Roots Of Molars Research Articles

Incidence of Caries and Pathological Findings in Different Positions of Impacted Third Molars: A Retrospective Analysis

Impacted third molars(3M), commonly known as wisdom teeth, are prone to caries and pathological formations depending on their position in the jaw. This study aimed to determine and compare the incidence of caries, pathological formations, and the superposition of the roots of the mandibular impacted third molar over the mandibular canal in different positions of impacted 3Ms. This retrospective study was conducted on orthopantomographs of patients who presented with 3M complaints at the Tokat Gaziosmanpaşa University Oral and Maxillofacial Surgery Department between 2019 and 2023. The 3M were classified according to their position by two researchers independently and were evaluated for caries, pathology, and nerve superposition. The position of the 3Ms classified using Pell and Gregory and Winter's classifications. The primary outcome variable was the presence of caries in the 3M. The secondary outcome variable was the presence of pathological formations around the 3M. The tertiary outcome variable was the superposition of the roots of the mandibular 3M over the mandibular canal. A total of 7,038 patients were included in the study, with 53.74% being female. The mean age was 32.15±7.2 years. The highest incidence of caries was associated with the vertical position in both maxillary and mandibular 3Ms (right maxillary: 9.98%, P<0.001; left maxillary: 12.74%, P<0.001; left mandibular: 11.66%, p=0.003; right mandibular: 11.69%, p=0.031). Pathological formations were most commonly observed in the vertical position, but the highest incidence was found in the horizontal or mesioangular positions (right maxillary: 36.84%, p<0.001; left maxillary: 40%, p<0.001; left mandibular: 62.04%, p<0.001; right mandibular: 62.25%, p<0.001). Nerve superposition was most common in the vertical position but was highest in the distoangular position (left mandibular: 74.69%, p<0.001; right mandibular: 76.66%, p<0.001). The position of 3Ms plays a critical role in the development of complications such as caries and pathological formations. Prophylactic extraction may be considered more seriously in cases where the position of the tooth poses a higher risk of complications.

Chronological age estimation based on dental mineralization for Syrian population.

Dental age assessment based on evaluating dental mineralization status is one of the most common methods used in forensic practice. The aim of this study is to enhance the accuracy of age diagnostics and provide reference data from the Syrian population for forensic application. After several selection steps, a total of 280 orthopantomograms (OPGs) from 140 males and 140 females from the Syrian population divided into 14 age groups between 12 and 25 years were analysed. Based on Demirjian's classification system, the mineralization stages of third molars (18, 28, 38 and 48) as well as lower second molars (37 and 47) were evaluated. Statistical investigations and evaluations were carried out to estimate the marginal probabilities of the subjects having attained ages 14 and 18 by generalized estimating equation models. Our results show that no significant differences can be revealed in the mineralization status with respect to jaw side and sex. In the Syrian population, third molars showing mineralization stage G provide evidence of reaching the age of 14 years with the highest standard of proof ("beyond reasonable doubt"). A completed mineralization in lower second molars (stage H) provides very high marginal probabilities (more than 90%) of the subjects having attained age 14 years. Nevertheless, this cannot exclude an age under 14 years. For the age threshold of 18 years, third molars showing incomplete root development (G dental stage or lower) are associated with a low probability (less than 40%) of the subject having reached 18 years of age. A person's probability of having attained 18 years of age is very high (82- 95%) when the roots of third molars are fully developed (stage H). Nevertheless, third molars at stage H do not conclusively exclude an age under 18 years.

Comparison of Micro-CT and Morphometric Outcomes in a Modified Experimental Rat Model of Periodontitis.

