The Clinical and Radiological Evaluation of Impacted Third Molar Position, Crown and Root Morphology.

OBJECTIVE: This study aimed to analyze the crown and root morphology of maxillary and mandibular third molars, and assess their position in relation to adjacent anatomical structures using clinical examination and radiographic images. MATERIALS AND METHODS: A total of 176 extracted impacted or partially impacted third molars were included in this study. Orthopantomogram images (OPG) were used to evaluate the number of roots, position, depth of impaction relative to the occlusal plane of the second molar, and angulation of maxillary and mandibular third molars. The extracted teeth were examined to determine the actual number of roots. The root morphology was classified using the Alavi classification system for maxillary third molars and the Machado classification for mandibular third molars. Additionally, the number of cusps, crown dimensions, and morphology were analyzed using digital and dental calipers. RESULTS: The extracted samples exhibited a significantly higher number of roots compared to the number assessed on OPG images (P<0.001). The majority of mandibular third molars had two fused roots (37.39%) and a five-cuspid crown (48.70%), while maxillary third molars had three fused roots (26.23%) and four cusps (42.62%). Both maxillary (60.66%) and mandibular third molars (61.74%) were predominantly vertically positioned. Regarding the depth of impaction, maxillary third molars were primarily classified as Class C (65.57%), while mandibular third molars were classified as Class B (47.83%). Differences in crown shape were observed, with maxillary crowns being mostly triangular (36.07%) and mandibular crowns being oval (38.26%). Maxillary third molars had shorter crowns compared to mandibular third molars (P<0.05). CONCLUSION: The root morphology of maxillary and mandibular third molars in the population of Bosnia and Herzegovina displays variability. Orthopantomogram imaging was found to be inadequate for accurate determination of the number of roots in third molars. The number of cusps on third molars cannot be relied upon as a predictor of the number of roots. The study's findings will have implications for dental practice, particularly for oral surgeons and restorative dentists.

Epidemiological, Clinical and Radiographic Features of Supernumerary Teeth in Nonsyndromic Bosnian and Herzegovinian Population: a Monocentric Study.

Background: Supernumerary teeth (ST) represent one of the most common developmental anomalies among humans. Objective: In this study, we set a goal to investigate ST prevalence in the Bosnian and Herzegovinian population along with characteristics and complications that ST can cause. Methods: This retrospective study was based on panoramic radiographs, CBCT images, and dental records. Analyzed ST characteristics were: type, morphology, location, eruption state, location in the arch, orientation, and associated clinical complications. Statistical analysis included univariate analysis and bivariate analysis using Fisher's exact test with a confidence interval of 95% (p<0.05). Results: On a sample of 10.237 patients, ST teeth appear in 100 patients with a prevalence of 0.98%. Out of 138 analyzed ST mesiodens was the most frequent (43.47%). The most common location of the ST was maxilla (77.53%). The majority of ST were impacted (90.5%) but with no complications (71.7%). There was statistically significant relationship (p<0.001) between the type of ST and location (mesiodens and distomolars were mostly found in the maxilla). The relationship between ST type and morphology was also statistically significant (p<0.001)-mesiodens was associated with conical morphology, parapremolar with supplementary, and distomolar with tuberculate morphology. The occurrence of ST-associated retention of adjacent teeth was correlated to the type of tooth (p<0.001). Conclusion: The present study found prevalence of ST in B&H population to be low. Although associated pathology was not high early diagnosis allows optimal patient management which reduces later complications.

The Influence of Vitamin D Serum Concentration on Third Molar Extraction Outcome: a Pilot Study.

