Search Results (29)

Molar incisor hypomineralization (MIH) is characterized by systemic hypomineralization affecting one to four first permanent molars (FPMs), often accompanied by lesions in incisors and potentially involving other primary or permanent teeth. MIH poses clinical challenges, including hypersensitivity, susceptibility to pulp involvement, and aesthetic concerns. Optical Coherence Tomography (OCT), an advanced, non-invasive imaging modality, has gained interest as a potential diagnostic tool in dentistry. This exploratory observational case-control study aims to compare the structural characteristics of MIH-affected and healthy teeth using in vivo OCT, focusing on identifying qualitative imaging patterns associated with enamel hypomineralization. This study included 50 mild MIH-affected permanent teeth from pediatric patients and 50 healthy permanent teeth as controls. Representative OCT scans were acquired, analyzed, and compared for both groups. In OCT imaging, healthy enamel and dentin appeared as two distinct superimposed layers defined by the dentin-enamel junction. Conversely, MIH-affected teeth exhibited characteristic subsurface hyper-reflective zones, indicative of hypomineralized enamel, with deeper hypo-reflective shadowing. This first in vivo study applying OCT to MIH-affected teeth demonstrates its potential as a non-invasive technique for the real-time assessment of enamel structural anomalies, supporting its future role in monitoring remineralization therapies and improving early detection strategies in pediatric dental care. Full article

Objective: This study aimed to evaluate the mean age of eruption of permanent teeth and their clinical emergence sequence in a longitudinal sample of children from a multi-ethnic urban population. Methods: A total of 854 children (413 females and 441 males), aged between 4 and 13 years, were examined annually for a minimum of 4 consecutive years, as part of their annual dental screening appointment. The presence of permanent teeth was recorded at each examination. Mean and median ages, with standard deviations, of individual tooth eruption were calculated, in addition to the eruption sequence, and the analysis of the data was performed using the lognormal distribution model. Regarding the error of the method, two examiners reviewed all relevant dental screening forms, and any discrepancies were resolved through consultation with the senior author. Results: The sequence of permanent tooth eruption followed a consistent pattern across sexes, with distinct differences between the maxillary and mandibular arches. In the maxilla, eruption began with the first molar, while in the mandible, it started with the central incisor. Mandibular teeth generally erupted earlier than maxillary teeth, with girls experiencing earlier eruption than boys, with some exceptions, and prolonged eruption periods. No statistically significant differences were found in the timing of eruption between contralateral homologous teeth. Conclusions: Based on the present data, the observed sequence of tooth eruption in a multi-ethnic urban population showed similar patterns across sexes. Mandibular teeth generally erupt earlier than maxillary teeth, with girls experiencing earlier eruption than boys. Full article

Background: Obstructive sleep apnea (OSA) is characterized by repetitive complete or partial closure of the upper airway during sleep, which is a potentially life-threatening disorder. A cephalogram is a simple and effective examination to predict the risk of OSA in orthodontic clinical practice. This study aims to analyze the relationship between craniofacial characteristics and the severity of OSA using polysomnography and cephalogram data. Gender differences in these parameters are also investigated. Methods: This study included 112 patients who underwent a complete clinical examination, standard polysomnography study, and cephalometric analysis to diagnose obstructive sleep apnea. This study divided the participants into male and female groups to study the correlation between cephalometric parameters and the severity of OSA. The analysis involved 39 cephalometric parameters. The severity of obstructive sleep apnea was evaluated by the apnea–hypopnea index (AHI) and the lowest nocturnal oxygen saturation (LSaO₂). Results: The final assessment included 112 adult participants (male/female = 67:45, mean age: 28.4 ± 7.29 years, mean male age: 28.8 ± 7.62 years, mean female age: 27.8 ± 6.79 years). Multivariate analysis revealed that the mandibular position, incisor inclination, facial height, and maxillary first molar position were strongly associated with OSA severity. Gender-specific differences in cephalometric predictors were identified, with distinct parameters correlating with the AHI and LSaO₂ in males and females. Notably, the LSaO₂ demonstrated stronger associations with craniofacial morphology in females than males. Conclusions: Cephalometric analysis can be effective in assessing the risk and severity of OSA based on the correlation between cephalometric parameters and the AHI/LSaO₂. There is a clear difference between the cephalometric parameters associated with OSA severity in male and female individuals. This gender-dependent pattern may assist the personalized diagnosis and management of OSA in clinical practice. Full article