To assess the correlation between micro-computed tomography (micro-CT) and linear morphometric measurements in terms of mandibular bone levels in a modified experimental periodontitis model in rodents to study the mechanisms of association between periodontal destruction and neuroinflammation. The proposed invivo experimental periodontitis model involves the administration of oral rinses with Porphyromonas gingivalis and Fusobacterium nucleatum, four times per week during 4, 8 or 12 weeks, in 24 male Wistar Hannover rats (180 g, 5 weeks old). After euthanasia, hemi-mandibles were collected. One hemi-mandible was analysed using morphometry, while the other was assessed with micro-CT. Linear measurements were taken at the buccal aspect and furcation level for both techniques, and volumetric measurements were also obtained with micro-CT. Passing-Bablok regression analysis was used to compare the results of both techniques, with morphometric measurements serving as the reference. Moreover, Lin's Concordance correlation coefficient was calculated to assess the level of agreement. Periodontal clinical variables with neuroinflammatory parameters from the frontal cortex were used to evaluate the association between the resulting condition and neuroinflammation. Twenty-one out of the initial 24 rats were analysed. The micro-CT linear measurements demonstrated high concordance values with the linear morphometric measurements at the buccal surfaces of the roots in molars (r = 0.714) but not at the furcation area (r = 0.052). At 12 weeks, there was a significant impact on neuroinflammation with significant decreases in iNOS levels and p-mTOR levels at 4 and 8 weeks. The proposed invivo experimental periodontitis model demonstrated a high degree of correlation between morphometric and micro-CT measurements in buccal areas but not at the furcation level. Concomitantly, there was a significant temporary modulation of the neuroinflammatory response.

Safe sites in the mandibular buccal shelf for orthodontic mini-screws: Tomographic study in different facial types

Objectives: The objective of this study was to verify safe sites on the mandibular buccal shelf (MBS) for extra-alveolar mini-screw insertion according to facial type. Material and Methods: In this retrospective study, 84 cone-beam computed tomography scans were equally divided into three groups according to the patient’s facial type: Group 1, hyperdivergent; Group 2, neutral; and Group 3, hypodivergent. The total buccal alveolar bone thickness was measured in five zones between the mesial root of the first molar and the distal root of the second molar, 3, 6, and 9 mm apical to the cementoenamel junction (CEJ). Results: MBS areas with adequate thickness for temporary anchorage device (TAD) insertion were as follows: Group 1, second molar distal root 9 mm from the CEJ; Group 2, second molar distal root 6 and 9 mm from the CEJ; and Group 3, second molar mesial root 9 mm from the CEJ and second molar distal root 6 and 9 mm from the CEJ. Conclusion: The safe zones on the MBS for TAD insertion were located on the distal root of the second molar, 9 mm from the CEJ, for all facial types. For neutral and hypodivergent patients, the site located on the second molar distal root, 6 mm from CEJ, was included; for hypodivergent patients, the site located on the second molar mesial root, 9 mm from the CEJ, was included.

Palatal root endodontic microsurgery in maxillary molars using the palatal approach: a case study

BackgroundIn clinical practice, the buccal approach is typically the primary choice for endodontic microsurgery. Owing to the thickness of the buccal bone plate, the distance between the buccal bone plate and palatal lesion location, and soft tissue traction, the palatal approach may be more suitable for microsurgery for apical periodontitis of the palatal roots of the maxillary molars. However, the length of the palatal root, location of the greater palatine artery (GPA) and foramen (GPF), and surgical field of observation make palatal surgery challenging.Case presentationWith the aid of Cone-beam computed tomography imaging, the palatal approach was successfully applied in nine cases of endodontic microsurgery of the palatal root of a maxillary molar with a periapical lesion in Hangzhou Stomatology Hospital from January to December 2022.ConclusionsComplete healing was assessed based on clinical symptoms and radiographic images at the 3- and 24-month follow-up visits in all nine cases. Several tips have been proposed including surgical positioning, incision design, palate flap modification, bone removal, and root-end resection.

