Evaluation of the Effect of Hyaluronic Acid Injection on the Reconstruction of Reduced Interdental Papillae in Patients Referred to Shiraz School of Dentistry.

Statement of the Problem: The occurrence of papillary defects adjacent to teeth or dental implants causes both the dental staff and the patients to be concerned about the esthetic issues. Interdental papilla reconstruction surgery is one of the most difficult and unpredictable mucogingival surgeries. Purpose: The present study aimed to investigate the efficacy of hyaluronic acid injection in the reconstruction of the interdental papilla. Materials and Method: This clinical trial study was conducted on four patients with 20 deficient interdental papillae who met the inclusion criteria. At first, local anesthesia was applied. Afterward, 0.2 mL of 1.6% hyaluronic acid (HA) gel was injected (at the tip of the papilla and 2-3 mm below the tip of the papilla) three times every two weeks. At baseline, three, and six months later, clinical photography was taken under standard conditions. The papilla height (the distance between the interdental papilla tip and the basis), black triangle area, and the distance between the interdental papilla tip and contact point of adjacent teeth were all measured using Image J software. Results: The effectiveness of using HA gel in reducing the black triangle area was 85.06%. Furthermore, the papilla length increased by 70.256% while contact to papilla distance decreased by 83.026%. At different times, the values of the studied variables in the three levels were significantly different (p< 0.05). Conclusion: Injection of HA with 1.6% concentration at two points of the interdental papilla was effective in interdental papilla reconstruction at the aesthetic zone, especially in long-term, follow-ups (especially 6 months).

The Effect of Different Image Processing Techniques on the Measurement Accuracy of Endodontics File Length.

Statement of the Problem: Different software capabilities have been used in digital systems to increase the diagnostic quality of radiographic projections. Considering the availability of different enhancement techniques, it is necessary to determine the suitability of each technique for various diagnostic cases. There is controversy between studies over the effect of different digital enhancement techniques on the accuracy of file length measurements in endodontics. Purpose: The present in vitro study aimed to determine the effect of the software capabilities on the diagnostic accuracy to determine endodontic file lengths in photostimulable phosphor (PSP) radiographs. Materials and Method: In the present in vitro study, standard access cavities were prepared in 44 extracted human single-rooted permanent teeth. An endodontic file was placed in each root canal. PSP sensors were used for digital imaging using the parallel technique. All the images were reviewed on a same monitor; once normally with no software enhancement and once using software manipulations including pseudo-color, sharpness, emboss, and edge enhancement. The distance from the file tip to the rubber stop was measured on the images by an electronic ruler. Results: Significantly, all of the image enhancement techniques presented shorter measurements comparing to the actual length. The results revealed the significant accuracy of the measured error in the pseudo-color enhancement technique compared to other techniques. Conclusion: The results revealed significant differences between the initial measurements (the gold standard) and those made on the manipulated radiographs. In all cases, the measurements were significantly lower than the real values. Therefore, none of these digital enhancement techniques can increase the accuracy of file length measurements significantly. However, manipulation with the pseudo-color option resulted in fewer errors compared to other options and the normal images. Hence, for precise measurements of the endodontic file lengths, pseudo-color processing algorithm can be suggested when using PSP sensors.

Unusual Case of External Juxta Coronal Odontoma.

Odontomas are benign tumors of jaws with mixed tissue, which are the result of proliferation of odontogenic epithelium and mesenchymal cells. They occur almost centrally and seldom peripherally. There is no report of such a lesion externally while attaching a tooth crown. In this case, we present a lesion on the buccal surface of the right maxillary central incisor crown, which is misconstrued with a dental overgrowth. Such cases may confuse diagnosis during clinical examination. Radiographically, such odontomas may be mistaken for various other lesions. Ultimate diagnosis should be relied upon microscopic evaluation and histopathological results.

Lip Repositioning, a Solution for Gummy Smile.

For many years oral esthetic problems treated by dentists were limited to those involving the teeth without giving consideration to the gingiva. However, today it is well established that these structures should be in balance to appear esthetically pleasing. More than 3mm gingival show during smiling is considered as 'excessive gingival display' also known as "gummy smile", which is not attractive. The current case series, presents three patients with gummy smile managed by lip repositioning surgery, each with 1 year follow up. Our objective was to introduce lip repositioning as a successful treatment modality to decrease gingival show using a simple and conservative surgical approach.