The purpose of the study was to evaluate the clinical endodontic diagnostic skills amongst undergraduate dental students at pre-clinical and clinical levels at Cardiff University School of Dentistry. An online questionnaire containing eight questions about endodontic diagnosis and hypothetical clinical scenarios was sent to all year 3rd, 4th, and 5th-year undergraduate dental students who were divided into G1, G2, and G3 groups. The data were analysed descriptively and reported in percentages. Around 121 students out of 226 responded to the questionnaire with a response rate of 53.5%. The overall correct response from G1 (3rd year) was 31.6% to 65.8%, G2 (4th year) was 73% to 93%, and G3 (5th year) was 73.2% to 92.7%. The study concludes that the 4th and 5th-year undergraduate dental students’ responses to the hypothetical clinical scenarios were higher than the 3rd-year students. However, regarding questions about the endodontic diagnosis, the percentages of correct answers were similar among all the 3rd, 4th, and 5th-year students. Therefore, further studies assessing endodontic diagnostic skills amongst the same cohort of students during their progression in the undergraduate course are recommended.

Background: The purpose of the research was to evaluate the content and delivery of the undergraduate endodontic curriculum. Methods: A needs assessment survey was distributed among the Deans of all the dental colleges in Saudi Arabia. Results: The response rate was 72%. All the colleges include foundational and advanced topics in their curriculum. Didactic lectures, clinical cases, self-directed learning assignments and projects, and videos are the most common teaching methods, whereas virtual learning and reading list are the least popular methods. The average staff-to-student ratio for preclinical and clinical training is 1:6 and 1:7, respectively. Eighty-six percent of colleges utilize dedicated endodontic clinics supervised by specialized endodontists. Eighty percent of colleges use simple cases for canal preparation and obturation. Most colleges do not use magnification and ultrasonic instruments. Saline and sodium hypochlorite are preferred irrigation solutions, whereas calcium hydroxide is the preferred inter-visit medicament. Many use MTA as an advanced material, calcium hydroxide as an inter-visit medicament, and provisional restoration after RCT. Conclusion: The content and delivery of the endodontic undergraduate curriculum are primarily uniform. The use of specialist endodontists dedicated endodontic clinics, rotary instruments, and advanced materials have emerged as curricular strengths. However, diversification of teaching strategies, use of magnification instruments, and an increase in the minimum number of endodontically treated teeth are leading areas demanding curricular improvement.

Lack of basic knowledge about the external and internal anatomies of the root canal system and common variations in teeth may lead to various procedural errors or treatment failure. In this study, the root canal configurations of mandibular incisors and the symmetry of the contralateral incisors of Saudi Arabian subpopulations were analyzed and determined using cone beam computed tomography (CBCT). A retrospective evaluation of 700 patients was conducted, and 1260 fully developed permanent mandibular central incisors were assessed. The number of root canals was determined, and the internal root canal anatomies were categorized based on Ahmed et al.’s criteria. The CBCT images were independently evaluated by 2 trained dentists and an endodontist. The data were assessed using the chi-square and one-way analysis of variance tests. All the mandibular central incisors included in the study were single-rooted. According to Ahmed et al’s classification system, the most common classification (82.6%) was ¹ManA¹ (Vertucci type I), followed by ¹ManA^1-2-1 (Vertucci type III; 13%). Second canals were more frequently recorded in the male participants than in the female participants. The root canal configuration between contralateral incisors was largely symmetrical. Most of the mandibular incisors in the examined Saudi Arabian population had a single canal. Nevertheless, a substantial number of patients had a complex root morphology. Hence, CBCT can be utilized as a potential supplementary tool during root canal treatment.

