Introduction: Surface treatment of avulsed tooth must be directed towards the debridement of necrotic periodontal fibers while having no effect on the cementum microhardness. The role of proteolytic enzymes on the periodontal ligament (PDL) surface and hardness of cementum has not been investigated in the literature. Aim: The present study aimed to evaluate the effect of 5.25% sodium hypochlorite (NaOCl), 10% bromelain, 10% papain and 10% panzyme on root surface topography and microhardness of avulsed teeth. Materials and Methods: Forty healthy premolars were freshly extracted and randomly allocated into five treatment groups based on the surface agent employed; Group 1: 50 ml saline, Group 2:20 ml of 5.25% NaOCl, Group 3: 20 ml of 10% bromelain enzyme, Group 4: 20 ml of 10% papain enzyme, and Group 5: 20 ml of 10% mixed panzyme enzyme. The specimens were then subjected to confocal laser scanning microscopy and scanning electron microscopic examination. Supplemental set of freshly extracted forty premolars were decoronated longitudinally and one-half from each specimen was submitted for Vickers microhardness testing before and after application of the above-mentioned agents. Statistical Analysis: Intragroup comparison of mean percentage hardness reduction was assessed using paired t-test. Results: Treatment with NaOCl led to complete removal of PDL fibers with the presence of cracks and crazes on the root surface along with a significant reduction in microhardness. Bromelain and papain revealed regular and even distribution, while few PDL fibers were evident with papain. Panzyme revealed a shiny surface with minute cracks and a significant reduction in microhardness. Conclusion: Ten percentage bromelain for 10 min was effective in the removal of necrotic PDL fibers and preserved the cementum integrity better.
{"title":"Does periodontal ligament removal using natural proteolytic enzymes alter the surface structure and microhardness of cementum of avulsed tooth? An in vitro analysis","authors":"S. Taneja, Chetna Dudeja, V. Bhalla, Punya Taneja","doi":"10.4103/sej.sej_80_22","DOIUrl":"https://doi.org/10.4103/sej.sej_80_22","url":null,"abstract":"Introduction: Surface treatment of avulsed tooth must be directed towards the debridement of necrotic periodontal fibers while having no effect on the cementum microhardness. The role of proteolytic enzymes on the periodontal ligament (PDL) surface and hardness of cementum has not been investigated in the literature. Aim: The present study aimed to evaluate the effect of 5.25% sodium hypochlorite (NaOCl), 10% bromelain, 10% papain and 10% panzyme on root surface topography and microhardness of avulsed teeth. Materials and Methods: Forty healthy premolars were freshly extracted and randomly allocated into five treatment groups based on the surface agent employed; Group 1: 50 ml saline, Group 2:20 ml of 5.25% NaOCl, Group 3: 20 ml of 10% bromelain enzyme, Group 4: 20 ml of 10% papain enzyme, and Group 5: 20 ml of 10% mixed panzyme enzyme. The specimens were then subjected to confocal laser scanning microscopy and scanning electron microscopic examination. Supplemental set of freshly extracted forty premolars were decoronated longitudinally and one-half from each specimen was submitted for Vickers microhardness testing before and after application of the above-mentioned agents. Statistical Analysis: Intragroup comparison of mean percentage hardness reduction was assessed using paired t-test. Results: Treatment with NaOCl led to complete removal of PDL fibers with the presence of cracks and crazes on the root surface along with a significant reduction in microhardness. Bromelain and papain revealed regular and even distribution, while few PDL fibers were evident with papain. Panzyme revealed a shiny surface with minute cracks and a significant reduction in microhardness. Conclusion: Ten percentage bromelain for 10 min was effective in the removal of necrotic PDL fibers and preserved the cementum integrity better.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"13 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86088895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalid A Merdad, Maram Alnaffaie, Rawan Balbaid, Asmaa Nakity, Faisal Alghamdi, D. Sabbahi, Saad Al Nazhan
