A Comparison of Immunohistochemical Expression of Epidermal Growth Factor Receptor and Human Epidermal Growth Factor Receptor 2 in Dental Follicles with Different Radiographic Sizes

Background

Odontogenic cysts and tumors develop from the dental follicle of asymptomatic impacted teeth. Odontogenic tissues express the epidermal growth factor receptor family (EGFR), which mediates cell proliferation, survival, and neoplastic differentiation. The present study aimed to compare the immunohistochemical expression of EGFR and human epidermal growth factor receptor 2 (HER2) in the dental follicle of impacted wisdom teeth with normal and abnormal radiographic size.

Methods

In this analytical study, immunohistochemical staining of EGFR and HER2 was performed on 30 normal and 30 abnormal follicles of impacted third molars. Follicles with a width of <2.5 mm were considered normal, whereas those with a width of ≥2.5 mm were regarded as abnormal. The immunoreactive score (IRS) was used to report the expression levels of EGFR and HER2. The obtained data were analyzed using SPSS software. Age and sex were compared in normal and abnormal groups with independent t test and Chi square test, respectively. P<0.05 was considered statistically significant.

Results

The EGFR and HER2 overall expression was high in all normal and abnormal follicles. The comparison of the percentage of stained cells and intensity of EGFR and HER2 staining in normal and abnormal follicles were not significantly different (P=0.73, P=0.63, P=0.95, respectively).

Conclusion

Due to the high expression of EGFR and HER2 in normal and abnormal follicles, as well as the lack of significant differences in these two groups, the radiographic size of dental follicles might not indicate the potential capabilities of their cells, and more research in this field is recommended.

Root Regeneration with Photobiomodulation of an Upper Lateral Incisor Associated with Root Resorption Due to an Impacted Maxillary Canine: A Case Report

Objective: To present a case report of maxillary lateral incisor root regeneration after severe root resorption, treated with photobiomodulation (PBM). Background: Impacted maxillary canines often come with the risk of maxillary lateral incisor root resorption, which is widely recognized as the predominant adverse effect in these situations. This progressive process of root resorption is currently irreversible, with no known way to reverse it. Materials and methods: A male patient was 14 years old. Radiographically it was observed that canine 23 is impacting against the root of 22 producing signs of root resorption and having a less than 1:1 crown-to-root ratio with mobility grade 1. From the beginning of the treatment, PBM-assisted orthodontics was proposed. To address the patient's dental concerns, the treatment plan outlined the extraction of the deciduous upper left canine tooth leaving the lateral as long as possible in the mouth. During each appointment, PBM was applied with a diode laser. The wavelength was 810 nm, Ap = 0.2 W, 4.4 J, 22 sec every 21 days, 13 applications in total (57.2J), with a 400 μm inactive surgical tip, in a scanning movement, 1 mm from the mucosa while moving following the vestibular surface of the upper left lateral and canine roots. Results: After 12 months, the 22 had root neoformation and complete closure of the apex with vitality. Conclusions: PBM with an 810 nm diode laser in this clinical case promoted root regeneration of an upper lateral incisor, with severe root resorption, owing to an impacted maxillary canine while still vital.

A retrospective analysis of the patient journey for children with an unerupted maxillary central incisor

BACKGROUND

Maxillary central incisors (MCI) are the third most impacted teeth. Timely multidisciplinary management is indicated as unerupted incisors can cause functional- and appearance-related distress.

AIM

To assess the patient journey for children with unerupted MCI, including referral, clinical assessment, surgical management and follow-up treatment, and highlight areas for improvement, as well as identify factors impacting orthodontic treatment burden (OTB).

DESIGN

A retrospective service evaluation of children aged 6-16 years who had surgical management of unerupted MCI under general anaesthetic (GA) between 2018 and 2021.

RESULTS

Fifty-two children with 62 unerupted MCI were identified. Mean age at referral was 8.8 years. Most children (82.7%) had supernumerary teeth in the anterior maxilla. Mean time between listing for GA and surgery increased from 4.3 to 15.2 months following the COVID-19 lockdown. Mean age at surgery was 10.4 years. Supernumerary removal and incisor exposure and bond was the most common treatment (56.6%). Most patients required hospital orthodontic treatment post-surgery (65.4%).

