The optimal activation of plastic aligner for canine distal movement: a three-dimensional finite element analysis.

This study aimed to investigate the optimal activation of plastic aligner for the canine distal movement by combining the stress and strain of periodontal ligament. Computer-aided design models of the upper canine, periodontal ligament, alveolar bone, and plastic aligner were constructed. The stresses and strains of periodontal ligament were acquired by fitting plastic aligner on the canine, which will cause the canine distal-direction movement. The activation of plastic aligner was set into 12 groups, including 0.050, 0.100, 0.125, 0.150, 0.175, 0.200, 0.225, 0.250, 0.275, 0.300, 0.350, and 0.400 mm. Assuming the volume-averaged hydrostatic stress (VAHS) ranging from 4.7 to 16 kPa to be the optimal stress, and an average strain no less than 0.3 to be the optimal strain. The optimal activation of plastic aligner was acquired based on the optimal stress and average strain. As the activation increased, the stress and strain of periodontal ligament increased visibly. The degree of activation of plastic aligner was nonlinearly and positively related to VAHS and average strain. According to the fitted curves, the activation corresponding to the optimal stress was 0.07-0.24 mm and the activation was not less than 0.21 mm based on the optimal strain. The optimal activation of plastic aligner for the canine distal movement was 0.21-0.24 mm in this study. The degree of activation affects the force system of orthodontic tooth movement, and it should be taken into consideration to obtain healthy and efficient tooth movement. The activation with 0.21-0.24 mm seems optimal for orthodontic tooth movement in the plastic aligner system in this study.

Permanent canine eruption into the alveolar cleft region after secondary alveolar bone grafting: Are there prediction factors for impaction?

INTRODUCTION: The aims of this study were to investigate the eruption pattern of maxillary permanent canines in the alveolar cleft area after secondary alveolar bone grafting and to assess the risk indicators for canine impaction. METHODS: The sample consisted of 75 patients with unilateral cleft lip and palate who underwent secondary alveolar bone grafting with rhBMP-2 with a mean age of 9.8 years of age at 1 center. A split-mouth study design was used, with the noncleft hemiarch comprising the control group. Panoramic radiographs taken before, immediately after, and 1 year after secondary alveolar bone grafting were used to assess the following parameters in both cleft side (CS) and noncleft side: canine mesiodistal angulation, canine height relative to the occlusal plane, canine mesial displacement, and superimposition with the neighboring maxillary incisors. The frequency of associated dental anomalies was compared between patients with and without CS canine impaction. Data were evaluated using analysis of variance, t tests, Fisher tests, and multiple logistic regression analysis (P <0.05). RESULTS: On the CS, maxillary canines were usually more mesially angulated and more distant from the occlusal plane compared with the noncleft side. The prevalences of canine impaction on the CS and noncleft side were 24% and 1.3%, respectively. Maxillary impacted canines on the CS demonstrated increased mesiodistal angulation and height at all time points. No association between CS canine impaction and mesial displacement (sectors) was found. An increased prevalence of lateral incisor agenesis on the CS was observed in the subgroup with canine impaction. CONCLUSIONS: Increased mesial angulation and lateral incisor agenesis on the CS are early risk indicators for maxillary canine impaction in patients with unilateral cleft lip and palate.

A Volumetric Assessment Using Computed Tomography of Canine and First Molar Roots in Dogs of Varying Weight.

Mandibular volume and tooth root volumes were shown to increase at different rates at locations containing the roots of the canine (C) and mesial and distal roots of the first molar (M1). Thirty-six dogs were included in this study. Data were generated using computed tomography at locations of the mandible involving the roots of the C and M1 teeth. Software was used to trace the external surface of the mandible, calculating the volume of the mandible at each location. Similar techniques were used to trace and calculate the volume of the C and M1 roots. Mandible volume, tooth root volume, and root percentage of mandible volume were analyzed and compared using the slopes of the best fit line. At the M1 mesial and distal roots, mandible volume ( P < .001) and root volume ( P < .001) were both noted to increase, with increasing weight at different rates. The rate of change in the root percentage by weight of M1 roots was not different ( P = .214). Each location demonstrated a different increasing rate of change for mandibular volume and increasing root volume. Results show that as patient's weight increases, the mandible and root volumes increase at different rates. Root percentage by volume at all three locations was noted to decrease by the same rate. Canine and M1 roots are proportionally larger than the supporting mandibular bone in smaller patients. Care should be taken to recommend periodontal disease prevention for owners of small dogs and consideration made when performing extractions or other surgery that may destabilize the mandible.

