Dent. J., Volume 10, Issue 4 (April 2022) – 23 articles

(1) Background: Antibiotics are used in every medical field including dentistry, where they are used for the prevention of postoperative complications in routine clinical practice during the third molar extraction. (2) Methods: This study is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The present systematic review aimed to evaluate and systematize the use of antibacterial drugs in order to prevent postoperative complications in outpatient oral surgery for wisdom teeth extraction. We conducted a systematic review using electronic databases such as Medline PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. Considering inclusion and exclusion criteria, we included randomized clinical trials published up to 2021 investigating the antibiotic prescription for third molar extraction. (3) Results: We selected 10 studies after the application of inclusion and exclusion criteria. The results showed that the most widely used antibiotic was amoxicillin both with and without clavulanic acid, in different dosages and duration. There were no statistically significant differences between treatment groups for development of postoperative complications. (4) Conclusions: Based on the analysis of the included studies, penicillin is currently the most widely prescribed group of antibiotics. The widespread use of this antibiotic group can lead to antimicrobial resistance (AMR). Due to increasing prevalence of bacteria resistance to penicillins, clinicians should carefully prescribe these antibiotics and be aware that the widespread use of amoxicillin may do more harm than good for the population. Full article

Introduction: The aim of the present study was to compare the quality of the root canal obturation obtained with two different techniques, i.e., thermoplastic gutta-percha introduced through a carrier (GuttaCore) and fluid gutta-percha (GuttaFlow2). Materials and Methods: The study included 40 permanent single-rooted human teeth, divided into two groups and obturated with Guttaflow (group G) and with GuttaCore (group T). The teeth were fixed and transversely sectioned, they were examined by scanning electron microscopy. The dentin–cement–gutta–percha interface and the percentage of voids produced by the two techniques were statistically analyzed. Results: GuttaCore showed a better filling in the apical third of the canal with a percentage of voids equal to 5%. GuttaFlow showed a lower percentage of voids in the middle and coronal thirds of the canal, 1.6% of coronal voids. Statistical analysis showed a statistically significant difference in the percentage of voids in the two groups (GuttaCore and Guttaflow2) in each portion. Conclusions: GuttaFlow2 seems to flow optimally in the middle and coronal third of the canal, with greater difficulty in filling the apical third. Due to the rigidity of the carrier, GuttaCore is able to reach better the most apical portions of the canals, with greater difficulty in creating the three-dimensional seal at the level of the middle third and coronal third. Full article

Oral squamous cell carcinoma (OSCC) is frequently diagnosed in the advanced stages. The purpose of this paper is to determine the salivary values of SCCA1, SCCA2 and TROP2 in patients with T1N0M0 OSCC and to compare them with the values obtained from healthy individuals. Unstimulated (UWS) and stimulated (SWS) saliva was sampled from 29 patients with T1N0M0 OSCC and 29 sex- and age-matched healthy individuals. Statistical difference was observed in SCCA1 and SCCA2 levels both in UWS and SWS samples. TROP2 was not measurable in most of the salivary samples. Both SCCA1 and SCCA2 could represent potential biomarkers for the early-stage OSCC. Research on a larger sample and biomarker validation is needed to assess the clinical potential of SCCA1 and SCCA2 in the OSCC early diagnostics. Full article

A one-year prospective human intervention study was performed to examine the effects of fermented lingonberry juice (FLJ), used as a mouthwash for six months, on salivary parameters. A total of 25 adult participants used 10 mL of FLJ as mouthwash 30 s daily for 6 months in addition to their normal oral homecare routines. Standard oral examinations and gathering of samples were performed at the beginning of the study and after six months and one year. Resting and stimulated saliva secretion rates, resting saliva pH, and stimulated saliva buffering capacity were determined. A questionnaire of participants’ subjective sensations of mouth dryness was also recorded at each timepoint. Fermented lingonberry juice mouthwash had positive effect to all five salivary parameters and were, according to the omnibus test, statistically significant during the study period. Analysis of the subjective dry mouth sensation questionnaires revealed that symptoms of xerostomia decreased due to the use of FLJ. This study revealed that the once-a-day use of FLJ mouthwash had a beneficial, increasing effect on salivary flow rates, buffering capacity, and salivary pH. FLJ thus can be safely used as an adjunctive and beneficial therapy in oral homecare, protecting teeth and oral mucosa, including periodontium, and also relieving dry mouth symptoms. Full article