CONCLUSION

Most children referred were below 9 years (60.1%); these children had reduced OTB compared to those who had been referred at an older age. Stage of root development was also a significant predictor in OTB. An unexpected finding was that conical supernumeraries were found to prevent MCI eruption.

Tissue Interactions in Dense Tissues of the Orofacial Region in Patients with Connective Tissue Dysplasia

AIMS

This study aimed to investigate the rate and quality of maturation of the mineral component of impacted teeth 38 and 48 and a fragment of the human lower jaw with connective tissue dysplasia (CTD) in different periods of postnatal ontogenesis.

METHODS AND MATERIAL

The study involved 102 males (76 with CTD and 26 without CTD), divided into age groups: 31-40, 41-50 and 51-60 years. For medical reasons, teeth 38 and 48 were removed from each patient, as well as a fragment of the alveolar part of the lower jaw in the projection of teeth 38 and 48 measuring 0.5 × 0.5 cm. The odontological parameters, the mineral density of the enamel and the lower jaw, the length and width of the enamel prisms, the spatial organisation of collagen fibrils and the dimensions of the bone plates of the lower jaw were determined.

RESULTS

A decrease in optical density was observed at the age of 41-50 and 51-60 years with dysplasia, which indicated a decrease in mineral density and the presence of total areas of hypomineralisation relative to the age of 31-40 years. In the age groups of 41-50 and 51-60 years, pronounced sclerosis and deformation of the delimiting elements were observed at the border of the connective tissue structures and the periosteum. At the age of 31-40 years, the level of stratification of the bone plates was local; after 40 years, it was generalised.

CONCLUSIONS

Progressive osteoporosis of the lower jaw and incomplete amelogenesis are obstacles to the correct and harmonious eruption of the lower 'wisdom' teeth after 30 years.

Assessment of Third Molar-related Symptoms Affecting Quality of Life using Nepali Version of Oral Health Impact Profile-14: A Descriptive Cross-sectional Study

INTRODUCTION

Impacted third molars often cause pain, infections, swelling, and functional limitations. This study is an attempt to assess impacted third molars-related symptoms affecting quality of life using standardised Nepali version of oral health impact profile-14 (OHIP-14) questionnaire.

METHODS

This descriptive cross-sectional study was conducted at Kathmandu Medical College Teaching Hospital from October 2021 to February 2022 after institutional ethical approval. Patients with impacted third molars were included by convenience sampling technique. Patients with psychiatric illness, taking psychotropic drugs, pregnant, and lactating females were excluded. third molars-related symptoms were recorded in OHIP-14 questionnaire. Data entered in Microsoft Excel sheet were analysed. The findings have been presented as frequency, percent, mean, and standard deviation. The point estimate was calculated at a 95% Confidence Interval.

RESULTS

Mean OHIP-14 score of participants was 21.77±11.59. Due to TM, "pain in the mouth" had score of (2.33±1.24) and followed by "uncomfortable experience on eating food" (2.12±2.15). Among seven OHIP-14 dimensions, "physical pain" with two items OHIP3 and OHIP4 had score of 4.53±2.19 implying most participants had "quite a lot" of physical pain due to TM: OHIP3 = 194 (50.2%) and OHIP4 = 183 (47.3%).

CONCLUSIONS

Impacted third molars-related symptoms were affecting quality of life of participants.

Combining public datasets for automated tooth assessment in panoramic radiographs

OBJECTIVE

Panoramic radiographs (PRs) provide a comprehensive view of the oral and maxillofacial region and are used routinely to assess dental and osseous pathologies. Artificial intelligence (AI) can be used to improve the diagnostic accuracy of PRs compared to bitewings and periapical radiographs. This study aimed to evaluate the advantages and challenges of using publicly available datasets in dental AI research, focusing on solving the novel task of predicting tooth segmentations, FDI numbers, and tooth diagnoses, simultaneously.

