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  • Esthetic crown lengthening in the treatment of gummy smile

    Esthetic crown lengthening in the treatment of gummy smile

    The aim of this article was to evaluate 1 year after surgerya surgical protocol that included gingivectomy and an apically positioned flapplus osseous resective surgery to correct excessive gingival display (EGD) inpatients with altered passive eruption (APE) of the maxillary anterior teeth.Six female patients aged 18 to 22 years were diagnosed with APE type 1B.Surgical crown lengthening with flap surgery and bone recontouring wasperformed to achieve the biologic width. Photographic images were analyzed toevaluate the stable improvement of crown length before the procedure(baseline), immediately after surgery (immediate postoperative), and at 3 and12 months postsurgery. Moreover, a lip repositioning procedure was alsoperformed in one case to complement the periodontal therapy. Compared withbaseline, an increase of 1.6 mm in the mean tooth crown height was observed inthe photographic analysis at 12 months. A minimal difference was observedbetween the mean tooth crown height immediate postoperative and at 12 months,which indicates stability of the gingival margin. In conclusion, the surgicalprotocol outlined in this article describing esthetic crown lengthening for thetreatment of APE/gummy smile resulted in predictable outcomes and stability ofthe gingival margin 1 year after surgery.

    Mauricio Andrés Tinajero Aroni / Suzane Cristina Pigossi / Elton Carlos Pichotano / Guilherme José P


  • A critical view on sodium hypochlorite accidents

    A critical view on sodium hypochlorite accidents

    Inadvertent extrusion of sodium hypochlorite toward theperiapical tissues is an infrequent, yet alarming complication during rootcanal treatment. Such accidents seem to occur more often in female patients andduring the treatment of maxillary teeth. Authors of case reports have proposeda number of possible causes for these accidents but corroborating evidence isusually lacking, so their aetiology is still a matter of debate. Varioustheories have been suggested to explain their occurrence and provide guidelinesfor clinicians in order to prevent them. Their management has been extensivelydiscussed in the literature and appears more straightforward. This review aimedto present a critical analysis of the evidence on sodium hypochloriteaccidents, highlight potential knowledge gaps and provide directions for futurecase reports and experimental studies.

    Zoi Psimma / Christos Boutsioukis


  • Surface-specific Correlation between Extrinsic Stains and Early Childhood Caries

    Surface-specific Correlation between Extrinsic Stains and Early Childhood Caries

    Purpose: This studywas designed to assess (i) the prevalence of extrinsic stains in preschoolchildren (ii) the correlation between extrinsic stains and the occurrence ofearly childhood caries (ECC) (iii) to compare the distribution of caries inpits and fissures, smooth surfaces or both among children with and withoutextrinsic stains. Methods: Across-sectional study was carried out among 1,486 children aged 0–3 years.Extrinsic stain and ECC were scored by two calibrated examiners. Correlationbetween ECC pattern and extrinsic stains was analysed by logistic regression.Caries distribution in fissures, smooth surfaces or both were analysed usingMann Whitney test and Pearson chi-squared test. Results:The prevalence of extrinsic stains among 0–3 years children was6.2%. Children with extrinsic stain had a 1.13-fold greater chance ofexhibiting ECC (OR = 1.132, 95% CI: 0.739–1.733). Statistically significantdifferences were found for fissure caries (p < 0.0002) and both smoothsurface and fissure caries (p < 0.0328) among children in both groups. Conclusions:Occurrence of ECC appears to have surface-specific variations inchildren with and without extrinsic stains. However, the interaction of theseindividual factors and their impact on oral health outcomes needs to beidentified through further research.

    Key words: cross-sectionalstudy, early childhood caries, epidemiology, extrinsic stain, public dentalhealth

    Murugan S. Muthu / Ankita Saikia / Jean Aishwarya Henry / Asaithambi Balamurugan


  • Effectiveness of Adjunctive Use of Low-Level Laser Therapy and Photodynamic Therapy After Scaling and Root Planing in Patients with Chronic Periodontitis

    Effectiveness of Adjunctive Use of Low-Level Laser Therapy and Photodynamic Therapy After Scaling and Root Planing in Patients with Chronic Periodontitis

    The aim of this split-mouth, randomized controlled clinicaltrial was to evaluate the efficacy of low-level laser therapy (LLLT) andphotodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) intreatment of chronic periodontitis. Each quadrant was categorized into controlgroup (SRP alone; two quadrants per patient), test group 1 (SRP + PDT), andtest group 2 (SRP + LLLT. The test groups showed significantly higherreductions in Gingival Index, probing depth, and clinical attachment level aswell as reductionsin Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans countsat 1-, 3-, 6-, and 9-month follow-ups when compared with the control group.

    Kaveri Kranti Gandhi / Rajdeep Pavaskar / Emil G. Cappetta / Howard J. Drew

Dental Radiology

  • Dental x-ray exposure is not associated with risk of meningioma: a 2019 meta-analysis

    Dental x-ray exposure is not associated with risk of meningioma: a 2019 meta-analysis

    The goal of this case series report is to demonstrate thepredictability of providing immediate restorations with an implant specificallydesigned to achieve high primary stability, and to report on 12-month survivaloutcomes. Twenty-nine implants were placed in eight patients with varioustooth-replacement needs, from single teeth to partially edentulous spans tofully edentulous mandibles. A new tapered-implant system (The Marc Nevins,Little Implant) was utilized that incorporates a self-tapping thread designwith a thread pitch and thread lead to improve primary stability at insertion.All implants were placed with a minimum insertion torque of 45 Ncm. Fourimmediate implants and two early placements at extraction sites were includedin the cohort. Twenty-seven implants were clinically successful at 1 year. Twoimplants in a healed ridge were found to have failed at 6 weeks postoperativein one patient wearing an ill-fitting removable partial denture. Theradiographic crestal marginal bone levels were recorded in millimeters from thetop of the implant platform to the first bone-to-implant contact. The meancrestal marginal bone level change was –0.57 ± 0.82 mm. This case series reportdemonstrates the ability of an implant designed for high primary stability toachieve successful integration in the presence of an immediate restoration forvarious clinical presentations, including single-tooth, multi-unit, andedentulous cases.

    Mel Mupparapu / Venkat Ramana Reddy Baddam / Krishna Prasad Lingamaneni / Steven R. Singer