Correction of a severe post-surgical iatrogenic class II anterior open bite with lingual appliances and mini-screws: a case report.

An iatrogenic open bite after orthognathic surgery is an uncommon malocclusion, with only one documented case reported in the literature. However, the open bite in this case report was not a true open bite, as it resulted from the interferences between the maxillary second molars and mandibular retromolar bones. This case report aims to present the management of a true iatrogenic open bite with posterior teeth in centric occlusion, occurring after mandibular setback surgery. The anterior open bite accompanied a severe class II malocclusion and increased lower anterior facial height. The patient was treated with fixed lingual appliances and mini-screws to distalize the entire maxillary arch and close the open bite. After treatment, a positive overbite and dental class I relationship was achieved. The treatment outcomes were stable at the 2-year follow-up. Lingual appliances combined with mini-screws may offer effective non-surgical management of iatrogenic open bite after orthognathic surgery. Clinical and Surgical Implications: Iatrogenic open bites can develop from various causes that include surgical options such as orthognathic surgery or in patients treated with occlusal splint therapy. These may be treated with the help of skeletal anchorage options such as orthodontic mini-screws.

Assessment of Bone Thickness at the Infra Zygomatic Crest Region for Various Orthodontic Miniscrew Implant (OMSI) Insertion Angles: A Cone-Beam Computed Tomographic Study.

Objective: To evaluate the infrazygomatic crest (IZC) bone and develop guidelines for the optimum placement of orthodontic miniscrew implants (OMSIs) along the distobuccal root of the permanent maxillary first molar. Methods: Bone thickness of the IZC region of 50 young adults (25 males and 25 females) aged 18-30 years were evaluated using cone-beam computed tomography images. The infrazygomatic bone thickness along the distobuccal root of the permanent maxillary first molar was assessed at various insertion angles (40° to 75° i.r.t the maxillary occlusal plane) with an increment of 5°. Student's t-test was used to compare the IZC bone thickness and height at the orthodontic miniscrew insertion site for males and females on the right and left sides. Results: The bone thickness of the IZC region above the distobuccal root of the permanent maxillary first molar was estimated between 4.39±0.25 mm and 9.03±0.45 mm for insertion angles from 40° to 75° to the maxillary occlusal plane. The corresponding OMSI insertion heights were 17.71±0.61 mm to 13.69±0.75 mm, respectively, above the maxillary occlusal plane. There were statistically significant gender and side-wise variations in bone thickness at the IZC area and insertion height. Conclusion: The safe position for OMSI placement at the IZC was 13.69-16 mm from the maxillary occlusal plane with an insertion angle between 55° and 75°. These parameters provide the optimum placement of OMSIs along the distobuccal root of the permanent maxillary first molar.

Management of a severe skeletal open bite case using temporary anchorage devices and multiloop edgewise arch wire technique.

The primary cause of complex AOB malocclusion is typically a combination of dental, skeletal, functional, and habitual factors. Open bite correction is a challenging treatment due to its complexity and the requirement for long-term stability, therefore, multidisciplinary treatment is often the best option for achieving stable esthetic outcomes.

Optimization of forensic identification through 3-dimensional imaging analysis of labial tooth surface using open-source software.

Purpose: The objective of this study was to determine the minimum number of teeth in the anterior dental arch that would yield accurate results for individual identification in forensic contexts. Materials and Methods: The study involved the analysis of 28 sets of 3-dimensional (3D) point cloud data, focused on the labial surface of the anterior teeth. These datasets were superimposed within each group in both genuine and imposter pairs. Group A incorporated data from the right to the left central incisor, group B from the right to the left lateral incisor, and group C from the right to the left canine. A comprehensive analysis was conducted, including the evaluation of root mean square error (RMSE) values and the distances resulting from the superimposition of dental arch segments. All analyses were conducted using CloudCompare version 2.12.4 (Telecom ParisTech and R&D, Kyiv, Ukraine). Results: The distances between genuine pairs in groups A, B, and C displayed an average range of 0.153 to 0.184 mm. In contrast, distances for imposter pairs ranged from 0.338 to 0.522 mm. RMSE values for genuine pairs showed an average range of 0.166 to 0.177, whereas those for imposter pairs ranged from 0.424 to 0.638. A statistically significant difference was observed between the distances of genuine and imposter pairs (P<0.05). Conclusion: The exceptional performance observed for the labial surfaces of anterior teeth underscores their potential as a dependable criterion for accurate 3D dental identification. This was achieved by assessing a minimum of 4 teeth.