Introduction: The proper protocol for the sterilization of instruments is essential in dental practice; especially because some clinicians think that new files directly from the manufacturers are already sterile and can be used directly on patients without the standard sterilization. Therefore, the aim of this study is to analyze the dental levels of professionals and their auxiliary staffs concerning awareness, knowledge, attitudes, and behaviors about sterilizing endodontic instruments and gutta-percha. Materials and Methods: This cross-sectional study was conducted in Jeddah, Saudi Arabia, using an online, randomly distributed survey for dental health-care practitioners. The survey questions were about the participants' demographics, knowledge, attitudes, and behaviors about sterilization techniques for endodontic files and gutta-percha. Data analysis consisted of simple descriptive statistics presented in frequency tables and percentages. Results: Of the 197 dental health-care practitioners surveyed, the majority (84.7%) stated that they use files directly from the manufacturer's packages, while only 15.3% reported sterilizing the new endodontic files before using them with patients. As for gutta-percha, 23.4% of the participants answered that they disinfected it before obturation. About 60% of the participants were unaware that the sterilization's expiry date was printed on the endodontic file packages. Conclusions: The results indicated that the majority of dental practitioners and students do not practice an effective sterilization protocol for endodontic files and gutta-percha. Based on these results, this study recommends that more education about sterilization protocols should be added to the infection control curriculum.
{"title":"Dental health-care professionals' awareness and knowledge of sterilization and disinfection practices for new, unused endodontic files and gutta-percha in Jeddah, Saudi Arabia","authors":"Khalid A Merdad, Maram Alnaffaie, Rawan Balbaid, Asmaa Nakity, Faisal Alghamdi, D. Sabbahi, Saad Al Nazhan","doi":"10.4103/sej.sej_176_22","DOIUrl":"https://doi.org/10.4103/sej.sej_176_22","url":null,"abstract":"Introduction: The proper protocol for the sterilization of instruments is essential in dental practice; especially because some clinicians think that new files directly from the manufacturers are already sterile and can be used directly on patients without the standard sterilization. Therefore, the aim of this study is to analyze the dental levels of professionals and their auxiliary staffs concerning awareness, knowledge, attitudes, and behaviors about sterilizing endodontic instruments and gutta-percha. Materials and Methods: This cross-sectional study was conducted in Jeddah, Saudi Arabia, using an online, randomly distributed survey for dental health-care practitioners. The survey questions were about the participants' demographics, knowledge, attitudes, and behaviors about sterilization techniques for endodontic files and gutta-percha. Data analysis consisted of simple descriptive statistics presented in frequency tables and percentages. Results: Of the 197 dental health-care practitioners surveyed, the majority (84.7%) stated that they use files directly from the manufacturer's packages, while only 15.3% reported sterilizing the new endodontic files before using them with patients. As for gutta-percha, 23.4% of the participants answered that they disinfected it before obturation. About 60% of the participants were unaware that the sterilization's expiry date was printed on the endodontic file packages. Conclusions: The results indicated that the majority of dental practitioners and students do not practice an effective sterilization protocol for endodontic files and gutta-percha. Based on these results, this study recommends that more education about sterilization protocols should be added to the infection control curriculum.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"1 1","pages":"94 - 99"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89136945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/1658-5984.367583
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{"title":"11th Saudi Endodontic Society International Conference 2022","authors":"","doi":"10.4103/1658-5984.367583","DOIUrl":"https://doi.org/10.4103/1658-5984.367583","url":null,"abstract":".","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"29 1","pages":"122 - 124"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84546462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Khaloufi, Lauzan Khalaf, N. Akerzoul, Fatima Zohra Hassani, B. Touré
