A Randomized Clinical Trial of Monolithic Single-Tooth Crowns: 1-Year Preliminary Results.

PURPOSE: To investigate the clinical results of single-tooth ceramic crowns in the posterior region produced from three different monolithic materials. MATERIALS AND METHODS: A total of 36 posterior single-tooth crowns were fabricated from lithium silicate glass-ceramic (LSGC; n = 12), lithium disilicate glass-ceramic (LDGC; n = 12), and polymer-infiltrated ceramic network (PICN; n = 12) in 27 patients. Restorations were evaluated for prosthetic and periodontal criteria at baseline (0) and after 6 and 12 months. Prosthetic evaluation was performed according to the modified United States Public Health Service (USPHS) criteria, and probing depth (PD), clinical attachment level (CAL), gingival bleeding time index (GBTI), and gingival (GI) and periodontal indices (PI) were evaluated in the periodontal assessment. Friedman and Kruskal-Wallis tests were used for statistical analyses (P = .05). RESULTS: All restorations were evaluated according to survival and success rates. No dropouts occurred. The survival rate of all three materials was 100% after 1 year. However, in the PICN group, a statistically significant difference was found between baseline and 12 months for color match (from A to B) and surface texture (from A to C; P < .001). CONCLUSIONS: Although long-term clinical follow-up periods are needed, all three ceramics showed clinically acceptable survival and success rates over 1 year. The ceramics evaluated in the present study could be preferred for single-tooth full-crown restorations in the posterior region.

Tratamento de odontoma composto e cisto dentígero: relato de caso / Treatment of compound odontoma and dentigeral cyst: case report

Introdução: o odontoma é considerado como um frequente tumor odontogênico benigno, podendo ser classificado em tipo composto ou tipo complexo. O cisto dentígero é o mais comum entre os cistos odontogênicos de desenvolvimento, onde envolve a coroa da unidade dentária no nível da junção amelocementária. Há poucos estudos na literatura do encontro das duas lesões, acometendo o mesmo local na cavidade oral. O diagnóstico pode ser constituído por exame clínico e de imagem. Objetivo: apresentar um caso clínico de odontoma composto e cisto dentígero em região de parassínfise mandibular esquerda abordando as caraterísticas clínicas destas duas lesões e as adequadas formas de tratamento. Relato de caso: paciente do sexo masculino, 16 anos de idade, compareceu ao ambulatório do Centro Odontológico da Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia), portando encaminhamento de ortodontista, solicitando exodontia da unidade dentária 33 inclusa associada a um odontoma. Ao realizar exames físicos e imaginológicos detectou-se a hipótese diagnóstica de odontoma composto associado a unidade dentária, envolto em folículo pericoronário ou cisto dentígero. Foi realizada biópsia excisional das duas lesões e exodontia da unidade. A análise histopatológica confirmou o diagnóstico para odontoma composto associado a cisto dentígero na unidade 33. Ao acompanhamento de 03 meses, paciente apresentou neoformação óssea da região de parassínfise mandibular, mediante a análise de novos exames imaginológicos. Discussão: há poucos estudos na literatura da associação entre as duas lesões, porém relatos afirmam que o odontoma pode ser encontrado associado aos cistos odontogênicos. Por conta da falta de maiores estudos dessa associação, há escassez de recomendações terapêuticas de acordo com faixa etária e extensão do acometimento das lesões. Considerações finais: lesões comumente assintomáticas, tem o diagnóstico constituído por exame clínico e avaliação de exames de imagem(AU)