Aim: To assess the views of the dental interns (DIs) and general dental practitioners (GDPs) in the Asir region of Saudi Arabia on antibiotic prescription for endodontic therapy. Methods: The link to a cross-sectional online survey with 16 quantitative and qualitative questions was e-mailed to 60 DIs at the College of Dentistry of King Khalid University (group 1 [G1]) and 60 GDPs at the governmental primary healthcare centers in the Asir region of Saudi Arabia (group 2 [G2]). The data obtained from the survey were then subjected to a comparative statistical analysis. The inter-group statistical comparison of the distribution of categorical variables was tested using the chi square test or the Fisher’s exact probability test if more than 20% of the cells had an expected frequency of less than 5. The p-values > 0.05 were considered statistically significant. The data were statistically analyzed using Statistical Package for Social Sciences (SPSS version 22.0, IBM Corporation, USA) for MS Windows. Results: The response rate was 83.3% for G1 and 63.33% for G2. Of the participants in G2, 39.5% had 1– 5 years’ clinical experience (the participants in G1 had no clinical experience). The number of endodontic emergency patients seen per day was significantly higher in G1 (88% and 63.2% of the participants in G1 and G2, respectively, were seeing 0– 3 endodontic emergency patients per day). There was an insignificant difference between G1 and G2 in awareness of the existence of antibiotic prescription guidelines in endodontic therapy (57.9% and 56.0%, respectively; p > 0.05). There was also an insignificant difference between the groups in the rate of antibiotic prescription for endodontic problems, with 84% of the G1 participants and 86.8% of the G2 participants prescribing antibiotics only for limited patients. In the analysis of the clinical-vignette items (Q11– 16), it was found that the rate of antibiotic prescription did not significantly differ between G1 and G2 (p > 0.05). No significant difference was found in the rate of antibiotic prescription for symptomatic reversible pulpitis, symptomatic irreversible pulpitis, and chronic apical periodontitis cases (p > 0.05). In contrast, the rate of antibiotic prescription for the symptomatic apical periodontitis, acute apical abscess, and systemic complications cases differed significantly (8% for G1 and 18.4% for G2, 54% for G1 and 76.3% for G2, and 98% for G1 and 73.7% for G2, respectively). Conclusion: No significant difference in the rate of antibiotic prescription was found between the DIs and GDPs in this study. However, both groups showed an inappropriate rate of antibiotic prescription for some endodontic conditions. Further and more extensive studies involving a wider geographical region and different colleges of dentistry in Saudi Arabia are recommended.

Background: This simulated study of 30 severely curved L-shaped root canals aimed to compare preparation time, aberrations, width measurements, and fractured files of three nickel–titanium (Ni–Ti) files, namely, ProTaper, ProTaper Next (PTN), and WaveOne (WO). Methods: Thirty simulated L-curved root canals of resin blocks were randomly divided into three groups. The canals were prepared to a tip size of 25 using ProTaper, PTN, and WO rotary file systems. Pre- and post-operative views for each sample were captured by a professional camera at a standardized distance and position. Blue India ink was injected into the pre-operative canals, and red India ink was injected into the post-operative canals to give a clear superimposition image. Five points were assessed through the halfway of the canal to the orifice (area between the beginning of curvature and apical end point). Preparation time, aberrations, width measurements, and fractured files were recorded and analyzed. Results: Mean preparation time was longest in ProTaper (4.89± 0.68 minutes). PTN and WO were the fastest in preparing the canals (about 3 minutes). A statistically significant difference was found between WO and ProTaper & PTN and ProTaper (p=0.000), while the difference was non-significant (p > 0.05) between WO and PTN. Nine aberrations consisting of three zips, one ledge and one outer widening were related to ProTaper, while WO recorded a ledge and fractured file, but for PTN system, it verified an outer widening and ledge. Only one WO file fractured, with no deformation observed in the other instruments. No significance was recorded among the width measurements in the different levels. Conclusion: ProTaper next achieved faster cutting than the ProTaper and WO file systems. PTN maintained the best apical termination position and produced the least canal aberration, followed by WO and ProTaper.

Background: An understanding of root canal morphology is vital for successful endodontic treatment. However, variations in the root canal system of permanent canines, especially in relation to population-based diversity, are not well-documented. This study thus aimed to analyze the root canal numbers, configurations, and bilateral symmetry in 1080 permanent canine teeth among 270 Saudi individuals using cone-beam computed tomography (CBCT), contributing to the existing body of knowledge and aiding clinicians in devising effective treatment strategies. Material/Methods: The CBCT images of 270 participants, encompassing 1080 canines (540 pairs of upper and lower canines), were scrutinized for root and canal counts. Canal configurations were assessed based on Ahmed's and Vertucci's classifications. Bilateral symmetry in these parameters was recorded and the data were statistically analyzed. Results: The study revealed variable prevalence of multiple roots and canals in maxillary and mandibular canines. Ahmed's and Vertucci's type I canal configuration was predominantly observed. Notably, significant bilateral symmetry was noted in root and canal numbers, and canal configurations. Conclusions: The most common configuration of permanent canines was a single root and canal, usually adhering to Ahmed's and Vertucci's type I classification. Mandibular canines showed a higher incidence of two canals than two roots. The extent of bilateral symmetry, especially in mandibular canines, could provide valuable insights for better contralateral tooth treatment planning.