Introduction: Nowadays, antibiotics are not correctly used among some dental practitioners. Thus, the misuse of antibiotics could lead to antibiotic resistance in the long run. The aim of this study was to evaluate the prescribing attitudes of dental practitioners in Northern Morocco when treating pulpal and periapical pathologies. Materials and Methods: This cross-sectional study involved 220 dental practitioners registered on the board of the National Council Order of Dentists of Morocco. A self-administered questionnaire, regarding the types of antibiotics used for endodontic treatment in healthy adult patients with endodontic pathological situations, was used and filled out via the E-mail addresses of practitioners chosen randomly. The data were analyzed with Jamovi (version 1.8.1). Quantitative variables were expressed as mean and standard deviation and qualitative variables as number and percentage. The Chi-square and the ANOVA tests were performed. The significance level was P < 0.05. Results: Forty percentage of dental practitioners prescribed amoxicillin as a first-line therapy for a patient who does not have a penicillin allergy and for patients with a penicillin allergy; azithromycin was the drug of choice prescribed by 41.1% of practitioners. The duration of prescription was 6.5 days ± 0.7. No statistically significant difference was noted regarding the duration of the prescription, in relation to age, sex, specialization, and country of graduation (P > 0.05). The acute apical abscess represents the pathology for which most antibiotics are prescribed. Practitioners aged between 24 and 35 years prescribe more than the oldest practitioners (P = 0.04). Antibiotics were also prescribed for the management of pulpitis and chronic apical periodontitis. The lowest prescription rates were noted among practitioners specializing in or having benefited from endodontic training. Conclusion: It emerges from this study that very few practitioners use antibiotics appropriately in treating pulpal and periapical pathologies. A real lack of knowledge has been noted with regard to indications, dosages, and duration.
{"title":"Attitudes of dental practitioners from Northern Morocco on the prescription of antibiotics during endodontic treatment: A survey","authors":"O. Khaloufi, Lauzan Khalaf, N. Akerzoul, Fatima Zohra Hassani, B. Touré","doi":"10.4103/sej.sej_61_22","DOIUrl":"https://doi.org/10.4103/sej.sej_61_22","url":null,"abstract":"Introduction: Nowadays, antibiotics are not correctly used among some dental practitioners. Thus, the misuse of antibiotics could lead to antibiotic resistance in the long run. The aim of this study was to evaluate the prescribing attitudes of dental practitioners in Northern Morocco when treating pulpal and periapical pathologies. Materials and Methods: This cross-sectional study involved 220 dental practitioners registered on the board of the National Council Order of Dentists of Morocco. A self-administered questionnaire, regarding the types of antibiotics used for endodontic treatment in healthy adult patients with endodontic pathological situations, was used and filled out via the E-mail addresses of practitioners chosen randomly. The data were analyzed with Jamovi (version 1.8.1). Quantitative variables were expressed as mean and standard deviation and qualitative variables as number and percentage. The Chi-square and the ANOVA tests were performed. The significance level was P < 0.05. Results: Forty percentage of dental practitioners prescribed amoxicillin as a first-line therapy for a patient who does not have a penicillin allergy and for patients with a penicillin allergy; azithromycin was the drug of choice prescribed by 41.1% of practitioners. The duration of prescription was 6.5 days ± 0.7. No statistically significant difference was noted regarding the duration of the prescription, in relation to age, sex, specialization, and country of graduation (P > 0.05). The acute apical abscess represents the pathology for which most antibiotics are prescribed. Practitioners aged between 24 and 35 years prescribe more than the oldest practitioners (P = 0.04). Antibiotics were also prescribed for the management of pulpitis and chronic apical periodontitis. The lowest prescription rates were noted among practitioners specializing in or having benefited from endodontic training. Conclusion: It emerges from this study that very few practitioners use antibiotics appropriately in treating pulpal and periapical pathologies. A real lack of knowledge has been noted with regard to indications, dosages, and duration.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"11 1","pages":"316 - 321"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82157648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The coronavirus disease 2019 (COVID-19) pandemic had a profound impact on dental care and academic education. This survey investigated the prevalence of the COVID-19 pandemic, symptoms, and its impact among endodontic trainees in the Kingdom of Saudi Arabia. Materials and Methods: This cross-sectional web-based survey targeted all endodontic residents in Saudi Arabia. A 22-item questionnaire was distributed to a total of 197 participants. The questionnaire included questions related to demographic information, COVID-19 impact on endodontic postgraduate training, the incidence of testing positive, symptoms experienced, and infection control