The Stockholm Studies are a series of investigations started in 1985 and still ongoing. Out of 105,798 inhabitants, aged 30 and 40 years and living in the greater Stockholm area in Sweden, 3273 subjects were randomly selected. Of them, 1676 were clinically examined focusing on oral health. The subjects were then followed up using national population and health registers in order to study associations between oral health parameters and systemic health outcomes and finally death. The 35 years of observation provides unique possibilities to analyze, for example, how periodontitis links to a number of systemic health issues. The results have consequently provided numerous new associations and confirmed earlier observations on how poor oral health is associated with heart diseases and cancer. Full article

Background: Numerous studies have been conducted to explicate the scope of emotional intelligence in educational success and coping with stress in different academic sectors, but very few have been conducted with dental students. This scoping review aimed to ascertain the role of emotional intelligence in academic performance and stress factors among dental students. Methods: All publications in the English language between 2001 and 2020 were retrieved employing MeSh keywords. Academic resources such as Pubmed, Pubmed Central, EMBASE, Web of Science, EBSCO-Host, Cochrane, PROSPERO, and ARU E-library were comprehensively searched for empirical research. One thousand, three hundred and fifty-nine papers were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards for inclusion and exclusion criteria. These publications were then evaluated further by deleting duplicates, examining full-text articles, and conducting an abstract assessment. This review included a critical appraisal of 24 articles. Results: The narrative analysis method was applied to evaluate the data retrieved from publications regarding EI, academic performance, and stress factors. The review found that EI had a greater impact on the educational success of dental students throughout their clinical years. Moreover, EI may be a key tool in coping with stress and negative emotions. Higher EI scores were shown to be associated with better performance in organizational and leadership abilities, which are important for career advancement. Conclusion: The review suggested including EI training in the dental curriculum. Furthermore, EI should be used as a selection criterion for admission to dental education. Full article

This article aimed to set into perspective the unique aspects of trust within the dentist–patient relationship by exploring the literature as well as historical aspects of dentistry in the association between trust/distrust and patient anxiety. In order to characterise this uniqueness, the assumptions for trusting in dentistry are compared and contrasted with other professions using a conceptual analysis. The professions of medicine, sociology, psychology, nursing and dentistry were check listed according to the tenets of a concept analytical approach reported by Hupcey et al., in 2001. Recommendations for patient/person-centred care, as opposed to dentist-centred care, that would improve trust are specified according to the literature. These include empowering patients, practicing active listening, empathy and relationship building that might benefit dental patients in relation to the perceived risks of anxiety or induced pain. It was concluded that global distrust of dominating dentists must give way to person-centred professional strategies so that dentists and patients can tackle their dental anxiety-trust challenges, both in the public’s image of the dental profession and in clinical relationships. Future directions would be to explore incentives for dentists to change to patient/person-centred care. Full article

Mouthguards (MG) are protective devices that can reduce the risks of facial trauma. However, many athletes do not use them. Additionally, MG wear with coincidental parafunctional activity has not been considered. The aim of this study was to evaluate the stress distribution as a consequence of a direct impact comparing a conventional MG with a novel hybrid appliance (HMG). Using computer-aided design (CAD) software, a human skull was modeled with the teeth inserted into their respective alveolus. The models were divided according to the MG type (conventional or hybrid). The geometries were exported to the computer-aided engineering (CAE) software and the materials were considered isotropic. Fixation was defined at the base of the maxilla. The load was applied using a hockey puck. The total deformation (mm) and the von Mises stress (MPa) results were obtained for the MGs (conventional and hybrid), upper teeth, lower teeth, and maxillary bone. Despite the presence of an MG, it is still possible to observe generated stress in all structures. However, the hybrid design was more efficient than the conventional design in reducing the displacement during the impact and consequently the stress on the upper teeth, lower teeth, and maxillary bone. Higher stress magnitude was more concentrated at the inner portion of the hybrid design than the conventional device. The HMG appliance decreased the stress concentration in the teeth and in the bone, limiting the areas susceptible to injuries to the regions directly impacted by the hockey puck. Although the novel HMG may mitigate injury, some stress will still result, and any possible injury should be evaluated by a dental professional. Full article

