1
|
Topbaş C, Şirin DA, Gezeravcı H, Özçelik F, Erdem Hepşenoğlu Y, Erşahan Ş. Relationships among barodontalgia prevalence, altitude, stress, dental care frequency, and barodontalgia awareness: a survey of Turkish pilots. PeerJ 2024; 12:e17290. [PMID: 38650648 PMCID: PMC11034504 DOI: 10.7717/peerj.17290] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Background Gas expansion in body cavities due to pressure changes at high altitudes can cause barodontalgia. This condition may compromise flight safety. Aim To investigate relationships among barodontalgia awareness, dental visit frequency, and barodontalgia prevalence in civilian and military pilots operating at high altitudes. Materials and Methods Civilian pilots from Turkish Airlines and military pilots from the Turkish Air Force, flying between November 2022 and January 2023, participated in this study. A 20-question survey was administered to 750 pilots, covering topics such as barodontalgia awareness, dental visit frequency, breaks after dental treatments, in-flight pain, and pain type and severity. The voluntary surveys were distributed by email. Results Of the 750 pilots, 526 completed the survey; 61% were aware of barodontalgia, and 81% of pilots who had experienced it reported pain at altitudes <2000 feet. The study revealed higher barodontalgia awareness among pilots who had experienced it, with the highest prevalence among jet pilots. Pilots with barodontalgia also showed a higher frequency of dental visits (p < 0.001). Additionally, this group reported more frequent interruption of flight due to dental treatment (IFDT), more problems experienced in flights after treatment (PFAT), and higher instances of bruxism or teeth clenching during flight, suggesting stress and anxiety (p < 0.05). Conclusions Barodontalgia, a type of pain linked to stress, significantly impacts pilot performance, and can threaten flight safety, even at lower altitudes. Thus, there is a need to educate pilots about stress management, barodontalgia awareness, and the importance of regular dental check-ups.
Collapse
Affiliation(s)
- Celalettin Topbaş
- Faculty of Dentistry, Department of Endodontics, University of Health Sciences, Istanbul, Üsküdar, Türkiye
| | - Dursun Ali Şirin
- Faculty of Dentistry, Department of Endodontics, University of Health Sciences, Istanbul, Üsküdar, Türkiye
| | - Hilal Gezeravcı
- Faculty of Dentistry, Department of Endodontics, University of Health Sciences, Istanbul, Üsküdar, Türkiye
| | - Fatih Özçelik
- Hamidiye Etfal Training and Research Hospital, Department of Medical Biochemistry, University of Health Sciences, Istanbul, Sisli, Türkiye
| | - Yelda Erdem Hepşenoğlu
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Istanbul, Esenler, Türkiye
| | - Şeyda Erşahan
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Istanbul, Esenler, Türkiye
| |
Collapse
|
2
|
Monteiro Czornobay LF, de Oliveira Rocha A, Leite CC, Menezes Dos Anjos L, Ribeiro de Andrade JS, Pacheco de Castro Henriques BA, Cardoso M, Machado R, da Silveira Teixeira C, de Fonseca Roberti Garcia L. A Global Overview on Electronic Apex Locator Use from 1968 to 2023: a Bibliometric Analysis. J Endod 2024:S0099-2399(24)00228-0. [PMID: 38614449 DOI: 10.1016/j.joen.2024.04.002] [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: 02/26/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/15/2024]
Abstract
INTRODUCTION This bibliometric review analyzed the research trends and main characteristics of articles related to Electronic Apex Locators (EALs). METHODS The search was conducted in November 2023 on the Web of Science Core Collection. Narrative and systematic reviews, observational and intervention studies, laboratory and clinical studies were included. Two researchers selected the articles and extracted the number of citations, year of publication, journal, study design, theme, country, continent, institutions, author, and keywords. Collaborative networks were generated using the VOSviewer software. The relationship between data was determined by Spearman's correlation. RESULTS The search resulted in 374 articles, of which 294 were included. Most cited article had 175 citations. The most prevalent journal was the Journal of Endodontics (n = 84). The predominant study design was the laboratory-based (n = 223). The predominant theme was the EALs accuracy (n = 175). Piasecki L was the author with the highest number of articles (n = 11). Only 8.16% of the studies were conducted in deciduous teeth. The country with the most studies was Brazil (n = 46). Asia (n = 107) was the continent with the highest number of publications. There was a weak positive correlation between the number of citations and impact factor (rho = .294), and a strong negative correlation between citations and year of publication (rho = -.710). CONCLUSIONS The majority of articles were laboratory-based studies conducted on permanent teeth, focusing on the accuracy of EALs. Future studies should prioritize research on deciduous teeth, systematic reviews, and, notably, clinical trials.
Collapse
Affiliation(s)
| | - Aurélio de Oliveira Rocha
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Christiane Cabral Leite
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Lucas Menezes Dos Anjos
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | | | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Ricardo Machado
- Department of Restorative Sciences, College of Dentistry, University of Oklahoma, Oklahoma City, OK, USA
| | | | | |
Collapse
|
3
|
Buchi-Velazquez A, Escobar-Torres D, Veloso V, Ferraro N. Clinical and radiographic characterization of external root resorption. Medwave 2024; 24:e2780. [PMID: 38574291 DOI: 10.5867/medwave.2024.03.2780] [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] [Indexed: 04/06/2024] Open
Abstract
Introduction The following bibliographic review was carried out with the purpose of recognizing the clinical and radiographic characteristics that must be considered in the diagnosis of external root resorption, including treatments. Methods A bibliographic search was carried out in PubMed/Medline, Cochrane Library and Google Scholar databases under the term "external root resorption", from 2010 to 2022 in Spanish and English. Experimental studies and bibliographic reviews were selected, and finally 17 articles were included. Results The results obtained indicated that each type of resorption presents specific clinical characteristics that differentiate them, these are: for external inflammatory resorption a negative pulp vitality; for replacement external resorption the absence of mobility and metallic percussion; for cervical external resorption a pink coloration of the crown; superficial external resorption does not present any type of clinical symptoms and transient apical collapse presents a transient change in color. Conclusion External root resorptions require accurate and early diagnosis. A clinical examination should be performed with emphasis on the following: probing, coloration, mobility, and vitality tests.
Collapse
Affiliation(s)
- Agustina Buchi-Velazquez
- Escuela de Odontología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Daniela Escobar-Torres
- Escuela de Odontología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Valentina Veloso
- Escuela de Odontología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Nicolás Ferraro
- Escuela de Odontología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| |
Collapse
|
4
|
Alkahtany SM, Alabdulkareem SE, Alharbi WH, Alrebdi NF, Askar TS, Bukhary SM, Almohaimede AA, Al-Manei KK. Assessment of dental students' knowledge and performance of master gutta-percha cone selection and fitting during root canal treatment: a pilot study. BMC Med Educ 2024; 24:371. [PMID: 38575914 PMCID: PMC10996191 DOI: 10.1186/s12909-024-05347-9] [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] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Misconceptions should be detected early in dental students' training to improve their clinical performance. Accordingly, this study aimed to assess undergraduate dental students' knowledge and performance of master gutta-percha (GP) cone selection and fitting during clinical endodontic courses at the College of Dentistry, King Saud University. METHODS Ninety-nine undergraduate dental students completed an online survey about their knowledge of master GP cone selection. Forty-five of these students were observed by faculty members in clinical endodontic courses while they fitted master GP cones during root canal treatments. The observers recorded the details of each student's cone-fitting techniques. The data were analysed using t-tests, one-way analysis of variance, and chi-square tests (p < 0.05). Inter- and intra-observer reliability were tested using Fliess' Kappa. RESULTS SURVEY All participants had good knowledge of over-extended cone management, while 80.8% knew how to properly manage a short cone. The proper flaring assessment method was selected by 86.9% of the female and 34.2% of the male students, and this difference was statistically significant (p = 0.0001). OBSERVATION The students labelled the working length on the master GP cone with an indentation in 64.4% of the cases and by bending the cone 35.6% of the time. Of all students, 84.4% encountered an apical stop, and this rate correlated significantly with the length of the cone on the master apical cone radiograph (p = 0.001). Improper shaping of the canal was the most common cause of ill-fitting cones (83.3%), while 16.7% of the students chose the wrong cone size. The final obturation length was adequate in 80% of the cases; 57.8% of the students were helped by instructors. CONCLUSIONS Most students had the basic knowledge required to solve problems related to the selection of master GP cones. However, in the clinical setting, more than half of the students required the assistance of an instructor to adjust their cone's fit. The presence of an apical stop had the most significant effect on the length of the fitted master GP cone on radiography. The most common cause of ill-fitting master cones was improper shaping of the canal.
Collapse
Affiliation(s)
- Sarah M Alkahtany
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia.
| | - Shaima E Alabdulkareem
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Wajd H Alharbi
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Norah F Alrebdi
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Tomather Sultan Askar
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Sundus M Bukhary
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Amal A Almohaimede
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Kholod Khalil Al-Manei
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| |
Collapse
|
5
|
Monsef E, Goodman X, Patil R, White SN. Dentists' knowledge of non-surgical root canal treatment, a systematic review. J Dent 2024; 145:104975. [PMID: 38580057 DOI: 10.1016/j.jdent.2024.104975] [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: 09/25/2023] [Revised: 03/06/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVES Dental practice is based upon dentists' cognitions, knowledge being foundational. Knowledge is attained through education and perception. Although knowledge is modulated by beliefs, attitudes, preferences, and behaviors, it is essential to evidence-based practice. Cross-sectional studies uniformly demonstrate that community NSRCT is of sub-optimal quality worldwide, is lack of knowledge a problem? Our purpose was to measure dentists' knowledge of root canal treatment (NSRCT). DATA Quantitative and qualitative data were extracted: purpose, topics assessed, authors cited knowledge sources, number of dentists studied, number of questions, authors descriptors of knowledge level,% correct answers by question, authors recommendations. SOURCES OVID Medline, EMBASE, Web of Science, and hand-searching. STUDY SELECTION Studies which had measured dentists' knowledge of non-surgical root canal treatment that was valuable, reliable, and had practical implications which could be implemented. A total of 51 papers from 19 countries measured the knowledge of 15,580 dentists using 445 questions on 29 root canal treatment topics. CONCLUSIONS 'Gold standards' were from literature, external bodies, or expert consensus in 47, 31, and 2 papers respectively. Levels of knowledge by percentage correct answers among studies were poor to moderate and varied considerably. The mean, for the 50 studies where overall study percentages could be calculated, was 57 %, standard deviation 17 %, and a range of 16 % to 82 %. Authors' adjectives describing knowledge levels were generally negative. Additional education was advised in 49 papers, but without evidence that education was inadequate; 6 papers recommended increased use of protocols; only 5 papers advocated research on the cause of lack of knowledge. CLINICAL SIGNIFICANCE Dentists' root canal treatment knowledge was found to be poor to moderate, as well variable. This may constrain quality of care. However, provision of information without attention to dentists' cognitions and motivations may not be successful. Educational strategies and goals should be re-evaluated. Evidence-based practice faces many barriers.
Collapse
Affiliation(s)
| | | | - Rucha Patil
- UCLA School of Dentistry, Los Angeles, CA, USA
| | | |
Collapse
|
6
|
Aljawhar AM, Ibrahim N, Abdul Aziz A, Ahmed HMA, Azami NH. Characterization of the root and canal anatomy of maxillary premolar teeth in an Iraqi subpopulation: a cone beam computed tomography study. Odontology 2024; 112:570-587. [PMID: 37957521 DOI: 10.1007/s10266-023-00870-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
This study aims to evaluate the number of roots and root canal morphology types of maxillary premolars in relation to a patient's gender and age in an Iraqi population using two classification systems. Cone beam computed tomography (CBCT) scans of 1116 maxillary premolars from 385 patients were evaluated for the number of roots and root canal morphology types according to Vertucci's classification and Ahmed et al. classification systems. Differences in the number of roots and root canal morphology types with regard to tooth type, patients' gender and age groups were evaluated and the degree of bilateral symmetry was determined. Chi-squared test was used for statistical analysis. About 51.1% of the 1st premolars were double rooted. The majority (87.9%) of the 2nd premolars were single rooted. The three-rooted form presented in only 1.2% and 0.7% of the 1st and 2nd premolars, respectively. Vertucci Type IV (Ahmed et al. code 2MaxP B1P1) and Vertucci Type I (Ahmed et al. code 1MaxP1) were the most common canal morphology types in the 1st and 2nd premolars, respectively. Females showed a lower number of roots and a higher prevalence of Vertucci Type I configuration (P < 0.05). Younger age groups showed a higher prevalence of Vertucci Type I configuration (P < 0.05). Bilateral symmetry was seen in more than half of the maxillary premolars. There is a considerable variation in the number of roots and root canal configurations of maxillary premolars in the studied Iraqi population, with a significant difference by gender and age groups. Ahmed et al. classification provided more accurate presentation of the root and canal anatomy in maxillary premolars compared to Vertucci's classification.
