Proximal Periodontal Support Adjacent to Untreated Peri-implantitis Lesions: A Cross-Sectional Analysis.

PURPOSE: To assess site-related features of peri-implantitis occurring adjacent to teeth and its association with the proximal periodontal bone level. MATERIALS AND METHODS: Periapical radiographs were collected from partially edentulous patients exhibiting peri-implantitis adjacent to teeth. The following variables were quantified: intrabony defect width (DW), implant marginal bone loss (MBLi), tooth marginal bone loss (MBLt), implant-tooth distance (ITd), intrabony defect angulation (DA), adjacent periodontal bone peak height (ABPh), and implant-tooth angulation (ITa). A correlation matrix using the Spearman correlation coefficient was created to explore the dependence of these variables. Univariate linear regression analysis was carried out by means of generalized estimating equations (GEE), using MBLt as dependent variable. RESULTS: Overall, 61 patients and 84 implants were included in this study, consisting of a total of 105 implant sites facing adjacent teeth. This resulted in 515 linear and 194 angular measurements. A total of 11 different statistically significant associations were demonstrated between the different variables analyzed. Moreover, the univariate regression analysis revealed significant positive associations between MBLt and MBLi (P = .013) and between MBLt and periodontitis (PD) (P = .014). These associations were confirmed in the multivariate model. CONCLUSIONS: Teeth adjacent to untreated peri-implantitis lesions are associated with proximal loss of periodontal support. This finding is more remarkable in scenarios that display short implant-tooth distance.

Dental and temporomandibular joint pathology of the red fox (Vulpes vulpes).

Skulls from 305 red foxes (Vulpes vulpes) were examined using predefined criteria to assess for the presence and severity of dental and temporomandibular joint (TMJ) pathology. Of the 305 specimens examined, 131 were male (42.9%), 103 were female (33.4%), 71 were of unknown sex (23.3%), 238 were adults (78.03%) and 67 were young adults (21.97%), with juveniles excluded from the study. Of a maximum of 12,810 possible teeth, 12,355 (96.5%) were present for examination, 72 (0.6%) were absent congenitally, 97 (0.8%) were acquired tooth loss and 280 (2.2%) were absent artefactually. Eight teeth (0.06%) in five specimens (1.6%) had abnormal tooth form and four (0.03%) supernumerary teeth were present across four (1.3%) specimens. Ten persistent deciduous teeth were present in seven (2.3%) specimens and six (0.05%) unerupted teeth were found in four (1.1%) specimens. Root number variation was present in 51 (0.4%) teeth, predominantly premolar teeth. Twenty-one (6.9%) specimens had lesions consistent with enamel hypoplasia and 42 (13.8%) showed root fenestrations in the maxillary alveolar bone. Periodontitis and attrition/abrasion were present in most specimens (56.7% and 96.1%, respectively). Three-hundred and eighty (3.1%) teeth were fractured, with the most common fracture type being root fractures. Eleven periapical lesions were found in nine (0.03%) specimens. Six-hundred and eight TMJs were evaluated and many specimens (11.5%) had evidence of low-grade TMJ osteoarthritis. Overall, these red foxes share similar dental pathology to other foxes, but had a higher prevalence of congenital tooth absence, persistent deciduous teeth, TMJ pathology and enamel hypoplasia.

A Review of Selected Dental Anomalies With Histologic Features in the Pediatric Patient.

Unique dental conditions in children include odontogenic cysts and tumors, hereditary dental diseases, developmental anomalies, and lesions associated with the eruption of the primary or permanent teeth. Many of these conditions have long lasting effects on the adult dentition in terms of affecting esthetics, function, and overall quality of life. Inherited dental syndromes affect the dental hard tissues specifically the enamel, dentin, and/or cementum in a generalized manner, involving both primary and permanent teeth. These conditions manifest in altered quality or quantity of the hard tissues, leading to fragility, tooth loss and dental diseases such as caries, periapical pathology, and periodontal disease. This category includes amelogenesis imperfecta, dentinogenesis imperfecta, dentin dysplasia, hypophosphatasia, and hypophosphatemia. Developmental defects such as regional odontodysplasia are defined by involvement of the primary and permanent dentition in a localized manner, identified in early childhood. This review will elaborate on the histologic findings in these selected dental conditions with a discussion on clinical and radiographic findings, as well as molecular features wherever appropriate.

