OBJECTIVES: This study aimed to investigate the clinical characteristics of deciduous fused teeth and their inherited permanent-tooth performance type by using panoramic radiographs. METHODS: A total of 14 404 panoramic radiographs of 3- to 6-year-old children with deciduous dentition were collected from January 2023 to July 2024. The incidence of deciduous fused teeth was observed, and the abnormality of permanent teeth was recorded. SPSS 24.0 software was used for statistical analysis. RESULTS: The incidence of deciduous fused teeth was 3.06% (441/14 404). The order of dental position was as follows: mandibular deciduous incisors and cusp teeth fused (58.18%) > mandibular deciduous central and lateral incisors fused (30.91%) > maxillary deciduous central and lateral incisors fused (8.89%) > deciduous incisors and supernumerary teeth fused (2.02%). Deciduous fused teeth were found in 226 boys and 215 girls, with no significant difference between the sexes (P>0.05). We observed one pair (87.76%, 387/441) and two pairs (12.24%, 54/441) of fused teeth (54/441), respectively. A total of 287 pairs of fusion teeth on the right side more than 208 pairs on the left side, and the difference between them was statistically significant (P<0.01). More fusion teeth existed in mandibular deciduous teeth (443 pairs) than in maxillary ones (54 pairs), and the difference between them was statistically significant (P<0.01). More unilateral deciduous teeth (387 subjects) were found than bilateral ones (54 subjects), and the difference between them was statistically significant (P<0.01). Three types of deciduous fused teeth with inherited permanent teeth were observed as follows: 1) 49.49% (245/495) of inherited permanent teeth was absent, 2) 46.67% (231/495) of inherited permanent teeth was not absent, and 3) the number of fused permanent teeth accounted for 3.84% (19/495). CONCLUSIONS The incidence of deciduous fused teeth was 3.06%, mostly occurring in the lower anterior teeth region, with no gender difference. One pair of fused teeth is commonly observed, more often on the right than the left. These fusions occur more frequently in the mandible than the maxillary, and unilateral cases are more common than bilateral ones. Deciduous fused teeth had a certain impact on inherited permanent teeth. Pediatric dentists should pay attention to and closely observe whether any abnormality exists in the permanent dentition for early detection to prevent the harm caused by deciduous fused teeth.
Humans ; Tooth, Deciduous/abnormalities* ; Male ; Child ; Female ; Child, Preschool ; Dentition, Permanent ; Radiography, Panoramic ; Fused Teeth/diagnostic imaging* ; Incisor/diagnostic imaging* ; Tooth, Supernumerary/diagnostic imaging* ; Incidence ; Mandible

OBJECTIVES: This study aimed to evaluate the clinical application value of in-situ crown reattachment technique combined with pulpotomy in the treatment of complicated crown-root fractures in young permanent anterior teeth. METHODS: A prospective study was conducted on 50 children with complicated crown-root fractures in young permanent anterior teeth, who were treated at the Pediatric Dentistry Department, Hospital of Stomatology, Xi'an Jiaotong University from June 2023 to June 2024. All patients underwent in-situ crown reattachment technique combined with pulpotomy. Clinical examinations, radiographic evaluations, and subjective satisfaction surveys (using a Likert scale of 1-10) were conducted at 1, 6, and 12 months postoperatively. Data were analyzed using SPSS 23.0. RESULTS: The loss-to-follow-up rate was 12% (6/50), with 44 cases completing the 12 months of evaluation. The clinical success rate was 93.18% (41/44), and the radiographic success rate was 97.73% (43/44). The subjective satisfaction scores showed a significant improvement in masticatory function from 7.03±0.52 at 1 month to 8.07±0.92 at 12 months postoperatively (P<0.05), whereas the scores for aesthetics, comfort, and quality-of-life impact showed no statistically significant differences (P>0.05). CONCLUSIONS In-situ crown reattachment technique combined with pulpotomy effectively treats complicated crown-root fractures in young permanent anterior teeth, demonstrating a high short-term clinical success rate, significantly improved masticatory function, and minimally invasive preservation of pulp vitality and root development potential. This technique provides an optimized treatment option for dental trauma in children, although its long-term efficacy requires further validation.
Humans ; Pulpotomy ; Tooth Fractures/surgery* ; Child ; Prospective Studies ; Male ; Female ; Tooth Root/injuries* ; Tooth Crown/injuries* ; Treatment Outcome ; Incisor/injuries* ; Child, Preschool

