Contrast arthrography of the equine temporomandibular joint.

Background: Disorders of the equine temporomandibular joint (TMJ) cause clinical problems and detailed investigations of this joint are becoming more common. Specialist radiographic projections have the potential to highlight osseous abnormalities; however, the ability to assess the intra-articular soft tissue structures is currently limited to computed tomography (with, or without contrast enhancement) or magnetic resonance imaging. Both modalities are expensive and not readily accessible. Objective: To develop a technique of contrast arthrography of both compartments of the equine TMJ in cadavers and then perform the refined technique in three living horses as a proof-of-principle. Study design: A descriptive, experimental, study. Methods: Contrast arthrography of the discomandibular and discotemporal joint compartments of both TMJs was performed in 12 cadaveric equine heads using needles placed in the caudal pouches of the respective joint compartments. Radiographs were taken using previously published techniques, repeated with the mouth open and after air had been injected into the joints, to perform a double-contrast study. The TMJs of three healthy horses were subsequently examined to determine the validity of the procedure in live animals. Results: Single and double-contrast arthrography allowed delineation of the dorsal and ventral surfaces of the intra-articular disc in addition to filling the rostral and caudal joint pouches of the independent joint compartments. Contrast extravasation was common, and in two instances iatrogenic disc penetration resulted in the false diagnosis of pathologic disc perforation. The techniques were well tolerated in all three live horses. Main limitations: Low number of horses. Conclusion: Contrast arthrography allows interpretation of intra-articular soft tissue structures, but caution is advised in diagnosing intra-articular disc perforation. Even with experience, accessing the discomandibular joint can be challenging.

Artificial intelligence (A.I.) in dental curricula: Ethics and responsible integration.

The use of artificial intelligence (AI) is deeply embedded in all aspects of our daily lives, promoting efficiency and safety in routine tasks at home and work. Likewise, dentistry is rapidly exploring new uses of AI for image analysis, electronic health records, and clinical decision-making. The accelerating advancement of AI and its application in dentistry demands dental education conscientiously integrate AI into curricula and equip graduates to use it ethically and responsibly in practice. The approach must be threefold: instill knowledge of the basic algorithms and appropriate application of AI, discuss its limitations/biases, and examine current and potential ethical challenges in practice. Furthermore, dental education must protect the public from intentional and unintentional harm introduced by AI. Therefore, the purpose of this perspective paper is to discuss various considerations for integrating AI into the dental curriculum, prioritizing patient safety by ensuring knowledgeable, safe, and ethical application by future providers.

Presentation of Localized Aggressive Periodontitis in Monozygotic Twins: Case Report.

INTRODUCTION: Localized aggressive periodontal disease is an uncommon finding observed in adolescents and children. Studies have been conducted to elucidate the etiology, contributing factors, and genetic roles in the phenomena. In particular, twin studies have shown genetic makeup to be a substantial risk factor for periodontitis. This case is, to the best of the authors' knowledge, the first to be presented in literature of a same dwelling, set of monozygotic twins, displaying similar presentation of localized aggressive periodontitis, however with different microbial profiles. CASE PRESENTATION: A set of 17-year-old black male monozygotic twins were referred for a full-mouth periodontal evaluation and any necessary periodontal treatment on July 7, 2007. A full-mouth radiographic series, periodontal charting, and intraoral photographs were performed on each individual. A family history was obtained through the biological mother, which yielded no known history of early tooth loss or treatment of severe periodontal disease. The father was not involved in the rearing of the children and his periodontal history was unavailable. An initial and surgical treatment plan was developed. Microbial analysis of subgingival plaque samples was collected on the affected sites. Initial treatment with scaling and root planing, subgingival irrigation, with administration of systemic antibiotics, and oral hygiene instruction, were rendered on both individuals. CONCLUSION: Within limitations of this report, it is demonstrated that different microbial pattern exists on aggressive periodontitis even in genetically identical individuals with the same environmental exposure.

A Manual Bristleless Toothbrush Demonstrates Slight Improvement in Gingival Recession Compared to a Conventional Soft Manual Brush.

PURPOSE: This randomized clinical trial tested whether a novel bristleless toothbrush design is more effective in preventing gingival recession in adults receiving periodontal maintenance than is a soft toothbrush with nylon bristles. MATERIALS AND METHODS: Twenty-three subjects with gingival recession were recruited who received regular periodontal maintenance care at Western University of Health Sciences Dental Center, and who did not exhibit signs of acute dental or systemic disease, occlusal discrepancies or parafunctional habits. These subjects were randomly assigned to to two groups, one using a soft nylon-bristled toothbrush, and the other using the experimental toothbrush that contains a brush head with short, soft, rubbery cones. Both groups received regular periodontal maintenance and periodontal exams by blinded examiners every 3-4 months, measuring probing depth, bleeding on probing, and plaque indices. Gingival recession was assessed clinically and through use of a stent on diagnostic casts obtained at each visit. RESULTS: Average probing depths, plaque levels, and the number of sites with bleeding on probing did not change over at least 9 months. After 9 months, there was a small but statistically significant improvement in gingival recession (0.4 mm, p < 0.01) at sites with gingival recession in the experimental toothbrush group compared to the control group. CONCLUSION: In periodontal maintenance patients, the bristleless toothbrush used in this study was as effective in plaque removal and prevention of gingival inflammation than a conventional toothbrush with soft nylon bristles, while increasing the possibility of gingival tissue rebound over denuded root surfaces.

Bone Loss in Furcation-involved Mandibular Molars: A Retrospective Analysis.

Purpose: The purpose of this retrospective study was to determine whether teeth with furcation involvement lose significantly more bone in furcation sites over time than interproximal sites of the same tooth.Methods: Existing radiographs were analyzed to compare the rate of bone loss between furcation and interproximal sites of the same tooth. Selection criteria included mandibular molars with furcation involvement and a minimum follow-up of 5 years. Using ImageJ software, anatomical landmarks were located and measured corono-apically.Results: Bone level change over time averaged 4.22 % ± 2.49 for interproximal sites and 4.55% ± 2.84 for furcation sites. Significant difference in bone loss was noted in furcation sites between compliant (a minimum of one periodontal maintenance appointments per year) and non-compliant (fewer than one periodontal maintenance appointments per year) sub-groups. No other sub-group variables were associated with significant bone loss.Conclusion: There were no significant differences in bone loss between furcation sites and interproximal sites of the same tooth. Compliant patients lost significantly less bone in furcation sites than non-compliant patients. Periodontal maintenance therapy may provide more effective debridement for mandibular molars that exhibit radiographic furcation bone loss than previously thought. Clinicians are encouraged to expand and explore a non-surgical approach for maintaining multi-rooted teeth with furcation involvement.

Crown Lengthening Needs and Outcomes in Adults Attending a Predoctoral Clinic.

In this retrospective study of 5,536 patients admitted over four years at a predoctoral dental clinic for comprehensive care, general dentists identified crown lengthening needs in 584 patients and 760 teeth. Only 51 patients and 68 teeth actually received crown lengthening procedures. For the other cases, patients discontinued treatment or chose extraction or restoration without crown lengthening procedures. Teeth that received crown lengthening procedures were most likely restored and functioning for at least one year.