OBJECTIVE: To compare the clinical effects of pulpotomy with two kinds of calcium silicate materials, and to evaluate the formation of dentin bridge and pulp calcification after pulpotomy of adult permanent teeth. METHODS: Patients who visited the General Department of Peking University School and Hospital of Stomatology from November 2017 to September 2019 and planned for pulpotomy on permanent premolars and molars with carious exposed pulp were selected. They were randomly divided into two groups. Bioceramic putty material iRoot BP (iRoot group, n=22) and mineral trioxide aggregate MTA (MTA group, n=21) were used as pulp capping agents, respectively. The patients were recalled after one year and two years. The clinical efficacy, dentin bridge index (DBI) and pulp calcification index (PCI) were recorded. Blinding method was used for the patients and evaluators. RESULTS: There was no significant difference in gender, mean age, dentition and tooth position between the two groups (P>0.05). Seven cases were lost during the first year (4 cases in iRoot group and 3 cases in MTA group). In the iRoot group, 1 case had transient sensitivity at the time of 1-year follow-up. The cure rate of the two groups was 100% at the time of 2-year follow-up. The proportion of dentin bridge formation was 38.9% one year after operation, 55.6% two years after operation. The proportion of partial or even complete disappearance of root canal image was 5.6% before operation, 38.9% and 55.6% one and two years after operation, respectively. The difference was statistically significant by rank sum test (P < 0.05). There was no significant difference in dentin bridge formation and pulp calcification between the two groups (P < 0.05). DBI and PCI after operation was as the same as those before operation (44.4% cases of DBI and 25% cases of PCI) or gradually increased (55.6% cases of DBI and 75% cases of PCI). Spearman's nonparametric correlation analysis showed that age was positively correlated with preoperative pulp calcification index (PCI0, P < 0.05), but not with the dentin bridge index (DBI1, DBI2), pulp calcification index (PCI1, PCI2) and the degree of change (DBI2 vs. DBI1, PCI1 vs. PCI0, PCI2 vs. PCI0) 1-year and 2-year after operation (P>0.05). CONCLUSION According to this study, good clinical effects were obtained within 2-year after pulpotomy of adult permanent teeth with MTA and iRoot. In some cases, the root canal system had a tendency of calcification aggravation, and there was no statistical difference in the development of this trend between the two groups.
Humans ; Adult ; Pulpotomy/methods* ; X-Rays ; Calcium Compounds/therapeutic use* ; Dentition, Permanent ; Molar/surgery* ; Treatment Outcome ; Silicates/therapeutic use* ; Aluminum Compounds/therapeutic use* ; Oxides ; Drug Combinations ; Dental Pulp Capping

OBJECTIVES: This study aimed to investigate the clinical characteristics of congenital deciduous teeth absence and its permanent teeth performance type by using panoramic radiographs. METHODS: A total of 15 749 panora-mic radiographs of 3-6-year-old children with deciduous dentition were collected from January 2020 to December 2021. The incidence of congenital deciduous teeth absence was observed, and the abnormality of permanent teeth was recor-ded. SPSS 24.0 software was used for statistical analysis. RESULTS: The incidence of congenital deciduous teeth absence was 2.54% (400/15 749), which was found in 217 girls and 183 boys, and the difference between the genders was statistically significant (P=0.003). The absence of one and two deciduous teeth accounted for 99.75% (399/400) of the subjects. In addition, 92.63% (490/529) of mandibular deciduous lateral incisor was congenitally absent, 44.80% (237/529) of deciduous teeth was absent in the left jaw, and less than 55.20% (292/529) was absent in the right; the difference between them was statistically significant (P=0.017). The absence of 96.41% (510/529) deciduous teeth in the mandibular was significantly more than that of 3.59% (19/529) in the maxillary, and the difference between was statistically significant (P=0.000). Furthermore, 68.00% (272/400) and 32.00% (128/400) of deciduous teeth were absent in unilateral and bilateral, respectively, and the difference was statistically significant (P=0.000). Four types of congenital deciduous teeth absence with permanent teeth were observed as follows: 1) 73.91% (391/529) of permanent teeth was absent; 2) 20.60% (109/529) of permanent teeth was not absent; 3) the number of fused permanent teeth accounted for 4.91% (26/529); 4) the number of supernumerary teeth was 0.57% (3/529). CONCLUSIONS Although the absence of congenital deciduous teeth is less common than that of permanent teeth, it affects deciduous and permanent teeth to some extent. Dentists should pay attention to trace and observe whether abnormalities are present in the permanent teeth and take timely measures to maintain children's oral health.
Male ; Female ; Humans ; Tooth, Deciduous ; Dentition, Permanent ; Tooth, Supernumerary/epidemiology* ; Anodontia/etiology* ; Tooth Abnormalities/complications* ; Fused Teeth/epidemiology*