MATERIALS AND METHODS

Datasets from the OdontoAI platform (tooth instance segmentations) and the DENTEX challenge (tooth bounding boxes with associated diagnoses) were combined to develop a two-stage AI model. The first stage implemented tooth instance segmentation with FDI numbering and extracted regions of interest around each tooth segmentation, whereafter the second stage implemented multi-label classification to detect dental caries, impacted teeth, and periapical lesions in PRs. The performance of the automated tooth segmentation algorithm was evaluated using a free-response receiver-operating-characteristics (FROC) curve and mean average precision (mAP) metrics. The diagnostic accuracy of detection and classification of dental pathology was evaluated with ROC curves and F1 and AUC metrics.

RESULTS

The two-stage AI model achieved high accuracy in tooth segmentations with a FROC score of 0.988 and a mAP of 0.848. High accuracy was also achieved in the diagnostic classification of impacted teeth (F1 = 0.901, AUC = 0.996), whereas moderate accuracy was achieved in the diagnostic classification of deep caries (F1 = 0.683, AUC = 0.960), early caries (F1 = 0.662, AUC = 0.881), and periapical lesions (F1 = 0.603, AUC = 0.974). The model's performance correlated positively with the quality of annotations in the used public datasets. Selected samples from the DENTEX dataset revealed cases of missing (false-negative) and incorrect (false-positive) diagnoses, which negatively influenced the performance of the AI model.

CONCLUSIONS

The use and pooling of public datasets in dental AI research can significantly accelerate the development of new AI models and enable fast exploration of novel tasks. However, standardized quality assurance is essential before using the datasets to ensure reliable outcomes and limit potential biases.

Role of αENaC in root resorption of adjacent teeth due to entirely impacted mandibular third molars

BACKGROUND

Entirely impacted mandibular third molar (EIM3M) concerns the pathological external root resorption (ERR) of the adjacent mandibular second molar (M2M) and formation of granulation tissue between two molars. The study aimed to clarify the effect of αENaC, a mechano-sensitive molecule, to explore the mechanical mechanism in this scenario.

METHODS

The force EIM3M exerted on M2M was proved by finite element analysis. αENaC expressions were tested by real-time polymerase chain reaction (PCR), immunoblotting and immunofluorescence. Inflammatory and epithelial-mesenchymal transition (EMT)-related molecules expressions were also detected by real-time PCR. The correlation was analyzed by Spearman's correlation analysis, and receiver-operator characteristic (ROC) curve was further exhibited.

RESULTS

The force was concentrated in the ERR area. αENaC was upregulated, positively correlated with ERR degree and localized to the fibroblasts in ERR granulation tissues. Moreover, αENaC was respectively and positively associated with elevated TNF-α and N-cadherin in ERR granulation tissues. More importantly, ROC analysis verified αENaC as a novel indication of the incidence of this disease.

CONCLUSIONS

Our finding revealed the force from EIM3M causing ERR of M2M, and elucidated the expression and localization of αENaC and its positive correlation with inflammation, EMT and disease severity, suggesting a novel indication in this disease.

3-dimensional analysis of nasal soft tissue alterations following maxillary Lefort I advancement with and without impaction using 3D photogrammetry scanner

PURPOSE

This study was designed to investigate the changes in nasal soft tissue following maxillary Lefort I advancement with and without impaction in subjects presenting a skeletal class III malocclusion, using a 3D photogrammetry scanner.

MATERIALS AND METHODS

Patients with class III malocclusion undergoing Lefort I advancement with and without impaction and bilateral sagittal split osteotomy with the standard technique were included in this study. Patients were divided into two groups: maxillary Lefort I advancement alone (group 1) and combined with impaction (group 2). Facial soft tissue landmarks of the nose including nasal height (NH), nasal length (NL), nasal tip projection (NTP), alar width (AW), alar base width (ABW), subalar width (Sbal), nasolabial angle (NLA), nasofrontal angle (NFA), and columella inclination (CI) before and at least 4 months after surgery were obtained by a 3D scanner.

RESULTS

Twenty-one patients were included in this study (Group 1: 11 and Group 2: 10). NH, NTP, and NL decreased significantly in both groups following surgery. In addition, Sbal decreased only in group 2. On the other hand, NLA and CI increased significantly in group 2. The inter-group comparison revealed a statistically significant difference in the alterations in NH, NL, and CI between the two groups.

