Multiple pulp stones emerge across all teeth during mixed dentition:A case report

BACKGROUND This paper reports a rare presentation of multiple pulp stones(PSs)emerging in all teeth during mixed dentition.It offers valuable insights into the clinical diagnosis,treatment,and prognosis of multiple PSs,shedding light on their occurrence during the mixed dentition period.CASE SUMMARY A 10-year-old girl presented with repeated pain in the mandibular right posterior teeth.Intraoral examination revealed carious lesions,abnormal tooth shapes,and anomalies in tooth number.Radiographic examinations showed multiple PSs with diverse shapes,sizes,and quantities in all teeth,alongside anomalies in tooth shape and number.Root canal therapy was initiated,but the patient initially lacked timely follow-up.Upon return for treatment completion,an extracted tooth revealed irregular calculus within the pulp cavity.CONCLUSION This case underscores the importance of considering multiple PSs in mixed dentition,necessitating comprehensive evaluation and management strategies.

Eruption Sequence of the Lower Permanent Dentition of Lufengpithecus lufengensis

The paper aims to reconstruct the eruption sequence of the permanent teeth of Lufengpithecus lufengensis. Eruption sequence here means the order of appearance of the tooth crowns out of the alveolar crypt. The permanent dental developments of five juvenile mandibles are observed and analyzed via radiograph. Using such records as the stages of crown and root formation, location of the crown occlusion relative to the alveolar margin, and wear degrees of the erupted teeth, the eruption sequence of the mandibular permanent teeth of Lufengpithecus lufengensis is reasonably derived as M1 I1 I2 M2 P3 P4 C M3. This order is seen to differ very markedly from that in modern humans, and to be similar to that in apes.

Is Caries in the Early Mixed Dentition Associated with Caries Development during Orthodontic Treatment?

Objective: To investigate if caries in the pre-treatment early mixed dentition is associated with caries development in the permanent dentition during orthodontic treatment. Material and Methods: We included 41 consecutive patients (29 girls, 12 boys) with a pre-treatment documentation in the mixed (mean age 9.4 years) and a post treatment documentation in the permanent dentition (age 14.9 years) (two-phased treatment time 4.5 (±1.6) years). The DMFT/S indices were calculated. High-risk and low-risk groups were defined according to dmfs + DMFS score before treatment. Results: Initial dmft/s + DMFT/S (SD) was 5.15 (3.60) and 8.32 (6.64);final DMFT/S was 2.76 (2.84) and 3.01 (3.20). The missing (because of decay) second deciduous molars were most powerfully associated with caries increment during treatment, showing significant correlations to second premolars (r = 0.47, p = 0.003), while fillings on second deciduous molars seem to influence the prevalence of fillings on permanent molars (r = 0.44, p = 0.001). The increment at surface level was 2.01 (2.61) in the whole sample and 2.60 (3.81) in the high-risk group (4 boys, 6 girls). Compared to the low-risk group (10 girls), post-treatment caries experience was significantly higher in the high-risk group (p = 0.029). Boys were more at risk than girls (p = 0.005). Conclusions: Children with elevated caries experience in the early mixed dentition are exposed to higher caries risk during orthodontic treatment. Thus, in prevision of treatment, caries should already be assessed in the mixed dentition, so that an extended prophylaxis program can be initiated.

Orthodontic Management of Occlusal Prematurity in Early Mixed Dentition

Premature contact is one of the most well-known occlusion disorders and can interfere mandibular movement remarkably. The masticatory system has ability to respond with the wide range of adaptive modalities. These adaptations can be functional, structural and/or behavioral. Therefore, this system, like any biological system, cannot be viewed as a rigid and immutable. This paper presents a clinical case which is demonstrating orthodontic management of occlusal prematurity in early mixed dentition by using a protrusive arch wire.