Introduction: odontoma is considered a frequent benign odontogenic tumor and can be classified as a compound or complex type. The dentigerous cyst is the most common among developmental odontogenic cysts, where it involves the crown of the dental unit at the level of the cementoenamel junction. There are few studies in the literature on the meeting of the two lesions, affecting the same site in the oral cavity. The diagnosis can be made by clinical and imaging examination. Objective: to present a clinical case of compound odontoma and dentigerous cyst in the left mandibular parasymphysis region, addressing the clinical characteristics of these two lesions and the appropriate forms of treatment. Case report: male patient, 16 years old, attended the outpatient clinic of the Centro Odontológico da Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia), having been referred by an orthodontist, requesting extraction of the included dental unit 33 associated with an odontoma. Upon physical and imaging examinations, the diagnostic hypothesis of a compound odontoma associated with a dental unit, surrounded by a pericoronal follicle or dentigerous cyst, was detected. Excisional biopsy of the two lesions and extraction of the unit were performed. The histopathological analysis confirmed the diagnosis of compound odontoma associated with dentigerous cyst in unit 33. At the 03-month follow-up, the patient presented bone neoformation in the mandibular parasymphysis region, through the analysis of new imaging exams. Discussion: there are few studies in the literature on the association between the two lesions, but reports state that odontoma can be found associated with odontogenic cysts. Due to the lack of further studies on this association, there is a lack of therapeutic recommendations according to age group and extent of lesion involvement. Final considerations: commonly asymptomatic lesions, the diagnosis consists of clinical examination and evaluation of imaging tests(AU)

Variation of Tooth Crown Size in Cleft Lip and Palate Patients.

AIM: This study aims to compare the mesiodistal (MD) and buccolingual (BL) tooth crown size (TCS) of adult patients with cleft lip and palate (CL/P) and patients without CL/P. MATERIALS AND METHODS: The sample of this study consisted of 146 adult patients, of both genders, of which 73 were included in the case group (with CL/P) and 73 were included in the control group (without CL/P). Data regarding gender and age and cleft type were collected. In addition, dental models were evaluated to obtain the TCS in the maximum distance of the MD and BL dimensions of all erupted permanent teeth (except third molars). The results were submitted to statistical analysis with a significance level of 0.05. RESULTS: In the upper arch, the central incisors (CI) were smaller in the case group for the MD and BL dimensions (p < 0.05). The lateral incisors (LI) and canine (C) were smaller only in the BL width (p < 0.05) and the second molars (SM), were smaller only in the MD dimensions. In the lower arch, there were significant differences only in the BL width between groups, the CI and LI presented smaller measurements in CL/P patients, while the left first molar (FM) and right first premolar (FPM) were larger (p < 0.05) than in patients without CL/P. CONCLUSION: Patients with CL/P have different sizes in certain teeth compared to patients without CL/P. CLINICAL RELEVANCE: Cleft lip and palate patients usually present important dental anomalies; thereby, the knowledge about trends in tooth size variations in CL/P patients can aid in dental and orthodontic treatment planning to obtain a stable, functional, and esthetic occlusion.

Critical appraisal of the 2020 IADT Guidelines: A personal commentary.

The 2020 International Association of Dental Traumatology (IADT) Guidelines feature several important changes in the treatment recommendations for traumatic dental injuries (TDIs) from the previous 2012 iteration of these Guidelines. This evidence-based narrative review aims to provide a detailed appraisal of five specific changes incorporated in the 2020 IADT Guidelines, based on the available literature evidence that may have prompted these changes. The paper discusses three excellent additions/changes to the new Guidelines: (i) inclusion of a core outcome set for reporting TDIs; (ii) more conservative management of primary dentition TDIs including the changed recommendations for radiation exposure and managing primary dentition luxation injuries; and (iii) the changes in the treatment recommendations for permanent dentition avulsion injuries. The paper further debates whether two other changes made in the current IADT Guidelines for-(i) intrusion injuries in immature teeth; and (ii) complicated crown-root fractures in mature teeth-have sufficient evidence to support the changed recommendations.

The infection control of post-and-core crown restoration.

Post-and-core crown is one of the most common forms of restoration of tooth after root canal therapy (RCT). Infection control is the core objective of RCT, which is usually well realized by endodontists. However, many prosthodontists often neglect the infection control of the tooth and the maintenance of the curative effect of RCT during the process of post-and-core crown, which may lead to the failure of the final restoration. The concept of integrated crown-root treatment advocated recently requires clinicians to consider the RCT and final restoration as a whole, rather than simply divided into two parts-endodontic treatment and restorative treatment. As the core content of integrated crown-root treatment, infection control should be taken seriously by clinicians and implemented throughout the whole treatment process, especially in the restorative treatment that is easily overlooked after RCT. Therefore, this article describes the infection control of post-and-core crown restoration, classifies the tooth requiring post-and-core crown restoration, and puts forward the measures of infection control before and during post-and-core crown restoration, in order to provide reference and guidance for clinical practice.

