The axial contour and proximal contact of the prosthesis affect periodontal health, food impaction, and patient satisfaction. This narrative review provides a summary of articles regarding the axial contour and proximal contact of a fixed dental prosthesis on periodontal health and physiologic function. By acquiring a comprehensive understanding of the axial contour and proximal contact of teeth and prostheses, as well as their functional significance, the virtual design of fixed dental prosthesis can be optimized to maintain periodontal health and promote physiologic function effectively.

The demand for orthodontic clear aligner therapy (CAT) has increased significantly over the last decade, offering advantages over the fixed appliances (FA) including enhanced aesthetics, better hygiene and comfort, along with minimal restrictions on the patient's diet. Moreover, a marked improvement in the efficacy of tooth movement using aligners has been documented. On the contrary, there have been known limitations of CAT including the compliances issues and the apparent lack of efficacy for certain types of tooth movement such as closure of extraction space compared to FA. Thus, evidence-based evaluation of the accuracy of prediction of tooth movement with clear aligners and their ability to effectively perform major tooth and root movements compared to FA are crucial. Although several systematic reviews have investigated various aspects of the effectiveness of CAT, we are yet to obtain a rather conclusive answer to this question. The current review attempted to summarize the evidence-based findings of most systematic reviews about CAT available to date. Major issues regarding the predictability of tooth movement, the role of attachments and auxiliaries in improving the effectiveness of CAT, and the treatment outcomes in comparison to FA were investigated. Clinical recommendation have been also elaborated based on the interpretation of the findings of all systematic reviews included in this study.

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

Purpose: The purpose of this study was to evaluate whether the presence of a space maintainer affects the accuracy of an intraoral scanner. Materials and Methods: The maxillary primary first molar typodont tooth was removed from the primary dentition typodont model and a band and loop type space maintainer was delivered. After the model was connected to a dental phantom, intraoral scan was performed using TRIOS 4 (3Shape A/S, Copenhagen, Denmark). The scan was repeated with the same technique without the space maintainer. Each scan was performed 10 times. All scan files into a GOM inspect 2018 software and evaluated the accuracy. The accuracy was evaluated on trueness and precision, and calculated using the root mean square value. Result: When there was a space maintainer in the oral cavity, the trueness value was 0.10±0.02 mm and the precision value was 0.15±0.03 mm. In the absence of the space maintainer, the trueness value was 0.12±0.03 mm and the precision value was 0.16±0.04 mm. There were no significant differences depending on the presence of a space maintainer (P>0.05). Conclusion: Within the limits of this study, the accuracy of the intraoral scanner was not influenced by the presence of space maintainer.

Purpose: The aim of this study was to evaluate the feasibility of deep learning techniques to classify the morphology and severity of peri-implantitis bone defects based on periapical radiographs. Materials and Methods: Based on a pre-trained and fine-tuned ResNet-50 deep learning algorithm, the morphology and severity of peri-implantitis bone defects on periapical radiographs were classified into six groups (class I/II and slight/moderate/severe). Accuracy, precision, recall, and F1 scores were calculated to measure accuracy. Result: A total of 971 dental images were included in this study. Deep-learning-based classification achieved an accuracy of 86.0% with precision, recall, and F1 score values of 84.45%, 81.22%, and 82.80%, respectively. Class II and moderate groups had the highest F1 scores (92.23%), whereas class I and severe groups had the lowest F1 scores (69.33%). Conclusion: The artificial intelligence-based deep learning technique is promising for classifying the morphology and severity of peri-implantitis. However, further studies are required to validate their feasibility in clinical practice.

Purpose: To evaluate the antimicrobial persistence of silver diamine fluoride (SDF) and silver fluoride (AgF) on Streptococcus mutans. Materials and Methods: An in vitro experiment was conducted to observe changes in the diameter of the inhibition zone of various materials, including AgF (Riva Star Aqua^TM step 1; SDI), potassium iodine (Riva star aqua^TM step 2; SDI), Fluor protector^® (FP, Ivoclar Vivadent), SDF (Riva star^TM step 1; SDI), Ampicillin (Sigma-Aldrich), Amphotericin B (Nexstar) and negative control on S. mutans. Result: SDF, AgF and FP exhibited significant antimicrobial persistence over the 4 weeks period (P<0.05). At day 28, the diameter of inhibition zone was larger in SDF than in AgF. Conclusion: SDF and AgF have significant antibacterial durability against bacteria commonly associated with dental caries, with the antimicrobial effect lasting for at least 4 weeks. Further clinical studies are needed to validate these findings in vivo.

Purpose: To investigate the effect of epidermal growth factor (EGF) with collagen matrix (CM) for increasing gingival thickness. Materials and Methods: In five mongrel dogs, bilateral gingival defects were surgically made on the maxillary canines. After two months, either a subepithelial connective tissue graft (group SCTG) or CM with EGF (0.1 ug/ml, group EGF) was grafted, and the flap was coronally positioned to cover the graft materials. The animals were sacrificed after three months. Intraoral scanning was performed for soft tissue analysis. Histologic and histomorphometric analyses were performed. Result: Two animals exhibited wound dehiscence during the healing phase, leaving three for analysis. No statistically significant difference was found in soft tissue changes (P>0.05). The level of gingival margin (GM) increased in both groups (1.02±0.74 mm in group SCTG vs. 1.24±0.83 mm in group EGF). Linear increases at the GM pre-augmentation in the soft tissue profile were 1.08±0.58 mm in group SCTG and 0.96±0.73 mm in group EGF. Histomorphometric parameters (keratinized tissue height, tissue thickness, and rete peg density) were not significantly different between the groups (P>0.05). Conclusion: EGF loaded onto CM led to comparable gingival phenotype enhancement to SCTG.