Background: Molar incisor hypomineralization (MIH) is the presentation of an enamel defect, where incisors and one (or more) molars are affected. Identifying MIH is significant in restoring its visual defect and avoiding pain or other consequences of this condition. The present cross-sectional study aimed to evaluate the awareness, ability, and confidence in identifying MIH among postgraduate residents in the state of Nevada. Methods: This cross-sectional study was conducted among postdoctoral dental residents at the School of Dental Medicine, University of Nevada, Las Vegas. This cross-sectional study used images of cases of MIH and a survey to collect the data. The survey included demographics, educational background, and basic knowledge of MIH. Results: The response rate to the invitation to participate was 91%. The confidence in identifying MIH was 100%, 50%, and 33.3% for pediatric, orthodontic, and general practice residency (GPR). A total of 70% were aware of this anomaly from their predoctoral dental education and indicated the need for further related education. There was 33% confusion with fluorosis and 16.6% with amelogenesis imperfecta. A total of 66.6% of the participants indicated that they require further education relating to MIH. Conclusion: Within the limitations of the present investigation, MIH awareness among the investigated groups varied but was highest amongst the pediatric residents. Full article

Evidence on periodontal education areas in which students have difficulties and their factors are limited. In this study, third- and fourth-year dental students’ knowledge was assessed as well as their confidence and ability in five periodontal educational areas using a mixed-method approach. A survey was used to collect data related to history-taking, medical examination, diagnosis, treatment planning, and follow-up. Student answers were compared to the consensual answers of an expert panel using the cosine-similarity index (CSI). Descriptive statistics assessed confidence and ability for diagnosis. Semi-structured individual interviews were used to collect data on reported reasons for difficulties in periodontal education. A content analysis was employed to analyze the interview data. Eighteen third- and fourth-year dental students completed the survey and eleven were interviewed. Students’ knowledge was adequate regarding diagnosis and treatment planning. Third-year students’ median CSI were 0.93 and 0.89, respectively. Fourth-year students’ median CSI were 0.9 and 0.93, respectively. Students felt confident in history-taking and examination but lacked confidence and ability in diagnosis and treatment planning. Reported reasons for difficulties in periodontal education were linked to both preclinical and clinical pedagogical issues. Further improvements in preclinical and clinical periodontal education are needed to address students’ lack of knowledge, confidence, and skills in key periodontal areas. Full article

Objective: The purpose of this study was to investigate the volumetric stability around immediate implants, in which a 360-degree socket-shield was retained using the CastleWall Surgical Technique (CWST). Material and methods: This retrospective study examined the results of the CWST used for 25 consecutive patients, involving 31 immediate implants. Silicone impressions taken prior to extraction, and at a review appointment were converted to STL files and compared. The median follow-up time was 14.2 ± 5.5 months. Volumetric changes and gingival recession on both buccal and lingual sites were measured. Papillary height changes were also evaluated from available photographs taken before and after treatment. Patients in the study completed a Visual Analogue Scale (VAS) for evaluation of post-operative discomfort and overall satisfaction with this procedure. Results: All implants integrated successfully without complications. Mean loss of buccal and lingual tissue was 0.30 ± 0.32 mm and 0.17 ± 0.27 mm, respectively. Mean recession at the mid-buccal and mid-lingual gingival margin was 0.66 ± 0.64 mm and 0.87 ± 0.84 mm, respectively. Mean recession of the mesial and distal papilla was 0.26 ± 0.55 mm and 0.29 ± 0.52 mm, respectively. Patients reported 97.74 ± 5.60% satisfaction with this procedure using the Visual Analogue Scale (VAS), with minimal post-operative discomfort. Conclusions: The results of this study showed excellent soft tissue stability and aesthetics were achieved using the CWST, with minimal postoperative pain. The other main advantage of retaining a 360-degree socket-shield, is there is more available surface area to lock the implant to the shield to prevent shield migration over time. Full article

Background: It has been reported that dyslipidemia prevalence and cardiovascular disease risk were increased in subjects with oral lichen planus diagnose. On the other hand, so far, there is no available data on the topic of cardiovascular risk (CVR) in subjects with oral lichen planus (OLP). The main aim of this study, due to lack of any other study covering this topic, was to investigate lipid profile and assess CVR in patients with OLP. Materials and Methods: To create a routine lipid profile, we collected triglyceride serum levels, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol from 63 OLP patients and 63 healthy people representing control subjects. For every patient their individual cardiovascular risk was measured. Results: In comparison with the tested control subjects, patients with OLP had all parameters of the lipid profile elevated, with no differences of statistical importance. Furthermore, the experimental (OLP) and control groups shared similar mean values of the lipid profile parameters. Conclusions: The association of OLP with cardiovascular risk was not established and further studies with more subjects involved are required to validate this connection. Full article