Evaluation of root position during orthodontic treatment via multiple intraoral scans with automated registration technology.

INTRODUCTION: This study aimed to introduce a method for dynamically monitoring root position with intraoral scans using automated crown registration and root segmentation with artificial intelligence technology and to evaluate its accuracy using a novel semiautomatic root apical distance measurement procedure. METHODS: The sample consisted of 412 teeth from 16 patients whose intraoral scans and cone-beam computed tomography (CBCT) were obtained before and after treatment. Crowns from intraoral scans and roots segmented from CBCT with artificial intelligence technology before treatment were registered, integrated, and divided into individual teeth. With an automated registration program, the virtual root was constructed by crown registration before and after treatment. The distance deviation of the root position at the apex between the virtual root and the actual root, which served as a control, was measured and decomposed into the distance deviation in the mesiodistal and buccolingual directions. RESULTS: The shell deviation of crown registration between CBCT and oral scan before treatment was 0.19 ± 0.04 mm and 0.22 ± 0.04 mm in the maxilla and mandible, respectively. The apical root position distance deviations were 0.27 ± 0.12 mm in the maxilla and 0.31 ± 0.11 mm in the mandible. There was no significant difference between root position in mesiodistal and buccolingual directions. CONCLUSIONS: Applying automated crown registration and root segmentation with artificial intelligence technology in this study improved the accuracy and efficiency of monitoring root position. In addition, the innovative semiautomatic distance measurement procedure can more precisely distinguish the root position discrepancy.

Gender-based evaluation of interproximal dimensions.

OBJECTIVE: The present study was formulated as a gender-based evaluation of the vertical apicocoronal (VAC), horizontal mesiodistal (HMD), and horizontal faciopalatal (HFP) dimensions of the interproximal area and their influence on the presence of interdental papillae and gingival thickness (GT) in maxillary anterior teeth. MATERIALS AND METHODS: A total of 120 patients in an age range of 20 to 40 years, divided equally into two groups based on gender, were evaluated for interproximal VAC, HMD, and HFP dimensions through radiovisiographic (RVG) images. Additionally, the existence of interdental papillae and GT were assessed clinically in the maxillary anterior sextant. RESULTS: The overall mean VAC dimensions in between the central incisors were greater in females than in males, with maximum mean values of 5.91 ± 0.33 mm and 5.03 ± 0.23 mm, respectively. The mean values for HMD and HFP showed a reverse trend, being greater in males than in females, with the differences being statistically significant. Similarly, the mean GT was greater in males than in females (P < 0.0001). It was also shown that as the VAC dimension increased, the existence of complete papillae in the interproximal areas reduced. CONCLUSIONS: The gender variability of intraoral characteristics such as VAC and GT dimensions and their influence on the existence of interdental papillae provide valuable guidelines that can be implemented in procedures in the maxillary anterior sextant. The associations between HMD and HFP dimensions and interdental papillae were not clearly evident, and further exploration in participants of different age groups would be useful and informative.

Impact of low intensity pulsed ultrasound on volumetric root resorption of maxillary incisors in patients treated with clear aligner therapy: A retrospective study.

