Impaction of permanent teeth during the replacement period is a relatively common occurrence in clinical practice. Tooth impaction occurs in the presence of factors that inhibit tooth eruption, such as supernumerary teeth or tumors. This is a report of permanent tooth impaction due to supernumerary teeth and pericoronal myxofibrous hyperplasia (PMH), a type of pericoronal hamartomatous lesion. An eight-year-old girl was diagnosed with an unerupted right maxillary central incisor. An inverted supernumerary tooth was present on the palatal side of the impacted central incisor, and PMH developed on the labial side of the central incisor. Interestingly, the alveolar bone on the labial side had completely disappeared. After the extraction of the supernumerary tooth and the removal of the PMH, the central incisors erupted, and the labial alveolar bone regenerated normally. Treatment for impacted teeth typically involves the removal of any existing lesions. This case is unique in that the alveolar bone of the impacted tooth regenerated following the extraction of the supernumerary tooth and removal of the PMH.

Mesiodens are classified as supernumerary teeth located in the maxilla, specifically in the palatal region between the central incisors. The prevalence of this condition varies between 0.15% and 1.9% among individuals. The presence of mesiodens can potentially affect the normal growth and development of teeth, leading to delayed eruption of permanent teeth, displacement or rotation of adjacent teeth, root resorption, and infectious pulpitis. This report discusses the case of a 14-year-old male patient who presented with a palatally placed mesiodens, which was completely erupted in the oral cavity. The patient underwent extraction for the removal of the mesiodens, and the procedure was successful with no complications reported during or after surgery. Early identification and surgical removal of mesiodens are crucial to preventing potential orthodontic and functional complications. This case highlights the importance of regular dental checkups for diagnosing supernumerary teeth. Timely intervention can lead to favorable outcomes, as demonstrated in this patient.

The reason to use post is to retain the core that holds the definitive prosthesis. The maxillary central incisor always poses a challenge during reconstruction using the post and core system. Dentapreg PINPost, a pre-cured flexible post made of fiber-reinforced composite (FRC), has many advantages over metallic posts and fiber posts. The purpose of this case report is to present an innovative technique to place both FRC posts and FRC sheets as a single assembly into the canal which gives a monoblock effect. This technique is feasible and may eradicate some of the problems associated with the failure of the post and core.

(1) Background: A missing bilateral maxillary lateral incisor (MBMLI) causes aesthetic and functional problems and a multidisciplinary approach is required for treatment. This study aimed to compare the changes in the mesiodistal axial angulations of the maxillary canines and central incisors with orthodontic treatment of MBMLI. (2) Methods: A total of 56 patients with MBMLI were included in the study, and three groups were formed: the control group (Group 1, n = 20) with untreated ideal occlusion and the space opening (Group 2, n = 20) and space closure (Group 3, n = 16) groups as treated study groups. The mesiodistal angulations between the long axes of the maxillary right canine (tooth no 13), right central incisor (tooth no 11), left central incisor (tooth no 21) and maxillary left canine (tooth no 23), and the bicondylar plane, were measured on the panoramic radiographs taken pre (T0) and post treatment (T1). p < 0.05 was accepted for statistical significance. (3) Results: At T0, while there was no significant difference between the mesiodistal angulations of the right-left maxillary canines and central incisors in all groups (p > 0.05), the mesiodistal angulations of the canines in the Group 1 were significantly higher than the study groups (p < 0.05). With treatment, while the mesiodistal angulation of the canines increased in Group 2, it decreased in Group 3 (p < 0.05). On the other hand, the mesiodistal angulation of the central incisors decreased in Group 2 and did not change in Group 3 (p > 0.05). At T1, the mesiodistal angulation of the canines was found to be lower in Group 3 than in Groups 1 and 2, while the angulation of the central incisors was found to be lower in Group 2 compared to Group 1 (p < 0.05). (4) Conclusions: In the orthodontic treatment of MBMLIs, changes in the mesiodistal angulations of the maxillary canine and central incisors should be taken into account for satisfactory outcomes. It was concluded that there should be a tendency to select the space closure method in which normal mesiodistal angulations are obtained in maxillary central incisors for aesthetics and planned incisor position, and also at a low cost.

Background and Objectives: According to the modified Williams theory, the shape of the maxillary central incisor corresponds to the shape of the maxillary alveolar ridge (dental arch) and the shape of the face. Moreover, the standards of beauty suggest that the center of the face of an individual with a full set of teeth should match the center of the maxillary and mandibular dental arches. The purpose of this study is to conduct a comparative cross-sectional study on the matching of the shape of the face, maxillary central incisor and maxillary dental arch as well as the matching of the midfacial line and dental arches in subjects with complete dentition. Materials and Methods: The study included 90 subjects of both sexes. The matching of the shape of the face and midfacial line, i.e., dental arches and maxillary incisors, was determined by analysing photographs, whereas the shape of the dental arch was determined by analysing plaster models. Results: No significant gender-related differences were found either in the shape of the maxillary central incisor that matched the shape of the maxillary dental arch (p = 0.349) or in the shape of the dental arch that matched the shape of the face (p = 0.697). However, a significant difference was noted in the shape of the teeth that matched the shape of the face (p = 0.043), which was more significantly impaired in men. In addition, the matching of the mid-face and the mid-dental arch was significantly greater in women (p = 0.016). Conclusions: The modified Williams theory was confirmed in most subjects, thus it can be considered a relevant guideline when determining the shape of teeth after their loss. The highest percentage of matching in both sexes was with the shape of the face and dental arch. There was no positive correlation between the middle of the maxillary and mandibular dental arch in most cases.

UNASSIGNED: The aim of this study was to determine the average dentin wall thickness (DWT) of the maxillary central incisor (MCI) required for performing finite element analysis (FEA) models of root development.
UNASSIGNED: A total of 137 intraoral periapical radiographs of MCI in children aged 7 to 11 years were examined and then classified into 5 groups according to root development stages, which included 1/2 of root development (S1), 3/4 of root development (S2), more than 3/4 of root development (S3), complete development with wide-open apex (S4) and complete development with closed apex (S5). DWT was measured at three reference (horizontal) lines: at a distance of 1 mm from the apex (M), 4 mm from the apex (L) and at the cervical line (K). The distal dentin wall thickness (M1, L1, and K1), the pulp thickness (M2, L2, and K2), the mesial dentin wall thickness (M3, L3, and K3), and the apex thickness (N) were measured using the diagnostic software Soredex Scanora 5.1.2.4. Statistical analysis compared the values of the parameters K, L, and M between developmental stages (multivariate ANOVA) and the linear correlations between the parameters (Pearson\'s correlation analysis). All analyses were performed at significance level α = 0.05.
UNASSIGNED: There were statistically significant differences between the developmental stages for parameters L and M, while no significant differences were found for parameter K. Most of the correlations between the parameters were statistically significant, with the values of the Pearson correlation coefficient R > 0.6 considered practically significant. All parameters on the same reference line for distal and mesial dentin wall thickness and for pulp thickness correlated well with each other (R = 0.46 - 0.68), but there was no statistically significant correlation with total root thickness on the same reference line (parameters K, L, or M), except for parameter K3 (R = 0.42).
UNASSIGNED: Despite the limitations of this study, the mean values of the selected parameters for the 5 groups of developmental stages of the maxillary central incisor could be used to model dentin wall thickness using finite element analysis.

Maxillary incisors are typically straightforward cases for root canal therapy. While it is commonly assumed that maxillary central incisors have a single root canal, they may occasionally exhibit variations in their root canal system anatomy. In this report, we present a case of a maxillary central incisor with multiple root canals and provide a review of relevant literature on this anatomical variation. A 13-year-old female with deep carious lesion in tooth 11 was admitted in Department of Endodontics. Following a precise clinical and radiographic examination, a maxillary central incisor with necrotic pulp and chronic apical periodontitis along with unusual root anatomy was found and considered for non-surgical root canal treatment. Successful treatment results depend on various factors and awareness of root canal system anatomy is one of them. Due to an increasing number of reported cases of maxillary central incisors with different anatomy, it is imperative to consider anatomical variations even in the most routine cases.