Collapse
Affiliation(s)
- Abdullah Mohammed Aljawhar
- Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Basrah, Basrah, Iraq
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Norliza Ibrahim
- Department of Oral & Maxillofacial Clinical Science, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Azwatee Abdul Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Noor Hayati Azami
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| |
Collapse
|
7
|
Liu H, Nio S, Shen Y. Sodium hypochlorite against Enterococcus faecalis biofilm in dentinal tubules: effect of concentration, temperature, and exposure time. Odontology 2024; 112:390-398. [PMID: 37646916 DOI: 10.1007/s10266-023-00850-9] [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: 05/06/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
This study aimed to evaluate the effectiveness of two sodium hypochlorite concentrations at different exposure times and temperatures against Enterococcus faecalis biofilms of varying ages in human dentinal tubules. Dentin blocks were infected with E. faecalis for either 3 days or 3 weeks of incubation. Subsequently, the samples were exposed to sterile water, 2%, and 5.25% sodium hypochlorite for 3 and 10 min at 20 °C and 60 °C . Viability staining and confocal laser scanning microscopy were used to assess the proportion of killed bacteria in the dentinal tubules after exposure. There are no significant differences in the efficacy of E. faecalis killing between 2% sodium hypochlorite at 60 °C for various exposure times and 5.25% sodium hypochlorite at different temperatures or exposure times (P > 0.05). When both solutions were compared at the same temperatures with a 10-min exposure time, no significant differences in the effectiveness of E. faecalis killing between 2% and 5.25% sodium hypochlorite were observed (P > 0.05). To optimize the effectiveness of sodium hypochlorite in killing E. faecalis while minimizing potential damage to root dentin and soft tissue, clinicians should prioritize increasing the temperature or exposure time of sodium hypochlorite, rather than raising its concentration.
Collapse
Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Stefanie Nio
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| |
Collapse
|
8
|
Asgary S. Successful autotransplantation using a mature impacted third molar: A case report. J Dent Sci 2024; 19:1228-1230. [PMID: 38618086 PMCID: PMC11010703 DOI: 10.1016/j.jds.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/12/2024] [Indexed: 04/16/2024] Open
Affiliation(s)
- Saeed Asgary
- Iranian Centre for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Daneshjoo Blvd., Evin, Shahid Chamran Highway, Tehran 1983963113, Iran
| |
Collapse
|
9
|
Martinho FC, Qadir SJ, Price JB, Tordik PA, Bernardes RA, Griffin IL. Real-Time Three-dimensional Dynamic Navigation for Root Post Space Preparation in Root Canal-treated Teeth: an In vitro Study. J Endod 2024:S0099-2399(24)00166-3. [PMID: 38522577 DOI: 10.1016/j.joen.2024.03.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION The aim of this study was to investigate the feasibility of a real-time three-dimensional dynamic navigation system (3D-DNS) for root post space preparation (RPSP) in root canal-treated teeth and compares the accuracy and efficiency of 3D-DNS to freehand (FH) for RPSP. METHODS Fifty-four maxillary molars were divided into two groups: 3D-DNS (n = 27) and FH group (n = 27). Cone beam computed tomography (CBCT) scans were taken pre- and post-operatively. The drilling path for the RPSP was virtually planned in the pre-operative CBCT scan in the X-guide software (X-Nav Technologies, Lansdale, PA). For the 3D-DNS group, the RPSP drilling was conducted under dynamic navigation. The 3D deviations and angular deflection (AD) were calculated. The residual dentin thickness (RDT) was determined after RPSP. The operation time and the total number of mishaps were recorded. Shapiro-Wilk, t-test or Mann-Whitney rank sum, weighted Cohen's kappa, and Fisher exact tests were used (p<.05). RESULTS The RPSP was completed in all samples (54/54). The 3D-DNS was more accurate than the FH, with significantly fewer 3D deviations and AD (All, p < .05). The 3D-DNS required less operation time than the FH (p < .05). For the 3D-DNS, no teeth had RDT < 1 mm, whereas 6/27 in the FH showed RDT < 1 mm after the RPSP. There was no difference in the total number of mishaps (p > .05). CONCLUSION Within the limitations of this in vitro study, the 3D-DNS is feasible for RPSP. The 3D-DNS improved the accuracy and efficiency of RPSP. The dynamic navigation system can potentially become a safe and reliable technology for RPSP.
Collapse
Affiliation(s)
- Frederico C Martinho
- DDS, MS, PhD - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Syed J Qadir
- DDS, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Jeffery B Price
- DDS, MS, MAGD, FICD, Clinical Professor & Director of Oral Radiology - Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- DMD, FICD, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ricardo A Bernardes
- DDS, MS, PhD, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Ina L Griffin
- DMD, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| |
Collapse
|
10
|
Calazans MAA, Pontual ADA, Pontual MLDA, Ferreira FABS, Santos A, Alcoforado MDLMG, Ramos-Perez FMDM, Madeiro F. A system for automatic classification of endodontic treatment quality in CBCT. Clin Oral Investig 2024; 28:223. [PMID: 38507031 DOI: 10.1007/s00784-024-05599-1] [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: 05/15/2023] [Accepted: 03/02/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES An evaluation of the effectiveness of a new computational system proposed for automatic classification, developed based on a Siamese network combined with Convolutional Neural Networks (CNNs), is presented. It aims to identify endodontic technical errors using Cone Beam Computed Tomography (CBCT). The study also aims to compare the performance of the automatic classification system with that of dentists. METHODS One thousand endodontically treated maxillary molars sagittal and coronal reconstructions were evaluated for the quality of the endodontic treatment and the presence of periapical hypodensities by three board-certified dentists and by an oral and maxillofacial radiologist. The proposed classification system was based on a Siamese network combined with EfficientNet B1 or EfficientNet B7 networks. Accuracy, sensivity, precision, specificity, and F1-score values were calculated for automated artificial systems and dentists. Chi-square tests were performed. RESULTS The performances were obtained for EfficienteNet B1, EfficientNet B7 and dentists. Regarding accuracy, sensivity and specificity, the best results were obtained with EfficientNet B1. Concerning precision and F1-score, the best results were obtained with EfficientNet B7. The presence of periapical hypodensity lesions was associated with endodontic technical errors. In contrast, the absence of endodontic technical errors was associated with the absence of hypodensity. CONCLUSIONS Quality evaluation of the endodontic treatment performed by dentists and by Siamese Network combined with EfficientNet B7 or EfficientNet B1 networks was comparable with a slight superiority for the Siamese Network. CLINICAL RELEVANCE CNNs have the potential to be used as a support and standardization tool in assessing endodontic treatment quality in clinical practice.
Collapse
Affiliation(s)
| | - Andréa Dos Anjos Pontual
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, 50670-420, Pernambuco, Brasil
| | - Maria Luíza Dos Anjos Pontual
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, 50670-420, Pernambuco, Brasil
| | - Felipe Alberto B S Ferreira
- Unidade Acadêmica do Cabo de Santo Agostinho, Universidade Federal Rural de Pernambuco, Cabo de Santo Agostinho, 54518-430, Pernambuco, Brasil
| | - Andrezza Santos
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, 50670-420, Pernambuco, Brasil
| | | | | | - Francisco Madeiro
- Escola Politécnica de Pernambuco, Universidade de Pernambuco, Recife, 50720-001, Pernambuco, Brasil
| |
Collapse
|
11
|
Mustafa M, Batul R, Karobari MI, Alamri HM, Abdulwahed A, Almokhatieb AA, Hashem Q, Alsakaker A, Alam MK, Ahmed HMA. Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review. BMC Oral Health 2024; 24:343. [PMID: 38493123 PMCID: PMC10944621 DOI: 10.1186/s12903-024-04101-3] [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: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population. METHODOLOGY An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies. RESULTS The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology. CONCLUSION This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.
Collapse
Affiliation(s)
- Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Hadi Mohammed Alamri
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Consultant Endodontics, Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz Abdulwahed
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Ahmed A Almokhatieb
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Qamar Hashem
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Abdullah Alsakaker
- Consultant endodontist, Department of endodontics, Prince Abdulrahman Advanced Dental Institute, Ministry of defence, Riyadh, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
12
|
Pires M, Martins JNR, Pereira MR, Vasconcelos I, Costa RPD, Duarte I, Ginjeira A. Diagnostic value of cone beam computed tomography for root canal morphology assessment - a micro-CT based comparison. Clin Oral Investig 2024; 28:201. [PMID: 38453706 PMCID: PMC10920457 DOI: 10.1007/s00784-024-05580-y] [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: 07/11/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The aim of this study was to assess cone beam computed tomography (CBCT) as a root canal anatomy diagnostic tool by comparison with micro-CT gold-standard. MATERIALS AND METHODS 216 two-rooted mandibular molars were first scanned in a CBCT device (200 μm voxel size) and posteriorly in a micro-CT scanner (19.61 μm). The volumes were sequentially screened to classify main root canal anatomy according to Vertucci classification, and for the presence of lateral canals and apical deltas, in both mesial and distal roots. RESULTS Both methods revealed a higher prevalence of Vertucci Type II and IV in the mesial root, and Vertucci Type I in the distal root. The percentage of agreement for main root canal anatomy classification between CBCT and micro-CT scores was high (85.2%). CONCLUSION Sensibility to detect both lateral canals and apical deltas with CBCT was low. These results attest to the fact that minor anatomical changes might be difficult to identify with CBCT imaging, hampering its diagnostic value.
Collapse
Affiliation(s)
- Mariana Pires
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Isabel Vasconcelos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Center for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Marinha Grande, Portugal
| | | | - Isabel Duarte
- TEMA - Centre for Mechanical Technology and Automation, Department of Mechanical Engineering, University of Aveiro, Aveiro, 3810-193, Portugal
- LASI - Intelligent Systems Associate Laboratory, Guimarães, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
13
|
Duarte Faria F, Cantiga-Silva C, Cardoso CDBM, da Silva Machado NE, de Oliveira PHC, Justo MP, Goto J, de Castilho Jacinto R, Sivieri-Araújo G, Cintra LTA. Influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis in Wistar rats. Odontology 2024:10.1007/s10266-024-00908-2. [PMID: 38457086 DOI: 10.1007/s10266-024-00908-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024]
Abstract
The aim of this study was to investigate the influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis (AP) in Wistar rats. Fifty-six rats were submitted to pulp exposure of the lower left first molar for the induction of AP. On the same day, intraperitoneal antibiotic therapy was administered once a day, for 15 days, until euthanasia. The groups were formed according to the different treatments (n = 8): C-control; GEN-treated with gentamicin (10 mg/Kg); AC-treated with amoxicillin (100 mg/Kg); MZ-treated with metronidazole (40 mg/Kg); AMP-treated with ampicillin (100 mg/Kg); AMC group-treated with amoxicillin + clavulanic acid (100 mg/kg); CLI-treated with clindamycin (60 mg/kg). After euthanasia, the jaws were collected and processed for (1) histological and histometric analysis using hematoxylin and eosin staining, (2) analysis of collagen fibers using Picrosirius Red staining and (3) bacteriological analysis using Brown-Brenn staining. The data were analyzed statistically (p < 0.05). AP induction was confirmed in all groups. The AMC group had the lower intensity of inflammatory infiltrate (p = 0.028) and less periapical bone resorption compared to control (p = 0.006). Regarding collagen maturation, PSR staining revealed a predominance of mature collagen fibers in all groups. The AC and AMC groups had the lower amount of mature fibers and the highest amount of immature fibers, compared to all other groups (p < 0.001). All groups showed bacterial contamination; however, the AC and AMC groups showed a lower extent of bacterial contamination compared to the control (p < 0.001). It can be concluded that systemic antibiotic therapy influences the development and progression of induced AP.
