This systematic review aimed to compare the efficacy of herbal agents with ethylene diamine tetraacetic acid (EDTA) in removing the smear layer during root canal instrumentation. The research question in the present study was to assess: “Is there a significant difference in reducing smear layer comparing EDTA and herbal agents?” Electronic databases (PubMed, Scopus, and Web of Science) were searched from their start dates to April 2022 using strict inclusion and exclusion criteria, and reviewed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Only in vitro studies comparing herbal agents with EDTA were included in the current systematic review. Two reviewers independently assessed the included articles. A total of 625 articles were obtained from an electronic database. Eighteen papers were included for review of the full text, out of which, ten papers were excluded because they did not meet the inclusion criteria. Finally, eight articles were included in the systematic review. The present systematic review considered only in vitro studies; hence, the result cannot be completely translated to strict clinical conditions. The results of the present systematic review have shown that quixabeira, morindacitrifolia, oregano extract, and neem show better smear layer removal compared to other herbal agents, whereas they showed reduced smear layer removal when compared with EDTA. Although, it was seen that most of the included studies did not report a high quality of evidence. Hence, the present systematic review concludes that herbal agents have reported to show inferior smear layer removal when compared to EDTA. Thus, as far as herbal based alternatives are concerned, there is no highest level of evidence to state its real benefit when used as a chelating root canal irrigant.

Background: Epidemiological studies have shown varying prevalence rates of dental anomalies worldwide, ranging from 5.2% to 56.9%, with a higher rate of 90.4% in patients with cleft lip and palate. In Saudi Arabia, studies have also reported varied prevalence rates, likely due to genetic differences or sampling variations. However, no research has yet evaluated the quality of these studies or provided an overall prevalence estimate, which is the aim of the present study. This systematic review aims to assess the prevalence and types of dental anomalies across various regions of the Kingdom of Saudi Arabia (KSA). Methods: A comprehensive literature search identified 10 relevant studies on different dental anomalies in Saudi Arabia. The quality of the enrolled studies was assessed using the Newcastle–Ottawa Scale (NOS), showing variability in the methodological quality of the included cohort studies, with several studies demonstrating a moderate to high risk of bias. Results: Common anomalies included hypodontia, hyperdontia, microdontia, and impacted teeth. This study highlights the varying prevalence of dental anomalies in different regions of Saudi Arabia, ranging from 2.6% to 45.1%. Conclusions: This review highlights the need for early diagnosis and tailored treatment approaches to mitigate the clinical challenges posed by these anomalies, underscoring the importance of standardized diagnostic criteria and further research to understand regional and demographic differences in the prevalence of dental anomalies in Saudi Arabia.

As endodontic hand files are essential tools for root canal instrumentation and treatment, these instruments have been a constant source of debate regarding whether to reuse them or use them just once. The aim of this in vitro study is to evaluate the sterility of five brands’ new endodontic files received from manufacturers without sterilization before clinical use via microbial culture (bacteria and fungi) and bioburden using scanning electron microscopic (SEM) analysis. This study included 25 K-type hand files with equal numbers from five brand groups (n=5; groups 1 to 5), named Tia Dent, Prevalent, Mani, Thomas, and Dentsply, respectively. The new files were exposed to microbial culture prior to clinical use and SEM analyses. A Fisher’s exact test was performed to compare the differences in contamination among the five tested groups. In the SEM, all the five brand groups showed one contaminated file out of five files (20%). Fisher's exact test findings revealed statistically significant variations between the five brand groups, as nine out of 25 (36%) files of the tested groups had positive contamination in the microbial culture experiment. Bacterial contamination was present in three (60%) of the five Tia Dent group files, four (80%) in the Prevalent group files, and two (40%) in the Mani group files. Those with fungal contamination were one (33%) in the Tia Dent group and one (25%) in the Prevalent group (P=0.027). The bacterial culture showed that 100% of the new K-files tested negative in both the Thomas and Dentsply groups. This study concluded that there was a bioburden on new endodontic K-type hand files of different brand groups before sterilization or when immediately used.

Background/Objectives: Large cystic lesions in the maxillofacial region present a challenge for clinicians due to their impact on the health and functionality of the involved teeth. This longitudinal, ambidirectional cohort study aimed to evaluate the prognosis of vital teeth affected by large cystic lesions following surgical intervention. Methods: Data were gathered from patients at King Abdulaziz University Dental Hospital and King Fahad General Hospital in Jeddah, Saudi Arabia, between July 2021 and August 2022. Seventeen individuals with large jawbone cysts were included in the study. Clinical and radiographic assessments were performed including sensibility testing and the function of teeth. The results indicated a linear relationship between the size of postoperative bony defects and the sensibility testing of teeth. Results: Of the 63 examined teeth, 54% did not receive endodontic treatment, 33% had pre-surgical treatment, and 12.7% had post-surgical treatment. The study revealed a high prevalence of inflammatory cysts, particularly in the maxilla. Surgical enucleation was the primary treatment modality, with few postoperative complications. Conclusions: This study highlights the necessity for standardized follow-up protocols and more extensive research to develop universal guidelines for managing large cystic lesions affecting vital teeth. Understanding the prognosis of cystic lesions is crucial for effective treatment planning and ensuring optimal patient outcomes.

Objective: To evaluate the effect of repeated usage of Reciproc and Reciproc Blue on their shaping ability and to determine the maximum number of artificial canals that they can prepare until fracture.

Utilizing a novel approach that concomitantly assessed cyclic fatigue and torsional overloading, we aimed to establish the maximum number of artificial canals that can be prepared by Hyflex EDM and NeoNiTi A1 operated at two different speeds until their separation. Forty-eight files were equally divided into four groups: (A) Hyflex EDM operated at 300 rotations per minute (RPM) and (B) at 500 RPM, and (C) NeoNiTi A1 at 300 RPM and (D) at 500 RPM. Files were used to completely shape 10 sequential artificial canals unless file separation occurred. Maximum number of canals prepared was noted and averaged. Fractography was conducted to determine the mechanism of file separation. Hyflex EDM prepared significantly more canals compared to NeoNiTi A1 (p = 0.008). When operated at 300 RPM, Hyflex EDM prepared significantly more canals compared to NeoNiTi A1 (p = 0.028), whereas no significant difference was observed when they were operated at 500 RPM (p = 0.116). One NeoNiTi file broke due to cyclic fatigue while another one separated due to torsional overloading. Hyflex EDM files showed signs of both mechanisms. Within the limitations of this study, one file safely prepared four to five canals before its fracture. There was a trend towards fewer prepared canals as the RPM increased.