OBJECTIVE: The aim of this study was to evaluate the volumetric root resorption in maxillary incisors following clear aligner therapy (CAT) with low-intensity pulsed ultrasound (LIPUS), and compare the results to CAT alone. MATERIAL AND METHODS: This retrospective study evaluated pretreatment (T0) and post-treatment (T1) cone-beam computed tomography imaging of 42 adult patients. Twenty-one patients (14 females, 7 males, mean age= 38.1±12.96 years) were treated using CAT with LIPUS device, whereas the other twenty-one matching controls patients (15 females, 6 males, mean age= 35.6±11.7 years) were treated using CAT alone. Images were analyzed and a segmentation protocol was applied on the maxillary incisors. Each segmented tooth volume was exported as a surface mesh in the Visualization Toolkit (VTK) file format. The VTK files for all maxillary incisors were coded and corresponding teeth volumes from T0 and T1 were superimposed. Clipping the crown of each tooth was done, then measurements of root volumes and differences between groups were performed. Changes in root volumes were assessed (p<0.05). RESULTS: Root loss was evident in all teeth in both groups, but was significantly increased in all maxillary incisors of the control group (p<0.001) and in upper left central incisor of LIPUS group (p=0.009). When both groups were compared, there was statistically significant minimal volumetric root loss in LIPUS group (3.50-7.32 mm3), when compared to control group (11.48-12.95 mm3) (p<0.05). CONCLUSION: LIPUS group showed less volumetric root resorption compared to control group during the studied treatment time using clear aligners.

Effect of attachment type on distal bodily movement of the maxillary canine in aligner orthodontics: a finite element study.

OBJECTIVES: To clarify the effect of attachment types on bodily movement of the maxillary canine in aligner orthodontics. MATERIALS AND METHODS: Using an aligner, the canine was moved bodily by 0.1 mm distally as a target position. Orthodontic tooth movement was simulated using the finite element method (FEM). The alveolar socket was displaced in the same manner as the initial movement caused by elastic deformation of the periodontal ligament. First, the initial movement was calculated, and then the alveolar socket was displaced in the same direction and with the same magnitude as the initial movement. These calculations were repeated to move the teeth after placement of the aligner. The teeth and the alveolar bone were assumed to be rigid bodies. A FEM model of the aligner was made based on the crown surfaces. The thickness of the aligner was 0.45 mm, and its Young's modulus was 2 GPa. Three types of attachments-semicircular couple, vertical rectangular, and horizontal rectangular-were placed on the canine crown. RESULTS: Regardless of the type of attachment, upon placement of the aligner on the dentition the crown of the canine moved to the target position, while the apex hardly moved. That is, the canine tipped and rotated. After repeating the calculation, the canine became upright and moved bodily regardless of the attachment type. In the aligner without an attachment, the canine did not become upright. CONCLUSIONS: There was almost no difference among attachment types in terms of achieving bodily movement of the canine.

Factors impacting the height of the interproximal papilla: A cross-sectional study.

OBJECTIVES: To determine the relationship between different parameters (age, periodontal phenotype, contact point height, and crown shape) and the height of the interproximal papilla around the teeth of/in the maxillary anterior sector. MATERIAL AND METHODS: A total of 45 subjects were involved in this study, with 315 interproximal papillae of the maxillary anterior sector. The interproximal papillae were clinically classified according to the Norland and Tarnow classification. The periodontal phenotype was assessed by periodontal probe transparency through the marginal gingiva. The height of the papilla, the height of the contact points, and the width/length ratio of the crown were also measured using the periodontal probe. The relationship between the variables was studied using Pearson's correlation. Statistical significance was set at a value of p < .05. RESULTS: A positive correlation was found between age and the papilla score. However, a negative correlation was noted between age and papilla height, with statistically significant values. A negative correlation was found between the papilla score and the rest of the studied clinical parameters. However, this correlation was not found with regard to the height of the papilla with the same parameters, except for the height of the contact points. CONCLUSIONS: A statistically significant relationship was noted between the appearance of the interproximal papillae and all the parameters studied.

Three-dimensional analysis of the relationship between mandibular retromolar space and positional traits of third molars in non-hyperdivergent adults.

