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Purpose To assess different types of dental injuries associated with facial bone fractures. Method One hundred dentate patients were selected randomly of all age and gender who had maxillofacial trauma only and having dental injury in association with facial bones fractures were included. They were thoroughly examined for injury/fracture to facial region as well as for dental injuries (teeth). Tooth injuries were noted according to Ellis classification. The data was collected, compiled, and put to statistical analysis. Results Dental injuries were more in females than males found to be statistically significant with ( p  < 0.05).Crown fracture of maxillary teeth was more as compared to mandibular except molars found to be statistically significant ( p  < 0.05). Root fracture was more in maxillary incisors followed by canine as compared to mandibular incisors and canines found to be insignificant. Avulsion, extrusion and luxation were more in maxilla as compared to mandible found to be significant. Conclusion Different types of tooth injuries associated with facial bone fracture found more in females and maxillary teeth.

Orthodontic miniscrews (OM) are widely used in modern orthodontic clinical practice to improve skeletal anchorage and have a high safety profile. A complication at the time of OM insertion is tooth root perforation or periodontal ligament trauma. Rarely, OM injury can cause permanent damage, such as ankylosis, osteosclerosis, and loss of tooth vitality. The aim of this work was to analyze potential risks and dental complications associated with the use of OMs. A search of the PubMed, Cochrane, Web of Science, and Scopus databases was conducted without a time limit using the keywords “orthodontic mini-screw” and “dental damage”, resulting in 99 studies. After screening and eligibility, including articles obtained through a citation search, 13 articles were selected. Four studies revealed accidental injuries caused by OM. Most of the damage was localized at the root level and resolved spontaneously with restorative cement formation after prompt removal of the OM, while the pain disappeared. In some cases, irreversible nerve damage, extensive lesions to the dentin–pulp complex, and refractory periapical periodontitis occurred, requiring endodontic and/or surgical treatment. The choice of insertion site was the most important element to be evaluated during the application of OMs.

To investigate whether masticatory fatigue affects the fracture resistance and pattern of lower premolars restored with quartz-fiber post-core and full crown, 44 single rooted lower premolars recently extracted from orthodontic patients were divided into two groups of 22 each. The crowns of all teeth were removed and endodontically treated and then restored with quartz-fiber post-core and full crown. Twenty-two teeth in one group were selected randomly and circularly loaded at 45° to the long axis of the teeth of 127.4 N at a 6 Hz frequency, and the other group was not delivered to cyclic loading and considered as control. Subsequently, all teeth in two groups were continually loaded to fail at 45° to the long axis of the teeth at a crosshead speed of 1 mm.min-1. The mean destructive force values were （733.88±254.99） and （869.14±280.26） N for the experimental and the control group, respectively, and no statistically significant differences were found between two groups （P〉O.05）. Bevel fracture and horizontal fracture in the neck of root were the major fracture mode of the specimens. Under the circumstances of this study, it seems that cyclic loading does not affect the fracture strength and pattern of the quartz-fiber post-core-crown complex.

Key Points Comparison of the sealing properties of three commonly used materials for repair of large perforations. Bacteria could penetrate into dentine even distant from the perforation filling. Teeth repaired with mineral trioxide aggregate were more resistant to bacterial leakage. Objective To evaluate the sealing ability of different repair materials and the pathway of bacterial penetration after closure of large pulp chamber floor perforations. Materials and methods Perforations were made in the furcation area of extracted human molars and sealed with either mineral trioxide aggregate (MTA), glass ionomer cement or resin composite. The bacterial leakage method was used with Enterococcus faecalis as microbial tracer. The time of leakage (in days) was recorded for each specimen. Statistical analysis of bacterial leakage was performed using the survival analysis and pairwise comparison of groups. A p-value less than 0.05 was considered statistically significant. Leaking specimens were prepared and inspected for the presence of bacteria by a scanning electron microscope (SEM). Results The percentage of leaking samples was significantly higher in resin composite than in the other groups and the negative control group (p <0.05). SEM inspection revealed the presence of bacteria in all leaking specimens. Bacteria were observed along the filling-dentine interface as well as in dentinal tubules at some distance from the filling. Conclusions The resin composite material leaked significantly more than the MTA and glass ionomer cements when used to repair large furcation perforations. Bacteria could penetrate into dentine even at a distance from the perforation filling.