Early orthodontic treatment refers to the orthodontic treatment of dental-maxillofacial deformities in the early deciduous or mixed dentition. More and more attentions has been paid to early orthodontic treatment. Many kinds of orthodontic appliances are emerging on the market with the rapid development of the orthodontic technology. At the same time, problems and increased risks have followed in early orthodontic treatment. The contents of the article include the establishment of deciduous occlusion and the characteristics of the deciduous dentition, the orthodontic principles of different stages of deciduous dentition, the oral bad habits during the deciduous dentition and the risk control of early orthodontic treatment.
Dental Occlusion ; Dentition, Mixed ; Humans ; Malocclusion/therapy* ; Orthodontic Appliances ; Tooth, Deciduous

Children in the mixed dentition grow rapidly, and various types of malocclusion often appear in this period. At the same time, there are many environmental factors affecting the development of the occlusion at this stage. Functional abnormalities related to lip, tongue, articulation and breathing, and impacted teeth should be actively intervened and blocked to avoid the continued development of the deformity. Appropriate orthopedic devices should be used in patients with skeletal malocclusion, if necessary, for growth modification and the influence of congenital factors and the prognosis of treatment should be fully evaluated. Over-intervention of the temporary malocclusions in the mixed dentition should be avoided. In conclusion, early orthodontic treatment in the mixed dentition requires a comprehensive assessment of the treatment need, risks, timing, cost and the ultimate benefit of the patient. The timing of orthodontic treatment is not the sooner the better. The indications must be strictly controlled, and the necessity and limitations must be carefully considered.
Child ; Dentition, Mixed ; Humans ; Malocclusion/therapy* ; Tongue ; Tongue Habits ; Tooth, Impacted

The early orthodontic treatment of malocclusion includes the growth modification of skeletal discrepancy, preventive and interceptive orthodontic treatment of the dental malocclusion or oral habit. Therefore, early orthodontic treatment is to guide the normal dento-maxillafacial growth and development, eliminate the adverse effect on function of masticatory system and the health of dental and periodontal tissues. Most of the patients in the early permanent dentition are still in their pubertal growth period. Although all kind of comprehensive orthodontic treatment could be started from early permanent dentition, early orthodontic treatment can still be used in the cases such as class Ⅱ malocclusion caused by underdevelopment of mandible and crossbite caused by underdevelopment of maxilla in the early permanent dentition. The article will discuss class Ⅱ malocclusion caused by underdevelopment of mandible and anterior and posterior crossbite caused by underdevelopment of maxilla which are feasible for early orthodontic treatment.
Dentition, Mixed ; Dentition, Permanent ; Humans ; Malocclusion/therapy* ; Malocclusion, Angle Class II/therapy* ; Maxilla

The minimally invasive fixed occlusal reconstruction of dentition defect is a sequential reconstruction process involving the minimally invasive restoration of the remaining natural teeth, the implant restoration of edentulous areas and the occlusal change from reversible to non-reversible. The simultaneous completion of minimally invasive natural teeth restorations and implant-supported crowns or bridges in an ideal occlusal design shows the obvious advantages of digital integration. The use of digital technologies such as intraoral scanning, kinematic face bow, virtual articulator and computer aided design and computer aided manufacturing (CAD/CAM), could be integrated in each stage of occlusal reconstruction, including the overall documentations and assessments before the restoration, the determination of the functional restoration space, the precise design and fabrication of the provisional and final restorations taking into account both esthetics and function and the preservation of the follow-up documentations and assessments after the restoration. The integration process can optimize clinical process and improve restoration accuracy. This article briefly describes the concept of minimally invasive occlusal reconstruction of dentition defects and the integration strategy of digital sequential restoration.
Humans ; Dentition ; Dental Implants ; Esthetics, Dental ; Mouth, Edentulous ; Computer-Aided Design ; Crowns ; Dental Prosthesis Design