Purpose: The COVID-19 pandemic altered the methodologies of dental education delivery, resulting in both immediate and more enduring changes. To assess student perceptions of learning effectiveness, graduating dental students from the class of 2020 were surveyed to identify student comfort with technology and content retention, individual motivation and mental focus, and access to resources pertaining to an abrupt transition to a virtual learning didactic seminar approach in March 2020. Methods: a voluntary, 18-question electronic survey was distributed to fourth-year dental students prior to graduation to assess perceptions of learning outcomes and preferences of a virtual seminar format relative to previous in-person didactic seminars experienced. Results: 34 of 80 dental students (42.5%) completed the electronic survey. Comfort and retention of concepts through virtual learning were reported ≥ by 91% and 85% of the respondents, respectively. Increased distractions and multitasking were reported with virtual learning in 56% and 71%, respectively. Desires to have all teaching conducted through virtual learning platforms was reported at 21%. Conclusions: the positive student responses obtained when comparing virtual to in-person seminars in the survey assessment demonstrates the long-term potential for such delivery modalities to be intentionally incorporated into an evolving predoctoral curriculum in a hybrid nature. Full article

This study aimed to evaluate the influence of needle design and irrigant flow rate on the removal of Enterococcus faecalis mature biofilms during sodium hypochlorite irrigation. Forty-eight single-rooted human teeth were instrumented (ProTaper F3), autoclaved and inoculated with Enterococcus faecalis to establish a two-week-old biofilm. E. faecalis biofilms were treated with Sodium hypochlorite that was injected in the root canals using three types of needles (NaviTip, ProRinse, IrriFlex). For the IrriFlex needle, one, two, or four bars of pressure was applied to the irrigating solution to increase flow rates. Bacteria were labeled with the LIVE/DEAD BacLight Bacterial Viability kit, and viability was assessed by flow cytometry (FCM). Results were statistically analyzed using one-way ANOVA and Tukey multiple comparison intervals (α = 0.05). Bacterial viability was significantly reduced after sodium hypochlorite passive irrigation but the number of viable bacteria retrieved from root canal specimens irrigated with the Pro-Rinse needle was significantly higher compared to NaviTip and IrriFlex needles (p < 0.05). When the irrigant flow rate was increased, the viability of bacterial biofilms was significantly reduced compared to passive irrigation using the IrriFlex needle (p < 0.05). Applying higher flow rates during irrigation using the IrriFlex needle did not further reduce bacterial viability. Full article

Background: After tooth extraction, the alveolar bone loses volume in height and width over time, meaning that reconstructive procedures may be necessary to perform implant placement. In the maxilla, to increase the bone volume, a mini-invasive surgery, such as a sinus lift using the crestal approach, could be performed. Methods: A crestal approach was used in this study to perform the sinus lift, fracturing the bone and inserting collagen (Condress^®). The single dental implant was placed in the healed bone after six months. Results: The newly formed bone was histologically analyzed after healing. Histomorphological analyses confirmed the quality of the new bone formation even without graft biomaterials. This is probably due to the enlargement of the space, meaning more vascularization and stabilization of the coagulum. Conclusion: Using just collagen could be sufficient to induce proper new bone formation in particular clinical situations, with a minimally invasive surgery to perform a sinus lift. Full article

Dental student training in clinical communication skills and behavioral aspects of treatment are lauded as clinically meaningful in the dental education literature. However, many dental school curricula still only provide didactic, one-time coursework with multiple choice examination assessment and little or no student skill-activating activities. This article aims to review literature relevant to optimizing clinical communication and behavioral skills in dental education. The review summarizes findings of several relevant reviews and usable models to focus on four themes: (1) special characteristics of dentistry relevant to communication skill needs, (2) essential components of dental student learning of communications skills, (3) clinical consultation guides or styles and (4) optimal curricular structure for communication learning effectiveness. Contexts of communications in the dental chair differ from medical and other allied health professions, given the current mostly dentist-dominant and patient-passive relationships. Patient-centered communication should be trained. Dental students need more practical learning in active listening and patient-centered skills including using role-play, videotaping and ultimately, real patient training. Medical consultation guides are often unwieldy and impractical in many dental contexts, so a shortened guide is proposed. Communication skills need to be learned and taught with the same rigor as other core dental skills over the entire course of the dental curriculum. Full article