Background: Orthodontic treatment with fixed appliances often induces pain. Despite existing research on pain management, the dynamic nature of orthodontic pain and its relationship with tooth movement remain underexplored. This study surveys adults under fixed appliance therapy to investigate pain dynamics, modifying factors, and perceived tooth movement, aiming to provide insights for improved patient care and treatment outcomes. Methods: This study focused on healthy individuals aged 18 to 50 undergoing fixed appliance treatment for up to six months after having braces bonded. A 24-question survey was administered over a one-month period. The survey explored pain intensity, pain dynamics, modifying factors, and perceived tooth movement. Results: Pain typically began within the first few hours after bonding and peaked the following day for most respondents. The upper incisors and molars were the most frequently reported areas of pain, corresponding to the teeth perceived as moving earliest. Chewing was identified as the primary external pain trigger. Gender significantly influenced pain perception, with women reporting higher pain levels and greater use of medication. The majority of participants managed without medication. Conclusions: Pain during the early phase of fixed appliance therapy follows a predictable pattern, with peak intensity occurring on the day after bonding. Pain perception strongly correlates with early tooth movement, particularly in the upper incisors. Gender differences were evident, but other demographic factors had minimal influence. Chewing was the primary pain aggravator, emphasizing the need for dietary modifications. Understanding these findings can help orthodontists develop personalized pain management strategies. Full article

Background/Objectives: The aim of this study was to examine the relationship between the mesiodistal and buccolingual alveolar diameters and the usual crown and cervical diameters and to test the reliability of these alveolar measurements for their application in dental anthropology in cases of missing teeth. Methods: A total of 127 skeletal individuals from the identified osteological collection of Certosa Cemetery (Bologna, Italy) were used in this study. After the evaluation of limiting factors, only the central incisor to the second premolar was analysed due to a null or small sample size for the molars. The mesiodistal and buccolingual diameters were measured at the level of the crown, cervix and alveolus. The relationship between the mesiodistal and buccolingual crown or cervical diameters and the alveolar measurements was assessed. Results: The buccolingual alveolar diameters showed consistently significant relationships with their equivalent cervical and crown diameters, while the mesiodistal alveolar diameters did not show consistent relationships. Furthermore, the patterns of phenotypic variation were similar for the alveolar, cervical and crown areas. Thus, the alveolar areas appear to show similar levels of variability compared with the equivalent crown and cervical areas. Conclusions: Alveolar measurements may serve as suitable proxies in comparative phenotypic variation studies and can be considered a useful supplement to the standard odontometric data collection strategy. The measurements proposed in this study for the evaluation of the alveoli are a valid alternative in situations in which teeth are not available for measurement, such as in forensic and archaeological contexts. Full article

ADAM10 is a multi-functional proteinase that can cleave approximately 100 different substrates. Previously, it was demonstrated that ADAM10 is expressed by ameloblasts, which are required for enamel formation. The goal of this study was to determine if ADAM10 is necessary for enamel development. Deletion of Adam10 in mice is embryonically lethal and deletion of Adam10 from epithelia is perinatally lethal. We therefore deleted Adam10 from ameloblasts. Ameloblast-specific expression of the Tg(Amelx-iCre)872pap construct was confirmed. These mice were crossed with Adam10 floxed mice to generate Amelx-iCre; Adam10^fl/fl mice (Adam10 cKO). The Adam10 cKO mice had discolored teeth with softer than normal enamel. Notably, the Adam10 cKO enamel density and volume were significantly reduced in both incisors and molars. Moreover, the incisor enamel rod pattern became progressively more disorganized, moving from the DEJ to the outer enamel surface, and this disorganized rod structure created gaps and S-shaped rods. ADAM10 cleaves proteins essential for cell signaling and for enamel formation such as RELT and COL17A1. ADAM10 also cleaves cell-cell contacts such as E- and N-cadherins that may support ameloblast movement necessary for normal rod patterns. This study shows, for the first time, that ADAM10 expressed by ameloblasts is essential for proper enamel formation. Full article