Collapse
Affiliation(s)
- Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Carolina de Barros Morais Cardoso
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Pedro Henrique Chaves de Oliveira
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Mariana Pagliusi Justo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Juliana Goto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Rogério de Castilho Jacinto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araújo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil.
| |
Collapse
|
14
|
Cecagno FL, De Martin AS, Fontana CE, Cavenago BC, Nascimento WM, Limoeiro AGDS, Bueno CEDS. Evaluation of the Ability of 3 Reciprocating Instruments to Remove Obturation Material: A Micro-Computed Tomography Study. J Endod 2024; 50:376-380. [PMID: 38147908 DOI: 10.1016/j.joen.2023.12.004] [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: 10/16/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION The purpose of this study was to evaluate the ability of the Reciproc, Reciproc Blue, and WaveOne Gold systems to remove filling material during endodontic retreatment of extracted human mandibular premolars. METHODS Thirty-nine teeth were instrumented with the Protaper Universal System to the F3 file and filled with the Tagger hybrid technique using an F3 gutta-percha cone and AH Plus cement. At the end of this period, the teeth were scanned with micro-computed tomography before and after removal of the filling material from the root canals. The teeth were divided into 3 groups (n = 13) based on the apical volume, depending on the systems used to remove the filling material. Group GR: Reciproc 40/.06; Group GRB: Reciproc Blue 40/.06; and Group GWG: WaveOne Gold 35/.06. The results were statistically analyzed using the tests of Kruskal-Wallis, Duncan, and analysis of variance at a significance level of 5%. RESULTS The results showed that there were no significant differences between the amounts of filling material removed, either for the apical and middle regions alone or in the overall evaluation for the 3 groups (P = .97). The time evaluation statistically showed that the GR and GWG groups required less time to clean the root canals than the GRB group. CONCLUSIONS Reciproc R40 files and WaveOne Gold Medium files required less time for endodontic treatment than Reciproc Blue R40 files. There was no difference in the ability to remove obturation material between the 3 instruments. No instrument was able to completely remove the filling material from the root canals.
Collapse
Affiliation(s)
- Fábio Luiz Cecagno
- Departament of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Alexandre Sigrist De Martin
- Departament of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Carlos Eduardo Fontana
- PUC Campinas, Center of Life Sciences, Programa de pós-graduação em Ciências da Saúde, Campinas, São Paulo, Brazil
| | | | - Wayne Martins Nascimento
- Departament of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Ana Grasiela da Silva Limoeiro
- Departament of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Carlos Eduardo da Silveira Bueno
- Departament of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil.
| |
Collapse
|
15
|
Olivieri JG, Encinas M, Nathani T, Miró Q, Duran-Sindreu F. Outcome of root canal retreatment filled with gutta-percha techniques: A systematic review and meta-analysis. J Dent 2024; 142:104809. [PMID: 38145805 DOI: 10.1016/j.jdent.2023.104809] [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: 09/25/2023] [Revised: 12/01/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023] Open
Abstract
OBJECTIVE The present systematic review and meta-analysis aimed to evaluate the success rate of root canal retreatment filled with gutta-percha and the variables related to retreatment success. DATA The PRISMA guidelines were followed for the present review. The study protocol was registered in the International Prospective Database of Systematic Reviews (PROSPERO CRD42021283134). Risk assessment was performed using the Newcastle-Ottawa scale. Funnel plots were used to detect publication bias and asymmetry was assessed using Egger's tests. SOURCES PubMed, Scopus, ScienceDirect, Cochrane, and additional sources were searched. STUDY SELECTION Studies published until 10 December 2022. Clinical studies evaluating the success of root canal retreatment filled with gutta-percha with at least a 1-year follow-up were selected. RESULTS Ten studies and one unpublished study fulfilled the inclusion criteria for quantitative analysis. The success rate of non-surgical root canal retreatment was 71% (95% CI: 66%-76%) with strict criteria and 87% (79% - 93%) with loose criteria for 1-3 years of follow-up, and 77% (66% - 86%) with strict criteria for a 4-5 years of follow-up. Endodontically retreated teeth with periapical lesions had a lower success rate under strict criteria. The tooth type, dental arch, initial periapical index (PAI) score, and the number of visits also affected the treatment success rate under strict criteria. For the loose criteria, teeth with larger periapical lesions and higher initial PAI scores had a lower success rate. CONCLUSIONS According to the present systematic review and meta-analysis, non-surgical root canal retreatment results in favourable outcomes. The presence of a periapical radiolucency, periapical lesions >5mm, a higher initial PAI score, multiple-visit retreatments, and mandibular and molar teeth resulted in a lower success rate. CLINICAL SIGNIFICANCE Non-surgical root canal retreatment filled with gutta-percha techniques is a relatively predictable procedure with a high success rate. Several variables can affect retreatment success, mainly the presence and size of a periapical lesion and the type of tooth.
Collapse
Affiliation(s)
- Juan Gonzalo Olivieri
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Marc Encinas
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Tousif Nathani
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Queralt Miró
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | |
Collapse
|
16
|
Ratushnyi R, Stakhanska O. Ergonomic interventions and endodontic treatment outcomes: An analysis of dentist working posture and error rates. Saudi Dent J 2024; 36:466-470. [PMID: 38525173 PMCID: PMC10960123 DOI: 10.1016/j.sdentj.2023.12.006] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 03/26/2024] Open
Abstract
Purpose Dentists spend a long time the day in the position. It is possible that this leads to discomfort that may translate to procedural errors during treatment, such as root canal treatment. This study aims to investigate the relationship of working posture and procedural errors in endodontic manipulations. Materials and Methods 32 dentists (17 men, 53.13%, and 15 women, 46.88%) from the University Dental Polyclinic of Uzhhorod National University (Uzhhorod, Ukraine) were included in the study. REBA, RULA, frequency of procedural errors were analysed using regression. Results This study revealed a surprising trend where a decrease in errors during endodontic treatment was associated with higher RULA and REBA scores, contrary to the expected increase in errors with higher ergonomic stress. Additionally, the research highlighted the significant impact of a dentist's handedness and tooth position in the dental arch on treatment ergonomics and efficiency, as observed and analyzed through ergonomic assessments and statistical methods. Conclusions The study conclusively demonstrated that optimal positioning and alignment during dental procedures significantly contribute to a reduction in procedural errors, underscoring the importance of ergonomics in clinical dentistry.
Collapse
Affiliation(s)
- Ruslan Ratushnyi
- Department of Surgery with a Course in Stomatology, Vinnytsya National Pirogov Memorial Medical University, 21018 Vinnytsia, Ukraine
| | - Olha Stakhanska
- Department of Orthopedic Dentistry, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine
| |
Collapse
|
17
|
Anton Y Otero CI, Marger L, Feilzer A, Krejci I, Abdelaziz M. Micromorphology of Root Canal Walls After Laser Activated Irrigation. Eur J Prosthodont Restor Dent 2024; 32:109-119. [PMID: 37988616 DOI: 10.1922/ejprd_2600antonyotero11] [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] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/17/2023] [Indexed: 11/23/2023]
Abstract
This study aims to investigate the effects of laser-activated irrigation on root canal dentin using different laser wavelengths. Sixty-six roots were prepared and split longitudinally. First, lasers with different power settings were tested on 34 samples, pre-etched with phosphoric acid, or remaining with a smear-layer to determine the test parameters. Selected parameters were then applied on thirty roots (9 groups) covered with smear layer: 1. Smear-layer removed; 2. Smear-layer untouched; 3. Conventional needle irrigation with NaOCl and EDTA; 4. ER:YAG laser; 5. 9.3 μm CO₂ laser; 6-9. Diode lasers. All lasers were applied in ultra-pure water as an irrigant. Root halves were examined by scanning electron microscope to analyze the intracanal dentin micromorphology on 9 consequent photos per specimen @ a magnification of 1000X. The results showed that conventional needle irrigation was effective in removing the smear-layer from coronal and middle root parts, while laser-activated irrigation had two main mechanisms: cleaning and opening of the dentinal tubules by removing the smear layer (Er:YAG laser) and melting of dentin (CO₂ and diode lasers) in all root parts. The study concluded that laseractivated irrigation with different wavelengths impacted the smear layer and root canal dentin differently through pure physical/mechanical effects.
Collapse
Affiliation(s)
- C I Anton Y Otero
- Division of Cariology and Endodontology, CUMD - University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - L Marger
- Division of Cariology and Endodontology, CUMD - University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - A Feilzer
- Department of Dental Material Sciences, Academic Center for Dentistry Amsterdam (ACTA) - Gustav Mahlerlaan 3004, 1081 LA Amsterdam
| | - I Krejci
- Division of Cariology and Endodontology, CUMD - University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - M Abdelaziz
- Division of Cariology and Endodontology, CUMD - University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
18
|
Wendling MM, Mantovani G, Fernandes BV, Carneiro DE, Santos RV, Sánchez-Ayala A. Occlusal Loading Effect on Stress Distribution of Endodontically Treated Teeth: Finite Element Analysis Study. Eur J Prosthodont Restor Dent 2024; 32:102-108. [PMID: 37812514 DOI: 10.1922/ejprd_2578wendling07] [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] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/17/2023] [Indexed: 10/11/2023]
Abstract
AIM Evaluate the influence of occlusal loading on the stress distribution of endodontically treated teeth after root canal preparation with different file's sizes and tapers by means of finite element analysis. METHODOLOGY Seven three-dimensional models of a single-rooted, single-canal lower second premolar were established, one healthy control and six endodontically treated and restored models. The shape of root canal preparations followed file configurations 30/.05, 30/.09, 35/.04, 35/.06, 40/.04, and 40/.06. Von- Mises equivalent stresses were calculated by applying 30 N, 90 N and 270 N loads to the buccal cusp tip, each one at 90º, 45º and 20º angles from the occlusal plane simulating occlusion, dental interference and laterality, respectively. RESULTS 45º loading was more prone to formation of higher stress values. The simulation of occlusion and laterality resulted in maximum stress areas located at the inner side of the root curvature, while under occlusal interference they were on the lingual surface over the tooth's long axis. CONCLUSIONS The angulation of occlusal loading and magnitude were determinants for stress distribution on dental structure. Both variations of size and taper were not determinants for the increase in the maximum stress areas.
Collapse
Affiliation(s)
- M M Wendling
- Department of Dentistry, Ponta Grossa Dental School, State University of Ponta Grossa (UEPG), Ponta Grossa, Paraná 8403090, Brazil
| | - G Mantovani
- NuMAT/PPGEM, Federal University of Technology of Parana, Ponta Grossa, Paraná 84017220, Brazil
| | - B V Fernandes
- Department of Dentistry, Ponta Grossa Dental School, State University of Ponta Grossa (UEPG), Ponta Grossa, Paraná 8403090, Brazil
| | - D E Carneiro
- Department of Dentistry, Ponta Grossa Dental School, State University of Ponta Grossa (UEPG), Ponta Grossa, Paraná 8403090, Brazil
| | - R V Santos
- NuMAT/PPGEM, Federal University of Technology of Parana, Ponta Grossa, Paraná 84017220, Brazil
| | - A Sánchez-Ayala
- Department of Dentistry, Ponta Grossa Dental School, State University of Ponta Grossa (UEPG), Ponta Grossa, Paraná 8403090, Brazil
| |
Collapse
|
19
|
Naved N, Umer F, Khowaja AR. Irreversible pulpitis in mature permanent teeth: a cost-effectiveness analysis of pulpotomy versus root canal treatment. BMC Oral Health 2024; 24:285. [PMID: 38418999 PMCID: PMC10902936 DOI: 10.1186/s12903-024-04052-9] [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: 07/04/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Evidence-based dentistry suggests pulpotomy as a potential alternative to root canal treatment in mature permanent teeth with irreversible pulpitis. However, the evidence surrounding the cost-valuation and cost-efficacy of this treatment modality is not yet established. In this context, we adopted an economic modeling approach to assess the cost-effectiveness of pulpotomy versus root canal treatment, as this could aid in effective clinical decision-making. METHODS A Markov model was constructed following a mature permanent tooth with irreversible pulpitis in an 18-year-old patient over a lifetime using TreeAge Pro Healthcare 2022. Transition probabilities were estimated based on existing literature. Costs were estimated based on the United States healthcare following a private-payer perspective and parameter uncertainties were addressed using Monte-Carlo simulations. The model was validated internally by sensitivity analyses, and face validation was performed by an experienced endodontist and health economist. RESULTS In the base case scenario, root canal treatment was associated with additional health benefit but at an increased cost (1.08 more years with an incremental cost of 311.20 USD) over a period of an individual's lifetime. The probabilistic sensitivity analysis revealed pulpotomy to be cost-effective at lower Willingness-To-Pay (WTP) values (99.9% acceptable at 50 USD) whereas increasing the values of WTP threshold root canal treatment was a cost-effective treatment (99.9% acceptable at 550 USD). CONCLUSION Based on current evidence, pulpotomy was a cost-effective treatment option at lower WTP values for the management of irreversible pulpitis in mature permanent teeth. However, by increasing the WTP threshold, root canal treatment became a more cost-effective treatment option over a period of lifetime of an individual.