Interrelationships Between Morphometric, Densitometric, and Mechanical Properties of Teeth in 5-Month-Old Polish Merino Sheep.

Interrelationships between morphological, densitometric, and mechanical properties of deciduous mandibular teeth (incisors, canine, second premolar) were investigated. To perform morphometric, densitometric, and mechanical analyses, teeth were obtained from 5-month-old sheep. Measurements of mean volumetric tooth mineral density and total tooth volume were performed using quantitative computed tomography. Microcomputed tomography was used to measure total enamel volume, volumetric enamel mineral density, total dentin volume, and volumetric dentin mineral density. Maximum elastic strength and ultimate force of teeth were determined using 3-point bending and compression tests. Pearson correlation coefficients were determined between all investigated variables. Mutual dependence was observed between morphological and mechanical properties of the investigated teeth. The highest number of positive correlations of the investigated parameters was stated in first incisor indicating its superior predictive value of tooth quality and masticatory organ function in sheep. Positive correlations of the volumetric dentin mineral density in second premolar with final body weight may indicate predictive value of this parameter in relation with growth rate in sheep. Evaluation of deciduous tooth properties may prove helpful for breeding selection and further reproduction of sheep possessing favorable traits of teeth and better masticatory organ function, leading to improved performance and economic efficiency of the flock.

The Effect of Composite Thickness on the Stress Distribution Pattern of Restored Premolar Teeth with Cusp Reduction.

PURPOSE: Different thicknesses of restorative material can alter the stress distribution pattern in remaining tooth structure. The assumption is that a thicker composite restoration will induce a higher fracture resistance. Therefore, the present study evaluated the effect of composite thickness on stress distribution in a restored premolar with cusp reduction. MATERIALS AND METHODS: A 3D solid model of a maxillary second premolar was prepared and meshed. MOD cavities were designed with different cusp reduction thicknesses (0, 0.5, 1, 1.5, 2.5 mm). Cavities were restored with Valux Plus composite. They were loaded with 200 N force on the occlusal surface in the direction of the long axis. Von Mises stresses were evaluated with Abaqus software. RESULTS: Stress increased from occlusal to gingival and was maximum in the cervical region. The stressed area in the palatal cusp was more than that of the buccal cusp. Increasing the thickness of composite altered the shear stress to compressive stress in the occlusal area of the teeth. CONCLUSION: The model with 2.5 mm cusp reduction exhibited the most even stress distribution.

Applications of cone-beam computed tomography to assess the effects of labial crown morphologies and collum angles on torque for maxillary anterior teeth.

INTRODUCTION: Currently, cone-beam computed tomography (CBCT) has been widely used because of its capacity to evaluate the anatomic structures of the maxilla, mandible, and teeth in 3 dimensions. However, articles about the use of CBCT to evaluate the relationships between the morphology of individual teeth and torque expression remain rare. In this study, we aimed to determine the influence of labial crown morphologies and collum angles on torque for maxillary anterior teeth using CBCT. METHODS: A total of 206 extracted maxillary anterior teeth were selected to establish scanning models using dental wax, and they were scanned by CBCT. Three-dimensionally reconstructed images and median sagittal sections of the teeth were digitized and analyzed with AutoCAD software (Autodesk, San Rafael, Calif). The angle α, formed by the intersection of the tangent at a certain vertical height on the labial surface from the incisal edge with the crown long axis, and the collum angle, were measured. RESULTS: The variations in angle α at different heights from the incisal edge for the same type of tooth were statistically significantly different (P <0.001). Moreover, the variations between collum angles and 0° for any type of maxillary anterior tooth were statistically significant (P <0.01). CONCLUSIONS: This study suggested that there are great differences in labial crown morphologies and collum angles for maxillary anterior teeth between persons, indicating that the morphologies of these teeth do play important roles in torque variations.