Severely worn dentition seriously affects patient's esthetics and function. Its etiology is complex, differential diagnosis is difficult, treatment process involves multiple disciplines, and requires esthetic and functional rehabilitation. A "8-step sequential treatment" for the rehabilitation of severely worn dentition has been established. In recent years, digital technology has been increasingly applied to the esthetic and functional rehabilitation of severely worn dentition. This article will describe the application of digital methods in the 8-step sequential treatment of severely worn dentition.
Humans ; Tooth Wear/rehabilitation* ; Esthetics, Dental ; Dentition ; Digital Technology

Stabilization with splint is an important surgical technology in traumatic dental injuries of permanent tooth. In order to standardize the clinical application of the technique and to improve the therapeutic effects of traumatic injured teeth, the Society of Stomatological Emergency, Chinese Stomatological Association organized relevant professional experts and put forward an expert consensus on the basis of considerable discussion. The contents of the present expert consensus covered indications for tooth fixation, material selection of splints and operation methods, applying to the treatment of tooth loosening, tooth displacement and tooth avulsion replantation caused by traumatic injuries. It is also suitable for preoperative and prognosis evaluations of traumatic injured teeth before tooth fixation.
Consensus ; Dentition, Permanent ; Humans ; Splints ; Tooth Avulsion/therapy* ; Tooth Injuries/therapy* ; Tooth Replantation/methods*

Vital pulp therapy(VPT)is an important pathway to preserve and maintain pulp tissue in a healthy state. VPT has been improved recently as the new progress achieved in pathobiology, bioactive materials and clinical research. The present review summarizes the clinical outcomes and prognostic factors of VPT, including direct pulp capping, partial pulpotomy and full pulpotomy in mature permanent teeth with carious pulp exposure, and briefly introduces the new progress in this field.
Calcium Compounds ; Dental Caries/therapy* ; Dental Pulp Capping ; Dentition, Permanent ; Humans ; Pulpotomy ; Silicates ; Treatment Outcome

To assess the treatment effectiveness of vital inflamed pulp therapy (VIPT) in immature permanent teeth with irreversible pulpitis and apical periodontitis. The faculty members in the Department of Pediatric Dentistry, the Ninth People's Hospital were invited to submit consecutive VIPT cases from June 2015 to June 2016 (follow-up periods>12 months). The cases were retrospectively reviewed, clinical symptoms and radiographic changes in periapical radiolucency were evaluated, meanwhile, the data of radiographic changes such as apical diameter and root length were calculated and analyzed with ANOVA. Totally thirteen submitted patients/cases were included (6 males and 7 females) in the present study,. The average age of patients was (9.9±1.4) years old. The average follow-up time was (26.5±6.8) months (17-37 months). At the 12-month visit, all 13 treated teeth survived, 9 out of 11 teeth with apical periodontitis showed normal radiographic manifestation. At the 3, 6 and 12 months visits, the within-case percentage changes in apical diameter were (8.0±5.1)%, (24.1±9.1)% and (70.3±10.7)%, respectively, while the within-case percentage changes in root length were (11.4±9.8)%, (14.5±9.8)% and (27.4±14.2)%, respectively. There were statistically significant differences in the changes of apical diameter (F=18.80, P<0.001) and root length (F=4.64, P=0.047) from the preoperative time to the postoperative follow-ups. VIPT might improve clinical outcomes, even achieve continued root development. VIPT can be an option in treating immature teeth with irreversible pulpitis and apical periodontitis.
Child ; Dentition, Permanent ; Female ; Humans ; Male ; Periapical Periodontitis/therapy* ; Pulpitis/therapy* ; Retrospective Studies ; Root Canal Therapy