[Recognition on dentin dysplasia type â ¡].

Dentin dysplasia type Ⅱ (DD-Ⅱ) is a subtype of hereditary dentin disorders. The dentin sialophosphoprotein (DSPP) gene has been revealed to be the causative gene, whose mutations could affect the normal tooth development process. The lesions involve both deciduous and permanent dentition, mainly manifested as tooth discoloration, attrition and even the subsequent malocclusion. If not treated in time, it will significantly affect the physical and psychological health of patients. The disease is difficult to be diagnosed in clinic accurately as its low incidence and hidden manifestations. The present article aims to discuss the clinical and radiographic characteristics, diagnosis, treatment of DD-Ⅱ, in order to improve the overall understanding on DD-Ⅱ for clinicians.

Is External Cervical Resorption an Established Manifestation of Systemic Sclerosis? A Case Report.

Scleroderma, or systemic sclerosis, is a multisystem autoimmune disorder characterized by hardening and fibrosis of the skin. To date, only a small number of case reports have established a relationship between scleroderma and external cervical resorption (ECR). The aim of this case report is to document the case of a patient with multiple external cervical resorption lesions, who was referred to our unit. A 54-year-old female patient, with a 10-year history of systemic sclerosis diagnosed by her rheumatologist, was referred to our unit regarding extensive ECR. A total of 14 maxillary and mandibular teeth with ECR were detected by clinical examination and cone-beam computed tomography. The characteristic vascularity of resorptive defects with profuse bleeding upon probing was not evident. The patient declined any active treatment owing to the desire to avoid lengthy and unpredictable treatment, which may hasten the loss of her teeth. General practitioners should be aware of the relationship between connective tissue disorders and ECR. Although not well established in the literature, the vascular changes implicated in scleroderma may stimulate the odontoclastic processes involved in ECR.

Clinical, genetic, epidemiologic, evolutionary, and functional delineation of TSPEAR-related autosomal recessive ectodermal dysplasia 14.

TSPEAR variants cause autosomal recessive ectodermal dysplasia (ARED) 14. The function of TSPEAR is unknown. The clinical features, the mutation spectrum, and the underlying mechanisms of ARED14 are poorly understood. Combining data from new and previously published individuals established that ARED14 is primarily characterized by dental anomalies such as conical tooth cusps and hypodontia, like those seen in individuals with WNT10A-related odontoonychodermal dysplasia. AlphaFold-predicted structure-based analysis showed that most of the pathogenic TSPEAR missense variants likely destabilize the ß-propeller of the protein. Analysis of 100000 Genomes Project (100KGP) data revealed multiple founder TSPEAR variants across different populations. Mutational and recombination clock analyses demonstrated that non-Finnish European founder variants likely originated around the end of the last ice age, a period of major climatic transition. Analysis of gnomAD data showed that the non-Finnish European population TSPEAR gene-carrier rate is ∼1/140, making it one of the commonest AREDs. Phylogenetic and AlphaFold structural analyses showed that TSPEAR is an ortholog of drosophila Closca, an extracellular matrix-dependent signaling regulator. We, therefore, hypothesized that TSPEAR could have a role in enamel knot, a structure that coordinates patterning of developing tooth cusps. Analysis of mouse single-cell RNA sequencing (scRNA-seq) data revealed highly restricted expression of Tspear in clusters representing enamel knots. A tspeara -/-;tspearb -/- double-knockout zebrafish model recapitulated the clinical features of ARED14 and fin regeneration abnormalities of wnt10a knockout fish, thus suggesting interaction between tspear and wnt10a. In summary, we provide insights into the role of TSPEAR in ectodermal development and the evolutionary history, epidemiology, mechanisms, and consequences of its loss of function variants.

Dental and temporomandibular joint pathology of the Arctic fox (Vulpeslagopus).

