1
|
El Hadidi YN, Taha AMA, El Sadat SMA, Saber SM. Anatomical Analysis of Inferior Alveolar Nerve Relation to Mandibular Posterior Teeth Using Cone Beam Computed Tomography: A Retrospective Radiographic Analysis Study. J Maxillofac Oral Surg 2024; 23:7-13. [PMID: 38312962 PMCID: PMC10831020 DOI: 10.1007/s12663-022-01792-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/08/2022] [Indexed: 10/14/2022] Open
Abstract
Introduction Cone beam computed tomography (CBCT) is reliable in the assessment of structures related to teeth. The assessment of the inferior alveolar neurovascular (IAN) bundle location using CBCT is considered one of its prime uses in different mandibular surgeries. Methodology Retrospective CBCT data of patients presented to the institute were assessed to measure relations of IAN. Measurements were taken to assess the bone thickness adjacent to IAN, the superior-inferior dimension between the canal and the teeth, and the dimension between the canal and the inferior border of the mandible. Results Out of the 170 patients the root apices nearest to the IAN were that of the second molars (1.76 ± 1.86 mm). The IAN was closest to the inferior border of the mandible at the roots of the second molars (8 ± 3.4 mm). The buccal bone thickness had its greater dimension buccal to the IAN at the area of the second molar (5.16 ± 1.26 mm). Conclusion Two mini-plates in trauma do not increase the risk of injury. It is advisable in apicectomy not to extend 1.5 mm apically. The thickness of the nerve-lateralization window should not exceed 2 mm. In body osteotomy procedure, perform surgery anterior to premolars as much as possible.
Collapse
|
2
|
Abdelfattah RA, Nawar NN, Kataia EM, Saber SM. How loss of tooth structure impacts the biomechanical behavior of a single-rooted maxillary premolar: FEA. Odontology 2024; 112:279-286. [PMID: 37394683 PMCID: PMC10776703 DOI: 10.1007/s10266-023-00829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
To evaluate the influence of the loss of coronal and radicular tooth structure on the biomechanical behavior and fatigue life of an endodontically treated maxillary premolar with confluent root canals using finite element analysis (FEA). An extracted maxillary second premolar was scanned to produce intact (IT) 3D model. Models were designed with an occlusal conservative access cavity (CAC) with different coronal defects; mesial defect (MO CAC), occlusal, mesial and distal defect (MOD CAC), and 2 different root canal preparations (30/.04, and 40/.04) producing 6 experimental models. FEA was used to study each model. A simulation of cycling loading of 50N was applied occlusally to stimulate the normal masticatory force. Number of cycles till failure (NCF) was used to compare strength of different models and stress distribution patterns via von Mises (vM) and maximum principal stress (MPS). The IT model survived 1.5 × 1010 cycles before failure, the CAC-30.04 had the longest survival of 1.59 × 109, while the MOD CAC-40.04 had the shortest survival of 8.35 × 107 cycles till failure. vM stress analysis showed that stress magnitudes were impacted by the progressive loss of coronal tooth structure rather than the radicular structure. MPS analysis showed that significant loss of coronal tooth structure translates into more tensile stresses. Given the limited size of maxillary premolars, marginal ridges have a critical role in the biomechanical behavior of the tooth. Access cavity preparation has a much bigger impact than radicular preparation on their strength and life span.
Collapse
Affiliation(s)
- Roaa Abdelwahab Abdelfattah
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt.
| | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt
| | - Engy M Kataia
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt
- Department of Endodontics, Ain Shams University, Cairo, Egypt
- Centre for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, 11837, Egypt
| |
Collapse
|
3
|
Galal DY, Nawar NN, Abou El Seoud M, Saber SM, Kim HC. Options for Access Cavity Designs of Mandibular Incisors: Mechanical Aspects from Finite Element Study. J Endod 2023; 49:1706-1712. [PMID: 37802135 DOI: 10.1016/j.joen.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/14/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION This study investigated different access cavity designs of mandibular anteriors in terms of their effect on the biomechanical behavior and longevity using finite element analysis (FEA). METHODS A 3-dimensional model of a mandibular incisor was created for FEA. After validating the intact tooth (IT) model, 4 experimental models were developed (traditional lingual access cavity [TLA], facial access cavity [FAC], incisal access cavity [ICA], and cervical access cavity [CVA]). Cyclic loading was simulated, and the number of cycles until failure (NCF) was compared to the IT model. Stress distribution patterns, maximum von Mises stresses (vMSs), and maximum principal stresses (MPSs) were analyzed mathematically. The safety factor was also calculated and demonstrated. RESULTS The maximum vMS registered on the IT model was 134.16 MPa. The FCA and the CVA provided the highest NCF (193.7% compared with the IT model) followed by ICA (58.2%) and TLA (21.4%). The vM and MPS analysis revealed that the lingual surface is a primary stress channel, and the presence of an access cavity significantly weakens the tooth structure. Although the maximum vMS registered for the IT model was 134.16 MPa, the maximum vMS was 73.97 MPa for both the FCA and the CVA, 152.27 MPa for the ICA, and 173.63 MPa for the TLA. CONCLUSIONS The facial and cervical access cavity designs provided considerable reinforcement to the endodontically treated mandibular incisors. With advancements in esthetic restorative materials and endodontic instruments, facial access design could emerge as the new standard for access cavity preparation in mandibular incisors.
