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Objectives To evaluate treatment time and patient perception of two surgical methods to expose a palatally displaced canine (PDC) into the oral cavity. Material and Methods A total of 30 consecutive patients between 11 and 18 years, with maxillary displaced canines were recruited. After gaining informed consent from the patients and custodians, the patients were randomized into two groups by an independent person. Both groups received a chain attached to the crown of the canine: in group A (control group) the chain was placed under the mucoperiosteal flap to an incision on the alveolar crest and in group B (test group), the chain penetrated the mucoperiosteal flap inferiorly to the crown of the canine. Outcome measures where time to expose the PDC into the oral cavity and the patient's experience of pain and discomfort during the treatment. Results Twenty‐six patients full‐filled the trial, mean age was 12.9 years, (SD 1.6 years). The time to expose the canines for the control group was 11.9 months (SD 6.5) and for the test group 6.7 months (SD 3.2) The conventional method showed less pain on the day of surgery. Conclusion The method used in the test group resulted in a 5‐month shorter time to expose the canine compared to the control group, and higher pain level on the day of surgery. For generalizability of the results, larger studies are needed.

Introduction This randomized clinical trial compared arch dimensional changes, dentoskeletal changes, and the rate of overbite correction in deep bite adults treated with fixed appliances and either maxillary incisor bite turbos (IBT) or canine bite turbos (CBT). Materials and methods Forty-six deep bite subjects treated with fixed appliances were randomized into IBT (n = 23) and CBT (n = 23) groups. Changes in intercanine width (ICW), arch height (AH), and Little’s Irregularity Index (LII) were analyzed from before treatment (T 0 ) to 3 months after aligning with 0.012” NiTi archwires in both arches (T 1 ). Cephalometric changes between T 0 and the visit when normal overbite was achieved (T 2 ) were assessed. Within-group and between-group comparisons were analyzed at a significance level of 0.05. Results In both groups, mandibular ICW, and maxillary and mandibular AH significantly increased while maxillary and mandibular LII decreased. Maxillary and mandibular incisor proclination and molar extrusion were observed. The IBT group showed significantly greater changes in mandibular ICW, maxillary and mandibular AH, and mandibular incisor proclination than the CBT group. However, the overbite correction rate and the LII reduction were not significantly different between the groups. Conclusions The IBT and CBT produced similar effects on arch dimensions and dentoskeletal changes. However, the IBT group demonstrated greater arch dimensional changes. Clinical relevance Clinicians may consider IBT if flaring incisors is desired. Alternatively, CBT is better for cases with limited incisor proclination and where minimizing arch dimension change is needed, such as in narrow ridge situations. Clinical trial registration The trial was registered at Thai Clinical Trial Registry on https://www.thaiclinicaltrials.org , under the identifier TCTR20230811013.

Background To evaluate the effectiveness of two minimally invasive surgical procedures in the acceleration of canine retraction: piezocision and laser-assisted flapless corticotomy (LAFC). Methods Trial design: A single-centre randomized controlled trial with a compound design (two-arm parallel-group design and a split-mouth design for each arm). Participants: 36 Class II division I patients (12 males, 24 females; age range: 15 to 27 years) requiring first upper premolars extraction followed by canine retraction. Interventions: piezocision group (PG; n  = 18) and laser-assisted flapless corticotomy group (LG; n  = 18). A split-mouth design was applied for each group where the flapless surgical intervention was randomly allocated to one side and the other side served as a control side. Outcomes: the rate of canine retraction (primary outcome), anchorage loss and canine rotation, which were assessed at 1, 2, 3 and 4 months following the onset of canine retraction. Also the duration of canine retraction was recorded. Random sequence: Computer-generated random numbers. Allocation concealment: sequentially numbered, opaque, sealed envelopes. Blinding: Single blinded (outcomes’ assessor). Results Seventeen patients in each group were enrolled in the statistical analysis. The rate of canine retraction was significantly greater in the experimental side than in the control side in both groups by two-fold in the first month and 1.5-fold in the second month ( p  < 0.001). Also the overall canine retraction duration was significantly reduced in the experimental side as compared with control side in both groups about 25% ( p  ≤ 0.001). There were no significant differences between the experimental and the control sides regarding loss of anchorage and upper canine rotation in both groups ( p  > 0.05). There were no significant differences between the two flapless techniques regarding the studied variables during all evaluation times ( p  > 0.05). Conclusions Piezocision and laser-assisted flapless corticotomy appeared to be effective treatment methods for accelerating canine retraction without any significant untoward effect on anchorage or canine rotation during rapid retraction. Trials registration ClinicalTrials.gov (Identifier: NCT02606331 ).