Orthopedic Correction of Class III Malocclusions during Mixed Dentition

Objective: The aim of this study was to compare the effect of face mask (FM) and Maxillary Bite Block (BB) in skeletal class III patients during mixed dentition with control group of the same class during their growth. Materials & Methods: Forty-two patients were selected based on clinical and cephalometric examination, with age ranged from 6 to 8 years according to definite criteria. Patients were classified into two groups: treated and control groups;all records were taken for every patient. Lateral cephalometric films were traced before and after treatment and analyzed. Results: Intermaxillary skeletal variables showed significant improvement in the treated group with an average increase of ANB angle (Maxilo mandibular difference angle) of 3.14°and an average increase in wits appraisal 2.15 mm. Conclusion: The study concluded that, treatment with face mask and maxillary bite block induced significant dentoskeletal changes.

Clinical follow-up of ceramic bridges with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects

Background Alternatives to the conventional auro-galvanoforming ceramic bridge need to be evaluated in long-term longitudinal studies before being recommended for restoration of dentition defects. This study aimed to evaluate the clinical performance of a ceramic bridge with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects. Methods In total, 114 ceramic bridges with auro-galvanoforming （primary coping and Ni-Cr pontic） were placed in 112 patients with dentition defects. Among them, 83 bridges in 82 patients were available for follow-up after 7 years. We evaluated marginal integrity, color match, gingival inflammation, fracture of ceramic bridges, and recurrent caries. Results Marginal integrity of the ceramic bridges was perfect in all patients. Most ceramic bridges maintained their original color. Fracture was found in three bridges; the rest were free of fracture, breakage, and loosening. Recurrent abutment caries were not found. Ceramic bridges with auro-galvanoforming （primary coping and Ni-Cr pontic） produced satisfactory clinical outcomes -- equivalent to the conventional porcelain-fused-to-metal restoration. This technique is especially useful for dentition defects of the molar area and is cheaper than restoration with noble metal bridges. Conclusions Ceramic bridges with auro-galvanoforming （primary coping and Ni-Cr pontic） performed well for the restoration of dentition defects during this follow-up period. More studies are warranted to further evaluate this technique as an alternative to the conventional porcelain-fused-to-metal restoration.

High-throughput sequencing identifies salivary microbiota in Chinese caries-free preschool children with primary dentition

Objectives:The study aimed at identifying salivary microbiota in caries-free Chinese preschool children using highthroughput sequencing.Methods:Saliva samples were obtained from 35 caries-free preschool children(18 boys and 17 girls)with primary dentition,and 16 S ribosomal DNA(r DNA)V3–V4 hypervariable regions of the microorganisms were analyzed using Illumina MiSeq.Results:At 97%similarity level,all of these reads were clustered into 334 operational taxonomic units(OTUs).Among these,five phyla(Firmicutes,Proteobacteria,Actinobacteria,Bacteroidetes,and Candidate division TM7)and13 genera(Streptococcus,Rothia,Granulicatella,Prevotella,Enterobacter,Veillonella,Neisseria,Staphylococcus,Janthinobacterium,Pseudomonas,Brevundimonas,Devosia,and Gemella)were the most dominant,constituting 99.4%and 89.9%of the salivary microbiota,respectively.The core salivary microbiome comprised nine genera(Actinomyces,Capnocytophaga,Gemella,Granulicatella,Lachnoanaerobaculum,Neisseria,Porphyromonas,Rothia,and Streptococcus).Analysis of microbial diversity and community structure revealed a similar pattern between male and female subjects.The difference in microbial community composition between them was mainly attributed to Neisseria(P=0.023).Furthermore,functional prediction revealed that the most abundant genes were related to amino acid transport and metabolism.Conclusions:Our results revealed the diversity and composition of salivary microbiota in caries-free preschool children,with little difference between male and female subjects.Identity of the core microbiome,coupled with prediction of gene function,deepens our understanding of oral microbiota in cariesfree populations and provides basic information for associating salivary microecology and oral health.