Evaluation of skeletal maturity using maxillary canine, mandibular second and third molar calcification stages.

OBJECTIVE: The objective of this study was to evaluate whether the calcification stages of maxillary canine, mandibular second molar, and mandibular third molar can be used for assessment of growth phase. MATERIALS AND METHODS: The study group consisted of 274 subjects. Pre-treatment digital panoramic and lateral cephalometric radiographs of the patients were analysed. The patients' age was ranging from 7 to 19 years. Right maxillary canine, mandibular second molar and third molar were used as a sample. The teeth mineralization was assessed using modification of Gleiser and Hunt method. The skeletal maturation was assessed by the cervical vertebrae maturation (CVM) method. RESULTS: A significant association was found between CVM stage 2 and maxillary canine (UC) stage 4, mandibular second molar (LM2) stage 4, and mandibular third molar (LM3) stage 1. CVM stage 3 corresponded with UC stage 5, LM2 stage 5, LM3 stage 2. CVM stage 4 matched with UC stage 5, LM2 stage 6 and LM3 stage 3. The highest correlations between CVM and calcification stages were in the group of the maxillary canine (r = 0.812, P < 0.01) and mandibular second molar (r = 0.824, P < 0.01). LIMITATIONS: Limitation of our study was that the study sample was not very big and the distribution value in the groups was very high, so it was impossible to check more statistical parameters. CONCLUSIONS: The calcification stages of UC, LM2, and LM3 as indicators of skeletal maturity could be clinically used with caution, until this method is verified with a larger sample group.

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

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

Ideal orthodontic alignment load relationships based on periodontal ligament stress.

OBJECTIVES: To test the hypothesis that periodontal ligament (PDL) stress relationships that yield resistance numbers representing load proportions between different teeth depend on alignment load type. MATERIALS AND METHODS: Finite element models of all teeth, except the third molars, were produced. Four different types of loads were applied, and the third principal stresses of different teeth in standardized areas of most compression were calculated. Based on these results, resistance numbers, representing the load proportions for each tooth derived from PDL stress, were determined. RESULTS: The third principal stress values for typical alignment loads in the areas of most stress were very different for different load types for each tooth. Differences in resistance numbers between teeth also varied with different loads. CONCLUSION: Resistance numbers, that is, load proportion numbers between teeth to achieve similar stress at the compressive PDL zone, depend on the type of applied load.

A finite element analysis of the maxillary first molar PDL with maxillary protraction in a mixed dentition Class III malocclusion.

OBJECTIVES: To analyze the stress distribution on the PDL of the maxillary first molar in a mixed dentition Class III malocclusion, using a Hyrax-type appliance and maxillary protraction. SETTING AND SAMPLE POPULATION: A Class III malocclusion in the mixed dentition was reconstructed based on CBCT images. MATERIAL AND METHODS: The 3D FEM comprised the maxilla, alveolar bone, right first permanent molar teeth, and PDL and consisted of 1 133 497 nodes and 573 726 elements. Maxillary protraction force was applied to a hook positioned close to the deciduous canines with 600 g and at 15°, 30°, and 45° downward angles to the maxillary occlusal plane. RESULTS: Analysis was carried out from the top and buccal view of the sagittal plane. The magnitude of the stresses at 15°, 30°, and 45° of protraction angulation resulted in the highest stress magnitude being in the region between the distobuccal and palatal roots, as well as on the distal surface of the mesial root. The vector direction in this area showed traction and mesial movement. With 30° and 45° protraction angulations, the stress was located only between the distobuccal and palatal roots, and the vector direction was more extrusive at 15°. CONCLUSIONS: The suggested orthodontic movement is in the mesial direction with a small amount of extrusion with 15° angulation and greater extrusion with 30° and 45°.

Upper canine inclination influences the aesthetics of a smile.

