Quintessence International, Pre-Print

Objectives: Tooth mobilization is a challenging orthodontic treatment. Inadequate interdisciplinary communication between surgery and orthodontics, as well as limited knowledge of the topography of the surgical field, can lead to unfavorable positioning of the appliance. This can result in dangerous force vectors for tooth movement. Comprehensive digital planning and customized tools could reduce these sources of error. Two cases of impacted canines were treated using cutting guides (CG) and customized attachments (CA). Methods and Materials: A CBCT and intraoral scan were taken for planning. A CAD process was used to design a CG and a CA according to the required force vectors (OnyxCeph3™, Image Instruments GmbH, Chemnitz, Germany). Using various CAM processes, the CG (Biomed Clear Resin, Formlabs GmbH, Berlin, Germany) and a CA dummy (Permanent Crown Resin, Formlabs GmbH, Berlin, Germany) were fabricated in a 3D printer (Form 3b, Formlabs GmbH, Berlin, Germany). The CA was fabricated from titanium using the SLM process (OrthoLIZE GmbH, Nienhagen, Germany). The teeth were surgically exposed using the CG and CA dummies. The CA was conventionally cemented using Transbond XT (3M Unitek, Monrovia, CA, USA). Results: All teeth were successfully exposed with the CG. The CA could only be placed in the predetermined position according to the digital planning. Conclusion: The 3D planned CG can help to shorten the surgical procedure and keep the surgical field as small as possible. The 3D planned CA allows precise positioning. The digitally planned force vectors should prevent side effects on adjacent teeth and allow targeted mobilization. However, studies are needed for further validation. Schlagwörter: Computer-aided Design and Manufacturing, Customized Appliance Design, Impaction, Orthodontics, Surgical procedure

Objective: The aim of this study was to quantitatively calculate and compare the changes in regenerated bone around the implant in graftless and grafted sinus lift procedures using fractal dimension (FD) analysis, and to provide an additional criterion for clinical preference. Methods and materials: The study included 65 patients (29 graftless and 36 grafted) at the Faculty of Dentistry in xxxxxxxxxxxxxxxxxxxxxx. Graftless and grafted sinus lift techniques were compared in terms of FD and bone density (BD) on panoramic radiographs. Student's t-test was used to compare the mean values of FD and BD in patients with graftless and grafted sinus lifting. Pearson's correlation coefficient was used to analyse the correlation of FD and BD data with age. Statistical significance was accepted at a p < .05. Results: The FD and BD were not statistically significant between two groups (p>.05). The FD and BD parameters were higher in men for both sinus lift techniques. Conclusions: This study has shown that the graftless and grafted sinus lift techniques have similar FD and BD outcomes. Therefore, we conclude that the graftless technique is preferable for maxillary sinus lift because of its relatively simple technique. Schlagwörter: bone density, fractal analysis, grafted sinus elevation, graftless sinus elevation, panoramic radiography

Purpose: To evaluate parents’ knowledge of the Israeli Ministry of Health guidelines on basic oral health practices and appropriate toothpaste usage for different pediatric age groups. Method: Anonymous questionnaires were distributed to parents attending the Pedodontics Department. The questionnaire included two sections: general questions and questions that were completed for all children in the family, categorizing them into three age groups—under 2 years, 2–6 years, and over 6 years. Results: A total of 242 questionnaires and 410 responses across different age groups were collected. Most respondents knew that teeth should be brushed as soon as the first tooth appears and believed that the first dental visit should be at age two (60.5% and 26.9%, respectively). However, only 15% of parents answered boths questions correctly. Toothpaste selection was primarily based on age (46.6%), with no significant differences across age groups for correct answer (p = 0.130). Awareness of the recommended fluoride concentration was low (16.1%), though parents of older children showed better knowledge (p = 0.040). Appropriate toothpaste amounts were used in 30.2% of the cases, with the 2–6 year age group demonstrating the highest awareness (p < 0.001). Only 3.7% of parents correctly answered all three toothpaste-related questions. Overall, the knowledge score for toothpaste guidelines was highest in the middle-aged group (31.21%, SD = 28.66, p < 0.001). Conclusion: A minority of parents are familiar with recommended early dental care practices and correct toothpaste usage. The findings emphasize the need to improve parental awareness from the very beginning of a child’s development. Schlagwörter: Toothpaste selection, Fluoride concentration, Toothpaste amount, Dental prophylaxis, Parents’ knowledge