Collapse
Affiliation(s)
- Dina Yehia Galal
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Mohammed Abou El Seoud
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt; Center for Innovative Dental Sciences, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
| |
Collapse
|
4
|
Nawar NN, Elkholy MMA, Ha WN, Bürklein S, Saber SM. Parallel endodontic education via social media: An exploratory survey study. AUST ENDOD J 2023; 49:512-523. [PMID: 37439393 DOI: 10.1111/aej.12773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/13/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
There is insufficient research to evaluate social media's influence on endodontic education. Therefore, this study assessed the percentage of students utilising Facebook in their education and the factors influencing their engagement. A survey was conducted on dental students, interns and dentists undertaking specialist programmes. Categorical data were analysed using Fisher's Exact test and multiple pairwise comparisons. The significance level was set at p < 0.05. Responses were received from 801 participants, with 98.4% using Facebook for endodontic knowledge. Although most students knew that scientific evidence is not always provided, they still deemed such information valuable as it was a practical demonstration of clinical cases. Most students turn to Facebook for endodontic education to compensate for the gap between their academic education and clinical practice. The utilisation of social media for education can be a concerning phenomenon and should not be ignored by academic institutes.
Collapse
Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, The British University in Egypt, Cairo, Egypt
| | | | - William Nguyen Ha
- Department of Endodontics, Sydney Dental School, University of Sydney, Sydney, New South Wales, Australia
| | - Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | | |
Collapse
|
5
|
Nawar NN, Abdelfattah RA, Kataia M, Saber SM, Kataia EM, Kim HC. Effect of Proximal Caries-driven Access on the Biomechanical Behavior of Endodontically Treated Maxillary Premolars. J Endod 2023; 49:1337-1343. [PMID: 37517584 DOI: 10.1016/j.joen.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION This study investigated the effects from the carious cavity and access from it on the fracture resistance of endodontically treated maxillary premolars using finite element analysis (FEA). METHODS A maxillary premolar was used to compare 3 types of access cavity related to having a proximal carious defect: caries-driven access (CDA), conservative access that has a mesial component (MCA), as well as traditional access with the same mesial component (MTA). Cyclic loading was simulated on the occlusal surface, and number of cycles until failure (NCF) was compared with the intact tooth model (IT). Mathematical analysis was done to evaluate the stress distribution patterns and calculated maximum von Mises (vM) and maximum principal stresses (MPS), with emphasis on pericervical region as a specific area of interest. RESULTS Maximum vM registered on the IT was 6.14 MPa. CDA provided the highest NCF with 92.28% of the IT, followed by MCA (84.90%) and MTA (83.79%). The vM and MPS analysis showed that the stress values and patterns are affected more by the proximity of the occlusal load to the tooth/restoration interface. Concerning the pericervical region, maximum vM was registered for IT (4.11 MPa), followed by CDA (4.85 MPa) and then MCA (8.13 MPa) and MTA (8.61 MPa), whereas the MPS analysis revealed that CDA showed the highest magnitude of tensile stresses. CONCLUSIONS A proximal CDA benefits the mechanical properties of maxillary premolars; however, its impact on the biological aspect should be assessed to provide a ruling for/against it.