This review aimed to identify newly discovered bacteria from individuals with periodontal/peri-implant diseases and organize them into new clusters (GF-MoR complexes) to update Socransky’s complexes (1998). For methodological development, the PCC (Population, Concept, Context) strategy was used for the focus question construction: “In patients with periodontal and/or peri-implant disease, what bacteria (microorganisms) were detected through laboratory assays?” The search strategy was applied to PubMed/MEDLINE, PubMed Central, and Embase. The search key terms, combined with Boolean markers, were (1) bacteria, (2) microbiome, (3) microorganisms, (4) biofilm, (5) niche, (6) native bacteria, (7) gingivitis), (8) periodontitis, (9) peri-implant mucositis, and (10) peri-implantitis. The search was restricted to the period 1998–2024 and the English language. The bacteria groups in the oral cavity obtained/found were retrieved and included in the GF-MoR complexes, which were based on the disease/condition, presenting six groups: (1) health, (2) gingivitis, (3) peri-implant mucositis, (4) periodontitis, (5) peri-implantitis, and (6) necrotizing and molar–incisor (M-O) pattern periodontitis. The percentual found per group refers to the number of times a specific bacterium was found to be associated with a particular disease. A total of 381 articles were found: 162 articles were eligible for full-text reading (k = 0.92). Of these articles, nine were excluded with justification, and 153 were included in this review (k = 0.98). Most of the studies reported results for the health condition, periodontitis, and peri-implantitis (3 out of 6 GF-MoR clusters), limiting the number of bacteria found in the other groups. Therefore, it became essential to understand that bacterial colonization is a dynamic process, and the bacteria present in one group could also be present in others, such as those observed with the bacteria found in all groups (Porphyromonas gingivalis, Tannarela forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans) (GF-MoR’s red triangle). The second most observed bacteria were grouped in GF-MoR’s blue triangle: Porphyromonas spp., Prevotela spp., and Treponema spp., which were present in five of the six groups. The third most detected bacteria were clustered in the grey polygon (GF-MoR’s grey polygon): Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Eikenella corrodens. These three geometric shapes had the most relevant bacteria to periodontal and peri-implant diseases. Specifically, per group, GF-MoR’s health group had 58 species; GF-MoR’s gingivitis group presented 16 bacteria; GF-MoR’s peri-implant mucositis included 17 bacteria; GF-MoR’s periodontitis group had 101 different bacteria; GF-MoR’s peri-implantitis presented 61 bacteria; and the last group was a combination of necrotizing diseases and molar–incisor (M-I) pattern periodontitis, with seven bacteria. After observing the top seven bacteria of all groups, all of them were found to be gram-negative. Groups 4 and 5 (periodontitis and peri-implantitis) presented the same top seven bacteria. For the first time in the literature, GF-MoR’s complexes were presented, gathering bacteria data according to the condition found and including more bacteria than in Socransky’s complexes. Based on this understanding, this study could drive future research into treatment options for periodontal and peri-implant diseases, guiding future studies and collaborations to prevent and worsen systemic conditions. Moreover, it permits the debate about the evolution of bacterial clusters. Full article

Objective: Mandibular full-arch distalization (MFD) is a popular approach, particularly in non-extraction cases. However, we still cannot confirm whether facial patterns affect the amount of limits. This study aimed to determine the anatomical MFD limits in patients with different facial patterns. Study design: Using computed tomography (CT), the shortest distances from the mandibular second molar to the inner cortex of the mandibular lingual surface and from the lower central incisor to the inner cortex of the lingual mandibular symphysis were measured in 60 samples (30 patients). The available distalization space in both regions was compared between groups with different facial patterns. Results: The available space in symphysis was more critical than that in retromolar area: the shortest distances to the inner cortex of the lingual mandibular symphysis at root levels 8 mm apical to the cementoenamel junction of the incisor were 1.28, 1.60, and 3.48 mm in the high-, normal-, and low-angle groups, respectively. Conclusions: Facial patterns affected the MFD capacity, and the thickness of the lingual mandibular symphysis was the most critical anatomic limit encountered. Practitioners should always pay attention to the possible impacts from facial patterns, especially in the treatment of high-angle cases. Full article