This study aims to evaluate which splinting method offers the most favorable prognosis in cases of dental trauma involving horizontal intra-alveolar root fractures. Search strategies were adapted for seven electronic databases and gray literature to identify studies evaluating the prognosis of horizontal intra-alveolar root fractures based on the type of splint used. The risk of bias in the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tools. A Bayesian network meta-analysis was conducted. A total of 3,174 references were retrieved, of which six studies met the inclusion criteria. No significant differences were found between the types of splints used and the healing outcomes of horizontally fractured intra-alveolar roots, including comparisons to cases without fixation. Across all studies, the degree of fragment displacement was a key factor influencing healing: the less displacement, the better the prognosis. Other treatment-related variables analyzed by the authors also played a role in determining tooth prognosis. There may be no difference regarding the type of splint used when considering the healing of horizontal intra-alveolar root fractures; however, other factors may have influenced this outcome. Understanding the fracture characteristics and the type of splinting intervention employed is essential for ensuring appropriate treatment in such cases.

Objectives This study aimed to investigate cracked teeth and vertical root fracture observable on micro-CT images of extracted roots of mandibular incisors, after fiber post removal. Materials and methods Thirty mandibular incisors were selected with any degree of slight incisal wear inspected with the aid of a stereomicroscope under 12x magnification, in order to have a group of young adult specimens according to the criteria of Hugoson et al. A sample of twelve mandibular incisors were selected, aged between 20 and 30 years old, with similar dentine volume and thickness. The specimens were scanned in a micro-computed tomography (micro-CT) device and submitted to root canal shaping, root canal filling, post space preparation, post placement and post removal. Results From a total of six experimental endodontic timepoints until post removal of 12 mandibular incisors, 64,800 cross-sectional images were analyzed and no vertical root fracture (VRF) or cracked tooth were detected. Conclusions Micro-CT assessment after ex vivo fiber post removal did not detect vertical root fracture or cracked tooth formation in the root canal walls of mandibular incisors. Clinical relevance This study highlighted that fiber post removal per se was not able to propagate VRF or cracked tooth formation or promoted any interruption of the integrity of human root dentin.

The evidence base on minimally invasive endodontic (MIE) treatment is limited. This study investigated the influence of MIE shaping on vertical root fracture (VRF) resistance and crack formation of root canal filled teeth. Human maxillary central incisors were randomized into six groups ( n  = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligaments. The root canals were either instrumented to size #40 and 0.04 taper (+MIE) or enlarged to ISO size #80 (−MIE). The canals were filled with cement-based (C) or adhesive resin-based (A) sealers in single-cone technique. The controls received no treatment or were left unfilled. After chewing simulation (staircase method, 25–150 N, 120,000×), the crack formation on the root surface was analyzed using stereomicroscope/digital imaging and classified (no defect, craze line, vertical crack, horizontal crack). Subsequently, the samples were loaded until fracture. The incidence of defects (56% vertical cracks) was not significantly different between the groups ( p  ≥ 0.077). VRF resistance was significantly higher in untreated teeth than in +MIE/C ( p  = 0.020) but did not significantly differ between the other groups ( p  ≥ 0.068). Minimal canal shaping did not reduce the risk of vertical root fracture and defects of root canal filled teeth.