Collapse
Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | | | - Mohamed Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Center for Innovative Dental Sciences (CIDS), Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt
| | - Engy Medhat Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Restorative and Dental Materials Department, National Research Centre, Doki, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
| |
Collapse
|
6
|
Saber SM, Elashiry MM, Sadat SMAE, Nawar NN. A microcomputed tomographic analysis of the morphological variabilities and incidence of extra canals in mandibular first molar teeth in an Egyptian subpopulation. Sci Rep 2023; 13:8985. [PMID: 37268728 DOI: 10.1038/s41598-023-36005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023] Open
Abstract
A well-protected microbial habitat may be present in the root and canal morphology, which is varied and complicated. Before initiating effective root canal treatment, a detailed knowledge of the root and canal anatomical variances in each tooth is a must. This study aimed to investigate the root canal configuration, apical constriction anatomy, location of the apical foramen, dentine thickness, and prevalence of accessory canals in mandibular molar teeth in an Egyptian subpopulation using micro-computed tomography (microCT). A total of 96 mandibular first molars were scanned using microCT, and 3D reconstruction was performed using Mimics software. The root canal configurations of each of the mesial and distal root were classified with two different classification systems. The prevalence and dentin thickness around middle mesial and middle distal canals were investigated. The number, location and anatomy of major apical foramina and the apical constriction anatomy analysed. The number and location of accessory canals were identified. Our findings showed that two separate canals (15%) and one single canal (65%) were the most common configuration in the mesial and distal roots, respectively. More than half of the mesial roots had complex canal configurations and 51% had middle mesial canals. The single apical constriction anatomy was the most common for both canals followed by the parallel anatomy. Disto-lingual and distal locations of the apical foramen are the most common location for both roots. Mandibular molars in Egyptians show a wide range of variations in root canal anatomy with high prevalence of middle mesial canals. Clinicians should be aware of such anatomical variations for successful root canal treatment procedures. A specific access refinement protocol and appropriate shaping parameters should be designated for each case to fulfil the mechanical and biological objectives of root canal treatment without compromising the longevity of treated teeth.
Collapse
Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, 81-11-11 El-Rehab, Cairo, 11841, Egypt.
- The Center for Innovative Dental Sciences, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt.
- Department of Endodontics, Faculty of Dentistry, Ain Shams University in Egypt, Cairo, Egypt.
| | - Mohamed Mohamed Elashiry
- Department of Endodontics, Faculty of Dentistry, Ain Shams University in Egypt, Cairo, Egypt
- Department of Endodontics, Dental College of Georgia, Augusta University, Cairo, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, 81-11-11 El-Rehab, Cairo, 11841, Egypt
| |
Collapse
|
7
|
Saber SM, Seoud MAE, Sadat SMAE, Nawar NN. Root and canal morphology of mandibular second molars in an Egyptian subpopulation: a cone-beam computed tomography study. BMC Oral Health 2023; 23:217. [PMID: 37061674 PMCID: PMC10105946 DOI: 10.1186/s12903-023-02939-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/04/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND This study was using Cone beam computed tomography (CBCT) to examine the anatomical variations in mandibular second molars in an Egyptian sub-population. METHODS A total of 350 CBCT images (215 females and 135 males, aged 15-65 years) of mandibular second molars were evaluated. Samples were evaluated in terms of: number of roots, number of root canals, roots' cross section as well as prevalence and configurations of C-shaped canals. Statistical analysis was done to highlight differences between different categories and their prevalence among genders (significance level was set at p < 0.05). Data were presented as frequency and percentage values and were analyzed using chi square test followed by pairwise comparisons utilizing multiple Fisher's exact tests with Bonferroni correction. The significance level was set at p < 0.05 within all tests. RESULTS Of the 350 mandibular second molars evaluated, 87.2% were non-C-shaped while 12.8% were C-shaped with no gender-based statistically significant differences (χ2 = 0.19, p = 0.656). Most samples had three root canals (80%) followed by two (16%), then one (3.2%), and finally four (0.8%) root canals. Among the non-C-shaped molars, presence of two roots was most common (83.4%) followed by presence of a single root (16.2%), and only one sample (0.2%) had three roots, and this had no correlation with gender (χ2 = 1.86, p = 0.431). In the mesial roots Type IV Vertucci was the most common configuration found (68.8%), while Type I was the most prevalent in the distal roots (91.8%). The long oval configuration was the most commonly found cross section in mesial roots while "oval" was the most prevalent in distal roots. CONCLUSION Egyptian sub-population shows highly variable morphological features in mandibular second molars, hence, CBCT is highly recommended on case-to-case conditions.