This current study investigated which angle of canine inclination (angle between canine tooth axis (CA-line) and the line between the lateral canthus and the ipsilateral labial angle (EM-line)) is perceived to be most attractive in a smile. The second objective was to determine whether laymen and dental experts share the same opinion. A Q-sort assessment was performed with 48 posed smile photographs to obtain two models of neutral facial attractiveness. Two sets of images (1 male model set, 1 female model set), each containing seven images with incrementally altered canine and posterior teeth inclinations, were generated. The images were ranked for attractiveness by three groups (61 laymen, 59 orthodontists, 60 dentists). The images with 0° inclination, that is CA-line (maxillary canine axis) parallel to EM-line (the line formed by the lateral canthus and the ipsilateral corner of the mouth) (male model set: 54·4%; female model set: 38·9%), or -5° (inward) inclination (male model set: 20%; female model set: 29·4%) were perceived to be most attractive within each set. Images showing inward canine inclinations were regarded to be more attractive than those with outward inclinations. Dental experts and laymen were in accordance with the aesthetics. Smiles were perceived to be most attractive when the upper canine tooth axis was parallel to the EM-line. In reconstructive or orthodontic therapy, it is thus important to incline canines more inwardly than outwardly.

Angulations of Anterior Teeth With Reference to the Alveolar Bone Measured by CBCT in a Chinese Population.

OBJECTIVE: To analyze angulations of anterior teeth with reference to the alveolar bone. METHODS: Cone-beam computed tomographic (CBCT) images of 105 participants were taken with the same machine (ProMax 3D Max CBCT), showing the intact anterior teeth. The angulations formed between the long axis of the anterior teeth and the alveolus were measured using cross-sectional images. The thicknesses of alveolar bone on different area of root surfaces were also measured. RESULTS: Maxillary anterior teeth were found to be close to the buccal alveolar surface in apical level with the angulations referred to alveolar bone in center incisor, lateral incisor, and canine were 17.65 ± 6.8, 18.79 ± 7.4, and 23.82 ± 6.96 degrees, respectively. Means of angulations of mandibular anterior teeth were less than 8 degree. The thicknesses of buccal bone at mid-root level in 77% to 90% maxillary anterior teeth were less than 1 mm. The determinations provided high intrarater/interrater reliability. CONCLUSIONS: The application of CBCT is reliable for a complete calculation of angulations and thicknesses in a Chinese Han population. As a result, adequate planning combined with image examination preoperatively would contribute to a favorable outcome.

Biomechanical effects of corticotomy approaches on dentoalveolar structures during canine retraction: A 3-dimensional finite element analysis.

INTRODUCTION: Corticotomy has proven to be effective in facilitating orthodontic tooth movement. There is, however, no relevant study to compare the biomechanical effects of different corticotomy approaches on tooth movement. In this study, a series of corticotomy approaches was designed, and their impacts on dentoalveolar structures were evaluated during maxillary canine retraction with a 3-dimensional finite element method. METHODS: A basic 3-dimensional finite element model was constructed to simulate orthodontic retraction of the maxillary canines after extraction of the first premolars. Twenty-four corticotomy approach designs were simulated for variations of position and width of the corticotomy. Displacement of the canine, von Mises stresses in the canine root and trabecular bone, and strain in the canine periodontal ligament were calculated and compared under a distal retraction force directed to the miniscrew implants. RESULTS: A distal corticotomy cut and its combinations showed the most approximated biomechanical effects on dentoalveolar structures with a continuous circumscribing cut around the root of the canine. Mesiolabial and distopalatal cuts had a slight influence on dentoalveolar structures. Also, the effects decreased with the increase of distance between the corticotomy and the canine. No obvious alteration of displacement, von Mises stress, or strain could be observed among the models with different corticotomy widths. CONCLUSIONS: Corticotomies enable orthodontists to affect biomechanical responses of dentoalveolar structures during maxillary canine retraction. A distal corticotomy closer to the canine may be a better option in corticotomy-facilitated canine retraction.

Finite element method analysis of the periodontal ligament in mandibular canine movement with transparent tooth correction treatment.