Twelve-month evaluation of the atraumatic restorative treatment approach for class Ⅲ restorations:An interventional study

BACKGROUND Atraumatic restorative treatment(ART)may be appropriate for populations without accessibility and affordability.More data are required regarding the success rate of ART in anterior teeth.AIM To evaluate the clinical performance of restoring class III cavities in anterior teeth of permanent dentition using the ART approach.METHODS A longitudinal interventional field study was carried out at two rural primary health centers,Tumkur district,India.A total of 54 teeth in 39 patients were evaluated for the survival rate of class III restorations in permanent anterior teeth using the ART approach in children and adult populations.Evaluation of ART restoration was carried out using Frencken J criteria,the mean procedure time,patient acceptance and reported pain severity during the ART approach were evaluated using a visual analog scale.Calculation of the cost of ART was also performed.RESULTS The mean time taken to perform the ART procedure was 14.79±5.8 min with the majority of patients reporting only mild pain.At 6 mo follow-up,72.2%remained in a good state,but this reduced to 27%at 12 mo.The cumulative survival rate of the restorations was 94.4%at 6 mo and 80.9%at 12 mo follow-up.Estimation of the direct cost for a single class III restoration was 186.50 INR(2.64 USD).CONCLUSION ART may be a good comprehensive option for basic oral health care for underserved or inaccessible populations,and preventive care for patients.

Orthodontic treatment combined with 3D printing guide plate implant restoration for edentulism and its influence on mastication and phonic function

BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract.Restorative treatment is the primary option for this disease.However,traditional restorations have many drawbacks,such as mismatch with the body,low reliability,and incomplete occlusal function recovery.AIM to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions.METHODS A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019.Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table.The control group received traditional implant restoration,whereas the intervention group received 3D printing guide plate implant restoration.Treatment outcomes,cosmetic appearance,dental function,implant deviation,and quality of life were compared between the two groups.RESULTS The overall response rate in the intervention group was significantly higher than that in the control group(95.35%vs 81.40%,χ^(2)=4.071,P=0.044).The number of cases with neatly trimmed cosmetic appearance(χ^(2)=4.497,P=0.034),complete coverage(χ^(2)=4.170,P=0.041),and normal occlusion(χ^(2)=5.512,P=0.019)in the intervention group was higher than that in the control group.After treatment,mastication,swallowing,and articulation were significantly improved in both groups.Masticatory(t=2.980,P=0.004),swallowing(t=2.199,P=0.031),and phonic functions(t=3.950,P=0.004)were better in the intervention group than those in the control group.The deviation value and the deviation angle(t=5.440,P=0.000)at the top(t=6.320,P=0.000)and middle parts of the implants(t=22.295,P=0.000)in the intervention group were lower than those in the control group after treatment.Functional limitations,psychosocial and physical pain and discomfort,and total scores decreased in both groups.The functional limitation(t=2.379,P=0.020),psychosocial(t=2.420,P=0.000),physical pain and discomfort(t=6.581,P=0.000),and total scores(t=2.140,P=0.035)were lower in the intervention group than those in the control group.CONCLUSION Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions,quality of life,and psychological health of patients with dentition defects.Therefore,it is highly recommended in clinic application.

Two-Phase Transplantation (TPTX) Concept: A New Approach for Instant Rehabilitation of Young Children after Avulsion of Central Incisor

Background: To present a new idea for rapid management of tooth avulsion in young children and adolescents (age: 6 to 16) by this case report. Case presentation: A nine-year-old boy presented with loss of upper permanent central incisor in early mixed dentition (6 to 10 years, phase I). The not yet fully resorbed primary canine was used as tooth transplant for the lost incisor. The intentional renounce on endodontic treatment of the primary transplant permits natural exfoliation of the transplant occurring either spontaneously or due to undermining resorption through the adjacent erupting teeth. In the late mixed dentition (10 to 16 years, phase II), the primary tooth transplant is electively removed and replaced by a premolar autotransplant for long-term rehabilitation of the meanwhile adolescent patient. Results: Primary canine autoTX acts as a temporary denture with instant surgical gap closure. Ensuing premolar autoTX in phase II then acts as permanent denture with excellent 10 years survival rates. Patient satisfaction issued by a questionnaire resulted in good to very good school grades for both phases of autotransplantation. Conclusions: The “TPTX” concept is a new surgical approach that immediately restores the patient’s function and aesthetics after tooth loss in early childhood supporting the growth of local bone and soft tissue in the growing adolescent jaw.