Aim: The aim of the present study is to compare the effectiveness of photobiomodulation therapy versus local 1.2% atorvastatin gel as an adjunct to subgingival instrumentation in the treatment of stage II or III periodontitis. Materials and methods: In this randomized study, a total of 60 individuals with pocket depths of 4-7mm bilaterally in both sexes (Males and Females) who were 25 years old or older, diagnosed with stage II or III periodontitis were selected. 60 Patients with at least 4 teeth demonstrating pocket depth of ≥ 4–7mm were selected. Exclusion criteria included patients with systemic conditions, smokers, pregnant or lactating women, and those who had received periodontal therapy or antibiotics within the previous six months. Baseline clinical parameters which include full mouth plaque scores, full mouth bleeding scores, probing pocket depth and clinical attachment level were recorded. All the eligible patients underwent supra and subgingival instrumentation. The patients were then randomly divided into two groups: GROUP-A: 30 Patient (120 pocket sites) received photobiomodulation (PBM) therapy with 680 nm for 60 sec(6J/cm2) with 0.1watt power GROUP-B: 30 Patient (120 pocket sites) received 1.2% Atorvastatin (ATV) gel as local drug delivery After the applications of local drug, the treated periodontal pockets were secured with N-butyl-2- cyanoacrylate. Patient were recalled at baseline and after 1 month and 3 months andClinical periodontal parameters were recorded. Results: On intergroup comparison, this trial demonstrated notable improvements in all clinical parameters at the 3 month interval after Subgingival instrumentation in combination with PBM or LDD. While in intragroup comparison, at 3 months interval, the reductions in probing depth and clinical attachment gain is more significantly evident in group-B (1.2%Atorvastatin gel) compared to group-A (PBM). These findings are consistent with the available literature, which recognizes subgingival instrumentation as an effective non-surgical therapy for periodontitis. Adjunctive treatment modalities are widely investigated to determine whether they can further enhance the clinical outcomes achieved by subgingival instrumentation. Conclusion: The principal results of this study showed improved periodontal status and a significant improvements in clinical parameters in patients in GROUP-B (1.2% Atorvastatin gel). Within the limitations of the study, it was concluded that both Photobiomodulation and 1.2% Atorvastatin gel can be effectively used as adjuncts to subgingival instrumentation in the treatment of periodontitis. Schlagwörter: Low level light therapy, Atorvastatin, Periodontitis, Drug delivery systems, Periodontal regeneration

Objectives: To assess blood flow alterations after horizontal Guided Bone Regeneration (GBR) and to evaluate correlations between blood flow and hard tissue changes. Method and Materials: Twelve mandibular surgical sites were involved in the current case series. GBR was carried out using a split-thickness flap design. Blood circulation was assessed with Laser Speckle Contrast Imaging at baseline as well as 1, 4, 6, 11, 13, 20, 27, and 34 days after the surgery, subsequently on a monthly basis until 6 months. Hard tissue alterations were measured horizontally and vertically using linear measurements. The first measurement point was 2 mm distal to the distal surface of the last tooth; additional measurement points were placed every 3 mm up to the 15th mm. Volumetric hard tissue loss and gain were also assessed. Results: Baseline blood circulation was statistically significantly higher on the buccal side. On the first postoperative day, all regions presented a statistically significant decrease in blood flow circulation. The buccal-inner region presented significant ischemia on day 6. Mean volumetric hard tissue gain and loss were 712.62 ± 317.08 mm3 and 222.431 ± 103.19 mm3, respectively. Mean baseline alveolar ridge width was 4.82 ± 1.02 mm, 6 months ridge width averaged 7.21 ± 0.99 mm. Vertical resorption measured 1.24 ± 0.5 mm. Correlations between blood flow changes and hard tissue alterations were only found on Day 34 and Day 60. Conclusion: Laser Speckle Contrast Imaging is an efficient method to measure flap microcirculation. No correlation was found between flap microcirculation changes hard tissue and alterations. Schlagwörter: Bone graft, Case-report/series, Guided Bone Regeneration, Membranes, Ridge augmentation