BACKGROUND: This study used the 3D finite element method to investigate canine's displacements and stresses in the canine's periodontal ligament (PDL) during canine's translation, inclination, and rotation with transparent tooth correction treatment. METHODS: Finite element models were developed to simulate dynamic orthodontic treatments of the translation, inclination, and rotation of the left mandibular canine with transparent tooth correction system. Piecewise static simulations were performed to replicate the dynamic process of orthodontic treatments. The distribution and change trends of canine's displacements and stresses in the canine's PDL during the three types of tooth movements were obtained. RESULTS: Maximum displacements were observed at the crown and middle part in the translation case, at the crown in the inclination case, and at the crown and root part in the rotation case. The relative maximum von Mises and principal stresses were mainly found at the cervix of the PDL in the translation and inclination cases. In the translation case, tensile stress was mainly observed on the mesial and distal surfaces near the lingual side and compressive stress was located at the bottom of the labial surface. In the inclination case, tensile stress was mainly observed at the labial cervix and lingual apex and compressive stress was located at the lingual cervix and labial apex. In the rotation case, von Mises stress was mainly located at the cervix and inside the lingual surface, tensile stress was located on the distal surface, and compressive stress was detected on the mesial surface. The stress and displacement value rapidly decreased in the first few steps and then reached a plateau. CONCLUSIONS: Canine's movement type significantly influences the distribution of canine's displacement and stresses in the canine's PDL. Changes in canine's displacement and stresses in the canine's PDL were exponential in transparent tooth correction treatment.

Signs and symptoms associated with primary tooth eruption: a clinical trial of nonpharmacological remedies.

BACKGROUND: To evaluate disturbances in primary tooth eruption and their management with nonpharmacological remedies. METHODS: In this nonrandomized clinical trial, 270 children aged between 8 and 36 months were selected and divided into 5 groups with 54 children initially enrolled in each group. The children were seen during an 8-day period during tooth eruption. At each appointment data were recorded from oral examination, tympanic temperature measurement and a questionnaire. The five methods used as remedies to reduce teething symptoms were: 1) cuddle therapy, 2) ice, 3) rubbing the gums, 4) teething rings and 5) food for chewing. Teething symptoms, the type of erupted tooth, symptoms of recovery and the mother's satisfaction with treatment were evaluated. RESULTS: Two hundred and fifty four children (mean age 16 ± 7.2 months) completed the study. The most frequent teething symptoms were drooling (92%), sleep disturbances (82.3%) and irritability (75.6%). These symptoms were more pronounced in low birth weight children (p > 0.05). Canine eruption led to more loss of appetite than incisor (p = 0.033) or molars eruption (p = 0.014). Low grade increases in body temperature were observed only on the day of eruption (36.70 ± 0.39 °C), when body temperature was significantly different compared to the day before and the day after eruption (both p < 0.001). There was no significant correlation between fever as reported by mothers and temperature readings obtained by the investigators. The most favorable results for time to recovery and the mother's satisfaction were seen when teething rings were used, followed by cuddle therapy and rubbing the gums. CONCLUSIONS: There was no association between teething and symptoms such as fever or diarrhea. Low birth weight children may have more teething symptoms. Teething rings, cuddle therapy and rubbing the gums were the most effective methods to reduce symptoms. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: code IRCT201211127402N3.

Crevicular alkaline phosphatase activity during the application of two patterns of orthodontic forces.

