Background and Objectives: The aim of this systematic review was to summarize currently available data of published articles that have investigated the post-treatment status of impacted maxillary central incisors (ICI) treated by the surgical-orthodontic approach. Materials and Methods: MEDLINE, Scopus, Cochrane Oral Health Group’s Trials Register, and ScienceDirect electronic databases were systematically searched with no publication date restrictions up to January 2021. Data assessing the status of ICI after combined surgical-orthodontic treatment and forced eruption duration were extracted, and the quality of the studies was evaluated. Results: In total, 7074 studies were identified, of which 42 articles were assessed for eligibility through full-text evaluation. Seven included studies (five retrospective studies, one randomized clinical trial, and one prospective clinical trial) met the inclusion criteria, representing 211 patients with unilaterally impacted maxillary incisors. The risk of bias ranged from moderate to high. The results show that the root length of immature ICIs increased significantly but remained shorter than that of homonym teeth at post-treatment. Periodontal parameters of treated ICIs were in a clinically acceptable range. Measurements of the alveolar bone showed a reduction of bone thickness and support. The average forced eruption duration ranged from 8.0 ± 4.5 to 14.41 ± 4.03 months. Conclusions: Based on existing evidence, it is reasonable to conclude that the surgical-orthodontic treatment affected the post-treatment status of ICI; however, the current literature is insufficient to draw concrete conclusions. Further well-conducted multi-center randomized studies with a large sample are needed to confirm this statement.
Background and Objectives. There is a deficiency of research on orthodontic movements and management strategies for traumatized teeth to avoid further treatment complications. The aim of the study was to evaluate the knowledge of Lithuanian orthodontists about dental trauma and the orthodontic management of traumatized teeth. Materials and Methods. Lithuanian orthodontists and orthodontic residents were introduced to the purpose, objectives and questionnaire of the study. The questionnaire was developed based on demographics, the participants’ personal experience, specific questions about dental traumas and orthodontic treatment tactics for patients with a history of dental trauma. Results. A total of 54 participants (42 orthodontists and 12 orthodontic residents) completed the survey. The overall response rate was 42.9%. The results of the survey revealed that the largest share of the study participants—61%—stated that they had treated traumatized teeth just a few times during the whole practice. Briefly, 53.7% of respondents inquired about the dental trauma history only if they saw signs of complications. The results of the survey revealed that the frequency of correct answers to questions about dental trauma was 63.7%, and that about the orthodontic treatment of traumatized teeth was 54.9%. It is worth noting that one-third of physicians pointed out the lack of information about the orthodontic management of traumatized teeth. Conclusion. The knowledge of Lithuanian orthodontists and orthodontic residents about dental injuries and the orthodontic treatment of traumatized teeth is insufficient. Further educational training is recommended.
Background and Objectives: Contemporary caries treatment seeks to preserve hard dental tissues as well as to promote lesion remineralization and biological tissue regeneration. While fluoride-based treatments remain the gold standard, their effectiveness has limitations, prompting interest in innovative remineralization technologies. Nano-hydroxyapatite (nano-HA) varnish and self-assembling peptide (SAP) P11-4 are promising biomimetic materials that promote enamel repair, yet long-term data on their efficacy are limited. The objectives of this study were to evaluate the effectiveness of nano-HA varnish and peptide P11-4 in restoring enamel surface hardness after artificial lesions in vitro and to compare them to a control group and fluoride varnish. Materials and Methods: Artificial enamel lesions were created on the buccal surfaces of 36 extracted human molars, which were randomly divided into four groups (n = 9): control, peptide P11-4, fluoride varnish, and nano-hydroxyapatite varnish. After applying the materials as per manufacturer instructions, specimens were stored in artificial saliva for 14 days. Enamel surface hardness was measured using the Vickers hardness test (HV) at baseline, after demineralization, and after remineralization. Statistical analysis was performed with “IBM SPSS 27.0” using non-parametric Kolmogorov–Smirnov, Kruskal–Wallis, Dunn’s, and Wilcoxon tests. Results: The mean baseline enamel hardness value was 323.95 (SD 33.47) HV. After 14 days of demineralization, the mean surface hardness of artificial enamel lesions significantly plummeted to 172.17 (SD 35.96) HV (p = 0.000). After 14 days of remineralization, the mean value significantly increased to 213.21 (SD 50.58) HV (p = 0.001). The results of the study revealed statistically significant enamel remineralization of the peptide P11-4 group in regard to the demineralized enamel (p < 0.05). In contrast, there were no significant results in other treatment groups (p > 0.05). Remineralization of enamel was the highest in samples from the P11-4 group (54.1%), followed by the nano-HA group (35.4%), FV group (17.8%), and control group (11.2%). There was a significant difference (p < 0.05) in the remineralizing ability between the peptide P11-4 and all other treatment groups. Conclusions: Self-assembling peptide P11-4 effectively remineralized artificial enamel lesions and proved to be significantly more effective compared to fluoride varnish and nano-hydroxyapatite varnish, showcasing its superior performance as a remineralizing agent.