CONCLUSION

Changes in the nose soft tissue occurred after both surgeries, but their type and extent were different. Actions taken to reduce unwanted changes need to be further investigated. To evaluate the changes, 3D photogrammetry scan is a feasible imaging technique that can be used, providing numerous benefits.

New complementary alternatives in third molar autotransplantation: A systematic review

BACKGROUND

Dental autotransplantation (DAT) is defined as the replacement or direct transfer of an impacted, semi-impacted or erupted tooth to a donor site, either to a post-extraction socket or to a surgically created socket within the same individual. The use of new technological advances, such as 3-D dental models based on computer-aided design, among others, have been reported to improve the success rate of DAT. Therefore, we aimed to perform a systematic review to explore the possible benefits that the use of these innovative techniques can provide when applied to DAT.

MATERIAL AND METHODS

The literature search was conducted in PubMed, Scopus, and Web of Science databases following the PRISMA guidelines. The research question was: "Are computerized technological advancements a useful tool for improving the success of third molar autotransplantation technique?

RESULTS

The initial literature search identified 195 articles, of which only 11 were included for qualitative analysis. All studies used 3D dental models based on computer-aided design data. Surgical guides and stereolithographic models were used by 4 and 1 study respectively. A total of 91 transplanted teeth were evaluated, out of which only 88 were considered within the parameters of clinical success (96.7%). Only 7 out of the 11 articles reported the specific autotransplanted tooth, being mandibular third molars the most prevalent autotransplanted teeth.

CONCLUSIONS

Although the application of new technologies for DAT increases the success rate of this technique, further primary studies are still needed to address long-term teeth survival rates and complications. The cost and availability to implement the integration of these techniques to DAT may be a variable to consider, as this can be a limitation for some patients or for low-income countries.

Premature loss of primary molars in children: space recovery through molar distalisation. A literature review

AIM

The integrity of primary dentition is essential in the development of the jaws and permanent occlusion. The consequences of a premature loss of primary molars are: space loss, crowding, risk of impaction of the permanent teeth, ectopic eruption, anomalous inclination of the teeth adjacent to the loss molar, reduction of arch length. The mesial displacement of the posterior permanent teeth during eruption can cause a loss of space, which can be regained with orthodontic appliances. Therefore, a careful diagnosis is of great importance to be able to decide what appliance is indicated to recover from this situation. Molar distalisation consists in displacing permanent molars distally, allowing them to reach class I relationship and to recover the correct space for the second bicuspids when the second deciduous molar has been lost early.

METHODS

The aim of this study is to carry out a narrative literature review regarding the different appliances and their effectiveness in regaining space after premature loss of the upper primary molars.

CONCLUSION

The paediatric dentist should be aware of the advantages and disadvantages related to each device and select the most appropriate distalisation appliance based on an individual plan of diagnosis and a careful treatment. The distalisation of the upper molar must be adequately stabilised and so it is important to consider also some retainers such as Nance's appliance, the Palatal Plate, the extraoral traction, the utility arch, or II Class elastic bands.

Prescription of panoramic radiographs in children using age-based prevalence of dental anomalies and pathologies

BACKGROUND

Panoramic radiographs (PRs) are used in the detection and diagnosis of developmental dental anomalies and pathologies (DDAPs) in children.

AIM

The primary objective of this observational cohort study was to evaluate the age-based prevalence of DDAP on PRs, whereas the secondary objective was to determine a threshold age for the detection of DDAP to provide supportive evidence for the prescription of PR in paediatric dental practice.

DESIGN

The study examined diagnostic PRs from 581 subjects aged 6 to 19 years. All PRs were reviewed by experienced, calibrated, masked examiners for the identification or presence of anomalies in size, shape, position, structure, and other developmental anomalies and pathologies (ODAP) of the face-neck region in a standardized condition. The data were statistically analyzed for interpretation.

RESULTS

Overall, 74% (n = 411) of the cohort had at least one anomaly (shape anomaly: 12%, number anomaly: 17%, positional anomaly: 28%, structural anomaly: 0%, and ODAP: 63%). The optimal Youden index cutoff for any anomaly was 9 years. Twelve and 15 years also showed predictive ability.

