in a group of 11- to 14-year-old children. PARTICIPANTS: Examination took place of a normal dlistribution of Irish schoolchildren age between I11 and 14 years in order to record the number of subjects with indications for radiographic investigation of . potentially ectopic maxillary canines. METHODS: Those subjects identified subsequently underwent radiographic examination and the number of subjects with potentially ectopic maxillary canines was established. Correlations within the latter sub-sample with anomalous or missing laterals, type of occlusion and female:male ratio were investigated. RESULTS: A total of 480 children were screened. Of the children aged 11 to 14 years, 32 (6.6%) had clinical indications for radiographic examination of potentially ectopic maxillary canines according to the criteria that had been set out. There were 11 maxillary canines, in 10 subjects, that had an unfavourable position for eruption and were considered to be potentially ectopic, and so 1.1% of the maxillary canines reviewed in this study showed a potential ectopic eruption position. CONCLUSIONS: The prevalence of potentially ectopic maxillary canines and associated dental features in an Irish population was found to be similar to those in other countries, and the practice of careful supervision and early diagnosis of any eruption disturbances of the permanent maxillary canines continues to be considered important due to the risks associated with their eruption.

In Vitro Assessment of Enamel Permeability in Primary Teeth with and without Early Childhood Caries Using Laser Scanning Confocal Microscope.

OBJECTIVE: To compare the permeability of the enamel of primary teeth from individuals free of Early Childhood Caries (ECC) with that from individuals affected with ECC by assessment of dye penetration using Laser Scanning Confocal Microscope (LSCM). STUDY DESIGN: Experimental in vitro study. Exfoliated primary maxillary anterior teeth (n = 44) were collected and divided into two groups (n=22 per group): samples with ECC (Group 1) and without ECC (Group 2). The samples were immersed in Rhodamine B dye solution for 1 day, cut longitudinally into 3 sections, observed using LSCM. Dye penetration depths in the incisal, middle, cervical thirds and on labial, lingual surfaces were recorded. Data were analyzed by the Mann-Whitney test (α = 5%, p < .005). RESULTS: The overall mean penetration depth for group 1 (100.6 µm ± 58.48 µm) was significantly higher than that of group 2 (31.55 µm ± 23.40 µm, p < .000). Mean penetration depth in the incisal, middle, and cervical thirds and on the labial and lingual surfaces of group 1 also presented significantly higher scores than in group 2 (p < .005). CONCLUSION: There was significantly more dye penetration in the ECC group than in the non-ECC group. This could be related to a higher level of enamel permeability in teeth affected with ECC.

Radiographic assessment of impacted teeth and associated pathosis prevalence. Pattern of occurrence at different ages in Saudi male in Western Saudi Arabia.

OBJECTIVES: To assess the prevalence of both impaction and associated pathosis in a Saudi population in Al-Madinah, Saudi Arabia based on digital panoramic radiographs. METHODS: This study was carried out from December 2013 to February 2015. Panoramic radiographs of 359male patients attending the Oral Diagnosis Clinics, Faculty of Dentistry, Taibah University, Al-Madinah, Saudi Arabia were reviewed. All images were evaluated to determine the prevalence and pattern of impacted third molars and canines, and associated pathosis. RESULTS: Among 359 panoramic radiographs examined, 124 patients had impacted teeth. The impacted mandibular third molars were the most prevalent impacted teeth, 77.6% had class II pattern of impaction. Among the impacted maxillary canines, 75% were mesioangular and among 66 impacted maxillary third molars, 63.6% had class C. Our study showed that 5.8% of Saudi patients had 3 or more impacted teeth, 13.1% had 2 impacted teeth, and 15.6% had one impacted tooth. Associated pathosis was found in 18.2% among impacted maxillary third molars, and 31.5% among impacted mandibular third molars. The incidence of impaction decreases with age.  CONCLUSION: The prevalence and pattern of impacted third molars among Saudis are almost similar to other racial populations. The number of missing wisdom increases with age. Although the percentage of pathosis associated with impaction was considerably low, it is essential to carry you regular oral examinations to preserve asymptomatic impacted teeth in good health.