Collapse
Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt
- Center for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), Cairo, Egypt
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mohammed Abou El Seoud
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt.
| |
Collapse
|
8
|
Nawar NN, Elkholy MMA, Ha WN, Saber SM, Kim HC. Optimum shaping parameters of the middle mesial canal in mandibular first molars: A finite element analysis study. J Endod 2023; 49:567-574. [PMID: 36965769 DOI: 10.1016/j.joen.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/27/2023] [Accepted: 03/17/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION This study investigated the effect of shaping parameters of two different configurations of middle mesial canals (MMC) on the biomechanical behavior and life span of a mandibular first molar using finite element analysis (FEA). METHODS A mandibular molar with an independent MMC and another with a confluent MMC were scanned via micro-CT, and FEA models were produced. For each tooth, an intact model and 5 experimental models were produced differed by parameters of how MMC was shaped: unshaped MMC, 25/.04, 25/.06, 30/.04, and 30/.06. Cyclic loading of 50 N was applied on the occlusal surface in vertical and oblique scenarios, and the number of cycles until failure (NCF) was compared to the intact models. In addition, mathematical analyses evaluated the stress distribution patterns and calculated maximum von Mises and maximum principal stresses. RESULTS For both the independent and confluent MMC models, shaping the MMC reduced the NCF. The lifelog percentage of models was inversely proportional with radicular shaping parameters during the vertical and oblique loading scenarios. The shaping size of 30/.06 resulted in lower lifelog percentage than the cases with shaping size of 25/.04 in both of the independent and confluent MMC models. For all models, oblique loading reduced NCF more than vertical loading. CONCLUSION Shaping the MMC should be kept as conservative as 25/.04. Also, whether the MMC is independent or confluent is a deciding factor in whether to increase the apical diameter or the root canal taper when larger shaping parameters are needed.
Collapse
Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Mostafa M A Elkholy
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; School of Dentistry, University of Western Australia, Perth, WA, Australia
| | - William Nguyen Ha
- Department of Endodontics, Sydney Dental School, University of Sydney
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
| |
Collapse
|
9
|
Soliman AH, Sharara H, El Hadidi YN, Saber SM. Autotransplantation of an Impacted Premolar Associated with a Unicystic Ameloblastoma: A Long-Term Follow-up Report of a Clinical Case (A Case Report and a Technical Note). J Maxillofac Oral Surg 2022; 22:502-504. [PMID: 37122801 PMCID: PMC10130279 DOI: 10.1007/s12663-022-01777-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022] Open
|
10
|
Saber SM, Alfadag AMA, Nawar NN, Plotino G, Hassanien EES. Instrumentation Kinematics Does Not Affect Bacterial Reduction, Post-Operative Pain and flare-ups: A Randomized Clinical Trial. Int Endod J 2022; 55:405-415. [PMID: 35100456 DOI: 10.1111/iej.13695] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/25/2022]
Abstract
AIM This randomized clinical trial aimed to assess the effect of instrumentation kinematics (reciprocation or continuous rotation) on bacterial reduction, post-operative pain and incidence of flare-ups after root canal treatment of single-rooted mandibular premolars with asymptomatic apical periodontitis. METHODOLOGY Sixty-six patients were included in this prospective, parallel, randomized clinical trial. Patients were randomly allocated into two groups (N=33) according to the kinematics of the shaping instrument: WaveOne Gold (WO) used in reciprocation or One Shape (OS) used in continuous rotation. Under complete asepsis, bacterial samples were taken before (S1) and after (S2) a standard cleaning and shaping protocol. Evaluation of bacterial reduction was done by both culture technique and quantitative real-time polymerase chain reaction (qPCR) analysis. Post-operative pain was evaluated using the visual analog scale (VAS) after 24, 48- and 72-hours following treatment, while flare-ups were recorded as a binary outcome (Yes/No). Independent and paired t-tests were used for inter and intragroup comparisons for bacterial count data respectively. For post-operative pain score, intergroup comparisons were analyzed using Mann-Whitney U test while intragroup comparisons were analyzed using Friedman test followed by pairwise comparisons utilizing Wilcoxon signed rank test with Bonferroni correction. The significance level was set at p≤0.05 within all tests. RESULTS All the allocated participants received the intervention and were analyzed. The comparison between culture and qPCR methods showed that qPCR analysis demonstrated significantly higher pre-instrumentation baseline bacterial count (p<0.05). The percentage of bacterial reduction, detected by either method, significantly decreased after instrumentation using either rotation or reciprocation kinematics (p<0.05). However, the difference between the WOG or OS files was statistically non-significant (p>0.05). The intra-group comparisons showed a significant reduction in post-operative pain with time (p<0.05) for both groups. However, the inter-group comparison demonstrated that the difference in post-operative pain after the use of either WOG or OS was statistically non-significant (p>0.05). The incidence of flare-ups between both groups was also not-significant (p=1). CONCLUSIONS Shaping kinematics, either rotation or reciprocation motions, had no impact on bacterial reduction and the incidence of post-operative pain and flare-ups after root canal preparation of single-rooted premolars with asymptomatic apical periodontitis.