Comparative Evaluation Of Different Anatomical Sites In Buccal Shelf Region For Mini Screw Insertion In Skeletal Class II And Class III Patients-A CBCT Study

Background: To evaluate different anatomical sites in buccal shelf region at different levels (4mm, 6mm, 8mm, 10mm) from cemento-enamel junction for mini screw insertion in skeletal class II and class III patients using cone beam computed tomography (CBCT). Materials and Methods: The sample consists of cone beam computed tomography images of 48 subjects (24 skeletal class II and 24 skeletal class III) were evaluated. Mandibular buccal shelf area was evaluated at the regions (i) mesial to lower first molar (ML6) (ii) between the mesiodistal roots of the first molar (iii) distal to lower first molar (DL6) (iv) mesial to lower second molar (ML7) (v) between mesiodistal roots of the second molar (vi) distal to lower second molar (DL7) and cortical bone thickness was determined at 4, 6, 8, 10 mm level from cemento-enamel junction Results: Mandibular buccal shelf bone thickness increases from mesial surface of first molar to distal surface of second molar and from cemento-enamel junction to 8 mm level. Comparative evaluation between class II and class III shows significant differences (p&lt;0.05) at the level of 8mm distal to second molar in the mandibular buccal shelf region. Conclusion: Skeletal class III subjects have more cortical bone thickness than class II subjects at the level of 8mm distal to second molar in the buccal shelf region.

Comparative Analysis of Impacted Mandibular Third Molar Root Proximity to the Mandibular Canal using Orthopantomography and Cone-beam Computed Tomography Imaging Modalities: A Pilot Study

Abstract Introduction: Fully detect risks of nerve damage, which can lead to temporary or permanent issues. Cone-beam computed tomography (CBCT) offers a three-dimensional (3D) view, providing more detailed visualisation of anatomical structures and their spatial relationships, which improves the accuracy of predicting nerve exposure. The study aims to evaluate and compare these imaging techniques’ effectiveness in categorising the relationship between third molars and the inferior alveolar canal, emphasising the importance of precise imaging for safer surgical outcomes. Materials and Methods: A pilot study involving 20 patients, representing 10% of the total sample size of 200, was conducted at Ahmedabad Dental College’s Department of Oral Medicine and Radiology. Investigators, trained to interpret radiological images from orthopantomography (OPG) and CBCT, compared their interpretations with those of two experts. A high inter-rater reliability was confirmed with a kappa statistic of 0.98. Following ethical approval, data were retrospectively collected from 20 cases, with digital OPG and CBCT images analysed and classified according to established criteria. Results: The results revealed a significant association between the results diagnosed through OPG and CBCT indicating similarity in their diagnosis. It was also seen that there was no bias towards the gender and the distribution was similar in case of diagnosis through OPG or CBCT. Conclusion: CBCT demands an in-depth understanding of anatomy and pathology, coupled with proficiency in operating imaging software and the ability to identify abnormalities in cross-sectional images. When executed and interpreted accurately, CBCT proves to be an exceptionally valuable tool in clinical dental practice. Its detailed 3D imaging capabilities enhance the assessment of complex cases, such as those involving intricate anatomical structures and pathologies. By providing comprehensive views that surpass traditional two-dimensional imaging, CBCT aids in precise diagnosis and treatment planning, making it an indispensable resource for addressing various dental conditions effectively.

Evaluation of Root Canal Morphology of the Maxillary Permanent First Molar among Iraqi Population: A Cone Beam Computed Tomography Study (Retrospective Study)

Purpose: Endodontic success mainly depends on the complete root canal system debridement, both mechanically and chemically. The maxillary first molar possesses one of the most complex root canal anatomy. The purpose of this study was to map the maxillary first molar's root canal anatomy and its variations. Cone Beam Computed Tomography (CBCT) was used to determine the prevalence of the Second Mesiobuccal Canal (MB2) and its possible relation to the gender of the patient in the Iraqi population. Materials and Methods: Images from documented archives of CBCT scans for 415 patients who had maxillofacial diagnosis or root canal treatment were used in this study. Totally 656 maxillary first molars (336 females and 320 males) were included. The root canal configuration, frequency of MB2, and its two-sided symmetry were observed. The (chi-square test) was used to calculate the gender correlation. The P-value of less than 0.05 (p &lt; 0.05) was considered significant. Results: In 61.1% of the cases, the MB2 canal was discovered with high bilateral symmetry (73.6%). Genders did not show any statistically significant differences. Conclusion: The existence of MB2 canal in the maxillary first molars is high and approximately more than half of the cases. No relation was found between the existence of the MB2 canal and the gender of the patient. CBCT is a clinically efficient method for the diagnosis and improvement of root canal therapy.