Collapse
Affiliation(s)
- Nighat Naved
- Operative Dentistry & Endodontics, Aga Khan University Hospital, Karachi, Pakistan
| | - Fahad Umer
- Operative Dentistry & Endodontics, Aga Khan University Hospital, Karachi, Pakistan.
| | - Asif R Khowaja
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| |
Collapse
|
20
|
Khosravifard N, Vadiati Saberi B, Khosravifard A, Hendi A, Shadi K, Mihandoust S, Yousefi Z, Mortezaei T, Ghaffari ME. Introducing a new auto edge detection technique capable of revealing cervical root resorption in CBCT scans with pronounced metallic artifacts. Sci Rep 2024; 14:4245. [PMID: 38379025 PMCID: PMC10879123 DOI: 10.1038/s41598-024-54974-1] [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: 11/27/2023] [Accepted: 02/19/2024] [Indexed: 02/22/2024] Open
Abstract
Cervical resorption is a serious threat to the longevity of the teeth. In this study, the Canny edge-detection algorithm was applied on CBCT images to compare the accuracy of original and Canny views for diagnosing cervical resorption in endodontically treated teeth. Intracanal metallic posts were inserted in 60 extracted teeth being randomly divided into three groups: control, 0.5 mm, and 1 mm cervical resorption. CBCT scans of the teeth were presented to three observers in both original and Canny formats with the accuracy being determined by receiver operating characteristic (ROC) analysis. The DeLong test was used for paired comparisons with the significance level set at 0.05. The highest accuracy belonged to Canny images in 1 mm resorption, followed by Canny images in 0.5 mm resorption, original images in 1 mm resorption, and original images in 0.5 mm resorption, respectively. The Canny images were significantly more accurate in the diagnosis of 0.5 mm (p < 0.001) and 1 mm (p = 0.009) resorption. Application of the Canny edge-detection algorithm could be suggested as a new technique for facilitating the diagnosis of cervical resorption in teeth that are negatively affected by metallic artifacts.
Collapse
Affiliation(s)
- Negar Khosravifard
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
| | - Bardia Vadiati Saberi
- Department of Periodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Khosravifard
- Department of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | - Amirreza Hendi
- Department of Dental Prosthesis, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Kimia Shadi
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Sanaz Mihandoust
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Yousefi
- Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Tahereh Mortezaei
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | | |
Collapse
|
21
|
Madfa AA, Almansour MI, Al-Zubaidi SM, Albaqawi AH, Almeshari SA, Khawshhal AA, Alshammari RH. Assessment of the quality of root canal fillings performed on extracted teeth by undergraduate dental students in a sample from Saudi Arabia. BMC Med Educ 2024; 24:157. [PMID: 38374029 PMCID: PMC10875893 DOI: 10.1186/s12909-024-05136-4] [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] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND The educational process in the field of endodontics commences with preclinical exercises to enhance students' proficiency in cleaning, shaping, and performing root canal fillings. Therefore, this study aimed to radiographically evaluate the technical quality of root canal fillings performed by preclinical students on extracted teeth at the College of Dentistry, University of Ha'il, Saudi Arabia. METHODS A total of 788 extracted human teeth received root canal treatment by undergraduate students. The samples were then gathered and radiographically assessed using the three quality criteria of length, density, and taper. The category of root canal fillings was classified as either acceptable or unacceptable. The criteria for evaluating the acceptability of filling quality were defined based on the presence of adequate length, density, and taper. The effectiveness of root canal fillings was also evaluated in relation to the tooth type, sex, and treatment year. The agreement between the examiners was evaluated using Cohen's kappa test, and the relationship between the research variables was determined using the chi-squared test. The significance threshold was set at 0. 05. RESULTS The overall quality of root filling was determined to be satisfactory in 532 (67.5%) of 788 endodontically treated extracted teeth. The majority of the research sample (88.1%) had enough length, 89.6% had adequate density, and 86.4% had acceptable taper. The quality of anterior teeth was substantially better than that of posterior teeth (p < 0.001). Our findings showed that the quality of root canals was better in 2022 than it had been in earlier years (p = 0.001). The three RCT quality criteria differed significantly when compared between sexes (p = 0.002). CONCLUSIONS The quality of the root canal fillings completed by undergraduate students was rated as acceptable. The findings of the research suggest that the implementation of routine assessments to evaluate the technical competence of undergraduate dental students performing root canal treatments could provide significant insights into the efficacy of the curriculum requirements.
Collapse
Affiliation(s)
- Ahmed A Madfa
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Kingdom of Saudi Arabia, Ha'il, Kingdom of Saudi Arabia.
| | - Moazzy I Almansour
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Kingdom of Saudi Arabia, Ha'il, Kingdom of Saudi Arabia
| | - Saad M Al-Zubaidi
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Kingdom of Saudi Arabia, Ha'il, Kingdom of Saudi Arabia
| | - Ahmed H Albaqawi
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Kingdom of Saudi Arabia, Ha'il, Kingdom of Saudi Arabia
| | - Saleh A Almeshari
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Kingdom of Saudi Arabia, Ha'il, Kingdom of Saudi Arabia
| | - Anas A Khawshhal
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Kingdom of Saudi Arabia, Ha'il, Kingdom of Saudi Arabia
| | - Rehab H Alshammari
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Kingdom of Saudi Arabia, Ha'il, Kingdom of Saudi Arabia
| |
Collapse
|
22
|
La Rosa GRM, Canova FS, Generali L, Pedullà E. The Role of Pecking Motion Depths in Dynamic Cyclic Fatigue Resistance: In Vitro Study. Int Dent J 2024:S0020-6539(24)00040-6. [PMID: 38350803 DOI: 10.1016/j.identj.2024.01.014] [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: 10/10/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE This is the first study evaluating the impact of different pecking motion depths on dynamic cyclic fatigue resistance of different endodontic instruments. METHODS Four nickel-titanium systems (Hyflex EDM OneFile 25/. ∼; Rotate 25/0.6; Mtwo 25/0.6; Reciproc Blue R25) were tested. Forty instruments from each group were subjected to 4 different pecking movements to evaluate their cyclic fatigue resistance. The distances for the pecking motion were 3-mm forward and backward, 1-mm (3-mm forward and 2-mm backward), 2-mm (4-mm forward and 2-mm backward), and 3-mm (5-mm forward and 2-mm backward). Speeds were 100 and 200 mm/min for the descending and ascending motion, respectively. The times to fracture (TtF) in seconds were recorded for each instrument. Data were statistically analysed by using 2-way ANOVA and Bonferroni multiple comparison post hoc test (P < .05). RESULTS All instruments had a significant increase in cyclic fatigue resistance during the forward dynamic motion compared with the axial continuous. Overall, the heat-treated instruments reported higher fatigue strength than the untreated files (P < .05). Reciproc Blue and Hyflex EDM showed higher TtF in the forward movements of 1-/2-mm and 2-mm (P < .05), respectively while Mtwo 25.06 and Rotate 25.06 in the forward movement of 3-mm (P < .05). CONCLUSIONS Within the limits of this in vitro study, the pecking motion depths had varying impacts on the cyclic fatigue resistance of instruments. Reciproc Blue and Hyflex EDM performed significantly better with pecking motions of 1-and 2-mm. Improving endodontic instrument durability through specific pecking depths has the potential for improving clinical performance and reducing instrument failures.
Collapse
Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Francesco Saverio Canova
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| |
Collapse
|
23
|
Rego LF, Bronzato JD, Souza APC, de-Jesus-Soares A, Frozoni M. In Vitro Evaluation of the Dynamic Cyclic Fatigue Resistance of a New TruNatomy Glider File after Different Cycles of Use. J Endod 2024:S0099-2399(24)00064-5. [PMID: 38311114 DOI: 10.1016/j.joen.2024.01.021] [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: 08/08/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Determination of the glide path is recommended before using rotary instruments. This study aimed to evaluate the dynamic cyclic fatigue resistance of new and used glider rotary instruments in up to 6 root canals. METHODS Seventy-two TruNatomy Glider files were used for the preparation of root canals of extracted lower molars, which were then submitted to the dynamic cyclic fatigue test carried out in a curved metallic artificial canal. The instruments were divided into 4 groups (n = 18): Control group, new instruments without any use in the root canal; Group 2U, instruments used in 2 mesial canals; Group 4U, instruments used in 4 mesial canals; Group 6U, instruments used in 6 mesial canals. The time to failure (TF) of the instrument was recorded, and the number of cycles to failure (NCF) was calculated. The data were submitted to 1-way analysis of variance and to the Games-Howell test for multiple comparisons, adopting a significance level of 5%. RESULTS TF and NCF were significantly affected by the number of file uses. The Games-Howell test revealed that TF and NCF were significantly greater in the control group than in Group 4U. In Group 2U, TF and NCF were intermediate and not significantly different from the control group. Group 6U had significantly lower TF and NCF than all other groups. CONCLUSION The TruNatomy Glider can be used as a glide path for up to 2 mesial canals of mandibular molars, whereas its use on 4 or 6 root canals is not suggested.
Collapse
Affiliation(s)
- Lorena Ferreira Rego
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
| | - Juliana Delatorre Bronzato
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
| | | | - Adriana de-Jesus-Soares
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marcos Frozoni
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
| |
Collapse
|
24
|
Alotaibi BB, Khan KI, Javed MQ, Dutta SD, Shaikh SS, Almutairi NM. Relationship between apical periodontitis and missed canals in mesio-buccal roots of maxillary molars: CBCT study. J Taibah Univ Med Sci 2024; 19:18-27. [PMID: 37868101 PMCID: PMC10585297 DOI: 10.1016/j.jtumed.2023.08.009] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/02/2023] [Accepted: 08/30/2023] [Indexed: 10/24/2023] Open
Abstract
Objectives The objectives of this study were to: (1) assess the frequency of missed canals in the mesiobuccal root (MB) of endodontically treated maxillary molars and its association with apical periodontitis (AP); (2) examine the correlation between the presence of a confluent or separate missed MB2 canal and the prevalence of AP; and (3) examine the correlation between the technical quality of endodontic treatment in the MB1 canal and the prevalence of AP. Methods We obtained and examined 800 cone-beam computed tomography (CBCT) scans from 800 patient records over 6 months. The parameters noted for each tooth included the tooth number; presence of missed canals in the MB root; configuration of missed MB2 canals (confluent or separate); technical acceptability of root canal treatment (RCT) of treated MB1 canals; and the CBCT periapical index score. Data were analyzed in SPSS version 24. Results A total of 203 maxillary molars from 148 CBCT scans were included. The MB2 canal prevalence was 88.2% in maxillary first molars and 62.7% in maxillary second molars. MB2 was found in 164 endodontically treated maxillary molars. During treatment, MB2 was missed in 150 (91.5%) and treated in 14 (8.5%) teeth. A total of 103 teeth (50.73%) had AP, which was observed in 67.3% of teeth with a missed MB2 canal but only 14.3% of teeth with a treated MB2 canal. The prevalence of AP was 43.7% in teeth with confluent MB2 canals and 80.9% in teeth with separate MB2 canals. Conclusion The MB2 canal frequency was significantly higher in the examined maxillary first molars than the maxillary second molars. The MB2 canal was missed in most teeth that underwent endodontic treatment. The AP prevalence was relatively higher in endodontically treated maxillary molars with missed MB2 canals.
