Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia

Innovative Damage Assessment of Endodontic Instruments Based on Digital Image Stacking

BACKGROUND/OBJECTIVES

The damage assessment of dental instruments, such as endodontic files, is crucial to ensure patient safety and treatment quality. Conventional scanning electron microscopy (SEM) has been the gold standard for this purpose; however, its limited accessibility and complex sample preparation protocols hinder its routine use in clinical settings. This study proposes a novel system that leverages digital photography and advanced image processing techniques as a viable alternative to SEM.

METHODS

Our system accurately detects early instrument damage by capitalizing on the high resolution of digital images. Its exceptionally user-friendly interface, portability, and key features make it highly suitable for daily clinical practice.

RESULTS

Our findings suggest that the proposed system provides image quality comparable to SEM.

CONCLUSIONS

Image stacking provides a practical, efficient, and objective method for assessing endodontic instruments' morphology. By detecting early damage, this system significantly improves the safety and quality of endodontic procedures, especially for reusable NiTi files, instilling confidence and security in its use. It offers a cost-effective and user-friendly alternative to traditional methods such as visual inspection and SEM, making it a comfortable and confident choice for both research and clinical settings.

Clinicians' perspectives, inducements, preferences, and clinical experiences regarding the use of electronic apex locator and apex locator integrated engine-driven instrumentation: a cross-sectional study

BACKGROUND

This study aimed to investigate the perspectives, preferences, and clinical experiences regarding using electronic apex locator and apex locator integrated instrumentation of dentists and endodontists.

METHODS

A web-based questionnaire consisting of 3 parts and 23 closed-ended questions to achieve the objective of the study was carried out in ethical conditions between August and October 2023. The first part of survey included demographic information, while the second part was about evaluating electronic apex locator usage. In the last part, only participants' use of apex locator-integrated instrumentation was evaluated. Data were analyzed at a significance level of p < 0.05.

RESULTS

A total of 297 clinicians, including 59 endodontists and 34 endodontic residents/Ph.D. students participated in the questionnaire. Endodontists and endodontic residents/Ph.D. students perform statistically significantly more root canal treatments per week on average (p = 0.001). For the working length determination method (multiple option question), 78.5% of participants use an electronic apex locator and 39.7% apex locator-integrated engines. However, the preference rate for electronic apex determination technique was generally 95.6%, with the full rate confirmation of endodontists and endodontic residents/Ph.D. students (100%). A total of 21 endodontists out of 59 prefer apex locator integrated engine-driven instrumentation. Although many of these specialized clinicians use this technique, they stated that they measure electronic working length passively for confirmation of the working length before (90.5%) and after the preparation (66.7%).

CONCLUSIONS

Dentists, as well as endodontists, are skeptical about apex locator-integrated engine-driven instrumentation. Using this technique as a supporter rather than a primary way for preparation within safe limits may give safer results in terms of treatment outcomes.

Exploring the Most Effective Apical Seal for Contemporary Bioceramic and Conventional Endodontic Sealers Using Three Obturation Techniques

Background and Objective: Despite a plethora of studies conducted to date, researchers continue to investigate the best sealer and obturation technique combinations. The aim of this study is to compare the apical seal provided by two bioceramic sealers (Endoseal and Endosequence) with that provided by a calcium hydroxide sealer (Sealapex), and to evaluate the effect of different obturation techniques (cold lateral condensation, continuous wave compaction and single cone) on the apical seal under a stereomicroscope. Materials and Methods: A total of 110 single-rooted mandibular premolar teeth were decoronated, cleaned and shaped using the Endosequence filing system to tip size 30/0.04 taper. Canals were irrigated with 5.25% NaOCl and 17% EDTA. The samples were randomly divided into 11 groups (9 experimental and 2 control groups) according to the designated sealer and technique. Samples were stored in an incubator for 7 days at 37 °C under 100% humidity. Samples were coated with nail varnish except for apical 2 mm and vertically placed in 0.2% rhodamine B dye solution for 48 h. Samples were split longitudinally and viewed under a stereomicroscope at 40× magnification. Results: Insignificant results were obtained between obturation techniques (p = 0.499) whereas statistically significant results were attained based on the type of endodontic sealer (p < 0.001). The overall lowest mean apical microleakage and best sealing ability was demonstrated by Sealapex (2.59 ± 1.20 mm) and amongst techniques by continuous wave compaction (3.90 ± 2.51 mm). Conclusions: Endosequence produced the best apical seal with the continuous wave compaction technique, whereas Endoseal did so with the bioceramic-coated single-cone technique. For the Sealapex sealer, the most effective apical seal was observed using cold lateral condensation. The quality and effectiveness of apical seal differed with the type of endodontic sealer and obturation technique used, and vice versa.

Online Questionnaire-Based Study to Evaluate the Attitudes and Use of Rubber Dental Dams by Saudi Dental Practitioners

BACKGROUND A dental dam is a protective sheet with an aperture and is used to prevent the spread of infection during dental procedures. This study aimed to use a 2-part online questionnaire to evaluate the attitudes and use of rubber dental dams by 300 Saudi dental interns, general dental practitioners, residents, specialists, and consultants in prosthodontics, endodontics, and restorative dentistry. MATERIAL AND METHODS The 17-item validated questionnaire consisted of 5 questions on demographics, 2 on knowledge, 6 on attitudes, and 4 on perceptions. It was distributed through Google Forms. The chi-square test was used to determine the associations between the study variables and perception questions. RESULTS A total of 41.67% participants were specialists/consultants, among which 59.2% were in the prosthodontics specialty, 12.8% in endodontics, and 28% in restorative dentistry. Most participants (84.67%) stated the necessity of using rubber dams during post and core procedures. A total of 53.67% had received enough training for using rubber dams during their undergraduate/residency education. The majority of participants (41%) also preferred using rubber dams during the prefabricated post and core procedures, and 28.33% stated that the remaining tooth structure was one of the major reasons for not using rubber dams during the post and core procedures. CONCLUSIONS Workshops and hands-on training should be conducted among dental graduates to instill a positive attitude regarding the use of rubber dams.