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Syrian subpopulation

AimTo investigate the root number and morphology of the maxillary second molars in the Syrian population besides bilateral symmetry, and the effect of gender.Methods250 Cone Beam Computed Tomography (CBCT) images (140 females, 110 males) were examined by two endodontists. The detailed analysis included the number of roots, the number of canals and their configurations, bilateral symmetry, and relation to gender. The evaluation was made according to Vertucci classification by analyzing the CBCT images at all levels (Axial, Coronal, Sagittal, Oblique, and 3D). The Chi-square statistical analysis was performed to compare the canals’ morphologies and bilateral symmetry in both genders via SPSS.ResultThe most common shape of the upper second molars is three roots (90.4%). There were significant differences between males and females regarding the symmetry of the number of roots (P < 0.05). The root canal configuration was mainly Vertucci type I classification in the Distobuccally (93.4%) and palatal root (99.6%). The most common type in the mesial root was type I (29.5%), showing all varieties of Vertucci classifications (except VII, and VIII) percentage of MB2 of 70.5%. The ratio of symmetry was (59.6%) with no significant statistical difference between the genders (P = 0.708).ConclusionMost maxillary second molars in the examined Syrian population were types (II) (associated with MB2 cases with three roots and four canals). In terms of symmetry, the number of roots surpassed the canal configuration. Males had a greater symmetrical tendency in the number of roots than females.

Comparative analysis of methods for measuring root canal curvature based on periapical radiography: A laboratory study.

To evaluate the agreement between six currently available periapical radiography-based methods for measuring the root canal curvatures in mesial roots of mandibular first molars, assessed by two examiners with different proficiency levels. Non-endodontically treated mesial roots of 41 human mandibular first molars were radiographed using the parallelling technique. Two independent observers (a specialist in endodontics and radiology and a final-year dental student) assessed their root canal curvature using the methodologies described by Schneider (1971, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 32, 271), Weine (1982, Endodontic therapy), Berbert and Nishiyama (1994, Revista Gaúcha de Odontología, 356), Luiten etal. (1995, Journal of Endodontics, 21, 26), Hankins and ElDeeb (1996, Journal of Endodontics, 22, 123) and Pettiette etal. (1999, Journal of Endodontics, 25, 230). Intra- and inter-examiner reliability was assessed using the intraclass correlation coefficient. The differences in curvature angle measured by the different methods were compared using the one-way anova for repeated measures test, followed by Tukey's post hoc analysis. The effect was calculated using the Cohen's d method. To determine the agreement between methods, the Bland-Altman analysis was used. The significance level was set at 5%. Agreement for the observers was excellent (>0.81) for the six methods considered. For the angle comparisons between methods, the maximum differences were for Schneider versus Weine (35.77°) and Luiten versus Hankins (35.14°), whilst the highest percentage of angles with a difference >10° were Weine versus Luiten and Berbert versus Pettiette (90%) and the comparison Weine versus Hankins presented with the lowest frequency (15%). Excellent agreement was found for five comparisons: Weine versus Luiten (0.940), Berbert versus Pettiette (0.917), Weine versus Pettiette (0.907), Luiten versus Pettiette (0.904) and Berbert versus Luiten (0.812). Compared to Schneider's method, the other methods showed a tendency of increasing difference as the angles became more acute. The other methods exhibited linear differences, remaining constant for smaller and larger angles. Reliability was excellent for all methods assessed separately. Maximum differences in curvature angles were found when comparing Schneider versus Weine and Luiten versus Hankins. Excellent agreement was found for Weine versus Luiten, Berbert versus Pettiette, Weine versus Pettiette, Luiten versus Pettiette and Berbert versus Luiten. In the presence of dilacerations, the method by Schneider was less sensitive.

