Assessment of the relationship between impacted mandibular third molars' angulation pattern and crowding severity: A cross-sectional study.

Mandibular crowding is the most common type of dental crowding among adolescents. Aims: To investigate the relationship between the angulation pattern of impacted mandibular third molars and the severity of mandibular anterior crowding. Methodology: A total of 69 participants with impacted mandibular third molars were included in the study, and their records were analysed. Results: There was no significant association between impacted mandibular third molars' angulation pattern and mandibular anterior crowding severity, as well as no correlation between gender and either impacted mandibular third molars' angulation pattern or mandibular anterior crowding severity. Conclusion: Our findings suggest that the angulation pattern of impacted mandibular third molars is not a significant contributing factor to the severity of mandibular anterior crowding. However, further studies with larger sample sizes are necessary to validate these results.

Prevalence of Vertical Root Fractures in a University Endodontics Program versus a Private Endodontics Office.

Introduction: Vertical root fractures (VRFs) typically have a poor prognosis with an extraction or occasionally root amputation as the preferred treatment. VRFs have been considered an epidemic, motivating changes in the access openings, as well as in the preparation and disinfection protocols of endodontic treatment. Hence, we aimed to evaluate the prevalence of VRFs by tracking cases in both a University Endodontic Program (UEP) and a private endodontics practice (PP). We also evaluated changes in prevalence during COVID-19 along with the alterations in the frequency of cases diagnosed by clinical and radiographic signs which were later confirmed by direct visualization compared to those in which the suspicion was based on clinical and radiographic signs alone. Methods and Materials: This retrospective study looked at the prevalence of VRF in patient records at UEP and a PP. Data for the pre-COVID-19 and COVID-19 time periods were extracted from patient records and referral letters then compared. Data for suspected and confirmed prevalence were compared. Results: The UEP group included 21,156 patients while the PP group comprised 7,209 patients. The prevalence of VRFs in the former cohort was 1.80%, while 2.62% of the latter cohort exhibited VRFs with a combined total of 2.01%. The combined total prevalence of VRFs pre-COVID-19 was 1.72%, increasing from 2.1% to 3.82% during COVID-19 (p < 0.0001). The same applied to suspected cases for both clinical settings. The increase in confirmed cases between the two periods was statistically significant for the UEP group (p=0.0202) but it was insignificant for the PP group (p=0.0721). Conclusion: The combined prevalence for VRFs was 2.01% for all years denying the claim that VRF is a pandemic phenomenon. COVID-19 period saw almost a double increase in the prevalence of VRF compared to pre-COVID-19 era. This was consequently associated with a significant increase in the number of suspected VRF cases.

Inverted Maxillary Third Molar Impaction within the Maxillary Sinus: A Rare Case Report.

BACKGROUND The maxillary third molar is considered one of the most impacted teeth and can present in different types based on the direction and depth of the impaction. However, the inverted type of maxillary third molar impaction is a rare condition, with few reported cases in the current literature. CASE REPORT We report an extremely rare case of a 48-year-old man with an inverted maxillary third molar situated in the maxillary sinus in direct contact with the posterior wall of the sinus, with a portion of the coronal part perforating the infratemporal fossa. Because of the anatomical and structural complexity of the impaction and because the tooth has never been symptomatic, the case was conservatively managed after weighing the risks and benefits of surgical intervention. A 2-year follow-up was made to ensure no changes in the impaction location, confirming the validity of the conservative approach. CONCLUSIONS This case is the first reported inverted maxillary third molar impacted in such an anatomical location. This reported case contributes to existing knowledge regarding this rare type of impaction and that this rare impaction location can present congenitally with a non-iatrogenic origin. A thorough dental history and clinical and radiographical examinations will aid dental professionals in their clinical decision making for patients with similar presentations.

Photobiomodulation vs NSAIDs in the management of postoperative dentoalveolar pain.

Background: Postoperative pain, the most common complication of dentoalveolar surgery, is routinely controlled by non-steroidal anti-inflammatory drugs (NSAIDs). However, despite its proven efficacy, the long-term consumption of NSAIDs is associated with several serious and adverse effects. As a result, photobiomodulation (PBM) or low-level laser therapy (LLLT) is used in many treatment modalities to reduce pain, inflammation, and promote healing. Aim of the study: To compare the analgesic effects of LLLT and Ibuprofen after surgical dental extraction. Materials and methods: A clinical trial study was conducted at Umm Al-Qura University Dental Clinics, involving 46 healthy patients between 20 and 60 years of age. The recruited patients were divided into two groups of 23 patients each. Group 1 (positive control group) was prescribed Ibuprofen and Group 2 (experimental group) was treated with LLLT. The pain was measured on days 1, 2, and 7 using the Numeric Pain Rating Scale (NPRS). Results: The mean level of pain decreased with both treatments. On the first postoperative day, the pain level in the laser therapy group was significantly lower than in the control group (U = 62.5, p = 0.024). The results indicated a significant decrease in pain level on the second postoperative day for both the control and experimental groups (Z = -3.61, p < 0.005, and Z = -3.1, p = 0.002, respectively). However, the pain level was lower in the control group, although the difference was not statistically significant (U = 79, p = 0.102). Conclusion: Considering the constraints of this study, NSAIDs were found to be significantly better at reducing pain than LLLT.

Pain Experience after Dental Implant Placement Compared to Tooth Extraction.

BACKGROUND: A patients' main concern when visiting the dentist is the pain experience during the procedure and postoperatively. Patients who are undergoing dental surgical procedures in particular may experience more concerns and higher level of anxiety and stress that can affect their psychology and decision-making ability. A thorough discussion with the patients about the planned surgical procedure and the expected postsurgical pain and discomfort level is crucial to reduce their fear and stress. Despite increasing popularity of dental implants, limited data are available on pain experience related to surgical implant placement. This review is to discuss and compare postoperative pain and discomfort level after dental implant placement procedure and tooth extraction. The review has a clinical significance as it can be used as a reference when explaining to the patients about the anticipated pain and discomfort level after implant placement. CONCLUSION: Informing patients about implant placement surgical procedure and the anticipated postsurgical pain can reduce their anxiety level and affect postsurgical pain and discomfort. Implant placement surgical procedure is less unpleasant than tooth extraction, with less postsurgical pain and limitation of daily activities.