Collapse
Affiliation(s)
- Badi B. Alotaibi
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Kiran I. Khan
- Department of Operative Dentistry, Frontier Medical and Dental College, Abbottabad, Pakistan
| | - Muhammad Q. Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Smita D. Dutta
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Safia S. Shaikh
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Nawaf M. Almutairi
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| |
Collapse
|
25
|
Ríos-Osorio N, Quijano-Guauque S, Briñez-Rodríguez S, Velasco-Flechas G, Muñoz-Solís A, Chávez C, Fernandez-Grisales R. Cone-beam computed tomography in endodontics: from the specific technical considerations of acquisition parameters and interpretation to advanced clinical applications. Restor Dent Endod 2024; 49:e1. [PMID: 38449497 PMCID: PMC10912545 DOI: 10.5395/rde.2024.49.e1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/26/2023] [Accepted: 10/13/2023] [Indexed: 03/08/2024] Open
Abstract
The implementation of imaging methods that enable sensitive and specific observation of anatomical structures has been a constant in the evolution of endodontic therapy. Cone-beam computed tomography (CBCT) enables 3-dimensional (3D) spatial anatomical navigation in the 3 volumetric planes (sagittal, coronal and axial) which translates into great accuracy for the identification of endodontic pathologies/conditions. CBCT interpretation consists of 2 main components: (i) the generation of specific tasks of the image and (ii) the subsequent interpretation report. A systematic and reproducible method to review CBCT scans can improve the accuracy of the interpretation process, translating into greater precision in terms of diagnosis and planning of endodontic clinical procedures. MEDLINE (PubMed), Web of Science, Google Scholar, Embase and Scopus were searched from inception to March 2023. This narrative review addresses the theoretical concepts, elements of interpretation and applications of the CBCT scan in endodontics. In addition, the contents and rationale for reporting 3D endodontic imaging are discussed.
Collapse
Affiliation(s)
- Néstor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sara Quijano-Guauque
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sandra Briñez-Rodríguez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Gustavo Velasco-Flechas
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | | | - Carlos Chávez
- Postgraduate Endodontics Department, IMED, Guadalajara, México
| | | |
Collapse
|
26
|
Shen S, Lu L, Liu H. Microscopic endodontic treatment of a mandibular second molar with taurodontism: A case report. Asian J Surg 2024; 47:1258-1260. [PMID: 38008614 DOI: 10.1016/j.asjsur.2023.11.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/10/2023] [Indexed: 11/28/2023] Open
Affiliation(s)
- Suqian Shen
- Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, China
| | - Le Lu
- Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, China.
| | - He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
27
|
de Araújo LP, Marchesin AR, Carpena LP, Gobbo LB, Ferreira NDS, de Almeida JFA, Ferraz CCR. Outcome of curcumin-based photodynamic therapy in endodontic microsurgery: A case report. Photodiagnosis Photodyn Ther 2024; 45:103994. [PMID: 38295923 DOI: 10.1016/j.pdpdt.2024.103994] [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: 01/11/2024] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Persistent apical periodontitis after root canal treatment may require surgical retreatment when non-surgical options are ineffective or impractical due to anatomical challenges or iatrogenic errors. Endodontic microsurgery (EMS) is a precise technique that aims to overcome extraradicular biofilm and root morphology issues. Photodynamic therapy (PDT) is an emerging supplementary disinfection approach that utilizes a photosensitizer agent and light to eliminate microorganisms through oxidative reactions. REPORT A 60-year-old male with persistent apical periodontitis in a left maxillary first molar underwent non-surgical root canal retreatment followed by surgical reintervention due to anatomical complexities. During surgery, PDT was performed using a novel curcumin-based photosensitizer agent. After the procedure, the tooth was retrofilled with bioceramic cement, and photobiomodulation was applied to enhance tissue healing. One year post-surgery, the patient exhibited complete periradicular repair and remained asymptomatic. DISCUSSION EMS is considered a last resort to salvage an endodontically treated tooth and has shown moderate success rates. PDT has demonstrated promise in improving periapical healing and reducing microorganisms. In this case, curcumin, diluted with 2 % chlorhexidine gel, served as an effective photosensitizer agent with antimicrobial properties. Moreover, performing photobiomodulation aided in cell recovery and reduced postoperative discomfort. CONCLUSION The proposed EMS treatment protocol with PDT using curcumin yielded positive outcomes in this case report. Further randomized clinical trials are necessary to assess the efficacy of this approach in EMS. Additionally, further research on curcumin-based photosensitizer agents encapsulated in nanoparticles and enhanced antimicrobial agents is recommended to refine this treatment protocol for routine use.
Collapse
Affiliation(s)
- Lucas Peixoto de Araújo
- School of Dentistry, Catholic University of Pelotas (UCPEL), Pelotas, RS, Brazil; Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
| | - Analu Rodriguez Marchesin
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Lucas Pinto Carpena
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
| | - Leandro Bueno Gobbo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Nadia de Souza Ferreira
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| |
Collapse
|
28
|
Miranda TC, Oliveira LA, Hilgert LA, Cunha-Filho M, Gelfuso GM, Gratieri T. Iontophoresis use for increasing drug penetration into root canals and dentinal tubules: A proof-of-concept study. J Dent 2024; 141:104797. [PMID: 38061412 DOI: 10.1016/j.jdent.2023.104797] [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: 10/30/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/22/2023] Open
Abstract
INTRODUCTION The success of endodontic treatment depends on the significant disinfection of the root canal system, its irregularities, and dentinal tubules. However, achieving complete disinfection remains challenging, with frequent failures and occurrence of secondary infections. Here, we propose using iontophoresis to increase the penetration and distribution of disinfecting agents into root canals, using methylene blue for proof-of-concept. METHODS The marker was applied in bovine root canals, and the radial distribution of the dye in the dentinal tubules was evaluated by optical microscopy. Iontophoresis was applied at 0.5 and 1.5 mA for 5 and 15 min. RESULTS A significant statistical difference (p < 0.05) was observed in the marker penetration between passive and iontophoretic applications. Both current density and application time had an important effect on methylene blue distribution, with a greater efficacy delivery to the apical region achieved after 1.5 mA for 5 min or 0.5 mA for 15 min, showing longer application time can compensate for lower application current. CONCLUSION Iontophoresis increases the penetration and distribution of methylene blue into bovine root canals and dentinal tubules, including its innermost portions. CLINICAL SIGNIFICANCE Iontophoresis has shown to be a promising technique for root canal and dentinal tubule disinfection.
Collapse
Affiliation(s)
- Thamires C Miranda
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Laudimar A Oliveira
- Department of Dentistry, Faculty of Health Sciences, University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Leandro A Hilgert
- Department of Dentistry, Faculty of Health Sciences, University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil.
| |
Collapse
|
29
|
Xu K, Lu L, Liu H. Microscopic endodontic treatment of a mandibular second premolar with three canals: A case report. Asian J Surg 2024:S1015-9584(24)00101-5. [PMID: 38242780 DOI: 10.1016/j.asjsur.2024.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Affiliation(s)
- Ke Xu
- Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, China
| | - Le Lu
- Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, China.
| | - He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
30
|
Coaguila-Llerena H, Raphael da Silva L, Faria G. Research methods assessing sodium hypochlorite cytotoxicity: A scoping review. Heliyon 2024; 10:e23060. [PMID: 38192787 PMCID: PMC10772573 DOI: 10.1016/j.heliyon.2023.e23060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 10/26/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
Sodium hypochlorite (NaOCl) cytotoxicity has been assessed using different methodologies, which has led to arbitrary interpretations. This scoping review aimed to discuss the different methodological protocols for assessing NaOCl cytotoxicity. A literature review performed in the PubMed and Embase databases up to July 2023 identified manuscripts reporting NaOCl cytotoxicity. The dataset identified 546 publications, further screened by 2 reviewers. Ninety studies were identified and mined methodologically to collect information on cell type, cytotoxicity assay, NaOCl dilution solutions, presence of fetal bovine serum (FBS), and NaOCl exposure time. The culture medium used in cytotoxicity assays contains buffering substances that neutralize the pH of NaOCl, thus reducing its cytotoxicity, an approach that may lead to bias when solutions with different pH are compared. For short exposure periods, as in simulations to evaluate the contact between irrigant and periapical tissue cells during chemo-mechanical preparation, NaOCl dilution should be performed with saline, which does not buffer the irrigant. For long exposure periods, as in simulations of irrigant extrusions, NaOCl should be diluted in the culture medium, to reproduce the expected buffering effect occurring in extrusions. The presence of FBS in culture medium can decrease NaOCl toxicity. There is no standardization of NaOCl cytotoxicity methodologies. This poses the risk of arriving at incorrect results and, therefore, pertinent tests must be refined.
Collapse
Affiliation(s)
- Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University -UNESP, Araraquara, São Paulo, Brazil
| | - Luana Raphael da Silva
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University -UNESP, Araraquara, São Paulo, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University -UNESP, Araraquara, São Paulo, Brazil
| |
Collapse
|
31
|
Rosado LPL, Fontenele RC, Farias-Gomes A, Freitas DQ, Neves FS. Influence of the metal post material, tooth location in the dental arch, and metal artifact reduction tool on vertical root fracture diagnosis in cone beam CT. Odontology 2024:10.1007/s10266-023-00889-8. [PMID: 38214844 DOI: 10.1007/s10266-023-00889-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024]
Abstract
This study aimed to evaluate the influence of the metal post composition, tooth location in the dental arch, and metal artifact reduction (MAR) on vertical root fracture (VRF) diagnosis in cone beam computed tomography (CBCT). Twenty-two unirradicular premolars (12 sound and 10 fractured) and two alveolar sockets of a mandible (anterior and posterior regions) composed the sample. CBCT scans of each tooth with a metal post placed into the root canal-silver-palladium (Ag-Pd), cobalt-chromium (Co-Cr), or nickel-chromium (Ni-Cr)-were individually acquired for each mandibular region, and two conditions of MAR, using a OP300 device (Instrumentarium, Finland). Images were assessed by five evaluators independently for VRF detection. Diagnostic values were calculated and compared among all groups using multi-way ANOVA with Tukey post hoc test to investigate the effect of post material, anatomical region, and MAR on VRF diagnosis (α = 0.05). Values of area under the receiver operating curve and specificity were not influenced by the studied factors (p > 0.05). Sensitivity was influenced by the MAR in both mandibular regions (p < 0.05). In the anterior region, sensitivity values increased when the MAR was enabled, regardless of the metal post material (p < 0.05). Similar behavior was noticed in the posterior region for Ni-Cr (p < 0.05) but not for Ag-Pd and Co-Cr posts (p > 0.05). The MAR improved the sensitivity in VRF diagnosis for all tested metal posts in the mandibular anterior region and for the Ni-Cr post in the mandibular posterior region. Therefore, for images obtained in the OP300 CBCT device, activation of the MAR is suggested in these cases.
Collapse
Affiliation(s)
- Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
- Department of Dentistry, University Center of Espírito Santo (UNESC), Colatina, ES, Brazil.
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Frederico Sampaio Neves
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
- Department of Propedeutics and Integrated Clinic, Division of Oral Radiology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, BA, Brazil
| |
Collapse
|
32
|
Usta SN, Erdem BA, Gündoğar M. Comparison of the removal of intracanal medicaments used in regenerative endodontics from root canal system using needle, ultrasonic, sonic, and laser-activated irrigation systems. Lasers Med Sci 2024; 39:27. [PMID: 38214804 PMCID: PMC10786972 DOI: 10.1007/s10103-024-03980-w] [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: 08/15/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
This study aimed to compare the syringe-needle irrigation (SNI), passive ultrasonic irrigation (PUI), EDDY, and shock wave-enhanced emission photoacoustic streaming (SWEEPS) techniques regarding calcium hydroxide and double antibiotic paste removal from the root canal in regenerative endodontic treatments. Eighty single-rooted human teeth were decoronated and enlarged up to #100 to stimulate the immature tooth model. Root canals were irrigated with 1.5% sodium hypochlorite followed by saline solution according to the regenerative endodontic treatment protocol. Dressed teeth were divided into 2 main groups regarding the used intracanal medicaments. Calcium hydroxide and double antibiotic paste were introduced to the canals, and teeth were stored for 3 weeks. Each medicament group was divided into 4 subgroups according to the activation techniques. Medicaments were removed using a 17% EDTA solution. Teeth were split longitudinally into two parts. The remaining medicaments were evaluated under a stereo microscope with a scoring system. Data were analyzed with the Kruskal-Wallis and Mann-Whitney U tests. Regardless of the used irrigation activation systems, there was no statistically significant difference between the removal of the CH and DAP from the root canal (P>0.05). While SWEEPS had the highest ability regarding the removal of intracanal medicaments, syringe-needle irrigation had the lowest (P<0.05). There was no statistically significant difference between PUI and EDDY (P>0.05). Complete removal of intracanal medicaments could not be achieved with any techniques. SWEEPS technology was more effective in removing intracanal medicaments in regenerative endodontic treatments compared to the sonic and ultrasonic irrigation activation systems.