Корекція пробіотиком пародонтального синдрому у тварин за умов ожиріння і хронічного стресу

The aim of this study was to investigate the effect of obesity and chronic stress on periodontal tissues, both separately and in the combined comorbidity of these conditions in rats, and the role of the probiotic Lactobacillus casei in the correction of periodontal syndrome under these conditions. Methods. The development of periodontal syndrome and the effectiveness of the probiotic Lactobacillus casei IMV B-7280, administered to rats from one month of age intragastrically in a volume of 1 mL (5 · 108 CFU) in two-week courses with breaks of 2 weeks, were studied in a model of glutamate-induced obesity and chronic stress - in combination and separately. In periodontal tissues, the total proteolytic and antitryptic activity, free fucose and glycosaminoglycans (GAG) content, catalase activity, thiobarbiturate active products (TBA reagents), and the content of oxidatively modified proteins (OMP) and molecules of average mass (AMM) were determined; in bone tissue, the molar root exposure coefficient was calculated. The anthropometric parameters of the animals and the Selye triad were studied. Results. We have substantiated the development of periodontal syndrome in animals with glutamate-induced obesity against the background of chronic stress, as evidenced by the activation of free radical oxidation of lipids and proteins, depolymerization of fucoproteins and proteoglycans of periodontal connective tissue, which causes exposure of molar roots by almost 65%. The administration of the probiotic Lactobacillus casei in two-week courses with intervals of 2 weeks to obese rats with chronic stress prevented the development of obesity, as evidenced by a significant decrease in visceral fat mass, Li index, and BMI, as well as the severity of stress syndrome, as evidenced by a decrease in ulcer formation, thymus involution, and adrenal hypertrophy. The periodontoprotective effect of Lactobacillus casei under the combined influence of obesity and chronic stress was proved by significant changes in oxidative stress, free fucose, and GAG content and a 1.5-times decrease in the molar root exposure ratio. Conclusions. Periodic administration of Lactobacillus casei to rats treated with sodium glutamate in the neonatal period against the background of chronic stress prevented the development of obesity, the severity of stress syndromeб and damage to periodontal tissues, as evidenced by the prevention of oxidative stress, increased catabolism of extracellular connective tissue proteins and antiresorptive effect.

Malocclusion and Deleterious Oral Habits in Vietnamese Children Between the Ages of 8 and 12 years: A Cross Sectional Study

Abstract Aim: This study aimed to determine the relationship between malocclusion and deleterious oral habits in the Vietnamese children aged 8–12 years. Materials and Methods: A cross-sectional descriptive analysis was undertaken on a total of 434 children (8–12 years old, 208 males and 226 females), separated into five age groups: 8 years old (16.8%), 9 years old (18.5%), 10 years old (20.7%), 11 years old (21.4%), and 12 years old (22.6%), with all four first permanent molars erupted, no previous orthodontic treatment, loss of the second primary molar or presence of the second primary molar root or decay, loss of surface material on the second primary molar, and underfilling of the second primary molar size in the mesiodistal direction. The deleterious oral habits and malocclusion were assessed through a clinical examination and questionnaires for parents. The descriptive statistical analysis revealed the following findings: mean and standard deviation. The chi-squared test and Fisher’s exact test were used to compare categorical variables. The data were considered significant at P &lt; 0.05. Result: Deleterious oral habits were found to have a significant relationship with malocclusion. Mouth breathing habits were associated with anterior open bites (P &lt; 0.05). The tongue thrusting habit was associated with anterior open bite (P &lt; 0.05), posterior crossbite (P &lt; 0.01), overbite greater than 4 mm (P &lt; 0.01), and angle class I malocclusion (P &lt; 0.05). Chewing habits on one side were associated with posterior crossbite (P &lt; 0.01) and posterior open bite (P &lt; 0.05). The habit of pen/pencil/nail biting was associated with midline deviation (P &lt; 0.05). As children got older, there was a greater need for orthodontic treatment for dental healthcare, according to the index of orthodontic treatment need. In the 8-year-old patient group, the need was 4.1%; in the 9-year-old patient group, it was 5%; in the 10-year-old patient group, it was 9%; in the 11-year-old patient group, it was 19.4%; and in the 12-year-old patient group, it was 22.4%. The distribution of orthodontic treatment needs for dental health was significantly different based on the number of deleterious oral habits children had (P &lt; 0.01). Conclusion: Abnormal oral habits were prevalent in about 30.6% of the study participants. Mouth breathing, tongue thrusting, pen/pencil/nail biting, and one-side chewing had a significant impact on malocclusion.