This review addresses the recent World Workshop Consensus Conference (WWCC) decision to eliminate Localized Aggressive Periodontitis (LAgP) in young adults as a distinct form of periodontitis. A “Consensus” implies widespread, if not unanimous, agreement among participants. However, a significant number of attendees were opposed to the elimination of the LAgP classification. The substantial evidence supporting a unique diagnosis for LAgP includes the (1) incisor/molar pattern of disease, (2) young age of onset, (3) rapid progression of attachment and bone loss, (4) familial aggregation across multiple generations, and (5) defined consortium of microbiological risk factors including Aggregatibacter actinomycetemcomitans. Distinctive clinical signs and symptoms of LAgP are presented, and the microbial subgingival consortia that precede the onset of signs and symptoms are described. Using Bradford–Hill guidelines to assess causation, well-defined longitudinal studies support the unique microbial consortia, including A. actinomycetemcomitans as causative for LAgP. To determine the effects of the WWCC elimination of LAgP on research, we searched three publication databases and discovered a clear decrease in the number of new publications addressing LAgP since the new WWCC classification. The negative effects of the WWCC guidelines on both diagnosis and treatment success are presented. For example, due to the localized nature of LAgP, the practice of averaging mean pocket depth reduction or attachment gain across all teeth masks major changes in disease recovery at high-risk tooth sites. Reinstating LAgP as a distinct disease entity is proposed, and an alternative or additional way of measuring treatment success is recommended based on an assessment of the extension of the time to relapse of subgingival re-infection. The consequences of the translocation of oral microbes to distant anatomical sites due to ignoring relapse frequency are also discussed. Additional questions and future directions are also presented. Full article

The periodontal disease pathobiont Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) may exert a range of detrimental effects on periodontal diseases in general and, more specifically, with the initiation and progression of Localized Stage III Grade C periodontitis (molar–incisor pattern). In this review of the biogeography of this pathobiont, the full range of geographical scales for A. actinomycetemcomitans, from global origins and transmission to local geographical regions, to more locally exposed probands and families, to the individual host, down to the oral cavity, and finally, to spatial interactions with other commensals and pathobionts within the plaque biofilms at the micron/nanoscale, are reviewed. Using the newest technologies in genetics, imaging, in vitro cultures, and other research disciplines, investigators may be able to gain new insights to the role of this pathobiont in the unique initial destructive patterns of Localized Stage III Grade C periodontitis. These findings may incorporate the unique features of the microbiome that are influenced by variations in the geographic environment within the entire mouth. Additional insights into the geographic distribution of molar–incisor periodontal breakdown for Localized Stage III Grade C periodontitis may derive from the spatial interactions between A. actinomycetemcomitans and other pathobionts such as Porphyromonas gingivalis, Filifactor aclocis, and commensals such as Streptococcus gordonii. In addition, while the association of A. actinomycetemcomitans in systemic diseases is limited at the present time, future studies into possible periodontal disease–systemic disease links may also find A. actinomycetemcomitans and its geographical interactions with other microbiome members to provide important clues as to implications of pathobiological communications. Full article

Grade C molar-incisor pattern periodontitis (C-MIP) is a disease that affects specific teeth with an early onset and aggressive progression. It occurs in systemically healthy patients, mostly African descendants, at an early age, with familial involvement, minimal biofilm accumulation, and minor inflammation. Severe and rapidly progressive bone loss is observed around the first molars and incisors. This clinical condition has been usually diagnosed in children and young adults with permanent dentition under 30 years of age. However, this disease can also affect the primary dentition, which is not as frequently discussed in the literature. Radiographic records have shown that most patients diagnosed in the permanent dentition already presented disease signs in the primary dentition. A hyperresponsive immunological profile is observed in local (gingival crevicular fluid-GCF) and systemic environments. Siblings have also displayed a heightened inflammatory profile even without clinical signs of disease. A. actinomycetemcomitans has been classified as a key pathogen in C-MIP in both dentitions. Scaling and root planning associated with systemic antibiotics is the current gold standard to treat C-MIP, leading to GCF biomarker reduction, some systemic inflammatory response modulation and microbiome profile changes to a healthy-site profile. Further studies should focus on other possible disease-contributing risk factors. Full article