measures. Descriptive and analytic statistics (Chi-square or Fisher's exact test) were used for the analysis. The significance level was set at P ≤ 0.05. Results: A total of 125 residents completed the survey. During June and July of 2020, most residents (45% and 50%) were required to perform only urgent endodontic care. Among the 125 residents, 52.8% reported being tested for severe acute respiratory syndrome coronavirus 2. Of these 66 who were tested, 13.6% had positive results. Eight of the nine residents who tested positive were male. Muscle pain, loss of smell and taste, fever, and headache were the most reported symptoms. A nonsurgical root canal treatment was the most common endodontic procedure performed among those surveyed (100%, n = 125), followed by endodontic emergency (84.8%, n = 106), with surgical endodontic treatment being far less frequent (27.2%, n = 34). Enhanced infection prevention and control measures were common practices during the pandemic; almost half of the residents reported using an N95 respirator or equivalent face mask. Residents continued to provide urgent care during the pandemic, and the majority returning gradually to practice as they had before the COVID-19 pandemic by December 2020. Conclusion: This survey showed a relatively low prevalence of COVID-19 among endodontic residents compared with other frontline healthcare workers. More male residents tested positive COVID-19. A more effective protection measurement should be made available and accessible to endodontic residents to ensure their safety and prevent interruptions to their clinical training.
{"title":"Estimating the prevalence of COVID-19 disease and its effect among trainees in the endodontic postgraduate programs in the kingdom of Saudi Arabia: A web-based survey study","authors":"Fahd Alsalleeh, Sara Alaathy, R. AlBlaihed","doi":"10.4103/sej.sej_60_22","DOIUrl":"https://doi.org/10.4103/sej.sej_60_22","url":null,"abstract":"Introduction: The coronavirus disease 2019 (COVID-19) pandemic had a profound impact on dental care and academic education. This survey investigated the prevalence of the COVID-19 pandemic, symptoms, and its impact among endodontic trainees in the Kingdom of Saudi Arabia. Materials and Methods: This cross-sectional web-based survey targeted all endodontic residents in Saudi Arabia. A 22-item questionnaire was distributed to a total of 197 participants. The questionnaire included questions related to demographic information, COVID-19 impact on endodontic postgraduate training, the incidence of testing positive, symptoms experienced, and infection control measures. Descriptive and analytic statistics (Chi-square or Fisher's exact test) were used for the analysis. The significance level was set at P ≤ 0.05. Results: A total of 125 residents completed the survey. During June and July of 2020, most residents (45% and 50%) were required to perform only urgent endodontic care. Among the 125 residents, 52.8% reported being tested for severe acute respiratory syndrome coronavirus 2. Of these 66 who were tested, 13.6% had positive results. Eight of the nine residents who tested positive were male. Muscle pain, loss of smell and taste, fever, and headache were the most reported symptoms. A nonsurgical root canal treatment was the most common endodontic procedure performed among those surveyed (100%, n = 125), followed by endodontic emergency (84.8%, n = 106), with surgical endodontic treatment being far less frequent (27.2%, n = 34). Enhanced infection prevention and control measures were common practices during the pandemic; almost half of the residents reported using an N95 respirator or equivalent face mask. Residents continued to provide urgent care during the pandemic, and the majority returning gradually to practice as they had before the COVID-19 pandemic by December 2020. Conclusion: This survey showed a relatively low prevalence of COVID-19 among endodontic residents compared with other frontline healthcare workers. More male residents tested positive COVID-19. A more effective protection measurement should be made available and accessible to endodontic residents to ensure their safety and prevent interruptions to their clinical training.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"51 1","pages":"269 - 276"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86565446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prasannasrinivas Deshpande, K. Patil, U. Hegde, M. Vijayan
