Konstantinos Ioannidis

Dental restorative resins available today still have limitations that may affect their durability. This study explores reinforcing a universal microhybrid dental composite resin with organomodified nanoclay at low filler loadings (0, 0.5, 1, 3, and 5 wt%). The morphology, structural features, and light transmittance of the composites were analyzed using scanning electron microscopy (SEM), X-ray diffraction (XRD), attenuated total reflection–Fourier transform infrared (ATR–FTIR), and UV–Vis spectroscopy. The degree of conversion and polymerization shrinkage were measured with ATR–FTIR and a linear variable displacement transducer (LVDT). Water sorption and solubility parameters and flexural properties were assessed gravimetrically and with a dynamometer, respectively. The composites mainly showed exfoliated structures and an improved degree of conversion. Polymerization shrinkage and solubility were lower than those of unmodified dental resin. The highest degree of conversion was observed in composites with 0.5–1 wt% nanoclay. The incorporation of 1 wt% nanoclay resulted in the lowest shrinkage and sorption, along with the highest flexural modulus and strength. Overall, the results suggest that low nanoclay concentrations can improve the physicochemical and mechanical properties of dental composites, highlighting their potential to develop advanced restorative materials that can address current clinical challenges.

Background/Objectives: Pre-eruptive intracoronal resorption (PEIR) in impacted or unerupted teeth often remains undiagnosed. The aim of this study was to investigate the prevalence of PEIR with the aid of cone beam computed tomography (CBCT) and propose a new three-dimensional (3D) classification for the analysis of the lesions. Methods: A total of 164 unerupted teeth diagnosed in CBCT scans, derived from an equivalent number of patients, were examined for the presence of PEIR, tooth type, angulation and position. A novel 3D classification system was proposed and all PEIR lesions were further classified. The classification system was used to stage PEIR lesions according to their extend from the enamel level apically, the circumferential spread and their proximity to the pulp chamber. Descriptive statistics were used to assess the prevalence and type of resorption. The association between PEIR, demographics, tooth type, position and angulation were studied. The estimation of the multivariate relationship between PEIR, patient’s demographics and tooth characteristics was conducted with the multiple binary logistic regression model. Results: The prevalence of PEIR was 33.5%, affecting mostly maxillary canines, and maxillary and mandibular molars. The prevalence of PEIR in ages over 45 years was significantly higher (p < 0.001). The presence of PEIR was significantly associated with buccal position (p = 0.002) and buccal angulation (p = 0.016) of the tooth. Conclusions: Due to the high prevalence of PEIR, CBCT may improve detection and 3D characterization when imaging is already clinically indicated, and influence treatment planning in selected cases.

Parastyle is a rare dental morphological trait characterised by an accessory cusp or tubercle, often found unilaterally on the buccal surface of the mesiobuccal cusp, mainly in the second and third maxillary molars. Its size may range from a small enamel pit to an independent, well‐developed cusp. When clinically present, parastyle may cause complications such as dental caries and sensitivity, localised periodontal disease and occlusal interference. This uncommon anatomical feature may further predispose to diagnostic and treatment challenges when pulp and periapical disease are established. In this case report, a rare second maxillary molar with a parastyle was diagnosed with pulp necrosis and apical periodontitis. Cone‐beam computed tomography was pivotal in addressing the anatomical complexity of the internal root and root canal morphology, particularly regarding the pulp space and the location of the root canal orifices beneath the parastyle. With regard to the efficiency of endodontic management, emphasis was placed on the diagnostic and anatomical challenges posed by such unusual and complex features, as well as on the need for an advanced disinfection regimen. This was addressed with magnification, modern endodontic instrumentation, irrigation and activation techniques, the use of interappointment dressing and root filling with gutta‐percha and a calcium silicate sealer. After 24 months, radiographic follow‐up confirmed a reduction in the size of the periapical lesion, and the tooth was asymptomatic and functional.

Background/Objectives: Pre-eruptive intracoronal resorption (PEIR) in impacted or un-erupted teeth often remains un-diagnosed. The aim of this study was to investigate the prevalence of PEIR with the aid of cone-beam computed tomography (CBCT) and propose a new three-dimensional (3-D) classification for the analysis of the lesions. Methods: A total of 164 CBCT of non erupted teeth scans were examined for the presence of PEIR, tooth type, angulation and position. A novel 3-D classification system was proposed and all PEIR lesions were further classified. The classification system was used to stage PEIR lesions, according to their extend from the enamel level apically, the circumferential spread and their proximity to the pulp chamber. Descriptive statistics were used to assess the prevalence and type of resorption. The association between PEIR, demographics, tooth type, position and angulation were studied. The estimation of the multivariate relationship between PEIR, patient’s demographics and tooth characteristics was conducted with the multiple binary logistic regression model. Results: The prevalence of PEIR was 33.5%, affecting mostly maxillary canines, maxillary and mandibular molars. The prevalence of PEIR in ages over 45 years was significantly high (p < 0.001). The presence of PEIR was significantly associated with buccal position (p=0.002) and buccal angulation (p=0.016) of the tooth. Conclusions: Due to the high prevalence of PEIR, CBCT is essential for baseline recording and monitoring of the lesions. The 3-D classification index enables the early detection of PEIR and may critically affect decision-making in restorative, orthodontic and surgical treatment planning.