This report presents a case of a 9-year-old child with a complicated crown-root fracture of the maxillary central incisor, accompanied with a root fracture. The treatment strategy was minimally invasive, focusing on vital pulp preservation, root fracture recovery, and crown restoration. The fractured crown was reattached using resin short posts to enhance retention, resulting in aesthetic and functional restoration of the anterior teeth. A 2-year follow-up revealed favorable clinical and radiographic outcomes.
Humans ; Child ; Tooth Fractures/therapy* ; Tooth Root/injuries* ; Incisor/injuries* ; Tooth Crown/injuries* ; Post and Core Technique ; Dental Restoration, Permanent/methods* ; Maxilla

Dental trauma is one of the relatively common emergencies in clinical dental practice, with a high incidence rate, and the maxillary central incisors are the most frequently affected. This article reports a case of a 17-year-old female patient who suffered traumatic complete avulsion of teeth 11 and 21, with tooth 21 lost after avulsion. The prognosis for replantation was poor due to the absence of the buccal alveolar bone wall of tooth 11. Therefore, tooth 11 was treated with extracorporeal root canal therapy and then replanted into the alveolar socket of tooth 21, which had better conditions, followed by elastic splint fixation. After 20 months of follow-up observation, the affected tooth maintained a stable functional position, with no periapical inflammation or ankylosis observed. Subsequently, delayed implant restoration at the site of tooth 11 was performed, ultimately achieving a favorable treatment outcome. This case may provide new insights and references for future clinical practices in tooth replantation.
Humans ; Female ; Tooth Replantation/methods* ; Incisor/injuries* ; Adolescent ; Tooth Avulsion/therapy* ; Maxilla ; Root Canal Therapy

OBJECTIVES: This study aimed to analyze the correlations and proportional relationships between maxillary anterior teeth (MAT) and facial measurements in Han Chinese individuals with the most attractive smiles, as evaluated by dental professionals. METHODS: Ten dentists with more than 5 years of clinical experience from different professional directions in a tertiary stomatological hospital were selected to evaluate the smile attractiveness of volunteers by visual analogue scale (VAS). Eighty-eight Han volunteers with the most attractive smile were selected. The perceived width of the MAT, the dimensions (height and width) of the maxillary central incisors (MCI), and the facial dimensions (intercanthal distance, interzygomatic distance, interalar distance, facial height and lower facial height) of the volunteers were measured on the frontal photos of the smile, digital oral model, and 3D face model. Pearson correlation analysis was performed to analyze linear correlations, and regression analysis was carried out to explore the proportional relationships. Reliability analysis using the intraclass correlation coefficient verified the stability of these proportional relationships. In addition, the correlations between MAT perceived width and the proportional relationships of (MCI) height to width ratio, with facial dimensions were explored and their reliability was verified. RESULTS: In Han Chinese individuals with the most attractive smiles, as evaluated by dental professionals, the Pearson correlation coefficients among MAT perceived widths were 0.813, 0.389, and 0.560. A proportional relationship existed between the lateral incisor and central incisor, and the ratio was 0.729. No significant correlations were found between MCI and the inner canthal distance, zygomatic distance, interalar distance, facial height, or the lower one-third facial height except for a negative correlation (r=-0.357) between MCI height and facial height in males and a positive correlation (r=0.249) between MCI width and interalar width when genders were combined. CONCLUSIONS Correlations exist among MAT perceived widths in Han Chinese individuals with the most attractive smiles, as evaluated by dental professionals. Partial correlations are observed between MCI height and width and facial measurements. The perceived width of the lateral incisor can serve as a reference indicator for predicting the perceived width of the central incisor, providing a reference for the aesthetic restoration of MAT in the Han ethnicity population.
Adult ; Female ; Humans ; Male ; China ; Esthetics, Dental ; Face/anatomy & histology* ; Incisor/anatomy & histology* ; Maxilla/anatomy & histology* ; Smiling ; East Asian People

Tooth resorption is the degradation of dental hard tissue due to the continuous action of odontoclasts. External cervical resorption refers to the cervical resorption of a tooth due to destruction and/or defects of the periodontal ligament or subepithelial cementum. In this paper, we report a case of maxillary central incisor with external cervical resorption after dental trauma and orthodontic treatment. The resorption site and morphology of the affected tooth were thoroughly analyzed by cone beam computed tomography prior to the operation. Dental operating microscope and layered external repair with composite resin and bioceramics ensured a perfect restoration of the resorption, and the vital pulp was preserved. The 6-year follow-up indicated a favorable treatment effect.
Humans ; Composite Resins ; Cone-Beam Computed Tomography ; Incisor/surgery* ; Maxilla ; Microsurgery/methods* ; Tooth Resorption/etiology*