The aim of the study was to determine the prevalence of moderate to severe periodontitis in 18–19th century skulls in the St Bride’s Lower Churchyard in London, UK. Materials and methods: A total of 105 adult skulls (66 M: F 39) from the Museum of London collection were examined for evidence of dental disease. The primary method was to measure the presence of moderate to severe periodontitis. Other dental pathologies were recorded such as tooth wear, calculus, and caries. Results: Overall, the prevalence of moderate to severe periodontitis in the sample was 21–24%. Males were observed to be more susceptible to periodontal disease than females. The severity of bone loss in the skull collection also increased with age. There was no significant difference in the amount of calculus deposition when comparing either age or sex. A total of 14% of the individuals in the sample showed signs of smoking. Conclusion: The results of the study indicated that the prevalence of moderate to severe periodontitis in an 18–19th century skull sample was 21–24%, which was higher than in previous studies. This may be due to the lack of basic personal mouth care and professional dental treatment as well as known risk factors such as smoking, stress, low socioeconomic status, and malnutrition. Full article

The objective was to compare marginal defects and evaluate discoloration for adhesively cemented veneers in vitro when using two cement removal techniques. Twenty premolars were prepared with chamfer and borders in enamel. IPS e.max CAD veneers were cemented using Panavia V5 and divided in two groups (n = 10): cement excess removed with a probe after tack-curing for 3–5 s, or cement excess removed with a brush, then completely polymerized. All teeth were stored in alginate gel until micro-CT examination. Scanning was performed twice: directly after cementation and after thermocycling (5000 cycles, between 5 and 55 °C). To analyze discoloration, teeth were colored using 0.5% basic fuchsine and examined under a stereomicroscope. Depth of dye infiltration was scored 0 (no discoloration) to 5 (discoloration along the entire margin). Statistically significant differences of cement defects before thermocycling were reported, where brushing showed more defects than probing (p = 0.0161). After thermocycling, the defects increased for both groups. Extensive discoloration was the most common (55.56%) when removing excess by probing; by brushing, 90% of the specimens exhibited slight discoloration (p = 0.008). Regression analysis showed no relationship between type of defect and degree of discoloration. Removing cement with a brush causes more marginal defects, however less discoloration after thermocycling. Full article

Introduction: Human papillomavirus (HPV) encompasses a large family of oncogenic viruses responsible for increasing rates of both cervical and oral cancer, particularly among minority and low-income populations. Although this represents an increasingly significant public health risk, few studies have screened for oral HPV within Nevada. Based upon this information, the primary objective of this study was to provide a temporal analysis of oral HPV screening among a primarily low-income, minority patient population. Methods: This retrospective analysis was reviewed and approved by the Institutional Review Board (IRB). In brief, unstimulated saliva samples were previously obtained from clinical patient volunteers who provided informed consent and pediatric assent (if applicable). DNA was isolated and screened using spectrophotometry for quality (A260:A280 ratio > 1.70) and quantity (concentration > 100 ng). Validated qPCR primers were used to screen repository samples for high-risk HPV strains HPV16 and HPV18. Results: A total of N = 930 samples were identified for this study, which involved n = 555 samples from adults and n = 375 from pediatric patients treated between 2011 and 2019. A demographic analysis revealed nearly equal distribution between males and females with most derived from non-White (minority) patients. A qPCR screening revealed an overall increase in high-risk HPV of 3.17-fold from 5.7% in 2011 to 18.1% in 2019 and a coefficient of determination or R² = 0.764, suggesting a strong, positive correlation between more recent sample years and HPV-positive results, which was observed among both pediatric (R² = 0.671) and adult (R² = 0.971) patients. In addition, although the average age among adult patients increased over time, a significant decrease was observed among pediatric patients from an average of 16.0 years to 14.81 years. Conclusions: These data suggest temporal changes and positive increases in the prevalence of oral HPV among both the pediatric and adult patient samples taken from this clinic population. These data are important as considerations are made regarding which HPV vaccination education and awareness programs are introduced and the specific populations most likely to benefit from these interventions. Full article