Anatomical relationship between maxillary posterior teeth and the maxillary sinus in an Indonesian population: a CT scan study

BackgroundThe anatomical proximity between the root apex of the maxillary posterior teeth and the maxillary sinus can lead to complications, including odontogenic maxillary sinusitis. While several studies have investigated similar variables in different populations, there is limited research on the Indonesian population. This study aimed to describe the anatomical position of the maxillary posterior teeth in relation to the floor of the maxillary sinus using CT scans.MethodsA total of 122 patients (432 maxillary premolars and 1,282 maxillary molars) underwent CT scans to evaluate 1,711 roots. The vertical relationship between the root apex of the maxillary posterior teeth and the maxillary sinus was classified into three types: IS (inside sinus), CO (sinus contact), and OS (outside sinus).ResultsThe IS type was predominantly found in the palatal roots of the first molars, accounting for 20% of the total roots in this type. The CO type was most frequently observed in the mesiobuccal roots of the second molars, representing 18% of the total roots in this type. The OS type was most commonly found in the first premolar, comprising 20% of the total roots in this type.ConclusionsThe palatal roots of the first molars exhibited the highest frequency of proximity to the maxillary sinus. CT scans can effectively assess the relationship between the root apex of the posterior teeth and the maxillary sinus.Clinical RelevanceClinicians should consider this information comprehensively when planning treatments for maxillary molars.

Effect of repetitive up-and-down movements on torque/force generation, surface defects and shaping ability of nickel-titanium rotary instruments: an ex vivo study

BackgroundThe screw-in effect is a tendency of a nickel-titanium (NiTi) rotary endodontic file to be pulled into the canal, which can result in a sudden increase in stress leading to instrument fracture, and over-instrumentation beyond the apex. To reduce screw-in force, repeated up-and-down movements are recommended to distribute flexural stress during instrumentation, especially in curved and constricted canals. However, there is no consensus on the optimal number of repetitions. Therefore, this study aimed to examine how repeated up-and-down movements at the working length affect torque/force generation, surface defects, and canal shaping ability of JIZAI and TruNatomy instruments.MethodsAn original automated root canal instrumentation device was used to prepare canals and to record torque/force changes. The mesial roots of human mandibular molars with approximately 30˚ of canal curvature were selected through geometric matching using micro-computed tomography. The samples were divided into three groups according to the number of up-and-down movements at the working length (1, 3, and 6 times; n = 24 each) and subdivided according to the instruments: JIZAI (#13/0.04 taper, #25/0.04 taper, and #35/0.04 taper) or TruNatomy (#17/0.02 taper, #26/0.04 taper, and #36/0.03 tape) (n = 12 each). The design, surface defects, phase transformation temperatures, nickel-titanium ratios, torque, force, shaping ability, and surface deformation were evaluated. Data were analyzed with the Kruskal-Wallis and Dunn’s tests (α = 0.05).ResultsThe instruments had different designs and phase transformation temperatures. The 3 and 6 up-and-down movements resulted in a smaller upward force compared to 1 movement (p < 0.05). TruNatomy generated significantly less maximum torque, force, and surface wear than JIZAI (p < 0.05). However, TruNatomy exhibited a larger canal deviation (p < 0.05). No statistical differences in shaping ability were detected between different up-and-down movements.ConclusionsUnder laboratory conditions with JIZAI and TruNatomy, a single up-and-down movement at the working length increased the screw-in force of subsequent instruments in severely curved canals in the single-length instrumentation technique. A single up-and-down movement generated more surface defects on the file when using JIZAI. TruNatomy resulted in less stress generation during instrumentation, while JIZAI better maintained the curvature of root canals.