MICRR is a rare disease affecting more than 3 teeth at a time and is known to gradually involve other teeth. The etiology of this progressive disease is unknown and is usually detected as an incidental radiographic finding. This article reports one such case involving 5 teeth in a 25 year old healthy male patient who reported the chief complaint of discomfort and vague dull pain in the left mandibular posterior tooth for 3 months. Intraoral examination revealed initial occlusal pit caries on mandibular left first molar (#36) with grade I mobility, which was nontender on percussion with no vestibular findings. A panoramic radiograph showed a well defined radiolucent lesion in the cervical region on the mesial and distal surfaces of tooth #36 and the distal cervical areas of mandibular left first (#34) and second premolar (#35). Tooth #36 was extracted due to poor prognosis and subjected to histopathological investigation, scanning electron microscopy (SEM), and energy dispersive X ray (EDX or EDS) analysis. Histopathological evaluation showed cervical resorption with surface resorptive irregularities with vacuolar changes, and SEM revealed areas of lacunar resorption with irregular borders. Results of EDX analysis showed atomic % of calcium (CA) and phosphate (P) of 4.8% and 3.4%, respectively, with a CA: P ratio of 1.41:1.
{"title":"Multiple idiopathic invasive cervical root resorption","authors":"Prasannasrinivas Deshpande, K. Patil, U. Hegde, M. Vijayan","doi":"10.4103/sej.sej_12_22","DOIUrl":"https://doi.org/10.4103/sej.sej_12_22","url":null,"abstract":"MICRR is a rare disease affecting more than 3 teeth at a time and is known to gradually involve other teeth. The etiology of this progressive disease is unknown and is usually detected as an incidental radiographic finding. This article reports one such case involving 5 teeth in a 25 year old healthy male patient who reported the chief complaint of discomfort and vague dull pain in the left mandibular posterior tooth for 3 months. Intraoral examination revealed initial occlusal pit caries on mandibular left first molar (#36) with grade I mobility, which was nontender on percussion with no vestibular findings. A panoramic radiograph showed a well defined radiolucent lesion in the cervical region on the mesial and distal surfaces of tooth #36 and the distal cervical areas of mandibular left first (#34) and second premolar (#35). Tooth #36 was extracted due to poor prognosis and subjected to histopathological investigation, scanning electron microscopy (SEM), and energy dispersive X ray (EDX or EDS) analysis. Histopathological evaluation showed cervical resorption with surface resorptive irregularities with vacuolar changes, and SEM revealed areas of lacunar resorption with irregular borders. Results of EDX analysis showed atomic % of calcium (CA) and phosphate (P) of 4.8% and 3.4%, respectively, with a CA: P ratio of 1.41:1.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"47 1","pages":"331 - 337"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82945229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The study aimed to assess the impact of fractionated radiation on push-out bond strength of sealer to dentin interface and on marginal adaptation of the sealer (Adseal, MTA Fillapex, and EndoSequence BC sealer) to irradiated dentin. Materials and Methods: Ninety maxillary central incisors were randomly divided into two groups: with irradiation (n = 45) and without (n = 45). All the samples to be radiated were exposed to fractionated dosage (60 Gy) through Co-60 gamma (1.17 and 1.33 Mev) photons. Specimens were prepared and subdivided into three subgroups (n = 15 each) according to assigned sealer Adseal, MTA Fillapex, and EndoSequence BC sealer. Later, the samples were sectioned into a 1 mm thick segment at each root third for bond strength and scanning electron microscope (SEM) analysis. SEM micrographs were analyzed with an ORION version 6 image analyzer. The percentage of failure mode after debonding was evaluated with a stereomicroscope. Bond strength data were analyzed using two-way analysis of variance and the Tukey's post hoc test. Results: Bond strength was significantly (P < 0.0001) decreased after radiotherapy (0.76 ± 0.12 Mpa) versus without radiation (0.93 ± 0.18 Mpa). Furthermore, when the pooled average of sealers was compared, significantly highest bond strength was perceived in Adseal (0.98 ± 0.18 Mpa) followed by EndoSequence BC (0.84 ± 0.13 Mpa). Coronal sections showed significantly (P < 0.0001) higher bond strength (0.99 ± 0.16 Mpa) compared to the middle (0.81 ± 0.14 MPa) and apical third (0.74 ± 0.12 Mpa). Qualitative SEM revealed a higher interfacial gap between sealer and irradiated radicular dentin. The percentage of mean change was recorded significantly high in MTA Fillapex (52%), then in EndoSequence BC (31%), and least was in Adseal (17%). Conclusions: Irradiated teeth resulted in consequential decreased adhesiveness and bond strength of dentin to root canal filling material. In addition, the highest bond strength was noticed in Adseal.
