Correlation between occlusal contact and root resorption in teeth with periodontal disease

Finite element models: A road to in-silico modeling in the age of personalized dentistry

OBJECTIVE

This article reviews the applications of Finite Element Models (FEMs) in personalized dentistry, focusing on treatment planning, material selection, and CAD-CAM processes. It also discusses the challenges and future directions of using finite element analysis (FEA) in dental care.

DATA

This study synthesizes current literature and case studies on FEMs in personalized dentistry, analyzing research articles, clinical reports, and technical papers on the application of FEA in dental biomechanics.

SOURCES

Sources for this review include peer-reviewed journals, academic publications, clinical case studies, and technical papers on dental biomechanics and finite element analysis. Key databases such as PubMed, Scopus, Embase, and ArXiv were used to identify relevant studies.

STUDY SELECTION

Studies were selected based on their relevance to the application of FEMs in personalized dentistry. Inclusion criteria were studies that discussed the use of FEA in treatment planning, material selection, and CAD-CAM processes in dentistry. Exclusion criteria included studies that did not focus on personalized dental treatments or did not utilize FEMs as a primary tool.

CONCLUSIONS

FEMs are essential for personalized dentistry, offering a versatile platform for in-silico dental biomechanics modeling. They can help predict biomechanical behavior, optimize treatment outcomes, and minimize clinical complications. Despite needing further advancements, FEMs could help significantly enhance treatment precision and efficacy in personalized dental care.

CLINICAL SIGNIFICANCE

FEMs in personalized dentistry hold the potential to significantly improve treatment precision and efficacy, optimizing outcomes and reducing complications. Their integration underscores the need for interdisciplinary collaboration and advancements in computational techniques to enhance personalized dental care.

Radiographic Evaluation of the Prevalence of External Root Resorption in Patients With Periodontitis in Indore: A Cross-Sectional Study

Objective Permanent teeth roots undergo resorption under pathologic conditions such as trauma, orthodontic treatment, pulpal infections, periodontitis, and periodontal therapy. The present study aimed to determine the prevalence of external root resorption (ERR) in patients with periodontitis as seen in orthopantomography (OPGs). Methodology This single-center, retrospective, cross-sectional radiographic study was conducted from January 2021 to December 2022, including 656 orthopantomographs (OPGs) from patients with periodontitis. OPGs were evaluated based on specific inclusion and exclusion criteria. ERR was assessed across mild, moderate, and severe periodontitis cases (Stage I/II/III/IV according to the 2017 American Academy of Periodontology) in both localized and generalized periodontitis and in cases of horizontal and vertical bone loss/defects. Data analysis was performed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Descriptive statistics were calculated and presented as numbers, percentages, and mean ± standard deviation. Categorical variables were compared using the chi-square test, with a p-value < 0.05 considered statistically significant. Results The study analyzed 656 subjects, with 226 (34.5%) showing external root resorption (ERR). ERR prevalence was higher among males (122, 38.6%) compared to females (104, 30.6%) (p = 0.031). ERR was more common in subjects with vertical bone loss (105, 49.1%) than those without (121, 27.4%) (p < 0.001) and in those with horizontal bone defects (55, 45.8%) compared to those without (171, 31.9%) (p = 0.004). By periodontitis severity, ERR occurred in Stage I (61, 21.2%), Stage II (108, 37.4%), and Stage III/IV (57, 72.2%) (p = 0.001). Localized periodontitis showed higher ERR prevalence (40, 44.0%) than generalized periodontitis (186, 32.9%) (p = 0.040). Age was not significantly associated with ERR (p = 0.423). Conclusion ERR was significantly associated with the severity of periodontitis, localized and generalized periodontitis, and horizontal and vertical bone defects. Prompt diagnosis and treatment planning are essential for preserving teeth affected by ERR, thereby supporting masticatory function, aesthetics, self-esteem, and the overall oral health-related quality of life for patients.

Multiple external root resorptions in a patient with Stage IV, Grade C periodontitis and autoimmune diseases: A case report

BACKGROUND

Pathological root resorption affects permanent teeth and is usually triggered by infectious-inflammatory stimuli and/or dental trauma. Periodontitis and traumatic occlusion have been reported as possible causative factors of root resorptions, whilst the impact of systemic diseases is less well understood. This case highlights the need for consideration of multiple risk factors, especially when presenting in combination.

METHODS AND RESULTS

A 62-year-old South Asian female presented with unstable Stage IV Grade C periodontitis, poor oral hygiene and multiple autoimmune conditions including oral lichen planus. Clinical and radiographic examination revealed multiple advanced apical and external root resorptions of the patient's molars associated with periapical bone loss, despite of a minimally restored dental status.

CONCLUSION

A likely etiology of this patient's multiple root resorptions is the presence of unstable periodontitis with periodontal-endodontic lesions, exacerbated by a dysbalanced immune response to infectious agents. Appropriate monitoring and managing of such patients can prevent or limit the pathological process of inflammatory root resorption.

KEY POINTS

Why is this case new information? This is the first report documenting advanced multiple external inflammatory root resorptions in a periodontitis patient with oral and systemic co-morbidities. What are the keys to successful management of this case? Early diagnosis, prevention and intervention to limit periodontal inflammation, endodontic infection and occlusal trauma. What are the primary limitations to success in this case? Late diagnosis of multiple root resorptions, palliative periodontal treatment due to poor oral hygiene compliance, and poorly controlled systemic inflammation favoring the persistence of a dysregulated immune response to the oral microbiota.

Identification and adjustment of experimental occlusal interference using functional magnetic resonance imaging

BACKGROUND

The purpose of this study was to use functional magnetic resonance imaging (fMRI) to quantify changes in brain activity during experimental occlusal interference.

METHODS

Fourteen healthy volunteers performed a rhythmical tapping occlusion task with experimental occlusal interference of the right molar tooth at 0 mm (no occlusion), 0.5 mm, and 0.75 mm. The blood-oxygen-level dependent (BOLD) signal was quantified using statistical parametric mapping and compared between rest periods and task periods.

RESULTS

In tapping tasks with experimental occlusal interference of 0.75 mm or 0.5 mm, there was clear activation of the contralateral teeth-related primary sensory cortex and Brodmann's area 46. At 0 and 30 minutes after removal of the experimental occlusal interference, the activation clearly appeared in the bilateral teeth-related primary sensory cortices and Brodmann's area 46. At 60 minutes after the removal of the experimental occlusal interference, the activation of Brodmann's area 46 had disappeared, and only the bilateral teeth-related primary sensory cortices were active.

CONCLUSIONS

The present results suggest that adjustments for experimental occlusal interference can be objectively evaluated using fMRI. We expect that this method of evaluating adjustments in occlusal interference, combined with fMRI and the tapping task, could be applied clinically in the future.