Nomogram to predict radicular grooves in maxillary lateral incisors in preoperative orthodontic population.

OBJECTIVES: This study aimed to develop and validate a predictive nomogram for diagnosing radicular grooves (RG) in maxillary lateral incisors (MLIs), integrating demographic information, anatomical measurements, and Cone Beam Computed Tomography (CBCT) data to diagnose the RG in MLIs based on the clinical observation before resorting to the CBCT scan. MATERIALS AND METHODS: A retrospective cohort of orthodontic patients from the School and Hospital of Stomatology, Wuhan University, was analyzed, including demographic characteristics, photographic anatomical assessments, and CBCT diagnoses. The cohort was divided into development and validation groups. Univariate and multivariate logistic regression analyses identified significant predictors of RG, which informed the development of a nomogram. This nomogram's performance was validated using receiver operating characteristic analysis. RESULTS: The study included 381 patients (64.3% female) and evaluated 760 MLIs, with RG present in 26.25% of MLIs. The nomogram incorporated four significant anatomical predictors of RG presence, demonstrating substantial predictive efficacy with an area under the curve of 0.75 in the development cohort and 0.71 in the validation cohort. CONCLUSIONS: A nomogram for the diagnosis of RG in MLIs was successfully developed. This tool offers a practical checklist of anatomical predictors to improve the diagnostic process in clinical practice. CLINICAL RELEVANCE: The developed nomogram provides a novel, evidence-based tool to enhance the detection and treatment planning of MLIs with RG in diagnostic and therapeutic strategies.

Comparative Evaluation of Connective Tissue Graft with Pouch/Tunnel Technique versus Connective Tissue Graft with Coronally Advanced Tunnel Flap for the Treatment of Maxillary Recession Cases in Severe Periodontitis.

BACKGROUND: The long-term stability for both the patient and periodontist remains an important priority after connective tissue graft to manage the gingival recession cases. The goal of this analysis was to assess and compare the connective tissue graft with Pouch/Tunnel technique versus connective tissue graft with coronally advanced tunnel flap for the treatment of maxillary recession cases in severe periodontitis. METHODS: The total sample size was comprised of 200 subjects. The control group, coronally advanced flap along with connective tissue graft (CTG) was comprised of 100 samples and test group, pouch/tunnel technique with connective tissue graft (POT + CTG) was also comprised of 100 samples. The clinical findings included medium root coverage (MRC) and absolute root (CRC) coverage, gingival (GT) distribution and keratinized tissue (KT) gain. Esthetic findings were also evaluated. All findings analyzed initially after 6th months and have been expanded to 4 years. RESULTS: There were no major variations between the MRC and CRC patient classes with non significant values. In the POT + CTG category, GT and KT improvements were slightly greater at 4 years, with a substantial improvement in texture in control group. CONCLUSION: Pouch/Tunnel technique along with connective tissue graft allows for the clinical coverage of gingival recessions that is equivalent to Coronally advanced flap with CTG, however this may improves the gingival thickness, KT and esthetic performance.

Self-etching adhesives: possible new pulp capping agents to vital pulp therapy.

Pulp capping is one of the solving for keeping vital pulp in the case of dentin caries, reversible pulpitis or traumatic pulp exposure. The presence of bacteria on the cavity walls or in the pulp was the major factor that leads to the failure of pulp capping. Traditional pulp capping agent, calcium hydroxide, may not prevent microleakage. Selfetching system is a newly developed adhesive system, which could provide less microleakage and would not break down or dissolve, preventing the oral fluids and bacteria from the pulp along the cavity wall. This may reduce such clinical problems as postoperative sensitivity, secondary caries and marginal discoloration. Researches showed that some kinds of self-etching adhesives induced the mild to moderate inflammatory pulp response, with negative bacterial staining. Inclusion of antibacterial components into self-etching system, such as 12-methacryloyloxydodecylpyridinium bromide (MDPB) may inhibit bacteria and provide better clinical effects. It is speculated that using the self-etching adhesive system containing the antibacterial agent, such as MDPB, to the dental pulp directly or indirectly, may inhibit bacteria after the placement of restoration as well as residual bacteria in the cavity.

The adverse effect of self-etching adhesive systems on dental pulp after direct pulp capping.

OBJECTIVES: To evaluate the histopathological changes in mechanically exposed dog pulps capped with three self-etching adhesive systems. MATERIAL AND METHODS: Seventy-two Class V cavities were prepared under rubber dam isolation in dogs. The pulps were exposed and capped with Clearfil SE Bond (Kuraray), Imperva FluoroBond (Shofu), Prompt L-Pop (3M ESPE), and Dycal (Dentsply; control capping agent), respectively. Histopathological examination of the teeth was performed at 7, 14, and 30 days postoperatively. Hematoxylin-eosin staining was performed to assess the inflammatory cell response, tissue disorganization, and hard tissue formation. Brown and Brenn staining was used to detect the presence of bacteria. The data were analyzed by Kruskal-Wallis and Nemenyi tests. RESULTS: Most pulps showed moderate to severe inflammatory responses. Hard tissue formation appeared at 14 to 30 days. Positive bacterial staining was observed in most specimens in experimental groups. The histological changes in the pulps of the experimental groups were more pronounced than in the control group. Differences in inflammatory response, tissue disorganization, and hard tissue formation were observed among teeth treated with the three self-etching systems. CONCLUSION: Microleakage has a critical influence on pulpal repair. It is not beneficial to cap the pulp with self-etching adhesive systems. Diverse pulpal responses were observed to the self-etching adhesive systems, and the histological changes were more pronounced than in the control pulps treated with Dycal. The effects of the self-etching adhesive systems are such that these materials require further study to address issues of bacterial microleakage during placement of restorations.