{"title":"Effect of therapeutic fractionated radiotherapy on bond strength and interfacial marginal adaptation of Adseal, MTA Fillapex, and EndoSequence BC sealer: An in vitro study","authors":"Monika Khangwal, R. Solanki, H. Rahman","doi":"10.4103/sej.sej_21_22","DOIUrl":"https://doi.org/10.4103/sej.sej_21_22","url":null,"abstract":"Introduction: The study aimed to assess the impact of fractionated radiation on push-out bond strength of sealer to dentin interface and on marginal adaptation of the sealer (Adseal, MTA Fillapex, and EndoSequence BC sealer) to irradiated dentin. Materials and Methods: Ninety maxillary central incisors were randomly divided into two groups: with irradiation (n = 45) and without (n = 45). All the samples to be radiated were exposed to fractionated dosage (60 Gy) through Co-60 gamma (1.17 and 1.33 Mev) photons. Specimens were prepared and subdivided into three subgroups (n = 15 each) according to assigned sealer Adseal, MTA Fillapex, and EndoSequence BC sealer. Later, the samples were sectioned into a 1 mm thick segment at each root third for bond strength and scanning electron microscope (SEM) analysis. SEM micrographs were analyzed with an ORION version 6 image analyzer. The percentage of failure mode after debonding was evaluated with a stereomicroscope. Bond strength data were analyzed using two-way analysis of variance and the Tukey's post hoc test. Results: Bond strength was significantly (P < 0.0001) decreased after radiotherapy (0.76 ± 0.12 Mpa) versus without radiation (0.93 ± 0.18 Mpa). Furthermore, when the pooled average of sealers was compared, significantly highest bond strength was perceived in Adseal (0.98 ± 0.18 Mpa) followed by EndoSequence BC (0.84 ± 0.13 Mpa). Coronal sections showed significantly (P < 0.0001) higher bond strength (0.99 ± 0.16 Mpa) compared to the middle (0.81 ± 0.14 MPa) and apical third (0.74 ± 0.12 Mpa). Qualitative SEM revealed a higher interfacial gap between sealer and irradiated radicular dentin. The percentage of mean change was recorded significantly high in MTA Fillapex (52%), then in EndoSequence BC (31%), and least was in Adseal (17%). Conclusions: Irradiated teeth resulted in consequential decreased adhesiveness and bond strength of dentin to root canal filling material. In addition, the highest bond strength was noticed in Adseal.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"56 1","pages":"289 - 296"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83501144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The mesial root of the mandibular molar is one of the most complex internal anatomies of human dentition. This study aimed to detect root canal morphology and the incidence of isthmus in the mesial root canal of the mandibular first molar using cone-beam computed tomography (CBCT) of different voxel size scanning modes compared to stereomicroscopic evaluation after teeth clearance. Materials and Methods: Sixty extracted mandibular first molars were collected, fixed in foam blocks, and scanned using CBCT with 150 and 400 μm voxel sizes. All the teeth were cleared and fixed in clear epoxy blocks for serial cross-sectioning from the apex, then examined using a stereomicroscope. Comparisons between cross-sectioned slices were achieved using Friedman's test (P ≤ 0.05). Results: There was a statistically significant difference between the cleared teeth, voxel sizes of 400 and 150 μm in the detection of the root canal and isthmus. Only voxel size 150 μm was able to detect the isthmus at 1 mm and 2.5 mm from the apex. Vertucci Types IV and II were the most common canal configurations reported, with a high incidence of isthmus at 4 mm and 5.5 mm from the apex. Conclusion: The 150 μm voxel size mode provides more accurate detection of the isthmus portion and root canal morphology. Vertucci Types IV and II were the most common canal configurations, and an isthmus with a high incidence was found at 4 mm and 5.5 mm from the apex of the mesial root of the mandibular first molar.