Objective Vertical root fracture (VRF) in endodontically treated molars (ETMs) is a multifactorial condition. However, the relationship between residual pericervical and apical dentine in ETMs and VRF has yet to be fully assessed. This study aimed to investigate the association between residual pericervical and apical dentine and VRF in ETMs. Material and Methods ETMs with VRFs (44 cases) and those without VRFs (92 controls) were included. Residual dentine at pericervical level and apical terminus of root canal filling (RCF) were assessed based on the ratio between the mesiodistal widths of the RCF and root on periapical radiographs. The ratio was converted into four categories: “intact canal”, “minimum preparation”, “traditional preparation”, and “excessive preparation” based on calculated cut‐off values. History of root canal re‐treatment (reRCT), and time from the primary root canal treatment (pRCT) were assessed as cumulative factors. Descriptive and logistic regression analyses were used to identify risk factors for VRF. Receiver operating characteristic curves were constructed, and the corresponding area under the curve (AUC) was used to determine the model as a diagnostic tool. Results “Excessive” category at both pericervical and apical dentine was more frequently observed in teeth with VRF (81.8%; 36/44, 61.4%; 27/44) than in the control group (65.2%; 60/92, 10.9%; 10/92). Residual apical dentine, tooth type, history of reRCT, and time from pRCT ≥ 15 years were significantly associated with VRF in the multiple binary logistic regression analyses (p < 0.05). Conclusions Successful pRCT with minimum canal preparation, particularly at the apical level, is essential to minimize the likelihood of VRF. In ETMs with an isolated periodontal probing depth ≥ 5 mm, assessing residual apical dentine, tooth type, reRCT history, and time since pRCT can effectively differentiate VRF from non‐VRF teeth (AUC, 0.940; p < 0.001), offering valuable diagnostic guidance.

To evaluate the physical behavior of intraradicular dental post subjected to high temperatures for forensic purposes. Methods: One hundred and twenty-six incisive bovine teeth were selected. The samples were randomly distributed into six groups (n = 21), according to the different posts: Exacto glass fiber Angelus™, Reforpost™ glass fiber Angelus™, Whitepost System DC glass fiber FGM™, Reforpost™ carbon fiber Angelus™, Reforpost™ I Metallic Angelus™, Ni-Cr post. Then, they were randomly divided into three subgroups (n = 7), according to the temperatures of incineration (600, 800 and 1000 °C). All teeth were photographed and radiographed pre- and post-incineration. The optical density of the posts was evaluated using ImageJ™ software. Results: Macroscopically, there was no association between temperature ranges and formation of cracks or root fractures, as well as radiographically, except for Reforpost™ Angelus™ glass fiber. Brown and gray colors were seen in root at 600°C, white at 800°C and 1000°C. In radiographic analysis, the materials showed a significant difference, with the temperature ranges and changes evaluated, except for Reforpost™ I metallic Angelus™. The analysis of the mean optical density of posts at pre- and post-incineration range moments revealed a significant difference between the materials Reforpost ™ glass fiber Angelus ™, Whitepost System DC glass fiber FGM™, Reforpost™ carbon fiber Angelus™. Conclusions: Different posts do not interfere with the macroscopic changes shown by the root. However, the posts showed radiographic and radiopacity changes depending on the material and temperature range evaluated, which is important data for determining their changes and contributing to the identification of victims. •This is the first study evaluating a wide range of dental posts.•Gray and brown colors are observed in root at 600°C and white at 800 and 1000°C.•Fiber posts showed maladjustment, dimensional change, radiopacity, bubbles.•Metal posts did not change their radiopacity regardless of temperature.•Each material showed change parameters of radiopacity in high temperatures.

Background Up to 25% of the tooth extraction after root canal treatment could be attributed to the vertical root fracture (VRF). The treatment choice for teeth with VRF would mostly be the extraction despite some repairing methods were also reported. The repairing treatment result of VRF would mostly depend on the fixation strength and the bioactivity of the repairing materials, especially for the posterior teeth with high masticating stresses. This case report designed a novel surgical treatment approach for the VRF of posterior teeth. Methods a maxillary premolar with buccal-palatal complete VRF was treated with a new dual-layered repairing approach using adhesive resin + iRoot BP Plus bioceramic cement to fill the modified fracture line with retention forms through the intentional replantation. Results At the 24-month review, the tooth showed desirable periodontal healing and normal function. Conclusions This case report indicated that the dual-layered repairing approach might be effective for saving the posterior teeth with VRF. Nevertheless, further clinical trials are needed for its long-term result.