Museum skull specimens from 224 Arctic foxes (Vulpes lagopus) were examined macroscopically using an established protocol for examination of mammalian skull specimens. Foxes were collected from coastal and island regions of Alaska, USA, except for two individuals. Collection years ranged from 1931 to 2016 with most specimens collected during the 1950s and 1960s. The study population comprised more females (n = 134, 59.8%) than males (n = 83, 37.0%) and individuals of unknown sex (n = 7, 3.1%). There were 108 (48.2%) young adults, 115 (51.3%) adults, and one (0.4%) individual of unknown age. A total of 8,891 teeth (94.5%) were available for examination. The most common types of pathology observed were periodontitis (n = 222, 99.1%), dental fractures (n = 175, 78.1%) and attrition/abrasion (n = 198, 88.4%). Periapical lesions (n = 12, 5.3%), temporomandibular joint (TMJ) osteoarthritis (n = 3, 1.3%) and root number variation (n = 5, 2.2%) were less common. Enamel hypoplasia was noted in eight foxes (3.6%), all of which were discovered on St. Matthew Island, Alaska, in 1963. As in other canid species, periodontitis, attrition/abrasion and tooth fractures are common in the Arctic fox, while TMJ pathology is rare. Loss of tooth crown substance probably reflects the influence of diet, interspecific and conspecific aggression and oral trauma due to trapping and hunting methods. The high prevalence of periodontitis is probably also due to the combined effects of diet, genetics and host immune reaction to oral bacteria.

Dental and temporomandibular joint pathology of the island fox (Urocyon littoralis).

Museum skull specimens from 318 island foxes (Urocyon littoralis) were examined macroscopically according to predefined criteria. The study population included males (n = 129, 40.6%), females (n = 93, 29.3%) and animals of unknown sex (n = 96, 30.2%), and comprised 182 (57.2%) adults, 118 (37.1%) young adults and 18 (5.7%) individuals of unknown age, with juveniles and neonates excluded. The number of teeth present for examination was 11,438 (85.6%) with 1918 (14.4%) absent artefactually, 4 (0.03%) absent congenitally and 243 (1.82%) lost ante mortem through acquired tooth loss. There were seven persistent deciduous teeth (0.05%) in three specimens and 11 supernumerary teeth (0.08%) in 10 specimens. Teeth with extra roots were found in 38 skulls (11.9%) with 0.48% of all teeth affected. Two (0.63%) specimens had one tooth with an abnormal form. Fifty-eight (18.2%) specimens had bone fenestrations. Of the alveoli examined, 5361 (46.9%) displayed bony changes suggestive of periodontitis, with 315 (99.1%) of skulls affected. Of the teeth available for examination in 310 specimens (97.5%), most (n = 6,040, 52.8%) had some degree of attrition or abrasion. Fractures affected 1217 (11.0%) of the teeth present in 266 specimens (83.6%). Twenty-three periapical lesions (0.20%) were present in 16 skulls (5.03%). Evidence of temporomandibular joint osteoarthritis was found in seven specimens (0.02%) on either the mandibular head of the condylar process or on the mandibular fossa of the temporal bone.

Orbital tooth - not always a teratoma : a case report.

A 7-year-old girl presented with a painless firm to cystic mass in the infero-temporal quadrant of her right orbit since birth. The mass had recurred with a cutaneous sinus after initial surgery. Right eye vision was affected by mass induced astigmatism. The anterior and posterior segments were normal. Magnetic Resonance Imaging of the orbit suggested a mature teratoma within the orbital bone. Mass excision showed a fully developed molar tooth within a cyst associated with a cutaneous sinus. Histopathological examination reported odontogenic choriostoma. We report this unique case of orbital odontogenic choristoma in an unusual location, associated with a cutaneous sinus, emphasizing the need for complete excision to prevent recurrence.

Diet-related dental wear in archaeological human populations of Chalcolithic and Bronze Age from North-Eastern Romania.

Dental macrowear is the non-pathological loss of hard tissues on the occlusal surface of the teeth. In archaeological contexts, the loss of tooth tissues is often correlated with lifestyles, habits, and with the physical properties of the consumed food - including preparation techniques. We report the first semiquantitative and quantitative assessment on dentine exposure of permanent second molars (M2) using the scale scoring technique, image analysis, and regression analysis on human teeth from Chalcolithic and Bronze Age archaeological populations discovered in North-Eastern Romania. We show an increase of dentine exposure percent (PDE) with the age-ranges, but no evidence of wear by sex were observed. In the linear regression analysis, the age and the dentine exposure percent, as variables, were correlated in 31% of the mandibular M2 molars and 49% in the maxillary ones (p < 0.001). Moreover, the multiple regression analysis involving the dentine exposure and the three variables that could influence the dental wear (i.e., age, occlusal area, and period) revealed no differences in dental wear between Chalcolithic and Bronze Age, as well as between different cultures of Bronze Age (i.e., Monteoru Culture and Noua Culture). Therefore, apart from age, occlusal area, and period, there may be other factors including diet and food-processing techniques that could be also considered when discussing the loss of tooth tissues in archaeological populations, especially farmers.