{"title":"Root canal morphology and incidence of isthmus in the mesial root canal of the mandibular first molar using cone-beam computed tomography of two different scanning modes","authors":"Mina Zaher, M. Rabie, H. Hassan","doi":"10.4103/sej.sej_54_22","DOIUrl":"https://doi.org/10.4103/sej.sej_54_22","url":null,"abstract":"Introduction: The mesial root of the mandibular molar is one of the most complex internal anatomies of human dentition. This study aimed to detect root canal morphology and the incidence of isthmus in the mesial root canal of the mandibular first molar using cone-beam computed tomography (CBCT) of different voxel size scanning modes compared to stereomicroscopic evaluation after teeth clearance. Materials and Methods: Sixty extracted mandibular first molars were collected, fixed in foam blocks, and scanned using CBCT with 150 and 400 μm voxel sizes. All the teeth were cleared and fixed in clear epoxy blocks for serial cross-sectioning from the apex, then examined using a stereomicroscope. Comparisons between cross-sectioned slices were achieved using Friedman's test (P ≤ 0.05). Results: There was a statistically significant difference between the cleared teeth, voxel sizes of 400 and 150 μm in the detection of the root canal and isthmus. Only voxel size 150 μm was able to detect the isthmus at 1 mm and 2.5 mm from the apex. Vertucci Types IV and II were the most common canal configurations reported, with a high incidence of isthmus at 4 mm and 5.5 mm from the apex. Conclusion: The 150 μm voxel size mode provides more accurate detection of the isthmus portion and root canal morphology. Vertucci Types IV and II were the most common canal configurations, and an isthmus with a high incidence was found at 4 mm and 5.5 mm from the apex of the mesial root of the mandibular first molar.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"1 1","pages":"309 - 315"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89221695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C-shaped canal configuration poses a challenge to the clinician, both at the diagnostic and treatment levels. The present case series aims to describe the management of mandibular premolars that have various C-shaped configurations. Three healthy Saudi females were referred to the endodontic department for the management of premolars that appear unusual radiographically. The teeth response was normal to palpation and percussion. The cold test was negative for the concerned premolars. A diagnosis of either necrosis or previously initiated was established for the pulpal condition. The periapical tissues were diagnosed as normal/asymptomatic apical periodontitis. Modern endodontic tools such as a limited field of view cone-beam computed tomography, the dental operating microscope, and nickel–titanium files were used to negotiate, clean, and shape the root canal system. While EndoActivator sonic irrigant activation was used to effectively disinfect the uninstrumentable ramifications, thermo-plasticized gutta-percha in continuous-wave compaction technique was used to fill the root canal system. During a 12-month follow-up, the clinical and radiographic evaluation revealed no signs and symptoms and periapical healing of the lesion associated with the tooth in case #1. The other premolars were also free of signs and symptoms, with normal apical tissues.