BACKGROUND: The anatomical position of the mandibular third molars (M3s) is located in the distal-most portions of the molar area. In some previous literature, researchers evaluated the relationship between retromolar space (RS) and different classifications of M3 in three­dimensional (3D) cone-beam computed tomography (CBCT). METHODS: Two hundred six M3s from 103 patients were included. M3s were grouped according to four classification criteria: PG-A/B/C, PG-I/II/III, mesiodistal angle and buccolingual angle. 3D hard tissue models were reconstructed by CBCT digital imaging. RS was measured respectively by utilizing the fitting WALA ridge plane (WP) which was fitted by the least square method and the occlusal plane (OP) as reference planes. SPSS (version 26) was used to analyze the data. RESULTS: In all criteria evaluated, RS decreased steadily from the crown to the root (P < 0.05), the minimum was at the root tip. From PG-A classification, PG-B classification to PG-C classification and from PG-I classification, PG-II classification to PG-III classification, RS both appeared a diminishing tendency (P < 0.05). As the degree of mesial tilt decreased, RS appeared an increasing trend (P < 0.05). RS in classification criteria of buccolingual angle had no statistical difference (P > 0.05). CONCLUSIONS: RS was associated with positional classifications of the M3. In the clinic, RS can be evaluated by watching the Pell&Gregory classification and mesial angle of M3.

Restoration longevity: Q: "How long will my crown last?" A: "78 years, Madame" - A case report.

This case report describes a post-retained crown placed on an anterior tooth that survived 78 years, with restoration repairs at 40 years and 58 years following placement. The history of the patient's other dental restorations and care showed a similar longevity.

Management of Crown-root Fracture with 180-degree Rotation Replantation: a Report of 2 Cases.

Intentional replantation involves a combination of periodontics, endodontics, prosthodontics and oral surgery. Crown-root fracture management is still complicated nowadays. A fracture line extending longitudinally to the subgingival area and intruding bioogical width could affect infection control, gingival health and crown restoration. In the present study, we present two cases. Case 1 involved a 23-year-old man who presented at our hospital with crown-root fracture of the maxillary left central incisor. A radiographic image of the tooth revealed a fracture line under the alveolar crest. The fractured tooth was treated with intentional replantation with 180-degree rotation, root canal treatment and veneer restoration. The patient was followed up for 60 months. The replanted tooth functioned well, and no symptoms of resorption or ankylosis were observed by radiographic examination. Case 2 involved a 20-year-old woman who was referred to our hospital for crown-root fracture of her maxillary teeth. A radiographic examination revealed complicated crown-root fracture of the maxillary right lateral incisor and both maxillary central incisors. The central incisors were treated with intentional replantation with 180-degree rotation. At the 48-month follow-up, the fractured teeth were found to have regained normal function based on clinical and radiographic examination. Limited case reports are available on a long-term follow-up of intentional replantation with 180-degree rotation. These two cases, particularly case 2, presented optimal healing after 4 years with unideal crown-root ratios. This case report suggests that this old method of preserving teeth with crown-root fractures can be used as a last resort to save teeth owing to its timesaving and microinvasive procedure.

Managing a Deep Subgingival Cusp Fracture: Case Reports.

Cuspal fractures are relatively common. Fortunately for esthetics, when a cuspal fracture occurs in a maxillary premolar, it most commonly involves the palatal cusp. Fractures with a favorable prognosis may be approached with a minimally invasive treatment to successfully retain the natural tooth. This report describes 3 cases of "cuspidization" to treat maxillary premolars with cuspal fractures. After identifying a palatal cusp fracture, the fractured segment was removed, resulting in a tooth that closely resembles a cuspid. Depending on the extent and location of the fracture, root canal treatment was indicated. Subsequently, conservative restorations sealed the access and covered exposed dentin. Full coverage restorations were neither required nor indicated. The resulting treatment provided practical and functional treatment with a good esthetic outcome. When indicated, the described cuspidization technique can conservatively manage patients with subgingival cuspal fractures. The procedure is minimally invasive and cost-effective and can be done conveniently in routine practice.

Mechanism of enamel damage in the grooves of molars during mastication.