CONCLUSION

The results suggest that PRs should be prescribed at ages 9, 12, and 15 years for the diagnosis of DDAP.

[Three-dimensional radiographic features of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor]

OBJECTIVE

To analyze the three-dimensional radiographic characteristics of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor using spiral computed tomography (CT) and cone-beam computed tomography (CBCT).

METHODS

Clinical records, histopathological reports, and CBCT or non-enhanced spiral CT images of 19 consecutive patients with calcifying odontogenic cyst (COC) and 16 consecutive patients with calcifying epithelial odontogenic tumor (CEOT) were retrospectively acquired, and radiographic features, including location, size, expansion, internal structure and calcification, were analyzed.

RESULTS

Among the 19 COC cases (12 males and 7 females, with an average age of 27 years), 89.5% (17/19) of the lesions originated from the anterior and premolar areas, 100.0% of them exhibited cortex expansion, and 78.9% had discontinued cortex. Among the 16 CEOT cases (3 males and 13 females, with an average age of 36 years), 81.3% (13/16) of the lesions were in the premolar and molar areas, 56.3% of them exhibited cortex expansion, and 96.8% had discontinued cortex. According to the distribution of internal calcifications, these lesions were divided into: Ⅰ (non-calcification type): absence of calcification; Ⅱ (eccentric marginal type): multiple calcifications scattered along one side of the lesion; Ⅲ (diffused type): numerous calcifications diffusely distributed into the lesion; Ⅳ (plaque type): with a ≥ 5 mm calcified patch; Ⅴ (peri-coronal type): multiple calcifications clustered around impacted teeth. Calcifications were present in 73.7% of COC lesions, including 9 type Ⅱ, 3 type Ⅲ and 2 type Ⅳ lesions, and 42.8% of CEOT lesions had calcification images, including 2 type Ⅲ and 5 type Ⅴ lesions. Six COC lesions had odontoma-like images. Moreover, 8 of 9 type Ⅰ CEOTs were histologically Langerhans cell-rich subtype, which had a smaller size (with an average mesiodistal diameter of 17.8 mm) and were not associated with impacted teeth.

CONCLUSION

COC lesions tended to originate from the anterior part of the jaw and exhibit cortex expansion, and were sometimes associated with odontoma. CEOT commonly occurred in the posterior jaw and had discontinued cortex. Two lesions had significantly different calcification map. Over 70% of COC lesions had calcification images, which were mostly scattered along one side of the cysts, far from the impacted teeth. Approximately 60% of CEOT lesions exhibited smaller size and non-calcification, and the remaining CEOT cases often had calcification images clustered around the impacted teeth.

[Nonimpacted third molars and the periodontal homeostasis of their adjacent second molars]

Due to the limitations of eruption time and space, third molars (M3s) are often impacted and induce a variety of oral diseases, bringing adverse effects on the health of their adjacent second molars (M2s). For a long time, a large number of studies have focused on the harm of impacted M3s (I-M3s) to the health of their adjacent teeth, while less attention has been paid to nonimpacted M3s (N-M3s) that have already erupted. In recent years, however, a growing number of studies and evidences have shown that the existence of N-M3s is also an important risk factor for various diseases of their adjacent teeth, whose hazard has not been taken seriously by dentists and patients. Based on the latest results of both domestic and international researches as well as our group, this review summarizes and explains the effects of N-M3s on the periodontal homeostasis and periodontal health of adjacent M2s, so as to provide reference for clinical decision-making of N-M3s and the healthy maintenance of their adjacent teeth.

The use of panoramic radiographs to address the oral health needs of vulnerable Canadian populations

Background

The high demand for oral health care services among vulnerable individuals combined with limited available resources requires a rethinking of the provision of oral health services. This study aimed to determine the usefulness of the dental panoramic radiograph (DPR) as an imaging tool to assess oral health and prioritize dental interventions in vulnerable patients.