{"title":"Management of mandibular premolars with various C-shaped root canal configurations: A case series","authors":"Najma Al-Mahroos, S. Al-Mahroos, Saad Al-shahrani","doi":"10.4103/sej.sej_27_22","DOIUrl":"https://doi.org/10.4103/sej.sej_27_22","url":null,"abstract":"C-shaped canal configuration poses a challenge to the clinician, both at the diagnostic and treatment levels. The present case series aims to describe the management of mandibular premolars that have various C-shaped configurations. Three healthy Saudi females were referred to the endodontic department for the management of premolars that appear unusual radiographically. The teeth response was normal to palpation and percussion. The cold test was negative for the concerned premolars. A diagnosis of either necrosis or previously initiated was established for the pulpal condition. The periapical tissues were diagnosed as normal/asymptomatic apical periodontitis. Modern endodontic tools such as a limited field of view cone-beam computed tomography, the dental operating microscope, and nickel–titanium files were used to negotiate, clean, and shape the root canal system. While EndoActivator sonic irrigant activation was used to effectively disinfect the uninstrumentable ramifications, thermo-plasticized gutta-percha in continuous-wave compaction technique was used to fill the root canal system. During a 12-month follow-up, the clinical and radiographic evaluation revealed no signs and symptoms and periapical healing of the lesion associated with the tooth in case #1. The other premolars were also free of signs and symptoms, with normal apical tissues.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"57 1","pages":"322 - 330"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74265181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena-Beatriz Bermúdez-Bejarano, A. Martins, A. Lorenzo, Ana Castro, Alejandro López
Introduction: Chemo-osteonecrosis of the jaw can be caused by the pharmacodynamics of bisphosphonates and periapical-pulp physiopathology. Therefore, the objective of this study was to carry out a bibliographic review on endodontic treatment and chemo-osteonecrosis of the jaw and its recommendations. Materials and Methods: An electronic systematic review has been prepared in the PubMed and manual verification from 2005 to 2020, according to the 2020 Prism Guidelines and using inclusion and exclusion criteria, under the terms: “Bisphosphonate AND root canal therapy” and “Bisphosphonate associated osteonecrosis of the jaw AND endodontics.” Results: The 22 selected articles were divided into two differentiated blocks. The first one includes endodontic treatment in patients with bisphosphonate therapy and its relationship with maxillary chemo-osteonecrosis. The second includes recommendations to be followed in patients on bisphosphonate and root canal therapy. Conclusions: Patients who were administered intravenous or intraoral bisphosphonates for more than 4 years with associated risk factors are more predisposed to chemo-osteonecrosis of the jaw. Endodontics is safe compared to other traumatic procedures.
{"title":"Implications of endodontic treatment in chemo-osteonecrosis of the maxillary jaw due to bisphosphonates. An updated review","authors":"Elena-Beatriz Bermúdez-Bejarano, A. Martins, A. Lorenzo, Ana Castro, Alejandro López","doi":"10.4103/sej.sej_246_21","DOIUrl":"https://doi.org/10.4103/sej.sej_246_21","url":null,"abstract":"Introduction: Chemo-osteonecrosis of the jaw can be caused by the pharmacodynamics of bisphosphonates and periapical-pulp physiopathology. Therefore, the objective of this study was to carry out a bibliographic review on endodontic treatment and chemo-osteonecrosis of the jaw and its recommendations. Materials and Methods: An electronic systematic review has been prepared in the PubMed and manual verification from 2005 to 2020, according to the 2020 Prism Guidelines and using inclusion and exclusion criteria, under the terms: “Bisphosphonate AND root canal therapy” and “Bisphosphonate associated osteonecrosis of the jaw AND endodontics.” Results: The 22 selected articles were divided into two differentiated blocks. The first one includes endodontic treatment in patients with bisphosphonate therapy and its relationship with maxillary chemo-osteonecrosis. The second includes recommendations to be followed in patients on bisphosphonate and root canal therapy. Conclusions: Patients who were administered intravenous or intraoral bisphosphonates for more than 4 years with associated risk factors are more predisposed to chemo-osteonecrosis of the jaw. Endodontics is safe compared to other traumatic procedures.","PeriodicalId":21485,"journal":{"name":"Saudi Endodontic Journal","volume":"364 1","pages":"261 - 268"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76558450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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