BACKGROUND: During mastication, molars are subjected to heavy stress. However, a full explanation of the effects of physiological loads on tooth structures is lacking. OBJECTIVES: The study aimed to determine stress in molars and identify the mechanism of enamel damage in the grooves of the teeth during computer-simulated mastication. MATERIAL AND METHODS: The study was carried out using the finite element method (FEM). A three-dimensional (3D) model of the first mandibular molar and of the crown of the opposing maxillary tooth was created. A food bite was introduced between the antagonistic teeth. The mastication cycle of the bolus was computer-simulated. The equivalent stress in the enamel and dentin of the mandibular molar was calculated according to the modified von Mises (mvM) criterion. RESULTS: During the simulated chewing activity, the highest equivalent mvM stress and tensile stress concentrated on the molar enamel around the central groove and the foramen cecum. The value of the equivalent mvM stress was close to the tensile strength of the enamel. According to the mvM criterion, the enamel in these areas was exposed to destruction, which coincided with the occurrence of class I caries. CONCLUSIONS: During mastication, significant tensile and mvM stress concentrates on the mandibular molar enamel around the central groove and the foramen cecum. High stress in these areas may cause prism microfractures and facilitate the bacterial penetration of the enamel.

3D reconstruction for maxillary anterior tooth crown based on shape and pose estimation networks.

PURPOSE: The design of a maxillary anterior tooth crown is crucial to post-treatment aesthetic appearance. Currently, the design is performed manually or by semi-automatic methods, both of which are time-consuming. As such, automatic methods could improve efficiency, but existing automatic methods ignore the relationships among crowns and are primarily used for occlusal surface reconstruction. In this study, the authors propose a novel method for automatically reconstructing a three-dimensional model of the maxillary anterior tooth crown. METHOD: A pose estimation network (PEN) and a shape estimation network (SEN) are developed for jointly estimating the crown point cloud. PEN is a regression network used for estimating the crown pose, and SEN is based on an encoder-decoder architecture and used for estimating the initial crown point cloud. First, SEN adopts a transformer encoder to calculate the shape relationship among crowns to ensure that the shape of the reconstructed point cloud is precise. Second, the initial point cloud is subjected to pose transformation according to the estimated pose. Finally, the iterative method is used to form the crown mesh model based on the point cloud. RESULT: The proposed method is evaluated on a dataset with 600 cases. Both SEN and PEN are converged within 1000 epochs. The average deviation between the reconstructed point cloud and the ground truth of the point cloud is 0.22 mm. The average deviation between the reconstructed crown mesh model and the ground truth of the crown model is 0.13 mm. CONCLUSION: The results show that the proposed method can automatically and accurately reconstruct the three-dimensional model of the missing maxillary anterior tooth crown, which indicates the method has promising application prospects. Furthermore, the reconstruction time takes less than 11 s for one case, demonstrating improved work efficiency.

Transient apical breakdown of a discoloured maxillary central incisor during orthodontic treatment: A case report.

Transient apical breakdown (TAB) appears to be a repair process taking place in the pulp and periapical area of traumatised teeth which may display crown discoloration and have no responses to pulp sensitivity tests. Few TAB cases induced by orthodontic forces have been reported so far. Presented is a case report in which TAB occurred on the maxillary right central incisor during orthodontic treatment. The affected tooth suddenly displayed crown discoloration and had no response to pulp testing at 6 weeks after the placement Invisalign Clear Aligner appliances. Condition of the discoloured tooth was monitored by periodic recall examinations without any active treatment. Six months after the occurrence of discoloration, the affected tooth recovered to its original shade and responded normally to pulp sensitivity tests.

Reattachment of Fractured Tooth Fragment by Multidisciplinary Treatment Approach.

Dental anterior fractures are common injuries, especially in those who practice extreme sports. This report describes a 25-year-old Bolivian patient who attended our private dental clinic in La Paz, Bolivia after experiencing an accident during downhill mountain biking. An intraoral examination revealed a fracture line on the buccal side in the middle third of the coronal portion of the right central maxillary incisor which extended towards the proximal and lingual sides. Multidisciplinary treatment, including crown lengthening, osteotomy, root canal treatment, fiberglass post insertion, and reattachment of the fracture segment was performed. A follow-up examination at 10 months later revealed that the tooth was completely reestablished both functionally and esthetically and that there was no periapical pathosis or discomfort. This outcome suggests that if a patient seeks a dental consultation soon after a complex crown-root fracture has occurred, and if the broken tooth segment is available, then reattachment offers an economical and simple treatment option which will allow immediate restoration of functionality and esthetic standards. Continued follow-up should form part of such a treatment plan to allow long-term pulp vitality and periodontal health status to be monitored.