Our research explores the interplay between Aggregatibacter actinomycetemcomitans (Aa) cytolethal distending toxin (Cdt) and the host’s inflammatory response in molar/incisor pattern periodontitis (MIPP). Cdt disrupts phosphatidylinositol-3,4,5-triphosphate (PIP3) signaling, influencing cytokine expression through canonical and non-canonical inflammasome activation as well as nuclear factor-κB (NF-κB) activation, leading to inflammation in MIPP. THP-1 differentiated macrophages (TDMs) exposed to Cdt exhibited an upregulation of pro-inflammatory genes and subsequent cytokine release. We analyzed the ability of a small molecule therapeutic, LGM2605, known for its anti-inflammatory properties, to reduce pro-inflammatory gene expression and cytokine release in Cdt-exposed and Aa-inoculated TDMs. LGM2605’s mechanism of action involves inhibiting NF-κB while activating the Nrf2–transcription factor and antioxidants. Herein, we show that this small molecule therapeutic mitigates Cdt-induced pro-inflammatory cytokine expression and secretion. Our study also further defines Cdt’s impact on osteoclast differentiation and maturation in MIPP. Cdt promotes increased TRAP+ cells, indicating heightened osteoclast differentiation, specific to Cdt’s phosphatase activity. Cathepsin K levels rise during this process, reflecting changes in TRAP distribution between control and Cdt-treated cells. Exploring LGM2605’s effect on Cdt-induced osteoclast differentiation and maturation, we found TRAP+ cells significantly reduced with LGM2605 treatment compared to Cdt alone. Upon LGM2605 treatment, immunocytochemistry revealed a decreased TRAP intensity and number of multinucleated cells. Moreover, immunoblotting showed reduced TRAP and cathepsin K levels, suggesting LGM2605’s potential to curb osteoclast differentiation and maturation by modulating inflammatory cytokines, possibly involving Nrf2 activation. In summary, our research reveals the intricate connections between Cdt, pro-inflammatory cytokines, and osteoclast differentiation, offering novel therapeutic possibilities for managing these conditions. Full article

Background: Dental Anomaly Pattern (DAP) is a collection of morphologic, numeric, and eruptive anomalies of teeth that are often observed together, suggesting a potential genetic relationship. Our objective was to assess the potential associations of Molar-Incisor Hypomineralization (MIH), a common developmental defect of enamel mineralization with a controversial etiology, with two specific components of DAP: (1) agenesis (AG) and (2) infraoccluded deciduous molars (IODM). Establishing such an association between MIH and one or both anomalies would provide evidence supporting a genetic link between MIH and DAP. Methods: We examined pretreatment intraoral standardized photographies and panoramic radiographs from 574 children aged 8–14 years, 287 having MIH and 287 without MIH, comparing the frequencies of AG and IODM in both groups. The subject samples were sourced from the databases of the orthodontic department at a university hospital. Results: The frequencies of AG in the MIH and non-MIH groups were 7% and 8%, respectively (p = 0.751). The corresponding frequencies of IODM were 27% and 19.2%, respectively (p = 0.082). That is, children with MIH did not exhibit an increased frequency of AG or IODM compared to those without MIH. Conclusions: These findings do not support the inclusion of MIH in DAP. Nevertheless, further analysis of possible associations is necessary to definitively validate or invalidate this hypothesis. Full article

To clarify the mechanics of tooth movement produced by a unique distalizer, Class II Carriere Motion appliance (CMA), in which the maxillary canine is connected to the maxillary first molar with a stiff bar, long-term tooth movement was simulated by the finite element method (FEM). The FEM models of the maxillary canine, premolars, and first molar were made based on a dental study model. The periodontal ligament (PDL) was constructed on the root and assumed to be a nonlinear elastic material. The teeth and the alveolar bone were assumed to be rigid bodies. The tooth moved by accumulating the initial movement produced by the elastic deformation of the PDL. When retraction force was applied to the canine from the mandibular dentition, the canine tipped or rotated clockwise and extruded due to the vertical component of the retraction force. The molar and premolars also tipped and moved distally, but hardly extruded because the vertical force did not act on them. As a result of these tooth movements, the canine protruded from the dentition. An interproximal space was created between the canine and the lateral incisor. These movement patterns were similar to those in other clinical studies using the CMA. Full article

Molar–incisor pattern periodontitis (MIPP) is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction affecting the molars and incisors. Formerly referred to as aggressive periodontitis, the terminology for this condition was revised after the 2017 workshop on the classification of periodontal and peri-implant diseases and conditions. Despite the modification in nomenclature, the treatment strategies for MIPP remain a critical area of investigation. The core principles of MIPP treatment involve controlling local and systemic risk factors, managing inflammation, and arresting disease progression. Traditional non-surgical periodontal therapy, including scaling and root planing, is commonly employed as an initial step together with the prescription of antibiotics. Surgical intervention may be necessary to address the severe attachment loss. Surgical techniques like resective and regenerative procedures can aid in achieving periodontal health and improving esthetic outcomes. This review article aims to provide an overview of the current understanding and advancements in the treatment modalities of MIPP. Through an extensive analysis of the existing literature, we discuss various modern therapeutic approaches that have been explored for managing this challenging periodontal condition. Full article