Objectives: This study aims to evaluate the efficacy of the rotary instrument XP-endo Finisher for the removal of Ca(OH)2 aided by different irrigation regimens. Methods: Sixteen double-rooted upper premolar human teeth were selected for the study. Thirty-two canals were prepared using a ProTaper Next rotary system up to X3. Then, the canals were filled with Ca(OH)2. The volume of Ca(OH)2 inside the canals was measured by microcomputed tomography (micro-CT). After that, the teeth were randomly allocated into two experimental groups, i.e., A and B (n = 16 canals). In group A, Ca(OH)2 was removed using the master apical file (X3). In group B, Ca(OH)2 was removed using a XP-endo finisher. In half of both groups (n = 8), syringe irrigation (SI) was used, while passive ultrasonic irrigation (PUI) was used for the other half. After removal, the remaining volume of Ca(OH)2 was measured. All data were statistically analyzed using two-way ANOVA with Tukey’s post hoc test. Results: The percentages of remaining Ca(OH)2 in the apical thirds of all canals were significantly higher as compared with the middle and coronal thirds in all groups (p < 0.05). There was no significant difference between different files and techniques (p > 0.05). Clinical Significance: This study presents a new method for the removal of Ca(OH)2 from root canals.
1 March 2021 in Clinical, Cosmetic and Investigational Dentistry
Aim: The aims of this study were to assess the prevalence and configuration of the second mesiobuccal (MB2) canal in the mesiobuccal MB root of permanent maxillary first molars at different root levels in a Saudi sub-population using cone‑beam computed tomography (CBCT) and to measure the inter-orifice distance between MB & MB2 at the pulpal floor level. Materials and Methods: This retrospective study was carried out on CBCT images of Saudi patients seen at King Abdul Aziz University. A total of 106 maxillary first molars were evaluated using a specialized software program (iCAT CBCT software). The prevalence of MB2, canal configuration and location of joining (apical-middle-coronal), if present was calculated. Also, the inter-orifice distance between both canals was measured at the level of the pulpal floor. Chi‑square and one-way analysis of variance (ANOVA) were used. Results: The MB2 canal was found in 92 (86.8%) maxillary first molar teeth. The MB and MB2 canals were joined in 61 (58%) cases, where the location of joining was 14 (23%), 17 (27%), and 31 (50%) in the coronal, middle, and apical third, respectively. The mean inter-orifice distance between both canals at the level of the pulpal floor was 2.52± 0.76 mm. Conclusion: The prevalence of MB2 canal in this Saudi sub-population was high. The prevalence decreased as the root canal approached the apical third. There was no correlation between the average distance and occurrence of canal joining. CBCT is useful in detecting and mapping the mesiobuccal root canal system, with a likelihood of enhancing the quality of root canal treatment.
Background: The study aims to investigate the pulp and periapical reaction and healing after capping with EndoSequence Root Repair Material (ERRM) combined with low-level laser application.Methods: In 6 rabbits, pulps were exposed via class V, half of the samples received a low-level diode laser at 980 nm. Thereafter, cavities were capped with regular-set ERRM. The specimens were processed for histomorphological examination after 2 weeks and two months.Results: After 2 weeks, images show mild inflammation and organized odontoblasts in lased group. The non-lased group shows more severe inflammation. The predentin thickness was thicker in the lased group with statistical significance (p < 0.05). After 2 months, inflammatory cells were sparse in both lased and non-lased groups. In the periapical area, group one showed dilated blood vessels and thick fibrous connective tissues. In group two, there were more numerous maturations of PDL fibers with scattered inflammatory cells and congested blood vessel.Conclusions: Using low-level laser therapy in combination with ERRM for pulp capping shortens the inflammatory phase and enhances healing.
The preservation of the original configurations of root canals during endodontic preparation is crucial for treatment success. Nickel-titanium (NiTi) rotary systems have been refined to optimize canal shaping while minimizing iatrogenic errors. This study aimed to evaluate and compare the shaping efficacy of the novel R-Motion (RM) and the established WaveOne Gold (WG) systems using micro-computed tomography (micro-CT). Twenty-four mesial canals of 12 double-rooted extracted mandibular first molars were randomly assigned to either the RM or WG groups, with the mesiobuccal (MB) and mesiolingual (ML) canals allocated accordingly. Root canals were prepared following the manufacturer’s protocols. In the RM group, crown-down technique up to a 25/0.06 taper was employed. For the WG group, the preparation was completed with a WG primary file (25/0.07 taper). Specimens were scanned using micro-CT scans before and after instrumentation to establish baseline and post-instrumentation datasets. The following parameters were evaluated, and values were calculated to compare the shaping ability of the two files: percentage of untouched canal walls, changes in surface area, canal volume, dentin thickness, canal angulation, structure model index, canal transportation, and centering ability ratio. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, NY), with a statistical significance set at P ≤ 0.05. Micro-CT analysis demonstrated comparable untouched canal surface areas and changes in surface area and volume between both RM and WG systems. Both systems effectively straightened canal curvature without significant differences in canal angulation. The RM files exhibited a statistically lower reduction in dentin thickness, indicating better preservation of structural integrity. Both RM and WG files displayed similar effective shaping abilities. However, RM caused less dentin removal and canal transportation. Thus, RM is recommended for its ability to balance effective canal shaping with structural preservation in a conservative manner.
This study aims to investigate the prevalence and pattern of idiopathic osteosclerosis (IO) and condensing osteitis (CO) in the jaws of a Saudi Arabian subpopulation with regards to gender, age, shape, localization, and tooth relationship. Digital panoramic and periapical radiographs with clinical data of 1,000 patients at King Abdulaziz University Dental Hospital were analyzed to determine the incidence of IO and CO lesions in relation to age, gender, location in the jaws, and dental status of the associated tooth. Descriptive statistics and chi-square tests were used for data analysis. Out of the 752 patients (495 females, 257 males), IO was identified in 66 (8.8%) patients, while 44 (5.9%) patients had CO. IO occurred more in females (68.2%) than males (31.8%). CO had a statistically significant higher rate of occurrence in females (81.8%) than males (18.2%) (P ≤ 0.05). IO and CO lesions were observed to be higher in individuals in their third decade, and 100% were in the mandibular molar area. Almost half of the identified IO (48.5%) had a rounded shape radiopacity, while CO mostly appeared irregular (63.6%). The prevalence of IO and CO in the studied Saudi subpopulation was low. Both lesions were more frequent in females in their third decade and were primarily found in the mandibular molar region.
Larization, and apexification procedures treated teeth in the endodontic department at King Abdulaziz University Dental Hospital performed by faculty and postgraduate residents. Materials and Methods: Thirty-three cases of VPT, revascularization, and apexification cases were evaluated. The outcome was assessed depending on the patient's signs and symptoms, healing of the apical periodontitis, and the signs of continued root development. Results: The overall results have shown that 60% of the cases were healed completely, 30% presented with incomplete healing, and 10% failed during the follow-up period and required further intervention. Conclusion: It has been concluded that the outcomes of VPT, revascularization, and apexification were fairly high as they favored healing of periapical periodontitis and root maturation with presentation of no signs and symptoms....