OBJECTIVE: The objective of this study was to test the hypothesis that using a gradually increasing orthodontic force would induce an increased activity of osteoblasts compared to a relatively constant orthodontic force. PARTICIPANTS AND METHODS: Twelve orthodontic patients participated in this study. In a split mouth design, one maxillary canine undergoing distal movement received a relatively constant continuous retraction force, while the contralateral canine received a gradually increasing retraction force. Gingival crevicular fluid (GCF) samples were collected from both experimental sites at weekly intervals and analysed spectrophotometrically for the activity of alkaline phosphatase enzyme, which was used as a biological marker for osteoblastic activity. RESULTS: With the exception of the maxillary first molar receiving gradually increasing orthodontic force, the results revealed a consistent pattern of alkaline phosphatase activity. This pattern included an initial rise from baseline to the first week, then a peak in the second week. This peak was followed by a reduction in enzyme activity in the third week. The overall increases in enzyme activity at the maxillary canines and the maxillary first molars in the relatively constant force group were 179·76% and 332·90%, respectively. The overall increases in enzyme activity at the maxillary canines and the maxillary first molars in the gradually increasing force group were 304·81% and 493·08%, respectively. CONCLUSION: The use of gradually increasing orthodontic force induces increased activity of osteoblasts during the initial stage of orthodontic tooth movement compared to that induced by a relatively constant orthodontic force.

Fundamentals of occlusion and restorative dentistry. Part I: basic principles.

This article presents the basic principles of dental occlusion and an overview of this subject area, which is important for dental professionals. Clinical relevance: A sound knowledge of dental occlusion is important in order to improve dental treatment outcome and achieve a long-lasting restoration.

Morphometric, densitometric and mechanical properties of mandibular deciduous teeth in 5-month-old Polish Merino sheep.

BACKGROUND: Caries, enamel hypoplasia, molar incisor hipomineralization, amylogenesis imperfecta, dentine dysplasia, hypophosphatasia and other dental disorders lead to tooth mineralization disturbances and structural abnormalities, decreasing masticatory organ functions. Dental disorders in sheep can lead to premature slaughter before they have attained final stage of their reproductive life and induce economic loss due to high flock replacement costs. Growth rate, health status and meat quality of sheep depends on tooth properties and quality determining in large extent efficiency of the masticatory apparatus and initial food break up. Considering lack of basic anatomical and physiological data on teeth properties in sheep, the aim of the study was to evaluate morphometric, densitometric and mechanical traits of deciduous mandibular incisor, canine and the second premolar obtained at the slaughter age of 5 months of life. RESULTS: The obtained results have shown the highest values of weight, total tooth volume, enamel volume and dentine volume in second premolar. Morphometric and mechanical parameters of incisors reached the highest values in first incisor and decreased gradually in second and third incisor, and in canine. Densitometric measurements have not revealed significant differences of the volumetric tooth mineral density in hard dental tissues between the investigated teeth. CONCLUSIONS: In conclusion, proposed methodological approach is noninvasive since the deciduous teeth undergo physiological replacement with permanent teeth. Deciduous teeth can be easy collected for analyses from large animal population and may reflect mineral status and metabolism resulting from postnatal growth and development of the whole flock. In individual cases, evaluation of properties of deciduous teeth may serve for breeding selection and further reproduction of sheep possessing favorable traits of teeth and better masticatory system functions.

The relationship between bending stress and the shape of maxillary canines in cercopithecoid monkeys.

Primate canines function in social displays but are also recruited for biting in agonistic encounters. Although the precise nature of the loads such behavior places on the canine crown is unknown, it is thought that bending is a major component of such loads. To date, modeling of canine bending strength has relied on idealized geometric representations. Accounting for the tapering of the crown as well as shape changes along an apical-basal axis provides a more realistic model for assessment of bending stress in canines. We provide such an accounting and evaluate the hypothesis that the morphology of the cercopithecoid canine represents a structural solution for maintaining constant maximum bending stress under apical or distributed loading in a parasagittal plane. This isostress hypothesis is analogous to a design criterion of minimum mass for a given structural requirement. Examining permanent maxillary canines from males and females representing eight West African cercopithecoid species, we reconstructed crown geometry from apex to base using microcomputed tomography. From reconstructed cross-sections, we determined section moduli about a buccolingual centroidal axis. We then determined what the taper should be for a variety of parasagittal loading distributions if the isostress hypothesis were true and compared these theoretical tapers to actual crown geometry. We found that a variety of loading distributions can be accommodated by the canines, particularly among males. These results suggest that our sample of canines are not optimized for resisting particular biting loads, but effectively limit stress gradients associated with a range of behaviors.

Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst.

Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis.