Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

Dental pathology has the potential to provide insight into the interpretation of the health and life style of past population. In particular, dental pathologies are strongly correlated to subsistence pattern, diet habits and food-preparation techniques. For this reason, my studies have focused on analyses of dental diseases (e.g., caries, abscesses, ante-mortem tooth loss, enamel hypoplasia, dental attrition, and periodontal diseases). The purpose of this study is to investigate the prevalence of dental pathologies of the Imdang population dating to between A.D. 3rd and A.D. 7th centuries (Three Kingdoms Period). In this study, through a macroscopic observation of dental remains from 138 individuals of the Imdang site, the prevalence of caries, abscess and ante-mortem tooth loss was examined. The association between sex, age and the frequencies of pathology was analyzed by the Chi-square tests. The results showed that the frequency of dental pathologies was consistently low level in Imdang population. Caries prevalence in the Imdang population was higher in females (6.15%) that in males (4.89). Among dental pathologies, abscess prevalence (0.7%) was lowest in Imdang population. Meanwhile, AMTL prevalence was 10.81% in males and 3.8% in females. There is a statistically significant difference between the anterior teeth of males and females (p<0.05). This study revealed that the rate of dental caries, abscess and AMTL in the Three Kingdoms Period population was relatively low level. This study is the first report of the patterns of dental pathologies in the Three Kingdoms Period population. It is necessary to investigate more number of pathologic markers that needed for deeper understanding of the multi-faceted nature of dental pathologies of ancient populations.
Abscess ; Dental Caries ; Dental Enamel Hypoplasia ; Female ; Food Habits ; Gyeongsangbuk-do* ; Humans ; Korea* ; Life Style ; Male ; Pathology* ; Prevalence ; Stomatognathic Diseases ; Tooth ; Tooth Loss

Happle-Tinschert syndrome is a disorder causing unilateral segmentally arranged basaloid follicular hamartomas of the skin associated with ipsilateral osseous, dental and cerebral abnormalities including tumors. Although a case with hemimegalencephaly was previously described, this is the first report of Happle-Tinschert syndrome with discrepant short left leg, ipsilateral skin lesions, hemimegalencephaly and frontal polymicrogyria.
Basal Cell Nevus Syndrome/diagnosis ; Child ; Dental Enamel/abnormalities ; *Frontal Lobe/pathology ; Hamartoma/*diagnosis/pathology ; Humans ; Leg Length Inequality/*diagnosis ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development/*diagnosis ; Skin Diseases/*diagnosis/pathology ; Syndrome

The objective of this systematic review was to assess tooth wear against ceramic crowns in posterior region in vitro and in vivo. An electronic PubMed search was conducted to identify studies on tooth wear against ceramic crowns in posterior region. The selected studies were analyzed in regard to type of crowns, natural antagonist, measuring protocol and outcome. From a yield of 1 000 titles, 43 articles were selected for full-text analysis; finally, no in vitro and only five in vivo studies met the inclusion criteria. As there is heterogeneity in design, used measuring method, ceramics and analysis-form, a meta-analysis was not possible. Results of these studies are very controversial which makes a scientifically valid comparison impossible. This review indicated that some all-ceramic crowns are as wear friendly as metal-ceramic crowns. Up to now, it has been impossible to associate tooth wear with any specific causal agent. The role of ceramic surface treatment that might be responsible for the changing in rate of tooth wear seems undetermined as yet through clinical trials. The literature reveals that studies on this topic are subject to a substantial amount of bias. Therefore, additional clinical studies, properly designed to diminish bias, are warranted.
Crowns ; Dental Enamel ; pathology ; Dental Porcelain ; chemistry ; classification ; Humans ; Metal Ceramic Alloys ; chemistry ; Surface Properties ; Tooth Crown ; pathology ; Tooth Wear ; etiology

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They are developmental epithelial-lined lesions which are formed from fluid accumulation in the space between the reduced enamel epithelium and the surface of crown. This may occure due to the obstructin of venous return caused by tooth impaction. The most prevalent location of dentigerous cysts are the third molar of mandible. While the single dentigerous cysts are the second most common odontogenic cysts following the radicular cysts of jaw, multiple cysts are observed in patients with some conditions such as mucopolysaccharidosis type IV, basal cell nevus syndrome, and cleidocranial dysplasia. They occur in young patients in the second or third decades of life, but it is a rare occurrence for children. A sixteen-year-old girl with painful swelling in the right mandible visited to our department. All routine laboratory test results were within normal limits. However, we were able to diagnose that she had facial asymmetry. Computed tomography showed a well-defined soft tissue mass obliterating right mandible ramus with an impacted tooth. We performed total enucleation of cyst and molar tooth. The pathology revealed a non-keratinized squamous epithelial lined cyst associated with an undamaged tooth.
Basal Cell Nevus Syndrome ; Child ; Cleidocranial Dysplasia ; Crowns ; Dental Enamel ; Dentigerous Cyst* ; Epithelium ; Facial Asymmetry ; Female ; Humans ; Jaw ; Mandible* ; Molar ; Molar, Third ; Mucopolysaccharidoses ; Odontogenic Cysts ; Pathology ; Radicular Cyst ; Tooth ; Tooth, Impacted

This in vitro study aims to evaluate the crystal and surface microstructure of dental enamel after cold-light bleaching treatment. Twelve sound human premolars were cross-split into four specimens, namely, mesio-buccal (Group LP), disto-buccal (Group P), mesio-lingual (Group NP) and disto-lingual (Group L) specimens. These four groups were treated using the standard cold-light bleaching procedure, a bleaching agent, a peroxide-free bleaching agent and cold-light, respectively. Before and after treatment, all specimens were analyzed by high-resolution, micro-area X-ray diffraction and scanning electron microscopy. Using a spectrometer, tooth color of all specimens was measured before and after treatment. The phase of the enamel crystals was identified as hydroxyapatite and carbonated hydroxyapatite. After treatment, specimens in Groups LP and P showed significantly weaker X-ray diffraction peaks, significant reduction in crystal size and crystallinity, significant increase in L* but decrease in a* and b*, and obvious alterations in the surface morphology. However, specimens in Groups NP and L did not show any significant changes. The cold-light bleaching treatment leads to demineralization in the enamel surface. The acidic peroxide-containing bleaching agent was the major cause of demineralization, whereas cold-light did not exhibit significant increase or decrease effect on this demineralization.
Color ; Crystallography ; Dental Enamel ; drug effects ; radiation effects ; ultrastructure ; Durapatite ; radiation effects ; Humans ; Hydrogen Peroxide ; pharmacology ; Hydrogen-Ion Concentration ; Lighting ; instrumentation ; Materials Testing ; Microscopy, Electron, Scanning ; Silicon Dioxide ; pharmacology ; Spectrum Analysis ; Tooth Bleaching ; methods ; Tooth Bleaching Agents ; classification ; pharmacology ; Tooth Demineralization ; pathology ; X-Ray Diffraction

Deletion or mutation of dentin matrix protein 1 (DMP1) leads to hypophosphatemic rickets and defects within the dentin. However, it is largely unknown if this pathological change is a direct role of DMP1 or an indirect role of phosphate (Pi) or both. It has also been previously shown that Klotho-deficient mice, which displayed a high Pi level due to a failure of Pi excretion, causes mild defects in the dentinal structure. This study was to address the distinct roles of DMP1 and Pi homeostasis in cell differentiation, apoptosis and mineralization of dentin and enamel. Our working hypothesis was that a stable Pi homeostasis is critical for postnatal tooth formation, and that DMP1 has an antiapoptotic role in both amelogenesis and dentinogenesis. To test this hypothesis, Dmp1-null (Dmp1(-/-)), Klotho-deficient (kl/kl), Dmp1/Klotho-double-deficient (Dmp1(-/-)/kl/kl) and wild-type (WT) mice were killed at the age of 6 weeks. Combinations of X-ray, microcomputed tomography (μCT), scanning electron microscopy (SEM), histology, apoptosis and immunohistochemical methods were used for characterization of dentin, enamel and pulp structures in these mutant mice. Our results showed that Dmp1(-/-) (a low Pi level) or kl/kl (a high Pi level) mice displayed mild dentin defects such as thin dentin and a reduction of dentin tubules. Neither deficient mouse line exhibited any apparent changes in enamel or pulp structure. However, the double-deficient mice (a high Pi level) displayed severe defects in dentin and enamel structures, including loss of dentinal tubules and enamel prisms, as well as unexpected ectopic ossification within the pulp root canal. TUNEL assay showed a sharp increase in apoptotic cells in ameloblasts and odontoblasts. Based on the above findings, we conclude that DMP1 has a protective role for odontoblasts and ameloblasts in a pro-apoptotic environment (a high Pi level).
Ameloblasts ; pathology ; Amelogenesis ; physiology ; Animals ; Apoptosis ; physiology ; Cell Differentiation ; physiology ; Dental Enamel ; pathology ; Dental Pulp ; pathology ; physiology ; Dental Pulp Cavity ; pathology ; Dentin ; abnormalities ; pathology ; Dentinogenesis ; physiology ; Extracellular Matrix Proteins ; genetics ; physiology ; Glucuronidase ; genetics ; Homeostasis ; physiology ; Hyperphosphatemia ; physiopathology ; Immunohistochemistry ; Mice ; Mice, Knockout ; Microscopy, Electron, Scanning ; Odontoblasts ; pathology ; Odontogenesis ; physiology ; Ossification, Heterotopic ; genetics ; pathology ; Phosphates ; physiology ; Tooth Calcification ; physiology ; X-Ray Microtomography

To obtain the caries experience and, plaque accumulation severity and pit and fissure morphology in first permanent molars in 7-8 children in Wuhan, as a reasonable prediction of caries risk and preventive attention in the future, a convenient sample of five primary schools in the vicinity of the Wuhan University School and Hospital of Stomatology was drawn. Two calibrated examiners orally examined all present grade 2 children in the classroom, using standard caries plaque and tooth morphology criteria. Dental caries was scored at enamel (D(2)) and dentine (D(3)) for tooth and surface level. Independent variables were age, gender and school. Data analysis used analysis of variance and t-test. The sample comprised 1 043 7- and 8-year-olds. The prevalence of dental caries in permanent dentition was 8.7% and in primary dentition, 68.7%. Mean Decayed, Missing, Filled Teeth/S (DMFT/S) scores were 0.11 and 0.14, respectively. Mean dmft/s scores were 2.8 and 5.0. The d-component constituted 75% of the d(3)mft index, while enamel carious lesions constituted 36% of the total number of carious lesions (d(2,3)-component). Prevalence of medium and deep pits and fissures was 84.6%. Prevalence of medium and severe plaque accumulation was 67.4%. Prevalence of dental caries in the deciduous and permanent dentitions of 7- to 8-year-old children was high. Deep pits and fissures in high caries risk children should be sealed.
Child ; China ; epidemiology ; DMF Index ; Dental Caries ; epidemiology ; prevention & control ; Dental Enamel ; pathology ; Dental Fissures ; pathology ; Dental Plaque Index ; Dentin ; pathology ; Dentition, Permanent ; Female ; Humans ; Male ; Molar ; pathology ; Prevalence ; Tooth, Deciduous

OBJECTIVETo compare the penetration abilities of resin infiltration into proximal lesions in primary molars with those of adhesive in vitro.

METHODSThirty-two extracted or exfoliated primary molars showing proximal white spot lesions were selected. Roots of the teeth were removed, and the crowns were cut across the white spot lesions perpendicular to the surface. Cut surfaces were examined (by stereo microscopy) and classified with respect to histological lesion extension (C1-C4): lesions confined to the outer half on enamel (C1), lesions confined to the inner half on enamel (C2), lesions confined to the outer half on dentin (C3), lesions extending into the inner half of dentin (C4). Corresponding lesion halves were etched for 120 s with 15% hydrochloric acid gel and were subsequently treated with either adhesive or resin infiltration. Specimens were observed with laser scanning confocal microscope (LSCM) in dual fluorescence mode. In confocal microscopic images, lesion depth and penetration depth of the resin infiltration or the adhesive in corresponding halves were measured, and penetration percentages were calculated respectively. Differences of the data between two groups were analyzed by Wilcoxon signed rank test. Variations of histological caries extensions were detected with Kruskal-Wallis H test.

RESULTSAt the same grading level (C1-C3) in histological caries extension, penetration depths of the resin infiltration group and the adhesive group were 240 (230, 260) µm vs 190 (150, 210) µm, 405 (300, 523) µm vs 180 (160, 200) µm, and 590 (430, 640) µm vs 180 (160, 200) µm respectively. There was significant statistical difference in the data between two groups (P < 0.05). Statistically significant difference in penetration depths of the resin infiltration group (at C1-C3) were found (P < 0.01). At the same grading level (C1-C3) in histological caries extension, percentage penetrations of the resin infiltration group and the adhesive group were [100.0% (96.2%, 100.0%)], [99.1% (95.7%, 100.0%)], [82.0% (81.1%, 92.2%)] and [79.2% (68.4%, 87.5%)], [41.8% (29.1%, 74.5%)], [30.2% (29.2%, 39.6%)], respectively. The difference between the above data was also significant (P < 0.05). Percentage penetrations of the resin infiltration group at C1 and C2 level was higher than those at C3 level (P < 0.05).

CONCLUSIONSThe resin infiltration is capable of penetrating almost completely into proximal lesions in primary molars.

Acid Etching, Dental ; methods ; Composite Resins ; chemistry ; Dental Caries ; pathology ; therapy ; Dental Cements ; chemistry ; Dental Enamel ; pathology ; Dental Enamel Permeability ; Humans ; Hydrochloric Acid ; pharmacology ; Molar ; pathology ; Surface Properties ; Tooth, Deciduous ; pathology

OBJECTIVETo evaluate the reliability and superiority of micro-CT in marginal leakage assessment of Class V restorations.

METHODSClass V preparations with gingival margins in dentin and occlusal in enamel were made in sixteen extracted non-carious human molars and restored with dental bonding agents and composite resin. All teeth were then immersed in 50% ammonia-silver nitrate solution for 12 hours, followed by developing solution for 8 hours. Each restoration was scanned by a micro-CT and silver leakage was measured and three-dimensional image of the silver leakage alone cavity wall were reconstructed. Afterward, all restorations were sectioned and examined for leakage depth using a microscope. The silver leakage depth of each restoration obtained by micro-CT and microscope were compared for equivalency.

RESULTSThe silver leakage depths in gingival wall obtained with micro-CT (0.78 mm) and microscope (0.74 mm) showed no significant difference (P > 0.05), while the judgment of leakage depths in occlusal wall in micro-CT image (0.40 mm) was affected by adjacent enamel structure, giving less leakage depths compared to microscope (0.72 mm)(P < 0.01). The three-dimensional shapes of the microleakages displayed clearly by micro-CT alone wall of Class V restorations were multiform and some leakages showed channels on their way to spreading.

CONCLUSIONSMicro-CT can detect precisely the silver leakage in the dentin wall of a restoration and display its three-dimensional shape fully. Enamel structure affects the detection of the silver leakage next to it.

Dental Cavity Preparation ; Dental Enamel ; diagnostic imaging ; pathology ; Dental Leakage ; diagnostic imaging ; pathology ; Dental Restoration, Permanent ; methods ; Humans ; Imaging, Three-Dimensional ; Microscopy ; Molar, Third ; diagnostic imaging ; pathology ; X-Ray Microtomography ; methods