Digitally planned surgical crown lengthening: a novel bone reduction strategy to correct a gummy smile.

This report describes the bone reduction guide which was digitally obtained to improve diagnosis, treatment outcome and follow-up. Treatment of gingival smiles due to altered passive eruption should include interdisciplinary planning and smile design to facilitate the prediction of treatment outcome. Crown lengthening surgery can be supported by digital tools to improve surgical planning and follow-up. A 30-year-old female patient was referred to a private dental clinic seeking solutions for her gingival smile. Based on the anatomical crown length, a smile design was created, and the patient was presented with a simulated smile before treatment. In the surgical phase, a full-thickness flap was raised in the upper jaw to achieve the desired outcome. Using cone-beam computed tomography to determine cementoenamel junction for smile design and treatment planning brings many benefits. Patients and clinicians can foresee treatment results. From there, appropriate changes can be made. The bone reduction guide is designed to rest on the bone to help the clinician cut the bone accurately and thoroughly follow the established plan.

Does the use of platelet-rich fibrin enhance the rate of orthodontic tooth movement? A systematic review and meta-analysis.

Introduction: This review synthesizes the available evidence pertinent to the effect of platelet-rich fibrin on the rate of orthodontic tooth movement during comprehensive orthodontic treatment. Method: This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Nine electronic databases were searched until January 2024 without restrictions, followed by a hand search of the reference lists. Controlled randomized split-mouth human studies assessing the effect of platelet-rich fibrin on the rate of orthodontic tooth movement were included. All relevant data from the included studies were extracted and pooled for qualitative and quantitative analysis. Risk-of-Bias was assessed using the Cochrane Risk of Bias tool. The certainty of the evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation tool. Results: From 515 studies, eleven randomized clinical trials were included for qualitative analysis and nine for quantitative analysis. The certainty of the evidence for these studies was low to moderate. The overall risk of bias for most studies was of some concern. The pooled estimate of the data from ten studies has a mean revealed difference of 1.31 (0.13-2.48) at a 95 % confidence interval with significant heterogeneity. Conclusions: This systematic review suggest that platelet-rich fibrin enhances the orthodontic tooth movement rate, but the evidence quality was moderate. Further, based on the currently available evidence, the effectiveness of platelet-rich fibrin on the acceleration of orthodontic tooth movement could not be fully established. Trial registration: PROSPERO: (CRD42021261836).

The Analysis of Intermolar Width and Skeletal Base Class as a Predictor of Potential Maxillary Canine Impaction in Permanent Dentition: A Cross-Sectional Study.

Objectives. This study aimed to analyze the inter-molar width and skeletal base class to predict maxillary canine impaction in permanent dentition. Methods. This cross-sectional study was carried out between September 2021 to March 2022. Patients aged between 13 and 20 years were recruited. These patients' cone-beam computer tomography(CBCT), lateral cephalogram, and dental casts were collected and analyzed. For statistical analysis, T-test and Chi-square tests were applied. Results. A total of 92 patients were enrolled in this study. Inter-molar width was significantly decreased in patients with impacted canine(P < .001). The skeletal base classification was statistically significant when compare with intermolar width(P < .05). The location of impaction (P = .060), type of impaction(P = .435), and side of impaction(P = .239) were determined to be statistically insignificant. Conclusion. The Inter-molar width was decreased in patients with impacted canine; therefore, it may be a potential risk factor. The skeletal classification was found to affect inter-molar width in impacted canine patients.

Exploring the feasibility of smartphone cameras for 3D modelling of bite patterns in forensic dental identification.

The field of bitemark analysis involves examining physical alterations in a medium resulting from contact with teeth and other oral structures. Various techniques, such as 2D and 3D imaging, have been developed in recent decades to ensure precise analysis of bitemarks. This study assessed the precision of using a smartphone camera to generate 3D models of bitemark patterns. A 3D model of the bite mark pattern was created using 3Shape TRIOSTM and a smartphone camera combined with monoscopic photogrammetry. The mesiodistal dimensions of the anterior teeth were measured using Rapidform Explorer and OrtogOnBlender, and the collected data were analyzed using IBM® SPSS® Statistics version 23.0. The mean mesiodistal dimension of the anterior teeth, as measured on the 3D model from 3Shape TRIOSTM and smartphone cameras, was found to be 6.95 ± 0.7667 mm and 6.94 ± 0.7639 mm, respectively. Statistical analysis revealed no significant difference between the two measurement methods, p > 0.05. The outcomes derived from this study unequivocally illustrate that a smartphone camera possessing the specific parameters detailed in this study can create a 3D representation of bite patterns with an accuracy level on par with the outputs of a 3D intraoral camera. These findings underscore the promising trajectory of merging smartphone cameras and monoscopic photogrammetry techniques, positioning them as a budget-friendly avenue for 3D bitemark analysis. Notably, the monoscopic photogrammetry methodology assumes substantial significance within forensic odontology due to its capacity for precise 3D reconstructions and the preservation of critical measurement data.