Background: In the academic world, the debate continues on the subject of how far a lack of vitamin D can affect the healing of various wounds. Objective: To determine if basal serum levels of vitamin D significantly influence clinical parameters linked to post-extraction wound healing after surgical removal of impacted/semi-impacted third molars. Methods: A total of 23 patients were included in this study. Clinical outcome parameters were: edema, trismus, pain, soft tissue healing, and dry socket signs. The research was divided into four stages. Results: Due to the high prevalence of hypovitaminosis D (91%), patients were classified into an insufficient (≥ 20 ng/ml) or a deficient group (<20 ng/ml). The results showed no statistically significant differences in pain, edema, trismus, or soft tissue healing between those two groups. A slight statistical interaction was observed in the clinical parameters related to edema and trismus assessment, but not statistically significant. We did not notice signs of "dry socket" on any of the patients. Conclusion: Within its limitations (low number of patients, high prevalence of vitamin D deficiency), this pilot study failed to find a significant influence of serum vitamin D concentrations in wound healing or post-surgery symptom (pain, edema, trismus) development after third molar extraction. Further clinical investigations are necessary to elaborate on this function of vitamin D more precisely.

Color Stability of Dental Composites after Immersion in Beverages and Performed Whitening Procedures.

Objectives: The study aimed to compare the color stability of two different light-cured composites after immersion in three liquids and the effectiveness of 16% carbamide peroxide (CP) in removing the discoloration. Material and methods: Color stability of a microhybrid (Z250, 3M ESPE) and nanocomposite (Z550, 3M ESPE) was evaluated after immersion in instant coffee, tea, Coca-Cola, and deionized water as a control group (n=5). Samples were kept in liquids for four hours daily at 37°C for 30 days. Furthermore, 16% CP was applied for the following 14 days, simulating night whitening. A digital spectrophotometer was used for color measurement based on the CIEL*a*b* color coordinates. The color changes (∆E) were measured at baseline, after immersion in the beverages, and also after the teeth whitening procedure. Mixed and factorial ANOVA followed by Bonferroni's post-hoc test were used for statistical evaluation (p≤0.05). Results: Tested resin composites showed a color change over the acceptability threshold (ΔE*> 3.48) after immersion in coffee and tea. Nanocomposite reported a significant increase in discoloration in coffee after 30 days (p <0.05). The color of both materials significantly changed (p<0.05) along all three L*a*b* axes in coffee and tea to darker, yellow, and red. Whitening with 16% CP was effective in removing external discoloration in both examined composite materials. Conclusion: Coffee and tea induced clinically detectable color changes in dental composites tested, with cumulative effects. Whitening represents an efficient method for the removal of surface discoloration in composite restorations.

The Effect of Bleaching on the Basic Colour and Discoloration Susceptibility of Dental Composites.

OBJECTIVES: To test the influence of a bleaching procedure using 16% carbamide peroxide (CP) on the colour of composite materials and their consecutive subjection to discolouration in beverages. MATERIALS AND METHODS: Nanocomposite Z550 (3M ESPE) and the microhybrid Z250 (3M ESPE) composite materials were selected for the research. 16% CP was applied to composite plates (15 samples each material) for seven hours a day for 14 days simulating at-home nightguard vital bleaching. The test samples were then divided randomly into three sub-groups and submerged in instant coffee, green tea and Coca Cola for 30 days. The control group (N=5) samples were kept in deionized water. Determination of the L*a*b* dimensions of colour of the polymerized discs was performed by calibrated spectrophotometer 24 hours later, after the bleaching procedure, and on days 7, 15 and 30 after immersion in the beverages. RESULTS: After application of 16% CP, there were perceptible changes in the colour of both test materials, which did not exceed the boundaries of acceptability (ΔE<3.48). Coca-Cola did not cause discolouration of the tested composites, but coffee and tea changed their colour above the level of perceptibility already seven days after immersion. A statistically significant difference in the change in colour was established between the materials when they were immersed in coffee (P<0.05). CONCLUSIONS: 16% CP does not affect the basic colour of the composites. Immersion in a beverage led to an unacceptable change in the colour of both test materials in coffee and tea, primarily towards black. The greatest discolouration after bleaching was shown by Z550 when immersed in coffee.

Sealing Ability of Mineral Trioxide Aggregate, Biodentine and Glass Ionomer as Root-End Materials: A Question of Choice.