Collapse
Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Ain Shams University, Cairo, Egypt.,Department of Endodontics, The British University, El-Shorouk city, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, The British University, El-Shorouk city, Egypt
| | | | - Ehab El-Sayed Hassanien
- Department of Endodontics, Ain Shams University, Cairo, Egypt.,El-Galala University, El-Galala city, Egypt
| |
Collapse
|
11
|
Saber SM, Hashem AA, Khalil DM, Pirani C, Ordinola-Zapata R. Efficacy of four local anaesthesia protocols for mandibular first molars with symptomatic irreversible pulpitis: A randomized clinical trial. Int Endod J 2021; 55:219-230. [PMID: 34800034 DOI: 10.1111/iej.13667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/18/2021] [Indexed: 11/28/2022]
Abstract
AIM To examine the efficacy rate of four anaesthetic protocols in mandibular first molars with symptomatic irreversible pulpitis (SIP). METHODOLOGY One hundred and sixty patients with a diagnosis of SIP were included in this randomized clinical trial. Patients were randomly allocated into four treatment groups (N = 40) according to the administered technique: Group 1 (IANB): standard inferior alveolar nerve block (IANB) injection; Group 2 (IANB + IO): standard IANB followed by a supplemental intraosseous infusion (IO) injection; Group 3 (IANB + PDL): standard IANB followed by a supplemental periodontal ligament (PDL) injection; Group 4 (IANB + BI): standard IANB followed by a supplemental buccal infiltration. Patients rated pain intensity using a verbal rating scale when the root canal treatment procedure was initiated, that is, during caries removal, access preparation and pulpectomy. Heart rate changes were recorded before, during and after each injection. The anaesthetic efficacy rates were analysed using chi-square tests, age differences using one-way anova, gender differences using Fischer Exact tests whilst heart rate changes were analysed using Kruskal-Wallis tests. Statistical significances were set at p < .05 level. RESULTS All the included patients were analysed. No differences in the efficacy rate were found in relation to the age or gender of the participants amongst the study groups (p > .05). IANB + IO injections had a significantly higher efficacy rate (92.5%) when compared to other techniques (p < .05), followed by IANB + PDL injections (72.5%), IANB + BI injections (65.0%), with no significant differences between the IANB + PDL or IANB + BI injections (p > .05). IANB injection alone had a significantly lower rate (40%) compared to the other techniques (p < .05). A transient but significant rise in the heart rate was recorded in 60% (24/40) of patients who received the IANB + IO injection compared to other groups (p < .05). CONCLUSIONS Inferior alveolar nerve block injection alone did not reliably permit pain-free treatment for mandibular molars with SIP. The use of an additional IO supplemental injection provided the most effective anaesthesia for patients requiring emergency root canal treatment for SIP in mandibular posterior teeth.
Collapse
Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, Ain Shams University in Egypt, Cairo, Egypt.,Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | | | - Dina Mahmoud Khalil
- Department of Endodontics, Faculty of Dentistry, Ain Shams University in Egypt, Cairo, Egypt
| | | | - Ronald Ordinola-Zapata
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
12
|
Elkholy MMA, Nawar NN, Ha WN, Saber SM, Kim HC. Impact of Canal Taper and Access Cavity Design on the Life Span of an Endodontically Treated Mandibular Molar: A Finite Element Analysis. J Endod 2021; 47:1472-1480. [PMID: 34139264 DOI: 10.1016/j.joen.2021.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This study investigated the impact of different canal tapers and access cavity designs on the life span of endodontically treated mandibular first molars using the finite element method. METHODS Finite element analysis was performed on simulated models with 3 access cavity designs (traditional, conservative, and truss). The mesial canals were prepared to either constant tapers of 25/.04 and 25/.06 or a variable taper corresponding to the cumulative canal preparation shapes of TruNatomy Prime (Dentsply Sirona, Charlotte, NC) and ProTaper Gold F2 (Dentsply Sirona). The distal canals in all models had a 40/.04 preparation. Using occlusal fingerprint analysis, all models were subjected to cyclic occlusal loading until model failure. The number of cycles until failure, the location of failure, stress distribution patterns, and the maximum von Mises stresses were assessed. RESULTS The traditional access models showed a lower life span than the conservative and truss models regardless of the canal taper, whereas there was not a notable difference in the conservative and truss models. The stresses migrated apically along the root surface and remarkably on the mesial aspect of the mesial root and the furcation area's outer surface. After root canal preparation with different tapers, there were no evident changes in the pattern and magnitude of the stresses distributed along the root surface. CONCLUSIONS The life span of the tooth is affected more significantly by the access cavity design than the root canal preparation taper. Because stress patterns migrate apically rather than concentrate in the pericervical area, crack initiation and propagation might occur anywhere on the root surface.