Use of surgical grafting as a part of multidisciplinary treatment for a patient treated with fixed orthodontic therapy to improve treatment outcomes.

Key Clinical Abstract: Multidisciplinary treatment options can help provide good clinical outcomes if these are appropriately sequenced and carried out correctly. This case exemplifies interdisciplinary involvement to ensure the patient received an improved esthetic outcome. Abstract: The presence of anterior diastemas may compromise the esthetics of a patient's smile, causing mental, and social trauma in many patients. After careful evaluation Periodontal, surgical, and prosthodontic treatments are sometimes required to ensure successful treatment outcomes using a multidisciplinary staged treatment approach. These approaches must be carefully planned to ensure timely treatment progress. Surgical intervention must be planned at the right point in treatment to ensure adequate healing before placement of esthetic restorations.

Frequency and etiological denominators of alveolar osteitis at Northern Province of Kingdom of Saudi Arabia-An observational study.

Objective: Alveolar osteitis is a painful complication that often arises after tooth extraction, presenting a significant clinical challenge. It is imperative to gain a comprehensive understanding of both its occurrence and the contributing factors to enhance the quality of dental care. The aim of this study was to assess the frequency and prevalence of alveolar osteitis among patients and compare these variables based on demographic characteristics (age and sex), the number of teeth extractions, operator experience, health status, and smoking habits in the target population. Methods: This cross-sectional observational study was conducted from May 2019 to April 2020. It included all patients above 16 years of age, of both genders, who underwent permanent tooth extraction for various reasons. Patient demographics, smoking habits, health status, operating dental surgeon's clinical experience, extraction technique, and the number of teeth extracted were recorded. Statistical analysis was performed using SPSS version 25. Chi-square test and regression analysis were used to assess differences between age, sex, smoking habit, dentist category, and the number of teeth extractions in relation to alveolar osteitis. Results: A total of 679 permanent tooth extractions were performed in 438 patients. Alveolar osteitis was observed in 107 cases (15.7%) following tooth extractions. Among these, 36 cases (33.6%) occurred in single tooth extraction cases, while 71 cases (66.4%) were present in patients with multiple extractions. Moreover, 67 cases (62.6%) of alveolar osteitis were found in cigarette smokers. In addition, 61 cases (57%) of dry sockets were reported after tooth extractions performed by dental interns, while 46 cases (43.0%) were noted in extractions performed by experienced dental surgeons and specialists. Conclusion: The study found a 15.7% incidence of alveolar osteitis in tooth extraction patients in the Al-Jouf region. Alveolar osteitis was more prevalent in males and the age group of 56-77 years. Multiple tooth extractions were associated with higher alveolar osteitis incidence, while operator inexperience increased post-extraction complication risks. In addition, a promising novel protocol and risk assessment scoring system have been devised which require further validation and future research.

3D Bitemark Analysis in Forensic Odontology Utilizing a Smartphone Camera and Open-Source Monoscopic Photogrammetry Surface Scanning

Abstract Bitemark analysis is a challenging procedure in the field of criminal case investigation. The unique characteristics of dentition are used to find the best match between the existing patterned injury and the suspected perpetrator in bitemark identification. Bitemark analysis accuracy can be influenced by various factors, including biting pressure, tooth morphology, skin elasticity, dental cast duplication, timing, and image quality. This review article discusses the potential of a smartphone camera as an alternative method for 3D bitemark analysis. Bitemark evidence on human skin and food should be immediately recorded or duplicated to retrieve long-lasting proof, allowing for a sufficient examination period. Various studies utilizing two-dimensional (2D) and three-dimensional (3D) technologies have been developed to obtain an adequate bitemark analysis. 3D imaging technology provides accurate and precise analysis. However, the currently available method using an intraoral scanner (IOS) requires high-cost specialized equipment and a well-trained operator. The numerous advantages of monoscopic photogrammetry may lead to a novel method of 3D bitemark analysis in forensic odontology. Smartphone cameras and monoscopic photogrammetry methodology could lead to a novel method of 3D bitemark analysis with an efficient cost and readily available equipment.