Dental and Temporomandibular Joint Pathology of the Steller Sea Lion (Eumetopias jubatus).

Skulls from 112 Steller sea lions (Eumetopias jubatus) were examined according to predefined criteria. Of the specimens, 73 (65.2%) were from males, 29 (25.9%) from females and 10 (8.9%) were of unknown sex, with 50 adults (44.6%), 61 young adults (54.5%) and one of unknown age (0.9%). The number of teeth evaluated was 3,521. Adults had more acquired tooth loss than young adults (P <0.0001). A total of 1,660 teeth (47.1%) from 111 specimens (99.1%) had evidence of attrition or abrasion. Adults displayed more attrition or abrasion than young adults (P <0.0001). A total of 241 teeth (6.8%) from 47 specimens (42%) had tooth fractures. Adults had more fractured teeth than young adults (P <0.0001). Bony changes consistent with periodontitis affected 36.7% of teeth. Adults had more teeth affected by periodontitis than young adults (P <0.0001). Temporomandibular joint osteoarthritis lesions were found in 54 specimens (48.2%) with more in adults than in young adults (P <0.0001). Although the significance of our findings is unknown, the occurrence and severity of these lesions may play an important role in the morbidity and mortality of Steller sea lions.

A systematic scoring system to determine the long-term prognosis for severely damaged teeth.

Many of the criteria commonly considered in treatment planning for severely damaged teeth are well known to clinicians. However, a systematic approach to decision-making is lacking. The purpose of this article is to introduce a quantitative systematic risk assessment scoring system (RASS) to determine the long-term prognosis for severely damaged teeth based on several important factors. Before any treatment decision is made, the dentist should take into account the role of systemic parameters such as the medical condition of the patient, smoking status, psychological factors, patient expectations with regard to the duration and overall cost of treatment, and periodontal health. In the assessment of local factors, emphasis should be placed on 5 parameters: crown to root ratio, root condition, risk of furcation involvement, complexity of the final restoration, and esthetic results. In the proposed RASS, each of these parameters is ranked using 4 color-coded levels of risk: optimal (green), favorable (blue), unfavorable (yellow), or hopeless (red). The presence of even 1 parameter in the red zone is sufficient to consider tooth extraction. If no parameter is in the red zone, the final decision should be made after the possible effects of all of the clinical conditions are weighed and the overall risk of treatment failure is determined. Clinical decision-making with regard to the preservation or extraction of severely damaged teeth is a challenging, multifactorial process. The RASS introduced in this article focuses on 5 main factors to simplify and organize the decision-making process; however, many other parameters may affect the final treatment decision. Moreover, no decision-making system can be definitively applied to all clinical scenarios, and the entire process depends on the knowledge, experience, and expertise of the clinician.

Evaluation of autofluorescence and image of oral pathogens and the tooth.

PURPOSE: To test the applicability of autofluorescence (AF) spectrum and image in the detection and identification of oral pathogens. METHODS: Oral pathogens (Candida albicans, Porphyromonas gingivalis, Streptococcus mutans) and teeth were used. To induce AF, the 405 nm laser was used as a light source, and AF was obtained and observed using a spectrometer, fluorescence camera, and microscope, respectively. RESULTS: The tested oral pathogens had similar spectral distributions, but their peak intensities and peak ratios were different. Their peak positions and spectral patterns were different from those of the tested sound and carious teeth. These differences were also found from the other referenced oral mucosa. Fluorescence image could localize the existence of oral bacteria. Oral pathogens could be imaged by fluorescence, but identification of each pathogen by image was not probable. CLINICAL SIGNIFICANCE: Oral pathogens can be observed and identified from the lesion if autofluorescence spectrum and fluorescence images are combined.