Collapse
Affiliation(s)
- Mostafa M A Elkholy
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt.
| | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - William Nguyen Ha
- University of Adelaide, Adelaide Dental School, Adelaide, South Australia, Australia
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Gyeongnam, Korea.
| |
Collapse
|
13
|
Eldeeb IM, Nawar NN, Saber SM, Hassanein EES, Schäfer E. Smear layer removal and sealer penetration with different tapers after using photon-initiated photoacoustic streaming technique. Clin Oral Investig 2021; 25:5025-5032. [PMID: 33538899 DOI: 10.1007/s00784-021-03813-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the effect of the photon-initiated photoacoustic streaming (PIPS) technique on irrigation performance with different instrumentation tapers in root canals regarding smear layer removal and subsequent sealer penetration. MATERIALS AND METHODS One hundred twenty human mandibular molars were divided into three equal groups according to the apical preparation taper (25/4%, 25/6%, and 25/8%). Each group was divided into two equal subgroups, one received passive irrigation (PI) while the other received PIPS activation of 2.5% sodium hypochlorite and 17% EDTA. Half the samples were evaluated using electron microscope images to assess smear layer removal. The other half was obturated using gutta-percha and rhodamine B-labeled AH Plus sealer before being sectioned horizontally at different root levels (coronal, middle, and apical) to evaluate the percentage of sealer penetration using CLSM. Mann-Whitney U and Friedman tests were used to analyze smear layer scores, while sealer penetration data were analyzed using the three-way analysis of variance (ANOVA) and Tukey's post hoc test. RESULTS Statistical analysis showed significantly better smear layer removal and better sealer penetration after PIPS activation when corresponding root thirds were compared (P<0.001). Only exception was sealer penetration in the apical third with root canal preparation of 25/4% where the difference between the irrigation methods was statistically insignificant (P>0.05). CONCLUSIONS The use of PIPS activation in the final irrigation protocol enhanced smear layer removal and sealer penetration into dentinal tubules if the taper of the prepared canal was at least 6%. CLINICAL RELEVANCE Increasing apical preparation taper significantly enhances PIPS performance in terms of irrigation activation thus enhancing smear layer removal and subsequent sealer penetration in dentinal tubules.
Collapse
Affiliation(s)
| | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University, 81-11-11 El-Rehab, Cairo, 11841, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Ain Shams University, Cairo, Egypt. .,Department of Endodontics, Faculty of Dentistry, The British University, 81-11-11 El-Rehab, Cairo, 11841, Egypt.
| | | | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| |
Collapse
|
14
|
Saber SM, Hayaty DM, Nawar NN, Kim HC. The Effect of Access Cavity Designs and Sizes of Root Canal Preparations on the Biomechanical Behavior of an Endodontically Treated Mandibular First Molar: A Finite Element Analysis. J Endod 2020; 46:1675-1681. [PMID: 32640266 DOI: 10.1016/j.joen.2020.06.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION This study aimed to compare the biomechanical properties of a mandibular first molar with different endodontic cavity designs and increasing sizes of root canal preparations using finite element analysis (FEA). METHODS The experimental finite element models were designed with 3 different endodontic access cavities and 2 sizes of canal preparations: traditional access cavity, conservative access cavity, and truss access cavity and #30/.04 and #40/.04 of root canal preparations. Vertical and oblique loads were applied with a 250-N static force to simulate masticatory forces. Mathematical analysis was performed to evaluate the stress distribution patterns. Maximum von Mises (VM) stresses were assessed at the occlusal surface; cervical line; and 1 , 3, 5, and 7 mm from the root apices. RESULTS Decreasing the size of the access cavity was associated with a higher magnitude of cervical stresses. The magnitude of VM stresses was maximum at the 7-mm level and was minimum at the 1-mm level from the root apex. Increasing the size of the access cavity was associated with the transmission of stresses to a further apical direction regardless of the extent of root canal enlargement. The root canal enlargement from #30 to #40 increased radicular VM stresses within all models. CONCLUSIONS Within the limitations of this study, conservative and truss access designs preserved a significant volume of tooth structure. The extent of root canal enlargement should be as small as practical without jeopardizing the biologic objectives of root canal treatment.