Channa Striata and Hyperbaric Oxygen Therapy Combination for Pressure Areas in Orthodontic Treatment

ABSTRACT Objective: To study the effect of using a combination of Channa Striata gel and hyperbaric oxygen therapy on pressure areas during orthodontic treatment. Material and Methods: The study was conducted using the ARRIVE Essential 10 guidelines. In this study, 35 3-4 months male guinea pigs (Cavia Cobaya) weighing 300-400 grams were used and divided into 5 groups (n=7). Decalcification was performed to dissolve the dental calcium and jawbone to cut the tissue properly. The decalcification was performed for 30 days. Then preparations were made with HE (Hematoxylin Eosin), observed using a microscope, and counted the number of osteoclasts and macrophages on a light microscope with 400 times magnification. The results of the preparations were analyzed using the SPSS program. Results: The Kruskal-Wallis test of macrophage cells and the ANOVA test of osteoclast cells showed significant results between all groups (p<0.05). Conclusion: The effect of hyperbaric oxygen therapy 2,4 ATA administered on days 8-14 and Channa Striata extract gel administered on days 3-14 can increase the number of macrophages in the periodontal ligament and osteoclasts in the alveolar bone in the pressure area during orthodontic tooth movement.

Are We Hearing Right? The Negative Impact of New SARS-CoV-2 Preventive Measures and Prolonged Use of Treatment Modalities during Orthodontic Treatment

Abstract Since the dental treatment involves the use of various instruments and machines, there is ample presence of both distracting as well as destructive noise, and these are defined based on various parameters. With an increase in safety measures incorporated into dental practices, such as extra-oral suction devices and respirators, there has also been a corresponding rise in noise levels usually present in a clinic. Previous clinical experiments and trials have shown that the noise in a dental office can permanently bring about hearing damage. In addition to this, working with added safety measures during the pandemic, such as the use of personal protective equipment, respirators, and face shields can decrease operator efficiency and the ability to communicate normally. Dentistry has already been demonstrated to be one of the most hazardous occupations because of the high risk of infections. An Orthodontist must protect their eyes and mouth from potentially hazardous situations and the ears to prevent hearing damage.

The Use of Bio-Inks and the Era of Bioengineering and Tooth Regeneration

Abstract Objective: To review existing literature and provide an update on the current use of Bio-Inks and potential future use. Material and Methods: A MeSH keyword search was conducted to find out relevant articles for this short review. Results: Bio inks used in 3D printing grafting require various properties essential for the selection. Combining multiple methods and improved properties is essential for developing successful bio-inks for 3D grafting of functional tissues and tooth pulp regeneration from stem cells. To date, researchers have made many efforts to grow teeth based on stem cells and inculcate regeneration of teeth along with surrounding tissues like alveolar bones and periodontal ligaments. Conclusion: 3D printing with Bio-Inks requires strict adherence to safety protocols for successful outcomes, making it difficult to employ this routinely.

Computer Vision Syndrome: Will the Pandemic Lead to Eye Problems for Dentists?

ABSTRACT Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features.

In Vitro Microscopic Evaluation of Metal- And Zirconium-Oxide-Based Crowns' Marginal Fit

ABSTRACT Objective To evaluate the marginal adaptation of computer-aided designing and computer-aided machining (CAD/CAM) fabricated cobalt-chromium and zirconium-oxide-based ceramic crowns compared to those produced by a conventional method. Material and Methods The study consists of three groups; 45 crowns fabricated from cobalt-chromium (CAD-CoCr) and 45 crowns manufactured from zirconium CAD/CAM technology (CAD-Z), and 45 control (C) which consists of conventional metal-ceramic crowns. The marginal discrepancies in vertical dimensions were assessed utilizing a microscope in four surfaces (mesial, distal, vestibular, and oral) for each crown. On completion of the microscopic evaluation, multivariate analysis of variance (MANOVA) was used to study the difference in the four surfaces, considered altogether. Two-way ANOVA revealed the effect of three systems used for gap measurements of each landmark. The differences observed were considered significant at p<0.05. Results There were no differences in the four surfaces revealed by АNOVА in the three groups when considered altogether. Two-way ANOVA of each surface discovered no differences among all groups as well. Conclusion The CAD/CAM crowns revealed a comparable and satisfactory marginal adaptation compared to conventional metal-ceramic crowns.