More molar distal movement than pretreatment cone-beam computed tomography posterior space available at the root level in mandibular dentition distalization with microimplants.

To compare the mandibular posterior space available before treatment and the distance of molar distalization achieved after mandibular dentition distalization with microimplants. A total of 66 Class I or III adult patients (mean age = 24.46 ± 4.89 years) who underwent molar distalization using microimplants were retrospectively included. The posterior space available distal to the second molar before treatment and the distance of distalization achieved after treatment were measured using axial cone-beam computed tomography images (0, 2, 4, and 6 mm apical to the second molar root furcation). Changes in lingual cortical thickness and molar root length after treatment were examined. Paired t-test or Wilcoxon signed-rank test was performed to compare measurements before and after treatment. Spearman correlation analysis was performed to assess the relationship between thinning of the cortical plate and root resorption. Achieved distalization distance was significantly greater than pretreatment posterior space available by 0.8 mm at all root levels (P < .001). The difference was greater toward the root apex level and greater in the Class III group than the Class I group. Lingual cortical thickness was significantly decreased after treatment along with resorption of the second molar distal root (P < .001). In addition, a positive correlation was found between thinning of the cortical plate and distal root resorption of the molar (P < .001). Achieved distalization distance of the mandibular molar using microimplants was greater than the pretreatment posterior space available. Thinning of the lingual cortex and root resorption were observed after distalization.

To evaluate the cortical bone thickness for ideal placement of infrazygomatic crest (IZC) and mandibular buccal shelf (MCS) bone screws in patients with different facial pattern using cone-beam computed tomography (CBCT)

This study aimed to measure the cortical bone thickness at different anatomical sites of InfraZygomatic Crest and Mandibular Buccal Shelf region for the ideal placement of IZC and MBS screws respectively in patients with different facial patterns using CBCT.Total participants were divided into 3 groups- GROUP A: horizontal growth pattern (FMA &amp;#60;22°); GROUP B: average growth pattern (FMA 22°-28°); GROUP C: vertical growth pattern(FMA &amp;#62;28°). Sixty CBCT images were taken into consideration. They were converted into standard DICOM format. Bone thickness were measured in the InfraZygomatic Crest (IZC) of the maxilla and in the Mandibular Buccal Shelf (MBS) region of the mandible using the Kodak CareStream CS 9300 Software.The results indicate that there was a highly statistical significant difference seen in the overall cortical bone thickness of IZC and MBS at various anatomical sites. The highest mean thickness was found to be at the MB70◦ maxillary 1st molar and distal root of the mandibular 1st molar. There was no difference in the bone thickness at the IZC region and at the MBS region seen between the horizontal and vertical facial patterns whereas the average facial patterns show the highest mean thickness but was not statistically significantThe study conducted on the Indian population yielded results demonstrating the possibly appropriate position for the IZC bonescrews and MBS bonescrews suggested that placing the IZC bonescrews at the mesiobuccal root of the maxillary 1st molar at an angulation of 70◦ and the MBS bonescrews at the distal root of the mandibular 1st molar at 11mm from the cementoenamel junction irrespective of the facial patterns could provide positive results.