Collapse
Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey.
| | - Berat Akın Erdem
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, University of Medipol, Istanbul, Turkey
| |
Collapse
|
33
|
Karobari MI, Batul R, Khan M, Patil SR, Basheer SN, Rezallah NNF, Luke AM, Noorani TY. Micro computed tomography (Micro-CT) characterization of root and root canal morphology of mandibular first premolars: a systematic review and meta-analysis. BMC Oral Health 2024; 24:1. [PMID: 38167114 PMCID: PMC10763367 DOI: 10.1186/s12903-023-03624-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/05/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Mandibular first premolars are familiar with their varied root canal morphology, causing difficulties and challenges for successful endodontic procedures. This systematic review and meta-analysis aim to study the characterization of root and canal morphology of the first mandibular premolar using micro-computed tomography. METHODOLOGY The literature search was conducted using electronic web databases like PubMed, Scopus, ScienceDirect and Cochrane with the chosen MeSH key words and data was retrieved until May 2023. Further to perform the statistical analysis, R v 4.3.1 software with "meta", 'metafor" "metaviz" " ggplot2" package was used, and results were represented by odds ratios (OR) and the percentage of forest plots along a 95 per cent confidence interval (CI). RESULTS The total number of studies meeting the inclusion criteria was 13; these studies were conducted on mandibular first premolar using Micro-CT; the total sample size was 1817. To scan the sample, an X-ray micro-focus CT system (Siemens Inveon CT, Erlangen, Germany) was used in four studies and seven different machines were used in the respective studies. Mimics 10.01 software (Materialize, Leuven, Belgium) and NRecon v.1.6.9 software (Bruker, Kontich, Belgium) were commonly operated. The minimum and maximum voxel size ranges between 11.94 and 50 μm. Vertucci's classification was frequently used (9), while one study applied Ahmed et al. and Vertucci's classification. CONCLUSION This systematic review provides essential information about the root and canal configurations, radicular grooves, accessory canals, and apical foramina through Micro-CT, aiming to improve the accuracy of endodontic treatment and help practitioners.
Collapse
Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Dental Research Unit, Centre for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
| | - Mohammad Khan
- New Age Health Science Research Center, Muradpur, Chattogram, 4331, Bangladesh
| | - Santosh R Patil
- Department of Oral Medicine and Radiology, Chhattisgarh Dental College & Research Institute, Sundra, India
| | - Syed Nahid Basheer
- Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE
- Center for Medical and Bio-Allied Health Sciences Research (CMBAHSR), Ajman University, Ajman, UAE
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
| |
Collapse
|
34
|
Barcelos Só G, Abrahão NB, Weissheimer T, Lenzi TL, Reis Só MV, da Rosa RA. Effect of Obturation Techniques on the Quality of Root Canal Fillings: A Systematic Review and Meta-analysis of in Vitro Studies. Iran Endod J 2024; 19:61-74. [PMID: 38577002 PMCID: PMC10988640 DOI: 10.22037/iej.v19i2.40210] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/12/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024]
Abstract
Introduction The current study aimed to compare the quality of root canal obturation performed with cold lateral condensation with other obturation techniques. Materials and Methods Diverse Search was conducted using six electronic/academic databases following PICOS (i.e. population, intervention, control, outcomes, and study design) strategy: (P) Extracted mature permanent teeth; (I) Obturation techniques except for cold lateral condensation; (C) Cold lateral condensation tyechnique; (O) Quality of root canal obturation; and (S) In vitro studies assessing parameters using micro-computed tomography. The statistical method used for the meta-analyses was the "inverse variance DerSimonian-Laird test". The heterogeneity data was calculated using the T2, Cochran Q test, and I2 statistics. Results Fifteen studies were included for the final analysis; one had a low risk of bias, eight a moderate risk, and six a high risk of bias. Ten studies were selected for meta-analyses; three studies comparing cold lateral condensation with carrier-based gutta-percha techniques [P=0.96; mean difference (MD)=-0.02; confidence interval (CI): (-0.77, 0.73); I2=21%]; three comparing cold lateral condensation with single-cone techniques [P=0.75; MD=-0.39; CI: (-2.77, 1.99); I2=92%]; two comparing cold lateral condensation and thermo-plasticized injectable techniques [P=0.37; MD=5.91; CI: (-7.13,18.94); I2=99%]; and five comparing cold lateral condensation with warm vertical condensation techniques [P<0.0001; MD=5.29; CI=(2.84, 7.74); I2=92%]. The overall effect reported significant results [P=0.0003; MD=2.69; CI=(1.23, 4.16); I2=96%]; favoring fewer voids and gaps for the other used obturation techniques. Conclusions Cold lateral condensation and single-cone techniques presented no statistical differences. Nonetheless, Warm vertical condensation technique had better results compared to cold lateral condensation.
Collapse
Affiliation(s)
- Gabriel Barcelos Só
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Natália Backa Abrahão
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Theodoro Weissheimer
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Tathiane Larissa Lenzi
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
35
|
de Almeida DSS, De Martin AS, Pedro Rocha DG, Fontana CE, Pelegrine RA, da Silveira Bueno P, Pinheiro SL. Influence of Passive Ultrasonic Irrigation of the Photosensitizer Used in Photodynamic Therapy on Microbial Reduction in the Root Canal System: An in Vitro Study. Iran Endod J 2024; 19:105-111. [PMID: 38577000 PMCID: PMC10988636 DOI: 10.22037/iej.v19i2.36934] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/11/2024] [Accepted: 03/09/2024] [Indexed: 04/06/2024]
Abstract
Introduction The success of endodontic treatment is based on microbial reduction promoted by the interaction of chemical and mechanical procedures. Photodynamic therapy (PDT) is used as an adjunct to conventional treatment, with significant microbial reduction. This study aimed to evaluate the influence of passive ultrasonic irrigation (PUI) of the photosensitizer (PS) used in PDT on microbial reduction in the root canal system. Materials and Methods Forty-five mesiobuccal root canals from extracted human mandibular molars that were inoculated with standard strains of Enterococcus faecalis, Candida albicans, and Streptococcus mutans for 21 days were selected. The root canals were prepared using the ProTaper Next system and randomly divided into 3 groups (n=15): 1) PDT: PDT alone; 2) PUI+PDT: PUI followed by PDT; and 3) PUI/PS+PDT: PUI of the PS followed by PDT. Microbiological samples were collected from the canals before and after using the protocols described above. The data were analyzed by analysis of variance (Tukey's test) at a significance level of 5%. Results Microbial counts before PDT, PUI+PDT, and PUI/PS+PDT did not differ significantly (P>0.05), showing methodological standardization in the microbial contamination of the root canal system. There was a significant reduction in microbial counts after PDT (61.05%), PUI+PDT (65.04%), and PUI/PS+PDT (68.58%) (P<0.01), but with no statistically significant difference between the three groups (P>0.05). Conclusion Based on the present findings, it was concluded that the combination of PUI with PDT or PS activation did not influence microbial reduction achieved by PDT alone.
Collapse
Affiliation(s)
| | - Alexandre Sigrist De Martin
- Endodontics, Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil;
| | - Daniel Guimarães Pedro Rocha
- Center of Life Sciences, School of Dentistry, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Carlos Eduardo Fontana
- Center of Life Sciences, School of Dentistry, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Rina Andréia Pelegrine
- Endodontics, Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil;
| | - Pelegrine da Silveira Bueno
- Endodontics, Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil;
| | - Sérgio Luiz Pinheiro
- Center of Life Sciences, School of Dentistry, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| |
Collapse
|
36
|
Campos GO, dos Reis Prado AH, de Assis Macedo IF, da Costa Ferreira I, da Costa Ferreira G, Benetti F, da Cunha Peixoto IF, Diniz Viana AC. Effect of Foraminal Enlargement on Periapical Healing in Necrotic Teeth: A Systematic Review. Iran Endod J 2024; 19:75-84. [PMID: 38577004 PMCID: PMC10988641 DOI: 10.22037/iej.v19i2.44037] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/17/2024] [Accepted: 03/15/2024] [Indexed: 04/06/2024]
Abstract
Introduction Foraminal Enlargement (FE) is a cleaning performed in the apical-most region of the tooth, in order to optimize root disinfection. This systematic review evaluated the influence of FE during root canal treatment on bacterial reduction and repair of the periapical lesion. Materials and Methods Searches in PubMed/MEDLINE, Scopus, Cochrane Library, Web of Science, Embase, Scielo, Lilacs and OpenGrey were performed until January-2024. Ex vivo and in vivo studies evaluating the effects of FE in the bacterial reduction and repair of the periapical lesion were included, respectively, followed by risk of bias assessment (modified version of Joanna Briggs Institute's for ex vivo studies and Systematic Review Centre for Laboratory animal Experimentation's risk of bias tools for in vivo studies). The meta-analysis was not feasible and a qualitative summary for each outcome was provided. Results Of 950 studies, 2 in vivo studies were eligible, using animal models with infected teeth. Of these two, periapical repair was evaluated with hematoxylin-eosin stain, and FE improved periapical healing. Regarding ex vivo studies, 3 were eligible, using extracted human teeth. The inoculations in ex vivo models were performed with Enterococcus (E.) faecalis, and FE reduced E. faecalis in the ex vivo models. Conclusions Foraminal enlargement seems to increase bacterial reduction within the root canal, and provide major periapical tissue repair on the histological analysis in animal studies. However, caution is necessary when translating these results to the clinical environment.
Collapse
Affiliation(s)
- Gustavo Oliveira Campos
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| | - Alexandre Henrique dos Reis Prado
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| | - Isabella Figueiredo de Assis Macedo
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| | - Isabella da Costa Ferreira
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| | - Gabriela da Costa Ferreira
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| | - Isabella Faria da Cunha Peixoto
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| | - Ana Cecília Diniz Viana
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil
| |
Collapse
|
37
|
Asgary S, Roghanizadeh L. Successful Management of a Typical Class 3 Invasive Cervical Root Resorption with Modified Pulpotomy: A Case Report. Iran Endod J 2024; 19:56-60. [PMID: 38223842 PMCID: PMC10787186 DOI: 10.22037/iej.v19i1.44253] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/23/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024]
Abstract
Invasive cervical root resorption (ICRR) is a rare and clinically complex condition marked by the progressive loss of dental hard tissues below the junctional epithelium. This case report outlines the management of a 32-year-old female patient presenting with ICRR class 3 affecting a maxillary incisor. Despite the absence of symptoms, the expansive nature of the defect warranted conservative surgical intervention. The procedure involved the surgical removal of inflamed tissues, followed by an ultraconservative modified pulpotomy utilizing calcium-enriched mixture (CEM) cement through a surgical window. The selected intervention is substantiated by its potential benefits, such as minimal removal of tooth structure and the inherent biocompatibility and sealing capabilities of CEM cement. A one-year follow-up revealed arrested resorption, re-establishment of periodontal attachment, and successful esthetic restoration, affirming the efficacy of vital pulp therapy in surgically addressing advanced ICRR. Accurate diagnosis, strategic treatment planning, and a patient-centered approach proved critical in achieving favorable outcomes.
Collapse
Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leyla Roghanizadeh
- Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
38
|
La Rosa GRM, Plotino G, Nagendrababu V, Pedullà E. Effectiveness of continuous chelation irrigation protocol in endodontics: a scoping review of laboratory studies. Odontology 2024; 112:1-18. [PMID: 37433927 PMCID: PMC10776731 DOI: 10.1007/s10266-023-00835-8] [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: 04/11/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
This scoping review aimed to synthesize and explore the current boundaries and limitations of laboratory research on the effectiveness of continuous chelation irrigation protocol in endodontics. This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Literature search was conducted on Pubmed and Scopus to identify all laboratory studies evaluating smear layer and hard-tissue debris removal or, antimicrobial efficacy, or dentine erosion induced by continuous chelation. Two independent reviewers performed the all review steps and the relevant items were recorded. Seventy-seven potentially relevant studies were identified. Finally, 23 laboratory studies met the eligibility criteria for qualitative synthesis. Seven studies focused on the smear layer/debris removal outcome, 10 on antimicrobial activity, and 10 on dentine erosion. In general, the continuous chelation protocol was equally or more effective in the cleanliness of root canals and antimicrobial activity compared with traditional sequential protocol. In addition, etidronate solutions seemed to be milder chelating agents compared to those with EDTA, thus resulting in reduced or no dentine erosion and roughness modification. Yet, the methodological differences among the included studies limit the results' generalizability. The continuous chelation seems to be equally or more effective in all investigated outcomes when compared with the traditional sequential protocol. The methodological variability among the studies and shortcomings in the methods employed limit the generalizability and clinical relevance of the results. Standardized laboratory conditions combined with reliable three-dimensional investigation approaches are necessary to obtain clinically informative findings.