Dental trauma is a common oral condition in children. For single-type trauma to young permanent teeth, timely treatment often results in a high survival rate for both the teeth and the pulp. However, in cases of complex dental trauma or when supernumerary teeth are impacted near the apex of the injured tooth, the prognosis is less predictable. This article reports a case of root fracture in an immature maxillary permanent central incisor combined with impacted supernumerary tooth in the apical region. After supernumerary tooth extraction and pulp revascularization therapy, the case demonstrated a good treatment outcome over a nearly 10-year follow-up period.
Child ; Humans ; Incisor/injuries* ; Maxilla ; Tooth Extraction ; Tooth Fractures/complications* ; Tooth Root/injuries* ; Tooth, Impacted/surgery* ; Tooth, Supernumerary/surgery*

When selecting implant guidance methods or judging whether the patient can be implanted, many doctors ignore or only use visual inspection to estimate a patient's mouth opening. This phenomenon often leads to failure to complete the implantation due to insufficient mouth opening or the deflection of the implant due to limited angle, resulting in the high incidence of corresponding complications. The main reason is that doctors lack accurate analysis and control of the overall geometric conditions of the intraoral surgical area, and three-dimensional position blocking of surgical instruments occurs during the operation. In the past, mouth opening was defined as the distance between the incisor edges of the upper and lower central incisors when the patient opens his mouth widely, and the implant area could be in any missing tooth position. When it is in the posterior tooth area, the specific measurement scheme of the mouth opening could not be simply equivalent to the previous measurement method in the anterior tooth area. However, how to measure quickly and conveniently the mouth opening of any surgical area to determine whether it could be implanted and meet the needs of the selected guidance method remains unclear. This paper introduces new concepts, establishes new classification and corresponding accurate measurement scheme of implant area, and establishes a decision tree of implant methods guided by the actually measured value. Results provide a quantitative basis for rational formulation and implementation of implant treatment.
Humans ; Mouth ; Dental Implantation, Endosseous/methods* ; Incisor ; Clinical Decision-Making ; Dental Implants

OBJECTIVES: To summarize the open-eruption technique of impacted anterior maxillary teeth, this study reports a technically improved operation on surgical exposure based on dental follicles and evaluates post-treatment periodontal health considering the effect of dental follicles. METHODS: Patients who underwent open-eruption technique with unilateral labially impacted maxillary central incisors were selected. The impacted teeth were assigned to the experimental group, and the contralateral unimpacted maxillary central incisors were assigned to the control group. In the surgical exposure, the new technique makes use of dental follicles to manage the soft tissue, so as to preserve soft tissue for better aesthetic results and healthier periodontal tissue. Tooth length, root length, alveolar bone loss, and alveolar bone thickness were recorded after the therapy. RESULTS: A total of 17 patients with unilateral maxillary central incisor impaction were successfully treated. The tooth length and root length of the two groups showed a statistically significant difference between the impacted and homonym teeth, with a shorter length in the impacted tooth (P<0.05). More labial alveolar bone loss was found in the experimental group compared with that in the control group (P<0.05). The outcomes of the cementoenamel junction width, pa- latal alveolar bone loss, and alveolar bone thickness did not indicate statistical significance between the experimental and control groups (P>0.05). CONCLUSIONS In the surgical exposure, the new technique uses dental follicles to manage the soft tissue and preserve it for better aesthetic results and healthier periodontal tissues.
Humans ; Tooth, Impacted/surgery* ; Incisor ; Alveolar Bone Loss/diagnostic imaging* ; Tooth Root ; Dental Sac ; Maxilla/surgery* ; Esthetics, Dental

Dens invaginatus is a rare developmental anomaly of the teeth that is caused by the infolding of enamel organs or the penetration of their proliferations into dental papillae before calcification has occurred. The presence of double dens invaginatus is extremely rare. This paper describes the use of cone beam computed tomography in the evaluation of a maxillary lateral incisor with double dens invaginatus and periapical periodontitis. The tooth was treated through microscopic root canal therapy. The tooth was free of clinical symptoms, and the periradicular lesion narrowed during the follow-up period of 1 year.
Humans ; Dental Pulp Cavity/abnormalities* ; Dens in Dente/pathology* ; Incisor/pathology* ; Root Canal Therapy ; Periapical Periodontitis/pathology*