Methods

This observational and retrospective study evaluated charts of patients who attended Public Health Dental Clinics (PHDC), Alberta Health Services (AHS), in Calgary, Canada, between January 2018 and December 2019. Data collected included sex and age at the time of image acquisition. The following radiographic findings were gathered: the number of missing, present, decayed, restored, and impacted teeth; periapical lesions; retained root; periodontal bone loss; odontogenic and non-odontogenic lesions in the jaws; carotid calcification; and incidental radiographic findings with clinical relevance.

Results

Of the 526 DPRs evaluated, 57.4% were from male patients and 42.6% were from female patients, with a mean age of 38.5 years. The average number of present teeth in females and males was 23.7 and 22.6, respectively. The most prevalent dental-related finding was periodontal bone loss (81.5%), followed by periapical lesions (59.6%) and impacted teeth (27%). Among non-dental findings, osseous lesions of the jaws were found in 10.4% of the patients, and carotid atheroma had a frequency of 3.2%.

Conclusion

The DPR is a useful adjunct to the clinical exam in this specific population. It provides an opportunistic overview of their oral health and necessary support to establish priorities in oral health care in a public health setting.

Deep learning driven segmentation of maxillary impacted canine on cone beam computed tomography images

The process of creating virtual models of dentomaxillofacial structures through three-dimensional segmentation is a crucial component of most digital dental workflows. This process is typically performed using manual or semi-automated approaches, which can be time-consuming and subject to observer bias. The aim of this study was to train and assess the performance of a convolutional neural network (CNN)-based online cloud platform for automated segmentation of maxillary impacted canine on CBCT image. A total of 100 CBCT images with maxillary canine impactions were randomly allocated into two groups: a training set (n = 50) and a testing set (n = 50). The training set was used to train the CNN model and the testing set was employed to evaluate the model performance. Both tasks were performed on an online cloud-based platform, 'Virtual patient creator' (Relu, Leuven, Belgium). The performance was assessed using voxel- and surface-based comparison between automated and semi-automated ground truth segmentations. In addition, the time required for segmentation was also calculated. The automated tool showed high performance for segmenting impacted canines with a dice similarity coefficient of 0.99 ± 0.02. Moreover, it was 24 times faster than semi-automated approach. The proposed CNN model achieved fast, consistent, and precise segmentation of maxillary impacted canines.

Effect of mandibular third molars on crowding of mandibular teeth in patients with or without previous orthodontic treatment: a systematic review and meta-analysis

OBJECTIVES

To assess the scientific evidence related to the role of the mandibular third molars on the late crowding of the lower anterior teeth in patients with or without previous orthodontic treatment. The secondary outcomes included changes in mandibular arch width and arch length.

MATERIALS AND METHODS

The databases PubMed, Scopus, ProQuest, and Google Scholar were searched from inception until April 2022. The included papers were studies evaluating the role of mandibular third molars on crowding of mandibular anterior teeth in patients of any age and gender, with mandibular third molars impacted or semi-impacted or erupted. Predetermined and prepiloted data collection forms were used to record the necessary information.

RESULTS

Thirteen observational studies were included in the present systematic review. Most of them were assigned an overall risk of bias of moderate risk while the rest of them were at high risk. Four studies found an association between the presence of mandibular third molar and mandibular incisor crowding. Finally, seven studies were included in the quantitative analysis. Three different meta-analyses were conducted: for patients (a) with or (b) without previous orthodontic treatment and (c) in combination for patients with and without previous orthodontic treatment. According to the pooled results of all three meta-analyses, random effects model yielded a significant benefit for those without third molars compared to those with third molars regarding crowding, mean Little's irregularity index and mean arch length.

CONCLUSIONS

Lower third molars may contribute to mandibular crowding and lower arch constriction. Further prospective research of high quality is needed to clarify the impact of third molars on anterior mandibular crowding.

The Showcases of Dental History - A Time Machine in Miniature at the University of Puerto Rico: Part I

The evolution of 20-year-old dental museum-like showcases located in the lobby and the main hallway of the School of Dental Medicine, Puerto Rico (PR) are described along with important professionals who impacted on this development.