Collapse
Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | | | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| |
Collapse
|
39
|
da Cunha Isaltino M, de Sousa WV, de Almeida Souto Montenegro L, Velozo Telles CT, da Silva MCFC, de Albuquerque DS. Pulp Canal Obliteration Following Traumatic Dental Injury in an Upper Lateral Incisor: A Case Report with 3-year Follow-up. Iran Endod J 2024; 19:134-138. [PMID: 38577003 PMCID: PMC10988638 DOI: 10.22037/iej.v19i2.43307] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/23/2024] [Accepted: 03/14/2024] [Indexed: 04/06/2024]
Abstract
Endodontic management of teeth afflicted with pulp canal obliteration faces a challenge due to the heightened risk of complications including excessive wear, perforation, and suboptimal chemomechanical preparation. This report aims to elucidate the clinical endodontic strategy employed in addressing pulp canal obliteration after a history of dental trauma and an associated periradicular lesion in an upper lateral incisor. A patient visited the dental emergency department with symptoms of apical swelling, acute persistent pain, and discoloration of tooth 22. Following comprehensive clinical evaluation and cone-beam computed tomography, the diagnosis of pulp canal obliteration involving the cervical and middle thirds of the tooth, alongside an acute periradicular abscess was established. Root canal was accessed using tomographic image planning, augmented by loupe magnification and ultrasonic instrumentation. Precise identification of the access cavity was radiographically confirmed, preceded by thorough irrigation with 2.5% sodium hypochlorite and subsequent cervical and middle third preparation. Verification of the working length by an electronic apex locator ensured precise apical preparation, followed by passive ultrasonic irrigation to optimize disinfection and to enhance penetrability of intracanal calcium hydroxide medication, administered for 15 days to eliminate microbial invasion. Upon resolution of symptoms, root canal obturation employing thermo-mechanical compaction and coronal sealing with composite resin was accomplished. Radiographic assessment after a one-year interval presented evidence of lesion regression and bone repair. Subsequent cone-beam computed tomography imaging at the three-year follow-up confirmed complete healing of the periradicular tissues, attesting to the efficacy of the endodontic intervention.
Collapse
Affiliation(s)
| | - Wesley Viana de Sousa
- Department of Dentistry, Universidade de Pernambuco (UPE), Recife, Pernambuco, Brazil
| | | | | | | | | |
Collapse
|
40
|
Jain P, Yu-Tong Lin R, Mishra K, Handral H, Dubey N. Three-dimensional eco-friendly bacterial nanocellulose (BNC) scaffold for regenerative dentistry: Characterization, cytocompatibility and differentiation potential. Dent Mater 2024; 40:151-157. [PMID: 37945385 DOI: 10.1016/j.dental.2023.11.001] [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: 08/04/2023] [Revised: 10/26/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Regenerative dentistry (RD) is an innovative strategy for treating necrotic teeth and regenerating damaged dental tissue. Biocompatible materials are pivotal for the advancement of RD, and the rising interest in environmental sustainability drives exploration of sustainable materials for dentistry. Bacterial nanocellulose (BNC) has emerged as a promising eco-friendly option and this study aims to assess BNC's suitability as scaffolds for regenerative dentistry applications. METHODS Different in vitro methods have been utilized to characterize the properties of BNC scaffolds in regenerative dentistry, such as scanning electron microscopy (SEM) to analyse surface property and porosity, as well as examining their absorption behaviour using phosphate-buffered saline and bovine serum. Dental pulp stem cell (DPSCs) attachment, viability, and proliferation were evaluated using SEM, live and dead, and tetrazolium reduction assays. The odontogenic potential of the scaffold was evaluated using Alizarin Red staining and qPCR (14 and 21 days). RESULTS Scanning electron microscopy (SEM) images and ethanol displacement method demonstrated the porous architecture of the BNC scaffold with an average porosity of 70.02 ± 4.74% and 50.26 ± 1.43% respectively. The scaffold absorbed 2846.54 ± 258.95 of BSA and 1648.63 ± 50.37% PBS after immersion in solution for 1 h, following pseudo first and second order kinetics. The biocompatibility assay indicated that cell density increased with time and that the scaffold was appropriate for cell adhesion and migration. Moreover, the BNC led to significantly higher mineralization and odontogenic expression compared to the control (BNC in conditioned media). SIGNIFICANCE BNC showed fast adsorption of bovine serum, allowed DPSC attachment, migration, and odontogenic differentiation. This suggests its suitability as a biocompatible scaffold for triggering in situ mineralized tissue regeneration for regenerative dental applications.
Collapse
Affiliation(s)
- Pooja Jain
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Ruby Yu-Tong Lin
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Keerti Mishra
- Department of Biological Sciences, National University of Singapore, Singapore
| | - Harish Handral
- Stem Cell Bioprocessing, Bioprocessing Technology Institute, A⁎STAR, Singapore 138668, Singapore
| | - Nileshkumar Dubey
- Faculty of Dentistry, National University of Singapore, Singapore; ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore.
| |
Collapse
|
41
|
Asgary S. Artificial Intelligence in Endodontics: A Scoping Review. Iran Endod J 2024; 19:85-98. [PMID: 38577001 PMCID: PMC10988643 DOI: 10.22037/iej.v19i2.44842] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
Artificial intelligence (AI) is transforming the diagnostic methods and treatment approaches in the constantly evolving field of endodontics. The current review discusses the recent advancements in AI; with a specific focus on convolutional and artificial neural networks. Apparently, AI models have proved to be highly beneficial in the analysis of root canal anatomy, detecting periapical lesions in early stages as well as providing accurate working-length determination. Moreover, they seem to be effective in predicting the treatment success next to identifying various conditions e.g., dental caries, pulpal inflammation, vertical root fractures, and expression of second opinions for non-surgical root canal treatments. Furthermore, AI has demonstrated an exceptional ability to recognize landmarks and lesions in cone-beam computed tomography scans with consistently high precision rates. While AI has significantly promoted the accuracy and efficiency of endodontic procedures, it is of high importance to continue validating the reliability and practicality of AI for possible widespread integration into daily clinical practice. Additionally, ethical considerations related to patient privacy, data security, and potential bias should be carefully examined to ensure the ethical and responsible implementation of AI in endodontics.
Collapse
Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
42
|
Asgary S, Dianat O. Invasive Cervical Root Resorption: A Comprehensive Review on Pathogenesis, Diagnosis, and Treatment. Iran Endod J 2024; 19:2-12. [PMID: 38223835 PMCID: PMC10787181 DOI: 10.22037/iej.v19i1.44246] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 01/16/2024]
Abstract
Invasive cervical root resorption (ICRR) is a dental pathology, marked by unexpected destruction originating in the cervical region of the tooth. This comprehensive literature review provides a holistic view into the pathogenesis, clinical manifestation, and precise management of ICRR, aiming to guide endodontists and enhance patient care and treatment outcomes. The review delves into the potential etiology of ICRR, covering contributing factors such as trauma, orthodontic treatment, and other pertinent conditions. It outlines the clinical and radiographic indicators, underscoring the crucial role of early detection and precise diagnosis in effectively managing and halting ICRR progression. The exploration of treatment approaches is thorough, ranging from non-surgical methods like vital pulp therapy or root canal treatment to surgical interventions. This review accentuates the essential role of interdisciplinary collaboration among diverse dental specialties in enhancing ICRR management. It highlights the importance of a consolidated strategy in enhancing treatment outcomes and preserving tooth structure and function. Moreover, it investigates prevention methods, risk evaluation, and identifies prospective research pathways to address the existing knowledge gaps.
Collapse
Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Omid Dianat
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Maryland, USA
| |
Collapse
|
43
|
Chidambaram JVN, Jayaprakash J, Arangannal P. Volumetric Analysis of Various Pediatric Rotary Files in the Preparation of Primary Root Canals Using Cone-beam Computed Tomography. Int J Clin Pediatr Dent 2024; 17:15-20. [PMID: 38559863 PMCID: PMC10978504 DOI: 10.5005/jp-journals-10005-2724] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Aim This study was planned to evaluate and compare the cleaning efficacy of three pediatric rotary files with the standard Protaper adult file system in primary teeth using cone-beam computed tomography (CBCT). Materials and methods A total of 40 extracted deciduous second molars, with palatal/mesial roots having at least two-thirds of root length and an intact furcation area, were distributed randomly among four groups, with each group containing 10 teeth. Canal preparation of group I (Pro AF Baby Gold), group II (Kedo SG Blue), group III (Prime Pedo), and group IV (Protaper) was done. Pre- and postoperative CBCT images were taken. The volumetric changes of the root canals were assessed and subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 16 and R Studio 3.1.1. Volumetric changes within the groups were analyzed using paired t-tests and between the groups using analysis of variance (ANOVA). Results The comparison of mean volume difference between groups using ANOVA was statistically significant with F = 4.467, p = 0.002. A Tukey post hoc test revealed that group IV was statistically significant compared with groups I (p = 0.033) and III (p = 0.008) but was not statistically significant with group II (p = 0.170). There was no statistically significant difference in volumetric changes within the three pediatric rotary file systems. Conclusion Protaper removed more dentin than all the pediatric rotary files, but it was not statistically significant over Kedo SG Blue. Among the pediatric rotary files, Kedo SG Blue removed more dentin than Pro AF Baby Gold and Prime Pedo, but they were not statistically significant. How to cite this article Nainer Chidambaram JV, Jayaprakash J, Arangannal P. Volumetric Analysis of Various Pediatric Rotary Files in the Preparation of Primary Root Canals Using Cone-beam Computed Tomography. Int J Clin Pediatr Dent 2024;17(1):15-20.
Collapse
Affiliation(s)
| | - Jeevarathan Jayaprakash
- Department of Pedodontics and Preventive Dentistry, Sree Balaji Dental College & Hospital, Chennai, Tamil Nadu, India
| | - Ponnudurai Arangannal
- Department of Pedodontics and Preventive Dentistry, Sree Balaji Dental College & Hospital, Chennai, Tamil Nadu, India
| |
Collapse
|
44
|
Ja'apar SAN, Ichwan SJA, Mustaffa M. In vivo cytotoxicity analysis of bioceramic root canal sealers on zebrafish embryo. J Dent Res Dent Clin Dent Prospects 2023; 17:242-249. [PMID: 38584992 PMCID: PMC10998162 DOI: 10.34172/joddd.2023.39163] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/13/2023] [Indexed: 04/09/2024] Open
Abstract
Background This study evaluated the cytotoxicity of four bioceramic root canal sealers (RCSs) in vivo. The embryonic zebrafish characteristics, such as mortality, survival, hatching, and general morphology, served as the parameters for assessing cytotoxicity. Methods The RCSs, namely GuttaFlow Bioseal, MTA Fillapex, CeraSeal Bioceramic, and iRoot SP, were mixed according to the manufacturer's guidelines. The extract solution was prepared by immersing the set RCS into 1X dilution of E3 solution. Then, the extract solution was delivered into a Petri dish where zebrafish embryos were allowed to develop. Cytotoxicity was evaluated 24, 48, 72, and 96 hours after fertilization. Results The Kruskal-Wallis test showed that except for GuttaFlow Bioseal, the mortality, survival, and hatching of zebrafish embryos for the remaining three bioceramic RCSs were significantly different from the negative controls (P<0.05). Significant differences were also evident in the mortality, survival, and hatching of zebrafish embryos between GuttaFlow Bioseal and three other RCSs (P<0.05). Conclusion GuttaFlow Bioseal was less cytotoxic than other bioceramics RCSs; MTA Fillapex, CeraSeal Bioceramic root canal sealer, and iRoot SP root canal sealer exhibited comparable cytotoxicity.
