This study evaluates the accuracy and repeatability of craniofacial measurements with a 3D light scanner, specifically the EINSTAR scanner, in comparison to traditional caliper measurements for facial anthropometry. Eleven volunteers were assessed by two examiners, one experienced and one inexperienced, who performed direct caliper measurements and indirect measurements using the scanner. Results indicated minimal differences between caliper and scanner results, with overall high accuracy and reliability demonstrated by correlation coefficients. Despite the slightly longer scanning time, the benefits of 3D imaging, including detailed surface mapping and virtual modeling, justify its integration into clinical practice, particularly in maxillofacial surgery and craniofacial assessment. Craniofacial measurements obtained with the EINSTAR scanner showed excellent reliability and accuracy, which qualifies this method for clinical and scientific use.
The consequences of traumatic injuries are pulp necrosis, periapical inflammation, and possible external cervical resorption (ECR). The concomitant cessation of root maturation and dentinogenesis in premature teeth result in a fragile tooth. Revascularization of the pulp might be an alternative treatment option. A 12-year-old patient was referred for retreatment of chronic apical periodontitis with acute exacerbation after root canal treatment of an upper central incisor. During gutta-percha removal, an ECR was detected. First, it was closed internally with Biodentine, followed by an external composite closure after a cone beam computed tomography evaluation. In the first session, chemomechanical cleaning was aided with sodium hypochlorite and hyperpure chlorine dioxide, and the canal was dressed with Ca(OH)2 until the next session. In the next session, only the low-toxicity, but adequate, bactericide hyperpure chlorine dioxide was applied for irrigation, before the provocation of periapical bleeding into the canal. The blood clots were covered with Biodentine, and the tooth was restored with composite filling. During the 24-month follow-up, clinical signs/symptoms had disappeared, and the periapical lesion was resolved. Increased root thickness in the apical third and decreased size of the apical foramen were detected. In conclusion, regenerative endodontic procedures could potentially be used to retreat immature teeth with persistent apical periodontitis and external cervical resorption.
Background: Periapical surgery is indicated for persistent periapical lesions that do not respond to conventional endodontic therapy, yet postoperative recovery is often hindered by pain, swelling, and delayed healing. Platelet-rich fibrin (PRF) membranes are autologous biomaterials with regenerative potential, capable of modulating inflammation and promoting tissue repair. Methods: This preliminary randomized controlled trial evaluated the effectiveness of PRF membranes in improving postoperative outcomes—specifically pain, swelling, and quality of life—after apicoectomy. Twenty patients requiring periapical surgery were randomly allocated to a PRF group (n = 10) or a control group (n = 10). In the PRF group, autologous PRF membranes were applied over the resected root-end and into the osteotomy cavity before flap closure. In the control group, no PRF membranes or any additional biomaterial were applied, apart from the standard root-end filling material (MTA), which was identically used in both groups as part of the routine apicoectomy protocol. All patients were blinded to allocation, and outcomes were assessed by an independent blinded evaluator. Facial swelling was quantified by 3D facial scanning, pain was recorded daily using a visual analog scale (VAS), and quality of life was evaluated with the PROMIS-29+2 Profile. Results: The PRF group showed significantly reduced swelling (mean volume difference, 7.12 cm3; p = 0.025), lower pain scores (VAS: 1.80 ± 1.22 vs. 3.80 ± 2.44; p = 0.034), and improved quality-of-life domains, including higher Physical Function (p = 0.032) and lower Sleep Disturbance (p = 0.008) scores. Conclusions: Within the limitations of this pilot study, PRF membranes enhanced postoperative recovery after periapical surgery by reducing swelling and pain while improving patient-reported outcomes. Larger multicenter trials are needed to confirm these preliminary findings.
Vital pulp therapy (VPT) preserves dental pulp and its functions, offering a minimally invasive alternative to root canal therapy. However, the impact of patient-related factors on success remains unclear. This study aimed to estimate the sample size for a multivariate model predicting VPT success for assessing capping material, age, sex, and pulp conditions. A prospective cohort study was conducted with the inclusion of twenty-seven adult patients with carious pulp exposure in mature permanent teeth. Treatment comprised direct pulp capping, partial pulpotomy, or complete pulpotomy with Mineral Trioxide Aggregate Plus (MTA+) or Biodentine. Success rates were evaluated at 6 months through clinical and radiographic examinations. Statistical analysis included Pearson’s Chi-square tests and logistic regression. The success rates were 64% in the Biodentine group and 92% in the MTA+ group (OR: 0.15; p = 0.108). Sex and age had no significant effect. Success declined with increasing pulp condition severity and treatment invasiveness. MTA+ had a higher incidence of discoloration, while Biodentine showed none. Sample size calculations suggested 140 participants would be needed to detect a significant effect of pulp condition. Both materials were effective, though MTA+ showed higher success based on the strict success criteria. More severe pulpitis correlated with lower success, but a larger study is needed for predictive models.
Promising research results have been obtained on the tissue-regeneration properties of PRF (platelet-rich fibrin) in dentistry and maxillofacial surgery. PRF presumably promotes healing and accelerates ossification. In this case report, the patient had a history of Gorlin–Goltz syndrome, also called nevoid basal cell carcinoma syndrome, an autosomal dominant neurocutaneous disease that was known for many years. As a consequence, cysts were detected in both the mandible and maxilla. We performed decompression on this 37-year-old patient, followed by a cystectomy on an extensive lesion in the right angle of the mandible. One cyst from each side of the body mandible and one from the maxilla were completely enucleated, as determined using an intraoral exploration. The resulting bone defect was filled with a composite graft composed of a mixture of A-PRF and a serum albumin-coated bone allograft (BoneAlbumin). The wound was then covered with a PRF membrane. The surgical sites were closed per primam. The postoperative period was uneventful. Biopsies were performed after three and six months of healing for histological micromorphometry analyses. Dental implants were placed at the sampling site. Three months after the implantation, the ossified implants were fitted with superstructures. To date, no complications have appeared with the bone augmentation. The authors interpret from the findings that the combination of A-PRF and BoneAlbumin can be validated as a prosperous bone substitute. It can be safely implanted after a 3-month ossification period.