Volumetric assessment and relationship of maxillary sinus floor with 1st &amp; 2nd molar root apices in different sagittal skeletal patterns – A CBCT study

Volumetric assessment and relationship of maxillary sinus floor with 1st &amp; 2nd molar root apices in different sagittal skeletal patterns – A CBCT study

Assessment of Incomplete Apical Bone Coverage of Maxillary Premolar and Molar Roots Using Cone Beam Computed Tomography in 161 Dogs.

This retrospective study assessed maxillary premolar and molar teeth and identified roots with incomplete apical bone coverage using cone beam computed tomography in 161 dogs. The associated dorsal anatomic sites that the roots communicated with were the ventral nasal meatus, maxillary recess, infraorbital canal, and pterygopalatine fossa. The study found that all roots of the maxillary premolar and molar teeth have the potential for incomplete apical bone coverage, with 26.7% having incomplete apical bone coverage. No significant association with sex was found. A significant association with weight was found, and this lowered with increasing body weight. Facial index, as a determinate of skull shape, was found to be significant in only 35.7% of roots in univariate and 14.2% of roots in multivariate modeling. Knowledge of the anatomy of these roots plays an important role in safe and effective extraction techniques, in reducing iatrogenic trauma, and in understanding the potential local effects of periodontal and endodontic disease.

Microhardness and energy dispersive X-ray evaluation of dentinal walls following chemical and electrochemical dissolution of fractured nickel-titanium file: An in vitro study

PurposeChemical dissolution of nickel-titanium (NiTi) files involves the application of a fluoride solution in direct contact with a damaged instrument, whereas electrochemical dissolution involves the application of an electrical current to the electrolyte, which accelerates fragment dissolution. This study aimed to determine the hardness and concentration of calcium and phosphorus (Ca and P) ions in dentinal walls following chemical and electrochemical dissolution of fractured ProTaper F2 files with a novel chemical solution.Materials & Methods: Thirty human maxillary first molar palatal roots with fractured ProTaper F2 files in the middle third (length, 2.5 mm were divided into three groups according to the treatment techniques used with a novel solution (NaF 12 g/L + NaCl2 60 g/L + MgCl2 60 g/L + CaCl2 60 g/L) at pH 5: Group 1: distilled water (control group), Group 2: electrochemical dissolution, and Group 3: chemical dissolution using the novel solution. The novel solution was placed for 10 min using an electrochemical technique, and for 30 min in contact with the separated instrument in the chemical group. The Vickers microhardness test was performed in three areas: at 3, 6, and 9 mm from the apex, and an energy-dispersive X-ray test for both Ca and P ions was performed. The analysis of variance (ANOVA) and Tukey's tests were used for statistical analysis. ResultsAccording to the one-way ANOVA analysis, no difference was observed between the tested approaches (P > 0.05) in the three areas evaluated (3, 6, and 9 mm), with no difference in the Ca/P ratio between the tested groups. ConclusionCompared to the control group, the use of chemical and electrochemical dissolution methods with the novel solution did not affect dentin hardness or dentinal structure in terms of the Ca/P ratio, thereby indicating promising results while saving time.

Postoperative Pain Comparison: Manual K-Files vs Pedoflex Rotary Files in Primary Molar Root Canals

This study evaluated postoperative pain in pediatric patients after root canal treatment with two file systems: Manual K-files and Pedoflex Rotary files. Sixty children, aged 6-10, were randomized into two groups of 30. Pain was assessed using a Visual Analog Scale (VAS) at 6, 12, 24, and 48 hours post-treatment. Results showed significantly lower pain levels in the Pedoflex Rotary file group at all time points (mean VAS at 6 hours: 2.4 vs. 3.8; at 12 hours: 1.8 vs. 3.2; at 24 hours: 1.2 vs. 2.5; at 48 hours: 0.6 vs. 1.8). Pedoflex Rotary files provide a more comfortable postoperative experience.