Collapse
Affiliation(s)
- Siti Aisyah Nadirah Ja'apar
- Department of Biotechnology, Kulliyyah of Sciences, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| | - Solachuddin Jauhari Arief Ichwan
- Department of Fundamental Dental and Medical Sciences, Kulliyyah of Dentistry (KOD), IIUM, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
- Dentistry Programme, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei
| | - Musliana Mustaffa
- Department of Restorative Dentistry, KOD, IIUM, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| |
Collapse
|
45
|
Yavaş E, Yekeler A, İlgen S, Uzunoğlu Özyürek E. In vitro assessment of the roles of initial preparation size and solvent application on apically extruded debris in endodontically treated teeth. J Dent Res Dent Clin Dent Prospects 2023; 17:250-255. [PMID: 38584998 PMCID: PMC10998170 DOI: 10.34172/joddd.2023.40665] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/02/2023] [Indexed: 04/09/2024] Open
Abstract
Background This study investigated the effects of solvent use and initial canal enlargement size on apically extruded debris (AED). Methods The palatal roots of 60 upper molars were assigned to two groups based on the initial preparation size: F3 or F4 ProTaper Universal files. The roots were obturated using the single-cone technique. Each group was subdivided based on the retreatment procedures: with or without solvent. After evaporation, the Eppendorf tubes were weighed using an electronic balance. The data were statistically analyzed (P=0.05). Results Using a solvent enhanced the amount of AED in samples initially prepared up to F3 or F4 files (P<0.05). When the solvent was used, the AED was greater in samples initially prepared up to the F4 file (P<0.05); however, when the solvent was omitted, the results were reversed (P<0.05). Conclusion Both parameters had a role in AED. Solvents should be used cautiously during root canal retreatment because of the potential for apical extrusion of filling materials. Using files with smaller tapers during initial preparation might be beneficial when considering the amount of AED compared to those with larger tapers.
Collapse
Affiliation(s)
| | | | | | - Emel Uzunoğlu Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| |
Collapse
|
46
|
Abbasi H, Saqib M, Maqsood A, Jouhar R, Rashid H, Ahmed N, Karobari MI, Heboyan A. The effectiveness of single antibiotic paste nitrofurantoin V/S double antibiotic paste in alleviation of post-operative pain of patients suffering from symptomatic irreversible pulpitis-A randomized controlled trial. SAGE Open Med 2023; 12:20503121231220794. [PMID: 38162909 PMCID: PMC10757438 DOI: 10.1177/20503121231220794] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Objective The present research evaluated and compared effectiveness between nitrofurantoin and double antibiotic paste in alleviating post-operative pain in patients suffering from symptomatic irreversible pulpitis. Methods There were 60 subjects enrolled who were allotted among three groups: Group 1 - Nitrofurantoin, Group 2 - double antibiotic paste, and Group 3 - Control. Succeeding access opening and chemo mechanical preparation, intracanal medicament was placed in the root canals. Using a numerical pain scale, pain scores were measured at the following time intervals: preoperative, 12, 24, 48, and 72 h. One-way ANOVA and post hoc statistical analysis were conducted, with a p-value of ⩽ considered as statistically significant. Results Preoperatively, most patients experienced moderate to severe pain. The patients in groups 1 and 2 reported considerable reduction in their pain scores (p ⩽ 0.001) on each time interval. However, patients in group 3 experienced a higher level of pain even at 72 h. No considerable distinction was found among participant's pain scores of groups 1 and 2 (p = 0.193). Conclusion For effective pain-relieving, both nitrofurantoin and double antibiotic paste can be successfully used in patients suffering from symptomatic irreversible pulpitis. However, when calcium hydroxide was used, patients experience high levels of pain.
Collapse
Affiliation(s)
- Hira Abbasi
- Department of Operative Dentistry and Endodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Muhammad Saqib
- Department of Operative Dentistry and Endodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Afsheen Maqsood
- Department of Oral Pathology, Bahria University Dental College, Karachi, Pakistan
| | - Rizwan Jouhar
- Department of Restorative Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Haroon Rashid
- Department of Prosthodontics, Ziauddin College of Dentistry, ZiauddinUniversity, Karachi, Pakistan
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| |
Collapse
|
47
|
Elmsmari F, Delgado LM, Duran-Sindreu F, Pérez RA, García ML, Teulé Trull M, Afrashtehfar KI, González JA, Sánchez-López E. Novel strategies enhancing endodontic disinfection: Antibacterial biodegradable calcium hydroxide nanoparticles in an ex vivo model. Int J Pharm 2023; 648:123627. [PMID: 37984620 DOI: 10.1016/j.ijpharm.2023.123627] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/18/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 11/22/2023]
Abstract
Due to the high failure rates associated to endodontic disinfection, this study aimed to investigate the antibacterial properties of poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) loaded with Ca(OH)2 for endodontic disinfection procedures. Ca(OH)2 NPs production and physicochemical characterization were carried out as well as multiple antibacterial tests using three bacterial strains and an ex vivo model of endodontic infection with extracted human teeth. Agar diffusion test and broth dilution determined the inhibition growth zones (n = 5) and the minimal inhibitory concentration (MIC, n = 5), respectively. Cell viability was assessed using Live/Dead staining with confocal microscopy (n = 5). Data was analysed using ANOVA followed by post-hoc analysis. After 24 h of incubation, Ca(OH)₂ NPs demonstrated a MIC of 10 µg/mL for Porphyromonas gingivalis (p < 0.001) and Enterococcus faecalis and 5 µg/mL for Fusobacterium nucleatum (p < 0.001). Although the agar diffusion test did not exhibit any inhibition area for Ca(OH)2 nor for Ca(OH)₂ NPs, this was probably due to the buffering effect of the agar medium. However, the antibacterial capacity was confirmed in an ex vivo model, where instrumentalized teeth were infected with Enterococcus Faecalis and treated after 28 days of culture. A significant reduction in bacterial metabolic activity was confirmed for Ca(OH)2 NPs (40 % reduction with a single dose) and confirmed by Live/Dead staining. In conclusion, Ca(OH)₂-loaded PLGA NPs present promising antibacterial efficacy for endodontic disinfection procedures.
Collapse
Affiliation(s)
- Firas Elmsmari
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, PO Box 346, United Arab Emirates; Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08195 Barcelona, Spain; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, PO Box 346, United Arab Emirates
| | - Luis María Delgado
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Fernando Duran-Sindreu
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Román A Pérez
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Maria Luisa García
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain; Institute of Nanoscience and Nanotechnology (IN(2)UB), University of Barcelona, 08028 Barcelona, Spain; Networking Research Centre of Neurodegenerative Disease (CIBERNED), Instituto de Salud Juan Carlos III, 28029 Madrid, Spain
| | - Míriam Teulé Trull
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08195 Barcelona, Spain
| | - Kelvin I Afrashtehfar
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, PO Box 346, United Arab Emirates; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; Artificial Intelligence Research Center (AIRC), Ajman University, Ajman PO Box 346, United Arab Emirates.
| | - José Antonio González
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08195 Barcelona, Spain.
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain; Institute of Nanoscience and Nanotechnology (IN(2)UB), University of Barcelona, 08028 Barcelona, Spain; Networking Research Centre of Neurodegenerative Disease (CIBERNED), Instituto de Salud Juan Carlos III, 28029 Madrid, Spain; Unit of Synthesis and Biomedical Applications of Peptides, IQAC-CSIC, 08034 Barcelona, Spain.
| |
Collapse
|
48
|
Ahlat M, Aydin C, Kaya S, Baysallar M. Identification of root canal microbiota profiles of periapical tissue diseases using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Anaerobe 2023; 84:102791. [PMID: 37925063 DOI: 10.1016/j.anaerobe.2023.102791] [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: 05/08/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES The purpose of this study was to identify microorganisms isolated from various periapical tissue diseases using Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF-MS) and classify them via an unsupervised machine learning approach. METHODS A total of 150 patients with various apical conditions and teeth in need of endodontic retreatment were divided into five groups, including Retreatment, Acute Apical Abscess, Chronic Apical Abscess, Acute Apical Periodontitis, and Chronic Apical Periodontitis. Samples were collected from root canals using paper points after agitating with a #10 K file then microorganisms were identified using MALDI-TOF-MS. Data were analyzed using a hierarchical clustering method. Quadruple clusters and dendrograms were formed according to similarities and dissimilarities. RESULTS A total of 80 species were identified representative of six different phyla. The most similar microorganism species identified were: ''Enterococcus faecalis'' between 21 and 23-year-old female cases in Retreatment group; ''Lactobacillus rhamnosus'' between 20 and 18-year-old male cases in Symptomatic Apical Abscess cases; ''Lactobacillus paracasei'' between 26 and 40-year-old male cases in Asymptomatic Apical Abscess cases; ''Enterococcus faecalis'' between 48 and 50-year-old female cases in Symptomatic Apical Periodontitis cases; ''Lactobacillus rhamnosus'' between 48 and 60-year-old male cases in Asymptomatic Apical Periodontitis cases. CONCLUSIONS MALDI-TOF MS can be considered a fast and high-throughput screening technique for microbial species identification in endodontics. Thus, it will provide valuable data for future research designs regarding periapical tissue diseases. As the MALDI-TOF MS database expands and comprehensive data becomes available, the relationship between microbial profiles and disease progression will become increasingly apparent.
Collapse
Affiliation(s)
- Mete Ahlat
- University of Health Sciences, Gulhane Faculty of Dentistry, Department of Endodontics, Ankara, Turkey.
| | - Cumhur Aydin
- University of Health Sciences, Gulhane Faculty of Dentistry, Department of Endodontics, Ankara, Turkey.
| | - Sinem Kaya
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
| | - Mehmet Baysallar
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
| |
Collapse
|
49
|
Gliga A, Săndulescu M, Amza O, Stănescu R, Imre M. Dental pathologies of endodontic origin and subsequent bacterial involvement - a literature review. Germs 2023; 13:373-380. [PMID: 38361538 PMCID: PMC10866160 DOI: 10.18683/germs.2023.1407] [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: 10/18/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 02/17/2024]
Abstract
Dental pathologies of endodontic origin are varied in nature, and include infectious and non-infectious causes. Through this review, we aim to provide a deeper understanding of the role of bacterial involvement and in the pathogenesis of endodontic pathologies, by reviewing the relevant literature on the most common bacterial species involved, and their capacity to organize as biofilms. Furthermore, we focus on the most important recent updates in the management of endodontic infections, from a multidisciplinary perspective.
Collapse
Affiliation(s)
- Alexandru Gliga
- DDS, PhD student, Department of Endodontics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Mihai Săndulescu
- DDS, PhD, Associate Professor, Department of Implant Prosthetic Therapy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Oana Amza
- DDS, PhD, Associate Professor, Department of Endodontics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Ruxandra Stănescu
- DDS, PhD, Assistant Lecturer, Department of Implant Prosthetic Therapy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Marina Imre
- DDS, PhD, Professor, Department of Prosthodontics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| |
Collapse
|
50
|
Javed MQ, Khan M, Khan KI, Almutairi N. Endodontic infection control practices among Pakistani general dental practitioners: A national cross-sectional questionnaire survey. J Taibah Univ Med Sci 2023; 18:1342-1349. [PMID: 37305026 PMCID: PMC10248868 DOI: 10.1016/j.jtumed.2023.05.014] [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: 02/17/2023] [Revised: 05/04/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
Objective This study was aimed at evaluating the self-reported endodontic infection control practices of general dental practitioners in Pakistan. Methods An e-questionnaire was sent to 619 general dental practitioners in several WhatsApp groups. Sixteen questions associated with various infection control measures recommended by the ESE were asked, including the use of various isolation methods/rubber dams, the selection of canal irrigants and anti-bacterial solutions, and practices regarding hand hygiene and use of examination gloves. The e-questionnaire also included questions associated with demographics. Data analysis was conducted in SPSS-24. Descriptive statistics were documented as percentages and frequencies. Results Of 619 GDPs, 350 responded (56.5% response rate), of whom 43.7% worked in private dental practices. The majority were women (64%), had graduated after 2010 (81.1%), and were 24-34 years of age (78.9%). A total of 72.3% of GDPs used cotton rolls, and 17.4% routinely used rubber dams for endodontic isolation; 89% did not disinfect the operative field; 80% reported using different concentrations of NaOCl during root canal instrumentation; and 0.9% reported not using any irrigant during endodontic procedures. A total of 61.7% reported always using intra-canal medication during multi visit endodontic treatment, among whom 82.5% reported using Ca(OH)2. Finally, 100% of respondents reported using gloves during endodontic treatment. Conclusion The results indicated that the GDPs tended to follow some of the endodontics quality standards recommended by the ESE, but the overall implementation of all guidelines requires improvement.
Collapse
Affiliation(s)
- Muhammad Q. Javed
- Deparment of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, 52571, Qassim, Saudi Arabia
| | - Mansoor Khan
- Department of Operative Dentistry, Foundation University College of Dentistry, Foundation University, Rawalpindi, Pakistan
| | - Kiran I. Khan
- Department of Operative Dentistry, Frontier Medical and Dental College, Abbottabad, KPK, Pakistan
| | - Nawaf Almutairi
- Deparment of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, 52571, Qassim, Saudi Arabia
| |
Collapse
|