Objectives The objective of this article is to establish a large sample‐based prediction model for maxillary canine impaction based on linear and angular measurements on panoramic radiographs and to validate this model. Materials and methods All patients with at least two panoramic radiographs taken between the ages of 7 and 14 years with an interval of minimum 1 year and maximum 3 years (T1 and T2) were selected from the Department of Oral Health Sciences, University Hospital Leuven database. Linear and angular measurements were performed at T1. From 2361 records, 572 patients with unilateral or bilateral canine impaction were selected at T1. Of those, 306 patients were still untreated at T2 and were used as study sample. To construct the prediction model, logistic regression analysis was used. Results The parameters analyzed through backward selection procedure were canine to midline angle, canine to first premolar angle, canine cusp to midline distance, canine cusp to maxillary plane distance, sector, quadratic trends for continuous predictors, and all pairwise interactions. The final model was applied to calculate the likelihood of impaction and yielded an area under the curve equal to 0.783 (95% CI [0.742–0.823]). The cut‐off point was fixed on 0.342 with a sensitivity of 0.800 and a specificity of 0.598. The cross‐validated area under the curve was equal to 0.750 (95% CI [0.700, 0.799]). Conclusion The prediction model based on the above mentioned parameters measured on panoramic radiographs is a valuable tool to decide between early intervention and regular follow‐up of impacted canines.

To investigate the effectiveness of AcceleDent Aura vibrating device on the rate of canine retraction. Thirty-two patients requiring extraction of upper first premolars and canine retraction were randomly allocated with a 1:1 ratio into either no-appliance group or the AcceleDent Aura appliance group. Canine retraction was done applying 150gm of retraction force using NiTi coil springs on 16 × 22 stainless steel archwires. The duration of the study was 4 months. Models were collected and digitized directly after extraction of upper first premolars and at monthly intervals during canine retraction for recording the monthly as well as the total distance moved by the canine. Digitized models were superimposed on the initial model and data were statistically analyzed. Anchorage loss, rotation, tipping, torque and root condition were evaluated using cone beam computed tomography imaging. Pain was evaluated by visual analog scale. No patients were dropped-out during this study. There was no statistically significant difference between both groups regarding the total distance travelled by the canine ( P  = 0.436), as well as the rate of canine retraction per month ( P  = 0.17). Root condition was the same for the two groups. Regarding the pain level, there was no statistically significant difference between the two groups at day 0 ( P  = 0.721), after 24 h ( P  = 0.882), after 72 h ( P  = 0.378) and after 7 days ( P  = 0.964). AcceleDent Aura was not able to accelerate orthodontic tooth movement. Pain level couldn’t be reduced by vibrational force with an AcceleDent device during orthodontic treatment. Root condition was not affected by the vibrational forces.

This cross-sectional study aimed to classify the radiographical characteristics of impacted maxillary canines that were surgically exposed following orthodontic traction and to find out which factor is most closely related to traction duration. This study enrolled 74 patients with 87 maxillary canines. Cone-beam computed tomography images, panoramic radiographs, and medical records were analyzed. Cystic-appearing lesion and resorption of adjacent roots were observed in 26.4% and 23.0% of cases, respectively. Impacted maxillary canines were mostly distributed in the lateral incisor area. The mean (± standard deviation) traction duration for the 47 teeth that met the study criteria was 13.9 (± 8.9) months. Impacted maxillary canines treated with surgical exposure and orthodontic traction showed increasing possibilities of palatal impaction and resorption of the adjacent root as they were located mesially ( p  < 0.05). The distance from the occlusal plane to the impacted maxillary canine showed the strongest positive correlation with traction duration ( r  = 0.519, p  < 0.01). When establishing treatment plans for patients with impacted maxillary canines, distance from the occlusal plane to the impacted canines, rather than the angle, should be considered in predicting the duration of treatment.

The aim of the study is to determine the effects of low level laser therapy on tooth movement during canine distalization by evaluating IL-1β, TGF-β1 levels in gingival crevicular fluid. Maxillary first premolars of the 15 Angle Class II division I patients (12–19 years old) were extracted. Right maxillary canines were distalized by standard protocol as control group whereas the left maxillary canines distalized by laser application. A gallium-aluminum-arsenide diode laser with an output power of 20 mW was applied as five doses from the buccal and the palatal side on the day 0, and the 3rd, 7th, 14th, 21th 30th, 33st, 37th, 60th, 63th, and 67th days. Gingival crevicular fluid samples were obtained with filtration paper at the initial, 7th, 14th, and 21th days, and the IL-1ß and TGF-ß1 cytokine levels were analyzed. Orthodontic models and periodontal indices were taken initially and on the days 30th, 60th, and 90th of canine distalization period. Tooth movement was assessed by scanning models (3Shape). The amount of tooth movement in the laser group was 40% more than the control group. First day IL-1ß levels were statistically higher than initial and 21st day levels ( P = 0.003, P  = 0.012). The rise in IL-1ß levels caused the negative correlations between 7th day IL-1β and 21st day TGF-β1 levels describes the tissue effects of laser application. Periodontal indices showed no sign of gingival inflammation during canine distalization period. As conclusion, laser does accelerate tooth movement and could shorten the whole treatment duration.