Collapse
Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, The British University, Cairo, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt.
| | | | | | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Yangsan, Korea.
| |
Collapse
|
15
|
Abstract
Summary Background. Studies proposed a link between gut microbiota and airway tract. Objective. Study the diversity and density of gut microbiota in healthy and asthmatic patients. Method. Semi-quantitative stool cultures were performed from fecal samples collected from 80 adult asthmatic patients and 40 healthy individuals. Data on gender, age, dietetic history, clinical examination and investigations as skin prick test and pulmonary function testing were also collected. Results.Lactobacilli were found to be higher among patient group than control group. E. coli density was statistically higher in patient than control group. No significant difference was detected between male and female patients or controls. Lactobacilli were statistically more prevalent in stool culture of male cases than that of male controls. No difference was found between female cases and controls. There was no relationship between type of microbial growth and disease related parameters including age, duration of illness, number of allergens and pulmonary function test in cases. Conclusion. Atopic asthma is significantly associated with gut microbiota Lactobacilli and E. coli. It is important to determine the organism involved, to focus on microbiome-driven disease and therapies.
Collapse
Affiliation(s)
- A M Okba
- Department of allergy and clinical immunology, Faculty of medicine, Ain Shams University, Cairo, Egypt
| | - S M Saber
- Department of clinical pathology, Faculty of medicine, Ain Shams University, Cairo, Egypt
| | - A S Abdel-Rehim
- Department of allergy and clinical immunology, Faculty of medicine, Ain Shams University, Cairo, Egypt
| | - M M Amin
- Department of allergy and clinical immunology, Faculty of medicine, Ain Shams University, Cairo, Egypt
| | - D A Mohamed
- Department of allergy and clinical immunology, Faculty of medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
16
|
Abstract
One hundred isolates of 27 species belonging to 13 genera of dematiaceous hyphomycetes were screened for production of cytochalasins A and B. Most of these isolates (94) were obtained from Assiut University Culture Collection, Botany Department, Faculty of Science, Assiut University, Egypt; three isolates from CBS, The Netherlands; two isolates from DSM, Germany; and one isolate from IMI, UK. The results revealed that 10 isolates of six species representing five genera of fungi produced cytochalasins A and/or B. These species are Alternaria chlamydospora, Cochliobolus spicifer, Diplococcum spicatum, Phoma herbarum, Phoma multipora and Setosphaeria rostrata. This is the first report for the production of cytochalasins A and/or B by these species of dematiaceous hyphomycetes.
Collapse
Affiliation(s)
- A A Zohri
- Department of Botany, Faculty of Science, Assiut University, Egypt
| | | |
Collapse
|
17
|
Zohri AA, Saber SM. Filamentous fungi and mycotoxin detected in coconut. Zentralbl Mikrobiol 1993; 148:325-32. [PMID: 8212938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Fifty-nine species and one variety belonging to 25 genera of fungi were isolated from 25 coconut samples on glucose-Czapek's (25 genera and 55 species + 1 variety) and dichloran-glycerol (8 genera and 32 species + 1 variety) agar media at 28 degrees C. The common fungi on both media used were Aspergillus flavus, A. niger, Penicillium chrysogenum and Cladosporium cladosporioides. On glucose-Czapek's agar, A. flavus var. columnaris, P. oxalicum, Alternaria alternata, Rhizopus stolonifer and Trichoderma hamatum were recorded as common fungi while A. sydowii and Eurotium chevalieri were isolated with high frequency only on dichloranglycerol medium. Chromatographic analysis of the chloroform extracts of the coconut samples revealed that 5 out of 25 samples tested were naturally contaminated with aflatoxin B1 (15-25 micrograms/kg) and 3 samples contaminated with ochratoxin A (50-205 micrograms/kg).
