This study aims to assess differences in biofilm bacterial composition between patients with low and high caries. Patients without a medical problem and with no history of antibiotic use, mouth wash or fluoride application in the previous 3 months were recruited. Caries was recorded at cavitation level; score was calculated by a national mean (dmft of 4.8 and DMFT of 2.7). Pooled biofilm samples were collected from mesial, distal, buccal, lingual, and occlusal surfaces. Based on caries experience, individuals were classified into low and high caries and both groups were compared regarding bacteria identified using 16S rRNA gene sequencing, and molecular phylogenetic analysis of the isolates was performed. A total of twenty seven randomly selected samples with low (n = 13) and high (n = 14) caries. Identification of oral bacteria was performed using 16S rRNA sequence, Rothia mucilaginosa and R. aeria were identified in low caries individuals, while R. dentocariosa was detected in high caries individuals. Two Streptococcus spp. were identified only in low caries S. salivarius and S. gordonii whereas S. sanguinis, S. mitis, S. sinensis, S. rubneri, S. vestibularis, S. cristatus and S. massiliensis were identified only in individuals with high caries. This study revealed the absence of R. mucilaginosa in the high caries subjects and its coexistence with the low caries subjects. Streptococcus mutans was insignificant contributor of caries among samples, while, Streptococcus sanguinis was the main constituent of high caries Saudi patients.

Background/Objectives: Gingival recession frequently affects the anterior mandibular region. Anatomical features, such as thin buccal bone, narrow keratinized gingiva, and root proximity, increase susceptibility to periodontal disease. Recession can progress over time and may be exacerbated by orthodontic treatment. However, it remains uncertain whether the severity of crowding before treatment contributes to recession after orthodontic therapy The present study aimed to determine whether a relationship exists between the degree of mandibular anterior crowding before orthodontic treatment and the development or progression of gingival recession after treatment completion. Methods: This retrospective study was conducted on 269 participants with pre- and post-treatment records. The Little’s irregularity index was used to assess the degree of crowding. Clinical photographs of the six mandibular anterior teeth (1614 sites) were digitally calibrated permit millimeter-based assessment of gingival recession and keratinized tissue (KT) width. Oral hygiene (OH) was also evaluated at both time points. Results: Post-treatment recession was detected in 76 teeth. (4.7% of sites) among 48 participants (17.8%). Pretreatment crowding severity was not significantly associated with the occurrence of recession after treatment. Pretreatment mucogingival deformities were independently associated with post-treatment gingival recession. Mandibular central incisors demonstrated the highest prevalence of post-treatment gingival recession. Conclusions: Pretreatment mandibular anterior did not appear to predict gingival recession at treatment completion. Periodontal characteristics may play a more important role in recession development, supporting careful periodontal evaluation before and throughout orthodontic care.

Purpose: Excessive gingival display (EGD) resulting from altered passive eruption (APE) is a clinical condition that is commonly managed by esthetic crown lengthening to achieve stable and symmetrical gingival margins. Determining the appropriate gingival and osseous resection levels remains a key step in achieving predictable surgical outcomes. Although digitally printed resin guides have been widely discussed, clinical data regarding milled metal dual-purpose guides remain limited. Patients and Methods: This single case report (n=1) describes the digital workflow for designing and fabricating a dual-purpose cobalt–chromium surgical guide to assist both gingivectomy and osteoectomy. The guide dimensions were determined by superimposing cone-beam computed tomography (CBCT) data with intraoral scan files to identify the cementoenamel junction (CEJ). The guide was fabricated using a subtractive milling process and used during esthetic crown lengthening in a patient diagnosed with altered passive eruption type I. Results: The milled metal guide appeared to provide stable positioning during surgery and helped guide both soft- and hard-tissue resection. At 6-month follow-up, gingival margins remained stable, symmetrical contouring was achieved, patient satisfaction was high, and no immediate postoperative complications were observed. Conclusion: This report presents a CBCT-integrated workflow for dual-purpose surgical guidance. The rigidity of the milled metal framework may assist intraoperative stability and support favorable short-term clinical outcomes in this case.

Objectives: To evaluate the dimensions of submandibular fossa concavity and its spatial relationship to the inferior alveolar canal (IAC) in the mandibular first- and second-molar regions using cone-beam computed tomography (CBCT). Methods: This retrospective cross-sectional study included CBCT scans from 126 patients (252 hemimandibles), with four measurement points evaluated per side (1008 points). Concavity occurrence, maximum depth, the position of the deepest concavity point relative to the IAC, and the distances from the alveolar crest to the upper and lower limits of the concavity were assessed. Linear mixed-effects models and generalized estimating equations were used to account for repeated measurements within patients. Results: Concavity was identified at 636 of 1008 measurement points (63.1%), including 247 of 504 first-molar points (49.0%) and 389 of 504 second-molar points (77.2%). Maximum concavity depth was significantly greater in the second-molar region (β for first versus second molar = −0.386 mm; 95% CI: −0.559 to −0.213; p < 0.0001), whereas gender was not significantly associated with depth (p = 0.4281). The deepest concavity point was most frequently located parallel to the IAC (477/636; 75.0%). The crest-to-upper-limit distance varied significantly across measurement intervals (p < 0.0001) and was shorter in females (p = 0.0014). No statistically significant predictors were identified for the crest-to-lower-limit distance. Conclusions: Submandibular fossa concavity was frequently observed in the evaluated posterior mandibular measurement points, particularly in the second-molar region. Maximum concavity depth differed significantly by tooth region but not by gender. These anatomical findings highlight the relevance of evaluating the lingual mandibular contour and its relationship to the IAC during preoperative implant assessment.