Objective: This study aimed to examine the morphology of maxillary canines (MxCs) by means of micro-computed tomography (micro-CT). Materials and methods: The root canal configurations (RCCs) of 97 maxillary canines of a mixed Swiss-German population were analyzed using micro-CT. After representing the internal morphology by 3-D software imaging, the RCC results were described using a four-digit system code indicating the main root canal from coronal to apical thirds and the main foramina number. Results: The most frequently observed RCCs of the MxC of the Swiss-German population were 1-1-1/1 (77.3%), followed by 1-1-1/2 (14.4%), 1-1-2/2 (4.1%), and finally 1-1-1/3 and 1-2-1/1 with 2.1% each. One physiological foramen was observed in 79.4% of the samples, two in 18.6%, and only 2.1% had three foramina. In 52.6% of the MxC samples, accessory and connecting canals were identified, with the majority located in the apical third of the root. Conclusions: This study contributes detailed information about the RCCs of MxC. The most prevalent RCC is 1-1-1/1, with accessory or connecting canals present in over half of the samples. However, it is noteworthy that in more than one-fifth of the examined samples, a particularly challenging RCC was observed. This should be considered when selecting treatment techniques. Clinical relevance: This study presents the root canal configurations in maxillary canines of a Swiss-German population and emphasizes the importance of influencing endodontic treatment decisions and outcomes.

Access cavity preparation is an important part of endodontic therapy, affecting the effectiveness of canal instrumentation and the durability of the tooth over time. Currently, most access preparation protocols are based on information from a Western population and do not address the anatomical differences of different ethnic groups. This retrospective CBCT study assessed specific odontometric measurements in maxillary anterior teeth—central incisors, lateral incisors and canines—using an Indian population to help identify a clinically relevant and conservative access cavity preparation. A total of six hundred cone-beam computed tomography (CBCT) images of maxillary central incisors, lateral incisors, and canines ( n  = 200 per tooth) were evaluated. Three measurements were made in sagittal view: the distance from the central fossa to the pulp chamber roof (CF–PC), the incisal edge to pulp chamber (IE–PC), and the central fossa to cingulum (CF–C). These images were obtained from Indian individuals aged 18 to 25 years. Differences attributable to sex-based variation, and between teeth, were statistically significant ( p  < 0.05). The lateral incisors had the largest amount of anatomical variability, while the canines had the steepest trajectory of access. These findings provide the first population-based CBCT base-line morphometric values for maxillary anterior teeth in India, and a practical guide to help achieve safe access design that is mindful of tooth anatomy and minimizes the invasiveness of the access.

Objectives This study aimed to assess possible dental side effects associated with long-term use of an adjustable oral appliance compared with continuous positive airway pressure (CPAP) in patients with the obstructive sleep apnea syndrome and to study the relationship between these possible side effects and the degree of mandibular protrusion associated with oral appliance therapy. Materials and methods As part of a previously conducted RCT, 51 patients were randomized to oral appliance therapy and 52 patients to CPAP therapy. At baseline and after a 2-year follow-up, dental plaster study models in full occlusion were obtained which were thereupon analyzed with respect to relevant variables. Results Long-term use of an oral appliance resulted in small but significant dental changes compared with CPAP. In the oral appliance group, overbite and overjet decreased 1.2 (±1.1) mm and 1.5 (±1.5) mm, respectively. Furthermore, we found a significantly larger anterior–posterior change in the occlusion (−1.3 ± 1.5 mm) in the oral appliance group compared to the CPAP group (−0.1 ± 0.6 mm). Moreover, both groups showed a significant decrease in number of occlusal contact points in the (pre)molar region. Linear regression analysis revealed that the decrease in overbite was associated with the mean mandibular protrusion during follow-up [regression coefficient ( β ) = −0.02, 95 % confidence interval (−0.04 to −0.00)]. Conclusions Oral appliance therapy should be considered as a lifelong treatment, and there is a risk of dental side effects to occur. Clinical relevance Patients treated with the oral appliance need a thorough follow-up by a dentist or dental-specialist experienced in the field of dental sleep medicine.