Collapse
Affiliation(s)
- A A Zohri
- Botany Department, Faculty of Science, Assiut University, Egypt
| | | |
Collapse
|
18
|
Abdel-Hafez AI, Saber SM. Mycoflora and mycotoxin of hazelnut (Corylus avellana L.) and walnut (Juglans regia L.) seeds in Egypt. Zentralbl Mikrobiol 1993; 148:137-47. [PMID: 8480455 DOI: 10.1016/s0232-4393(11)80117-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Fifty-one species and 3 varieties appertaining to 20 genera were collected from 20 samples of each of hazelnut and walnut seeds on glucose- and 40% (W/V) sucrose-Czapek's agar at 25 degrees C and 45 degrees C with the most common mesophiles were Aspergillus flavus, A. fumigatus, A. niger, Cladosporium cladosporioides, C. herbarum, Penicillium chrysogenum, P. citrinum and P. oxalicum. Fusarium (represented by F. equiseti, F. moniliforme and F. oxysporum) was recovered from walnut seeds in moderate frequency (on glucose-Czapek's agar). Eurotium (E. amstelodami, E. chevalieri, E. repens and E. rubrum) was completely absent on glucose agar, but it was isolated in high frequency from the two types of seeds on 40% sucrose-Czapek's agar. Aspergillus fumigatus and Rhizomucor pusillus were the most common thermophilic fungi in hazelnut and walnut seeds on glucose agar at 45 degrees C. Humicola grisea var. themoidae and Thermoascus aurantiacus were encountered rarely from walnuts. The nuts samples were assayed for natural occurrence of aflatoxins B1, B2, G1 and G2, citrinin, ochratoxin A, patulin, sterigmatocystin, zearalenone, T-2 toxin and diacetoxyscirpenol by thin layer chromatography analysis. Aflatoxin was detected in 90% of hazelnut samples (25-175 micrograms/kg) and 75% of walnut samples (15-25 micrograms/kg). Zearalenone was detected in one sample of walnut (125 micrograms/kg). This is the first report for the presence of zearalenone in walnut. The other mycotoxins were not detected.
Collapse
Affiliation(s)
- A I Abdel-Hafez
- Botany Department, Faculty of Science, Assiut University, Sohag, Egypt
| | | |
Collapse
|
19
|
Saber SM. Fungal contamination, natural occurrence of mycotoxins and resistance for aflatoxin accumulation of some broad bean (Vicia faba L.) cultivars. J Basic Microbiol 1992; 32:249-58. [PMID: 1460568 DOI: 10.1002/jobm.3620320407] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Using glucose-Czapek's and 10% NaCl glucose-Czapek's agar media incubated at 28 +/- 2 degrees C, nine genera and 18 species were identified from 10 different cultivars seed of broad bean. Aspergillus and Penicillium were the most common genera on the two types of media used. The most common fungal species were Aspergillus flavus, A. niger, A. tamarii and Penicillium chrysogenum. Thin-layer chromatographic analysis indicated that seeds of one cultivar only was naturally contaminated with aflatoxins B1, B2, G1 and G2. Nine mycotoxin-free cultivars of broad bean were examined for resistance or susceptibility for aflatoxin production when inoculated by Aspergillus flavus IMI 89717. Results obtained revealed that seeds of two cultivars were highly resistant, two cultivars showed partial resistance and the remaining were susceptible to the establishment of A. flavus and aflatoxin accumulation. The results did not show any relationship between morphological characters (colour, shape and size) and the amount of aflatoxin produced on the different broad bean seed cultivars. Also the results reveal absence of significant variation in the total nitrogen of the highly susceptible, partially resistant and highly resistant groups of broad bean seeds examined. Mean values of calcium, total phosphate and potassium of both seed coat and seed kernel of the susceptible seeds were low as compared to those of partially and highly resistant seed cultivars. The susceptible seeds contained higher levels of magnesium, zinc and sodium while the resistant seeds contained lower ones.
Collapse
Affiliation(s)
- S M Saber
- Botany Department, Faculty of Science, Assiut University, Sohag, Egypt
| |
Collapse
|
20
|
Abstract
Thirty-nine species and 16 fungal genera were isolated from Egyptian cotton seeds, cotton seed meal and cotton seed cake on 1% glucose-Czapek's agar medium incubated at 28 degrees C. Aspergillus was the most frequent genus and it emerged in 87-100% of the samples contributing 70-98% of total fungi in the three substrates tested. The most common species were A. niger, A. flavus, A. fumigatus, A. terreus and Rhizopus stolonifer; A. niger, A. fumigatus and Penicillium corylophilum; and A. niger, A. flavus, A. terreus, A. nidulans and Rhizopus stolonifer, respectively. Cotton seeds and cotton seed products were naturally contaminated by aflatoxin B1 and B2. About 16% of the different substrates tested were positive for aflatoxin contamination. No citrinin, ochratoxin A, patulin, sterigmatocystin, diacetoxyscirpenol, T-2 toxin or zearalenone were detected in the samples assayed.
Collapse
Affiliation(s)
- M B Mazen
- Botany Department, Faculty of Science, University of Assiut, Egypt
| | | | | |
Collapse
|