Maxillary central incisor is considered the tooth with least anatomical variations. In literature, the prevalence of single root and single canal in maxillary central incisor has been reported as 100%. Only a handful of case reports suggesting more than one root or one canal are available and are mostly associated with developmental anomalies such as gemination and fusion. This article describes a rare case report of retreatment of a maxillary central incisor with two roots with normal clinical crown which was confirmed by cone-beam computer tomography (CBCT). A 50-year-old Indian male patient presented with pain and discomfort on a root canal-treated anterior tooth. Pulp sensibility testing of left maxillary central incisor was negative. Intraoral periapical digital radiograph revealed an obturated canal with suspected outline of a second root which got confirmed with cone shift technique. The tooth was treated under dental operating microscope during which two canals were located and retreatment was completed. Postobturation, CBCT was performed to study the root and canal morphology. Clinically and radiographically, all the follow-up examinations revealed an asymptomatic tooth without any active periapical lesion. The present case report emphasizes the fact that clinicians should approach each case with an open mind having a thorough knowledge of the normal tooth anatomy and should suspect variations in every case to ensure successful endodontic outcome.

The failures in endodontic treatments are often related to anatomical variations. Some anatomical changes in anterior teeth occur in patients with cleft lip and palate. This paper aims to report the endodontic retreatment of a maxillary central incisor with two roots and two canals on a patient who presents cleft lip and palate. A male patient, 11-year-old, reported pain when chewing related to the left maxillary central incisor tooth (tooth 21) which featured a sinus tract after primary endodontic treatment. In periapical radiograph, it was observed an alteration on the anatomy of the root on the tooth 21, which featured a radiolucent area on the dental apex and had been properly endodontically treated. In cone-beam computed tomography (CBCT) images the presence of an accessory root in the palatal region was observed, that had not been prepared, or filled. Thus, the non-treated accessory canal was instrumented with the crown-down technique and filled with gutta-percha and endodontic sealer. After 1 year of follow-up, the patient presented the tooth with a normal masticatory function and no painful symptoms. Therefore, it can be concluded that the additional root canals may be present and the CBCT is an important tool to evaluate the internal root morphology. In cleft lip and palate patients, the root canals morphology should be carefully analyzed due to high prevalence of dental anomalies which may influence the success in endodontic treatment.

To develop a coupled-lines system to determine the anteroposterior position of maxillary central incisors (U1) for smiling profile esthetics.
Thirty Asian females with ordinary and good facial harmony were selected as the study sample and the control sample, respectively. Three-dimensional facial images and 45°- and 90°-angled profiles were collected. The anteroposterior relationships between U1 and upper- and mid-facial soft tissue landmarks were measured. By morphing photos of the study sample, two artificial images were created to represent the well-balanced 45°- and 90°-angled profiles and were further processed with combined variations of soft tissue subnasale (SSn)-Glabella and the mid-point of facial axial points of the bilateral central incisor (mFA)-SSn distances. Esthetic assessments were performed on these images by layperson (n = 94) and orthodontist (n = 94) raters.
Both upper- and mid-facial soft tissue landmarks were indispensable in assessing anteroposterior positions of U1 for well-balanced smiling profiles. As assessed in 45°- and 90°-angled profiles, the most esthetically sensitive parameters were mFA-Glabella and mFA-SSn distances. A coupled-lines system was constructed, comprising the Glabella and SSn vertical lines. In smiling profiles with optimal esthetics, the mFA point was at 2 to 5 mm posterior to the Glabella vertical and concomitantly 4 to 7 mm posterior to the SSn vertical, as perceived by orthodontists. Laypersons gave a wider range for mFA-Glabella distances, at 2 to 6 mm.
The coupled-lines system could serve as a reliable reference for determining esthetically optimal anteroposterior positions of U1 for female facial profiles.