Purpose: This study investigated the orthodontic tooth movement after weekly parathyroid hormone (PTH) injection in mongrel dogs and analyzes bone formation activity on the tension and pressure sides of the tooth movement in mongrel dogs. Materials and Methods: Three mongrel dogs were used in this study. The first premolar was extracted and orthodontic force using 150 g of closed coil springs between the canine and second premolar was applied. The low-dose PTH group (PTH_1) and high-dose PTH group (PTH_2) received weekly injections of 1.61 ㎍/kg and 3.23 ㎍/kg of PTH, respectively. The control group received weekly injections of 1 ml of saline. Clinical, histomorphometric analysis were carried out. Result: The orthodontic tooth movement was greatest in the PTH_2 group and the lowest in the control group. Fluorescence staining images showed higher bone remodeling on the tension side of the tooth movement in the PTH_1 and PTH_2 groups. PTH_2 group showed a thicker labeling band than the PTH_1 group. PTH_2 group showed the highest mineral apposition rate and bone formation rate, followed by the PTH_1 group and the control group. Conclusion: Weekly intermittent PTH injection, especially in the short-term and at higher doses with orthodontic force, successfully increased orthodontic tooth movement and bone remodeling in mongrel dogs.

Purpose: This study is to investigate the distribution of natural tooth shades in the Korean elderly population to quantify the correlation and changes of tooth color with age and gender. In addition, the possible effects of habits on tooth color were assessed. Materials and Methods: The tooth color of one of the maxillary central incisors of 200 Korean individuals aged 50 to 89 years, males and female, was measured using the portable intraoral spectrophotometer (VITA Easyshade V). CIELab and CIELCh color coordinates were recorded. We conducted the survey about the tobacco smoking, chronic disease, medication, eating habits, oral health behaviors and satisfaction with tooth color. Experimental data were statistically analyzed by using the t-test (P<0.05), two-way analysis of variance and Pearson's correlation test. Result: The most frequent color in the Korean elderly population was 3M3 & A3.5 shade. L^* and h^* values decreased, whereas C^*, a^* and b^* values increased progressively with age. There was a significant interaction between age and color coordinates for b^* values (r=0.245, P<0.05). Males generally have significantly higher C^*, a^*, b^* values and lower L^*, h^* value compared to females. Individuals who consumed alcohol had a higher L^* value (P<0.05). Conclusion: Within the limitation of this study, the central incisors were getting darker, more reddish, and yellowish with age. Information on the chromatic range of natural teeth by age and gender could help to select colors for esthetic dental restorations.

Lesch-Nyhan syndrome is a rare X-linked recessive disorder characterized by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyl transferase, which is important in the metabolism of purines. Prevalence of Lesch-Nyhan syndrome is 1:100,000 to 1:380,000 live births, and Lesch-Nyhan syndrome mainly affects males. It is characterized by neurologic dysfunction, uric acid overproduction, and cognitive and behavioral disturbances. The self-mutilation is the most distinctive symptom in Lesch-Nyhan syndrome, appearing about 1 year of age. It is expressed as persistent bites in the oral mucosa, tongue, lips, and fingers, which leads to the total or partial destruction of the affected tissues. Several medical and dental management methods might be performed in Lesch-Nyhan syndrome patients. Dental approaches to prevent injuries caused by self-mutilation include treatments with oral appliances such as mouth guards or lip bumpers, extraction, and orthognathic surgery. This report described two brothers with Lesch-Nyhan syndrome, who injured themselves on oral tissues. The methods of tooth reduction and extraction were performed to prevent injuries caused by self-mutilation.

Fibrous dysplasia (FD) accompanying osteomyelitis (OM) has been reported to result in recurrent, refractory pain and swelling. Although radical resection of the lesions has been suggested, effective surgical treatment strategies have not yet been established due to the limited number of studies on this pathological condition. In this report, we present the conservative surgical management of FD accompanying OM in two patients who exhibited recurrent signs and symptoms. The present report suggests that OM occurring in patients with FD can be successfully managed with conservative surgical treatment and following removal of the odontogenic origin although bone defect in which inflammatory fibro-osseous lesions is removed through decompression surgery may exhibit regeneration of dysplastic bone. In addition, for the prevention of OM in patients with FD, careful clinical examination and thorough management of dental-related pathologies are necessary with regular follow-up examinations to screen for the possibility of malignant changes.

Treatment of multiple gingival recession defects is usually more challenging than that of single gingival recession. Various techniques for the treatment of multiple gingival recession have been established. Recently, vestibular incision subperiosteal tunnel access (VISTA) technique has been considered to exhibit high predictive ability. Connective tissue graft (CTG) has also been considered a gold standard technique owing to its high predictability of root coverage. However, this technique requires a suitable donor site and has clinical disadvantages, such as additional pain. Thus, in this case presentation, platelet-rich fibrin (PRF) was used as an alternative material for CTG along with VISTA. We herein report cases of two patients with Miller's class I and III multiple gingival recession defects, respectively. These patients underwent VISTA along with the use of a PRF membrane. They were followed up for 12 months postoperatively, and their clinical parameters, including probing depth, depth of gingival recession, clinical attachment level, and width of attached gingiva at baseline and at 2, 6, and 12 months postoperatively, were assessed. The patient with class 1 recession defects exhibited a significant amount of root coverage, which remained stable during the follow-up period. Whereas the patient with class 3 recession defects had lesser amount of coverage compared to class 1 patient. The partial coverage observed may be attributed to not only anatomical factors but also the technique-sensitive nature of the procedure. Considering these results, the use of VISTA along with PRF is a viable option for treating gingival recession, as it does not cause discomfort to patients. However, various factors need to be considered during the surgical procedure.