¿Es el "diente rosado" válido en el contexto forense actual? / Are "pink teeth" relevant to current forensics?

Introducción: El "diente rosado" es un fenómeno post mortem. Se caracteriza por una tonalidad rosa, rojiza y hasta púrpura, que puede observarse en los dientes. Su primera referencia se remite a 1829, cuando Thomas Bell lo describió, y genera polémica desde hace casi dos siglos. La temática plantea varias interrogantes: ¿sería más lógico nombrarlo "red teeth" o "purple teeth"?, ¿qué provoca esa tonalidad más intensa?, ¿la coloración rosada indica determinada causa de muerte?, ¿queda para siempre o puede desaparecer por diversos factores? Objetivo: Describir los indicadores de que el "diente rosado" o "pink teeth" pueda aún ser considerado un elemento importante para la investigación forense actual. Comentarios principales: Luego de la experiencia acumulada con los casos trabajados durante los últimos 20 años y la revisión bibliográfica realizada, se evidencia que el fenómeno aparece sobre todo en las piezas dentales anteriores y premolares monorradiculares. Además, puede verse tanto ante mortem como post mortem. Por causas diferentes el post mortem necesita de varios días para instaurarse y es un evento tafonómico, evidenciable tanto en muertes violentas como naturales, aunque la variación en su tonalidad depende de diversos factores. Consideraciones globales: Teniendo en cuenta la experiencia obtenida por los autores, y lo referido en la bibliografía sobre el tema, se evidencia que este signo, fenómeno o hallazgo (al aclararse las interrogantes planteadas) aún puede ser muy significativo y orientador en el contexto forense actual(AU)

Introduction: "Pink teeth" are a post-mortem phenomenon characterized by a rose, reddish and even purple shade of color which may be observed in teeth. Their first reference dates back to 1829, when Thomas Bell described them. They have been a topic of debate for almost two centuries. The subject poses several questions: Would it be more logical to name them "red teeth" or "purple teeth"? What causes the increase in color intensity? Does the pink shade signal a specific cause of death? Does it remain forever or may it disappear for a variety of reasons? Objective: Describe the indicators that "pink teeth" may still be considered an important element in current forensic research. Main remarks: Based on the experience gathered from the cases analyzed in the last 20 years and the bibliographic review conducted, it is evident that the phenomenon appears mainly in anterior teeth and single-rooted premolars. On the other hand, pink teeth may be observed ante mortem as well as post mortem. For a number of reasons, post mortem pink teeth take several days to form, and they are a taphonomic phenomenon, present in violent as well as natural deaths, though their change in tone depends on various factors. General considerations: Founded on the experience obtained by the authors and the bibliography about the topic, it is evident that this sign, phenomenon or finding (upon clarification of the questions posed) may still be very significant and enlightening in the current forensic context(AU)

Clinical extension of proximal carious lesions compared to bitewing radiographs using photostimulable phosphor plates (PSP).

OBJECTIVES: The aim of this study was to evaluate the use of digital bitewing radiographs using photostimulable phosphor (PSP) plates in the estimation of the true extension of proximal carious lesions. METHODS: The sample size was calculated to be 70 teeth. Adult patients with a minimum of one posterior tooth with primary proximal caries lesions were included. A preoperative bitewing radiograph was taken and the extension of the carious lesion was measured from the most prominent point on the adjacent sound tooth to the deepest axial point of the lesion. An experienced general dentist provided the restorative treatment and made a polyvinyl siloxane impression of the cavity preparation. Clinical caries extension was measured from the most prominent point of the adjacent tooth until the deepest boundary of the axial wall of the preparation on the impression. Postoperative radiographs were taken at the completion of restorative care. The bitewing radiographs were done using PSP plates and caries extension measurements were performed using measuring tools of the digital radiography software. Pairwise comparisons were made between preoperative and postoperative radiographs, and the true clinical depth measurements using paired t-tests. RESULTS: In total, 73 teeth from 44 subjects were included. A significant difference of 0.82 mm was found between preoperative radiographs and clinical measurements (p<0.001). Similarly, comparisons between preoperative and postoperative radiographic measurements showed significant differences of 0.99 mm (p<0.001). CONCLUSIONS: The study found that the true clinical extension of proximal caries after non-selective caries removal was significantly deeper than the preoperative radiographic extension assessment. This was not influenced by the tooth type, the location of the tooth, or the affected tooth surfaces. CLINICAL SIGNIFICANCE: When a non-selective caries removal strategy is adopted, clinicians should be aware that PSP bitewing radiographs underestimate the true clinical extension of proximal caries lesions. This will have an impact on clinicians' practice and restorative treatment decisions.