OBJECTIVES: The goal of this study was to determine the sealing ability of MTA, Biodentine, and Fuji IX as root-end materials after ultrasonic retrograde preparation using a dye penetration method. MATERIALS AND METHODS: Seventy permanent anterior teeth were used in this study. Root canals were prepared using rotary endodontic files, and obturated using the lateral condensation technique. The resection of the root apices was performed perpendicularly to the long axis, and 3 mm deep retrocavities were made by ultrasonic tips. The samples were randomly divided into three experimental groups (N=20) and two control groups (N=5). The root-end cavities were filled with mineral-trioxide aggregate (Rootdent MTA, TehnoDent, Russia) in Group 1, Biodentine (Septodont, Saint Maur des Fossés, France) in Group 2 and Fuji IX GP (GC Corporation, Tokyo, Japan) in Group 3. The retrocavities of the positive control group were left unfilled, while retrocavities in the negative control group were sealed using a flowable composite material. The samples were made transparent, and dye penetration was assessed under a stereomicroscope (x10). The data were analyzed with the Kruskal-Wallis test and the Mann-Whitney U-test. RESULTS: The Biodentine group had a lower mean leakage value than the MTA and Fuji IX groups, and the difference was statistically significant (P<0.01). No statistical difference in apical microleakage was found between the MTA and Fuji IX groups (P>0.05). CONCLUSION: Within the limitations of this study, it was concluded that Biodentine provides better sealing ability as a root-end material than MTA and Fuji IX. There was no statistically significant difference between the sealing ability of MTA and Fuji IX as root-end materials.

Canal Aberration Assessment in Simulated Root Canals: a Comparative Study.

AIM: The aim of this study was to compare time of preparation and canal aberrations in a simulated root canals after using three different rotary systems: Endostar E5, Endostar E3 and T One File Gold. MATERIALS AND METHODS: A total of 90 endodontic training blocks were used in this study and divided into three groups consisting of 30 each (n = 30). Blocks processing was performed by thirty dentists without any prior experience in rotary instrumentation techniques. In the first group blocks were prepared using Endostar E5, in second one with Endostar E3 and in third one with T One File Gold system. The preparation time was measured. The postoperative image of each block was taken by stereomicroscope and canal aberrations (ledge and instrument fracture) was recorded. Statistical analysis was done by SPSS software. RESULTS: Instrumentation with T One File Gold system is significantly faster compared to instrumentation with Endostar E5 and Endostar E3 systems (p <0.05). There are no statistically significant differences in the type and number of procedural errors between Endostar E5, Endostar E3 and T One File Gold systems when the operators have no previous experience in rotary instrumentation techniques. CONCLUSION: Under the conditions of this study, the incidence of examined canal aberrations were similar for all tested systems. The preparation time was significantly shorter with single file system.

Biomechanics of cervical tooth region and noncarious cervical lesions of different morphology; three-dimensional finite element analysis.

OBJECTIVE: The present study aims to investigate the influence of presence and shape of cervical lesions on biomechanical behavior of mandibular first premolar, subjected to two types of occlusal loading using three-dimensional (3D) finite element method (FEM). MATERIALS AND METHODS: 3D models of the mandibular premolar are created from a micro computed tomography X-ray image: model of sound mandibular premolar, model with the wedge-shaped cervical lesion (V lesion), and model with saucer-shaped cervical lesion (U lesion). By FEM, straining of the tooth tissues under functional and nonfunctional occlusal loading of 200 (N) is analyzed. For the analysis, the following software was used: CTAn program 1.10 and ANSYS Workbench (version 14.0). The results are presented in von Mises stress. RESULTS: Values of calculated stress in all tooth structures are higher under nonfunctional occlusal loading, while the functional loading is resulted in homogeneous stress distribution. Nonfunctional load in the cervical area of sound tooth model as well as in the sub-superficial layer of the enamel resulted with a significant stress (over 50 [MPa]). The highest stress concentration on models with lesions is noticed on the apex of the V-shaped lesion, while stress in saucer U lesion is significantly lower and distributed over wider area. CONCLUSION: The type of the occlusal teeth loading has the biggest influence on cervical stress intensity. Geometric shape of the existing lesion is very important in the distribution of internal stress. Compared to the U-shaped lesions, V-shaped lesions show significantly higher stress concentrations under load. Exposure to stress would lead to its progression.