This study assessed the longitudinal impact of early preventive dental visits on the number of dental operative procedures in a prevention-oriented pediatric dental practice. Inclusion criteria consisted of patients zero to four years of age with at least two years of preventive services provided by the practice. Early preventive visits were the intervention and dental operative procedures were the assessed outcome. The goal was to determine if preventive visits at an early age decreased the number of operative procedures needed by the patient. The patients were divided into two groups: those with older siblings in the practice and those without older siblings in the practice. A secondary outcome was to compare these two patient groups to determine if a child who had older siblings previously treated in this preventive practice had better outcomes than those without siblings in the practice. ANCOVA tests were used to compare the average number of operative procedures in two age groups (<2 years and ≥2 years), and for those with and without dental insurance, in addition to children being younger sibling versus children without sibling, adjusting for the effect of covariates. The study sample consisted of 363 pediatric patients. Patients’ age at first visit ranged from 0 to 4 years old (mean = 2.13; SD = 1.15). The average number of operative procedures per year increased as the age at first visit increased (p < 0.05). The average number of operative procedures in two age groups (<2 years and ≥2 years) differed (p < 0.05) with those whose age at first visit ≥2 years experiencing more dental operative procedures than the younger group. The average number of operative procedures was similar between younger siblings (mean = 1.91; SD = 7.44) and children without siblings (mean = 1.54; SD = 2.1) (p > 0.05). The difference in the average number of operative procedures in children with insurance (mean = 1.59; SD = 5.25) and children without insurance (mean = 1.58; SD = 2.38) was non-significant (p > 0.05). More dental cleaning examinations were associated with fewer dental operative procedures (p < 0.05). These findings demonstrate that dental examinations before two years of age and more dental cleaning examinations lead to a decrease in the number of dental operative procedures needed by children. Full article

Cantilevers generate statically determined force systems. The frontal segment loading with symmetric and asymmetric cantilevers in a three-piece intrusion base arch can be used to correct midline asymmetry. Three types of 0.017″ × 0.025″ beta-titanium cantilevers: tip-back (TB), deep curve (DC), utility arch (UA) were tested on typodonts simulating intrusion of the maxillary anterior segment. Typodonts with symmetric and asymmetric cantilevers were scanned with intraoral scanner (3Shape, TRIOS, Copenhagen, Denmark) before (T0) and after (T1) the experiment, scans were superimposed using Mimics software (Materialise, Leuven, Belgium). Data were analysed with qualitative analysis. All cantilevers generated vertical and horizontal forces. For symmetric design, the DC and TB displayed intrusive force with retrusive component, UA intrusion and protrusion. The asymmetric cantilevers produced transverse displacement of anterior segment. DC created lateral, UA medial force, the anterior segment displacement was consistent with the used configuration. The movement of an anterior segment with TB is smaller compared to DC and UA. Symmetric cantilevers configurations can achieve simultaneous intrusion and retrusion or protrusion of the anterior segment. The asymmetric design with transversal force can clinically aid the correction of midline discrepancies. The effect of the cantilever configuration on delivered force direction was confirmed. Full article

The incidence of tooth wear has steadily increased in all Western populations during the past decades. A through-care strategy, extendable for a lifetime, has become crucial to prevent the extensive loss of sound dental structure and to make an eventual retreatment affordable in the long term. An interceptive treatment using resin composite materials and no-preparation approaches meets these requirements. Moreover, continual developments in digital dentistry makes possible to predict the treatment plan for the restorative rehabilitation of the mouth. The availability of digital resources allows clinicians to increase predictability for excellent esthetics and good functional results. This article provides a step-by-step description of a full-mouth additive rehabilitation achieved by employing digital workflows and direct resin composite restorations. A comprehensive functional and esthetic evaluation of the treatment is proposed and discussed. Full article

Age estimation in children is fundamental in both clinical and forensic fields. The aim of this study was to evaluate the accuracy of the Cameriere’s European and Italian formulae for age estimation in Sardinian children and adolescents, a genetically isolated population. A sample of 202 orthopantomograms of healthy Sardinian children and adolescents (100 females and 102 males) aged between 6 and 17 years was retrospectively evaluated. The seven left mandibular teeth were assessed with the Cameriere’s European and Italian formulae. The teeth with closed apex (N0) were counted and, in the teeth with open apex, the distance between the inner sides was calculated. All variables showed a significant and negative correlation with age except N0 and g. Sex (g), the variables s, N0, and the first-order interaction between them, contributed substantially to the age measurement (p < 0.001). Although the value of x5 had a low prediction level, it generated the following multiple linear regression formula, specific for the Sardinian sample: Age = 10.372 + 0.469 g + 0.810 N0 − 1.079 s − 0.398 s ∙ N0 − 0.326 × 5. Only the Sardinian and European formulae allowed to obtain an acceptable interclass agreement (both the lower and upper >0.7). The results showed that the European formula could be accurate for assessing age in this sample of children and adolescents. Full article