Unusual teeth in unusual places: Criteria for identifying teratomatous dental elements in archeological contexts.

OBJECTIVE: This paper describes the dental elements (i.e., teeth and incomplete tooth-like structures) formed by mature cystic teratomas and provide some diagnostic criteria to aid in their paleopathological identification and analysis. MATERIALS: Hard tissue structures from 13 clinically-derived mature cystic teratomas excised between 2003 and 2007. All are from female patients (N = 13) between the ages of 17 and 56. METHODS: A dental and osteological inventory identified number of teeth and tooth types present in each specimen. RESULTS: Of the 13 specimens, nine contained dental elements. The number per teratoma ranged from one to seven. A wide variety of tooth types were present in the teratomas with some teeth independent of, and others embedded within, bony matrices. CONCLUSIONS: While some teratoma teeth exhibit distinguishable types and laterality, the majority will exhibit some degree of abnormality in size, form, developmental completion, or association with other irregular bony elements. SIGNIFICANCE: Give the modern clinical prevalence and yet relatively few paleopathological cases reported, it is likely that mature teratomas are under-identified in the archeological record. The diagnostic criteria presented in this paper can aid paleopathologists in their identification and analysis of these neoplasms. LIMITATIONS: Precise paleopathological identification of teratoma elements can be difficult; particularly when they are no longer constrained or contextualized by unmineralized neoplastic borders. As such, there is a risk that such remnants may be mistaken for fetal parts or disassociated elements. SUGGESTIONS FOR FURTHER RESEARCH: Application of these criteria, paired with careful excavation techniques, is advised.

Evaluation of dental caries detection with quantitative light-induced fluorescence in comparison to different field of view devices.

This study evaluated dental caries detection ability between the Qraycam and Qraypen on the same dental caries lesions. A total of 178teeth from 61patients were imaged using Qraypen C®(QC) and Qraycam Pro®(QP) devices and evaluated using analysis software (QA2). Occlusal, secondary, and proximal dental caries were evaluated and scored according to International Caries Detection and Assessment System(ICDAS II) and X-ray criteria. Bland-Altman plots were used to compare quantitative light-induced fluorescence(QLF) parameters obtained from the different QLF devices. Sensitivity, specificity, and area under the receiver operating characteristic curve(AUROC) were calculated. The ΔFaver. of the QLF-parameters showed that the mean difference between the two different QLF devices was close to zero and that the ± 5 error value was included in the mean ± 1.96SD range for the detection of dental caries. The accuracies for diagnosing occlusal dental caries were 0.83-0.96 and 0.81-0.82 and the accuracies for diagnosing proximal dental caries were 0.52-0.62 and 0.52-0.71 for the QC and QP devices, respectively. In conclusion, the ΔFaver. obtained from the QP showed diagnostic value mainly for screening of demineralized teeth. For teeth selected through screening, the depth of the lesion must be precisely evaluated using additional QP and radiographic imaging.

A computed tomographic study of endodontic and apical changes in 81 equine cheek teeth with sagittal fractures.