Prognostic factors, outcomes, and complications for dental autotransplantation: an umbrella review

BACKGROUND

Dental autotransplantation (DAT) is a biological way of replacing missing or compromised teeth for patients. The techniques often necessitate a multi-disciplinary approach. The prognosis and success of the procedure may be impacted by variable factors in varying degrees.

OBJECTIVE

Evaluating outcomes and complications of DAT, including prognostic factors using an umbrella review.

SEARCH METHODS

Six databases were searched for all relevant systematic reviews published up to 30 June 2022. No restrictions were applied to language or publication date.

SELECTION CRITERIA

Systematic reviews and meta-analyses of DAT studies.

DATA COLLECTION AND ANALYSIS

Identification, screening, eligibility, and quality assessment using the AMSTAR 2 tool were performed independently by two authors (M.C. and S.A.). Two studies (20%) scored moderate, six studies (60%) scored low, and two studies (20%) scored critically low. Data were analysed using a random effects meta-analysis, and meta-regression was performed to investigate the effect of open and closed apices on the dependent variables. The results were summarised as relative risk ratios.

RESULTS

A total of 310 studies were eligible for inclusion, of which 20 studies were selected for full-text evaluation. Ten systematic reviews were included, 9 of which had a meta-analysis. Overall findings suggest that DAT offers favourable success and survival rates. Meta-regression results indicate that a closed apex increased the proportion of ankylosis and resorption, reduced survival but had no effect on success during the observational period.

LIMITATIONS

A varying degree of heterogeneity and bias was present in all systematic reviews. The samples of donor teeth included in the systematic reviews also varied morphologically.

CONCLUSIONS

DAT is a technique-sensitive procedure requiring a multidisciplinary team, vigilant case assessment and thorough consideration of the respective prognostic factors involved. Despite methodological limitations reported across studies, DAT shows favourable success and survival rates, with a distinctive advantage of bone induction and soft tissue thickness preservation, and should, therefore, be considered as a viable treatment modality. Standardisation of clinical guidelines and practice are highly recommended.

REGISTRATION

CRD42020202484.

Knowledge, attitudes, and practice of non-medical students regarding impacted teeth: a cross-sectional study

OBJECTIVES

To explore the knowledge, attitudes, and practice (KAP) of non-medical students regarding impacted teeth and the factors associated with KAP.

MATERIALS AND METHODS

This cross-sectional study enrolled non-medical students at two universities (Northeastern University and Shenyang Conservatory of Music) in northeastern China between December 2022 and February 2023. Scores > 70% were defined as adequate knowledge, positive attitudes, and proactive practice.

RESULTS

A total of 519 non-medical students participated in this study. Most participants were male (54.72%), ≤ 20 years of age (72.83%), and freshmen (36.03%). The mean knowledge score was 4.98 ± 3.46 (possible range: 0-10), indicating poor knowledge (49.80%). The multivariable analysis showed that having impacted teeth were independently associated with adequate knowledge (OR = 3.114, 95% CI: 1.589-6.103, P = 0.001). The mean attitude score was 24.65 ± 3.78 (possible range: 7-35), indicating favorable attitudes (70.43%). The knowledge (OR = 1.182, 95% CI: 1.116-1.251, P < 0.001), junior grade (OR = 0.541, 95% CI: 0.327-0.895, P = 0.017), senior grade and above (OR = 0.477, 95% CI: 0.274-0.829, P = 0.009), and a history of impacted tooth extraction (OR = 2.386, 95% CI: 1.048-5.436, P = 0.038) were independently associated with the good attitudes. The mean practice score was 21.45 ± 5.64 (possible range: 6-30), indicating positive practice (71.50%). The knowledge (OR = 1.074, 95% CI: 1.017-1.133, P = 0.010) and female (OR = 1.501, 95% CI: 1.052-2.141, P = 0.025) were independently associated with the proactive practices.

CONCLUSIONS

Non-medical students had poor knowledge but favorable attitudes and good practice toward impacted teeth. Non-medical students require additional education and awareness about the importance of early detection and management of impacted teeth.

CLINICAL RELEVANCE

The study highlights the need for improved education and awareness among non-medical students regarding impacted teeth.