Computed tomography assessment of hypodontia and crown size in hemifacial microsomia.

OBJECTIVE: Our aims were to assess the prevalence of hypodontia in unilateral hemifacial microsomia (HFM), and to compare tooth (crown) size between affected and unaffected sides. DESIGN: In a retrospective cross-sectional study of South Australians, computed tomography (CT) scans were used to assess hypodontia and crown size (mesiodistal length, buccolingual width and crown height). The inclusion criteria were the absence of other congenital anomalies and the availability of CT scans. The exclusion criteria were the lack of extraction history or reproducible landmarks for morphometric assessment. The final sample comprised 41 participants in both dentitions, including 32 children and 9 adults (median age 13.9 years, range 0.4 - 47.6 years; 19 males and 22 females). Hypodontia was assessed in all participants, and the permanent crown size in 30 (73.2%) participants. Linear mixed-effects models were performed to determine if crown size was significantly different between the two sides, controlling for sex, HFM severity, and tooth and jaw type. RESULTS: Hypodontia occurred in none of the participants in the primary dentition, but in 6/30 (20%) participants in the permanent dentition (3/30 each on the affected and unaffected sides). There was no significant difference in the mean crown dimensions between the two sides, but the crown size was larger in males (p < 0.05), except for mesiodistal length, and became progressively smaller with increased HFM severity (p < 0.05). CONCLUSIONS: Hypodontia spared the primary dentition but featured prominently in the permanent dentition. The permanent crown dimensions were unaltered between the two sides.

Vertical soft tissue augmentation to treat implant esthetic complications: A prospective clinical and volumetric case series.

INTRODUCTION: Challenging implant esthetic complications are often characterized by implant malpositioning and interproximal attachment loss of the adjacent teeth. However, limited evidence is available on the treatment of these conditions. The aim of this study was to evaluate the clinical, volumetric, and patient-reported outcome following treatment of peri-implant soft tissue dehiscences (PSTDs) exhibiting interproximal attachment loss on adjacent teeth, performed through vertical soft tissue augmentation with implant submersion. METHODS: Ten subjects with isolated PSTD in the anterior maxilla characterized by adjacent dentition exhibiting interproximal attachment loss were consecutively enrolled and treated with horizontal and vertical soft tissue augmentation, involving crown and abutment removal, two connective tissue grafts, and submerge healing. Clinical outcomes of interest included mean PSTD coverage, mean PSTD reduction, clinical attachment level (CAL) gain at the implant and adjacent sites and soft tissue phenotype modifications at 1 year. Optical scanning was used for assessing volumetric changes. Professional assessment of esthetic outcomes was performed using the Implant Dehiscence coverage Esthetic Score (IDES), while patient-reported esthetic assessment involved a 0-10 visual analogue scale. RESULTS: The mean PSTD depth reduction and mean PSTD coverage at 1 year were 2.25 mm, and 85.14%, respectively. A mean keratinized tissue width (KTW) gain of 1.15 mm was observed, while the mean gain in mucosal thickness (MT) was 1.58 mm. A mean CAL gain of 1.45 mm was obtained at the interproximal aspect of the adjacent dentition at 1 year. Greater linear dimensional (LD) changes were observed at the midfacial aspect of the implant compared to the interproximal sites. The mean final IDES was 6.90 points, while patient-reported esthetic evaluation was 8.83 points. CONCLUSIONS: The present study demonstrated that vertical soft tissue augmentation with a submerged healing is an effective treatment approach for the treatment of challenging PSTDs with adjacent dentition exhibiting interproximal attachment loss. This technique can be effective in resolution of esthetic complications in most cases, providing a substantial gain in interproximal attachment levels at the adjacent dentition.