BACKGROUND: Sagittal fractures of equine cheek teeth are commonly observed during oral examination. There are few reports on the apical and endodontic pathology associated with such fractures seen during computed tomographic (CT) examination. OBJECTIVES: This study aimed to document the prevalence of CT changes indicative of apical disease in equine cheek teeth, which have suffered a sagittal fracture involving the clinical ± reserve crown. STUDY DESIGN: This study is a retrospective case series. METHODS: CT examinations of equine heads with sagittal fractures of cheek teeth present were reviewed: 81 teeth from 49 horses were identified to have a sagittal cheek tooth fracture. The images were evaluated for apical pathology including gas (in the endodontic system and periapically), widened periodontal space, periapical sclerosis, apical clubbing, cementoma/hypercementosis, lamina dura loss, associated sinusitis and sinus mucosal swelling. An apical infection grading system was created to give each tooth a score. Hounsfield units were used to measure the density of the endodontic, apical and periapical regions. The fracture length ratio was recorded. Statistical analysis was performed using a generalised estimating equation to evaluate predictors of apical infection and associations between clinical signs and CT abnormalities. RESULTS: Eighty-seven sagittal fractures (56 buccal, 17 palatal/lingual and 14 midline) from 81 teeth were recorded (74 maxillary and 7 mandibular). Apical infection was diagnosed in 73% (37/51, P = .05) of buccal, 55% (6/11, P = .07) of palatal/lingual, 100% (13/13) of midline, 100% (6/6) of multiple fractures and 96% (23/24, P = .008) of fractures involving infundibula. There was no significant relationship between apical infection and the presence of clinical signs associated with dental pathology (P = .4). There was no significant association between fracture length ratio and apical infection (P = 1.0). Midline sagittal fractures were significantly associated with sinusitis when compared with all other maxillary fractures (odds ratio [OR] 5.92, 95% confidence interval [CI] 1.67-20.83, P = .006). Loss of the lamina dura was not significantly associated with apical infection (P = .5). MAIN LIMITATIONS: There is a maxillary cheek tooth bias in the data set and the subjective grading system. CONCLUSIONS: A large proportion of fractured cheek teeth have evidence of apical infection on CT examination and therefore warrant treatment.

3D Visualization of Dynamic Cellular Reaction of Pulpal CD11c+ Dendritic Cells against Pulpitis in Whole Murine Tooth.

In dental pulp, diverse types of cells mediate the dental pulp immunity in a highly complex and dynamic manner. Yet, 3D spatiotemporal changes of various pulpal immune cells dynamically reacting against foreign pathogens during immune response have not been well characterized. It is partly due to the technical difficulty in detailed 3D comprehensive cellular-level observation of dental pulp in whole intact tooth beyond the conventional histological analysis using thin tooth slices. In this work, we validated the optical clearing technique based on modified Murray's clear as a valuable tool for a comprehensive cellular-level analysis of dental pulp. Utilizing the optical clearing, we successfully achieved a 3D visualization of CD11c+ dendritic cells in the dentin-pulp complex of a whole intact murine tooth. Notably, a small population of unique CD11c+ dendritic cells extending long cytoplasmic processes into the dentinal tubule while located at the dentin-pulp interface like odontoblasts were clearly visualized. 3D visualization of whole murine tooth enabled a reliable observation of these rarely existing cells with a total number less than a couple of tens in one tooth. These CD11c+ dendritic cells with processes in the dentinal tubule were significantly increased in the dental pulpitis model induced by mechanical and chemical irritation. Additionally, the 3D visualization revealed a distinct spatial 3D arrangement of pulpal CD11c+ cells in the pulp into a front-line barrier-like formation in the pulp within 12 h after the irritation. Collectively, these observations demonstrated the unique capability of optical clearing-based comprehensive 3D cellular-level visualization of the whole tooth as an efficient method to analyze 3D spatiotemporal changes of various pulpal cells in normal and pathological conditions.

Association between Dietary Pattern and Periodontitis-A Cross-Sectional Study.

The aim of the study was to investigate the relationship between specific known dietary patterns and the prevalence of periodontal disease in a northern population-based cohort study. We evaluated data from 6209 participants of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Dietary intake was assessed with the food frequency questionnaire (FFQ2). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Ordinal logistic regression models were used to determine the association. Ordinal regression analyses revealed a significant association between higher adherence to the DASH diet/Mediterranean diet and lower odds to be affected by periodontal diseases in an unadjusted model (OR: 0.92; 95% CI: 0.87, 0.97; p < 0.001/OR: 0.93; 95% CI: 0.91, 0.96; p < 0.001) and an adjusted model (age, sex, diabetes) (OR: 0.94; 95% CI: 0.89, 1.00; p < 0.0365/OR: 0.97; 95% CI: 0.94, 1.00; p < 0.0359). The current cross-sectional study identified a significant association between higher adherence to the DASH and Mediterranean diets and lower odds to be affected by periodontal diseases (irrespective of disease severity). Future randomized controlled trials are needed to evaluate to which extent macro- and micronutrition can affect periodontitis initiation/progression.