Radiographic assessment of unerupted permanent maxillary canines and their relationship to the phases of dentition in mixed dentition Spanish children: a retrospective cross-sectional study

PURPOSE

Evaluate if there is a significant association between the position and inclination of the unerupted maxillary canine measured on a panoramic radiograph, and their relationship to gender, age of the patient and stage of dentition.

METHODS

138 panoramic radiographs were examined for this retrospective cross-sectional investigation. Only patients living in Madrid, Spain with mixed dentition were included. These measurements were performed on radiographs, considering the inclination and position of the maxillary canines with regards to the midline, and height with respect to the occlusal plane. Spearman's correlation coefficient was used to analyze the relation among the canine angle and height. p < 0.05 was considered to be significant.

RESULTS

The prevalence of patients with an altered canine angle was 10%, while 43.5% had an apparently abnormal position (overlapping at least half of the adjacent lateral incisor root). No statistically significant association was found between these two variables. In 5% of the patients, the maxillary canine was with an anomalous angle and position. Significant differences were obtained when comparing canine height between children with ectopic canines and normal canines (p = 0.032).

CONCLUSION

No significant association was found between the position and inclination of the unerupted maxillary canine in our sample. Ectopic maxillary canines had a higher incidence in girls, although we did not find statistically significant differences between genders. We observed a higher prevalence of abnormal position and inclination of the permanent maxillary canine in early mixed dentition. Maxillary canines were significantly elevated, further from the occlusal plane, in children with ectopic canines.

Statistical shape analysis of maxillary palatal morphology in patients with palatally displaced canines

OBJECTIVE

Maxillary morphology has long been a subject of interest due to its possible impact on palatally and labially displaced canines. This study aims to conduct a comparison of the palate morphology between individuals with palatal and labially displaced canines and control subjects using statistical shape analysis on a coronal cross-sectional of CBCT images.

MATERIALS AND METHODS

Patients aged between 12 and 43 years with palatally or labially displaced canines referred to Hamadan School of Dentistry between 2014 and 2019 were recruited for this retrospective study. The sample included 29 palatally displaced canines (PDC), 20 labially displaced canines (LDC), and 20 control groups (CG). Initially, the maxillary palate coronal section was acquired and landmarked in the region between the right and the left first molar. Procrustes and principal component analyses were used to identify the primary patterns of palatal shape variation. Statistical tests were then performed to examine both shape and size differences.

RESULTS

According to the results of Hotelling's T2 test, there is a significant difference between the mean shape of palate in PDC and CG (P = 0.009), while the difference between the PDC-LDC and LDC-CG groups is not significant. The longest full Procrustes distance was observed between PDC and CG (distance = 0.043), and the shortest full Procrustes distance was observed between LDC and CG (distance = 0.029). The first two principal components accounted for 84.47% of the total variance. The predictive accuracy of the discriminant analysis model showed that 72.46% of cases were correctly classified into the three study groups.

CONCLUSIONS

In terms of centroid size, there was no significant difference in the sectional area between the three groups, but the difference between the mean shape of palate in the PDC and CG groups was significant. The PDC group showed more prominent mid-palatal area in the molar region.

Prevalence, Severity, and Description of Dental Anomalies in Children Treated for Acute Lymphoblastic Leukemia

Purpose: To assess the prevalence and severity of and describe dental anomalies in children treated for acute lymphoblastic leukemia (ALL) under recent Dana-Farber Cancer Institute (DFCI) protocols. Methods: Patients aged between 14 and 25 years old having received a diag- nosis of ALL before the age of 11 years and after September 2000 received clinical and radiographic oral examinations. Results: Dental anomalies were observed in 26 (51.0 percent) of 51 subjects. Microdontia was the most prevalent dental defect (39.2 percent). Impacted permanent second molars were observed in five (9.8 percent) patients. Being age five years or younger at diagnosis significantly increased the prevalence and severity of dental anomalies (P<0.001). Conclusions: Recent DFCI protocols showed a decreased prevalence of dental disturbances. The anomalies observed may still alter the development of the dental arches and occlusion in pediatric ALL survivors. Further research is needed to confirm the association between ALL treatment and permanent second molar impaction.