Alveolar Canal Research Articles

Jaw bone changes in panoramic radiography in patients with hyperparathyroidism

Background and aims: The current investigation aimed to evaluate jaw bone changes, and compare the presence of gonial cortex bone thickness, mental index (MI), lamina dura (LD), lower dental canal, and bone density in panoramic radiography, in patients with hyperparathyroidism. Methods: The present cross-sectional descriptive-analytical study was performed on 17 healthy individuals and 17 patients who suffered from resorptive hypercalciuria in the dialysis center of Shahid Beheshti hospital in Babol in 2018. If patients had two or more decayed teeth, they were referred to a specialized maxillofacial clinic by the dentist for free panoramic imaging. Mandibular cortical index, LD, bone change, mandibular resorption (MR), and general cortical indices underwent examination. Results: The mean age of the control and case groups was 36.58±11.81 years and 40.23±14.32 years, respectively (P=0.424). In addition, the mean MI was 4.27±0.87 and 2.98±0.75 in the control and case groups, respectively (P<0.001). Based on the results, the mean gonion region’s cortical bone thickness was 0.93±0.23 and 1.09±0.24 in the case and control groups, respectively (P<0.001). Further, bone changes (P=0.036) and MR (P=0.017) were significantly different in the case and control groups. However, LD vision showed no significant difference in the hyperparathyroidism and the control groups (P=0.141). Conclusion: The results demonstrated a decrease in the thickness of the cortical bone in the guinea pig, mental region, and lack of dental canal in resorptive hypercalciuria compared to healthy individuals.

Integrative approach for supernumerary teeth: a single-center retrospective analysis.

This study aimed to provide a comprehensive case analysis from a single center, with the objective of clarifying the optimal timing and recommendations for a preferred treatment strategy customized to the specific presentation of each type of supernumerary tooth identified in the research. A retrospective study was conducted on patients who presented with a supernumerary tooth and were treated interdisciplinarily at the clinic. In total, 55 patients with 81 supernumerary teeth of the permanent dentition were analyzed, 30 males and 25 females. The dentition status of the patients was as follows: 31 patients with mixed dentition, no patients with primary dentition, and 24 patients with permanent dentition. The diagnosis of supernumerary tooth was primarily made by general or pediatric dental practitioners and/or orthodontists. Patients were then referred to maxillofacial surgeons for treatment decision. The timing of treatment was mainly determined by the oral surgeon, based on the recommendations of the other specialists involved. Cases involving maleruption or malalignment of permanent teeth required both surgical and orthodontic treatment. Patients over 9 years old were treated either under local anesthesia or sedation, whereas those under 9 years old were treated under deep sedation or general anesthesia. A comprehensive investigation of cases involved the utilization of CBCT at the supernumerary tooth site to facilitate treatment planning. There was a significant correlation between younger age and the preference for treatment under sedation or general anesthesia (P = .01, t test). Similarly, a strong association was found between younger age and the need for additional orthodontic treatment (P = .016, t test). Cases of surgical removal of a supernumerary tooth at a young age typically did not require orthodontic traction of the permanent tooth, in contrast to cases of late surgical intervention (patients over 11 years old), which often did necessitate such traction. There was a strong tendency for treating supernumerary teeth in the maxilla. The proximity of supernumerary teeth to vital anatomical landmarks significantly influenced treatment decisions. Patients with supernumerary teeth near the mental foramen or the inferior dental canal in the premolar area were exclusively placed under follow-up care (P = .002, Pearson chi-square test). However, in the maxilla, the proximity of supernumerary teeth to vital structures such as the floor of the nose and the incisive nerve did not affect the treatment approach, and those supernumerary teeth were mostly removed. A team approach for managing supernumerary teeth is recommended. The timing of treatment should carefully consider the advantages and disadvantages of early versus late intervention. Early surgical treatment in cases where eruption is disturbed might result in spontaneous eruption, eliminating the need for orthodontic traction of the permanent teeth.

Ectopic Dental Canal: A Case Report Highlighting a Unique Bifid Mandibular Canal Variant

Bifid mandibular canals are common anatomical findings with variations based on direction and location of branching, which carry significant clinical implications for endodontic and surgical dental procedures. This case study describes a previously unreported ectopic dental canal that branches off the superior border of the mandibular canal, enters the apex of a mandibular second molar, traverses through the root, anastomoses with the root canal system, and subsequently exits through the lingual aspect of the root. The anastomosis of this ectopic dental canal with the mesial lingual canal led to significant bleeding during rotary instrumentation. This unique anatomical variation demonstrates the importance of a thorough cone-beam computed tomography analysis to identify critical structures prior to undertaking dental procedures involving the root apices of mandibular posterior teeth and adjacent areas.

Prevalence and topography of bifid and trifid mandibular canal in Turkish Western Anatolia Population: evaluation of the inferior alveolar canal with CBCT.

Various anatomical variations of the inferior alveolar canal increase the incidence of surgical complications; Therefore, this study aimed to evaluate the frequency and configuration of bifid and trifid mandibular canals using cone beam computed tomography (CBCT) in the Turkish subpopulation. The inferior alveolar canal was evaluated on 1014 hemi-mandibles in the CBCT (I-CAT 3D Imaging System) images of 513 patients. The frequency and configuration of the bifid and trifid mandibular canal (MC) were examined. The relationship between bifid MC configuration and dental status and age groups was analyzed. The distance of the accessory canal to the buccal and lingual walls and the alveolar crest was measured. The diameter of the main canal and accessory canal was measured and its relationship with dental status and age groups was evaluated. Bifid MC was found in 266 hemi-mandibles (24.7%) and 212 (41.3%) of 513 patients. The most common type of bifid MC was the retromolar canal (87 sides), followed by the forward canal without confluence (41; 4%) and the dental canal (34; 3.4%). 10 of the dental canals were opening to the 1st molar, 14 of the 2nd molars, and 10 of the 3rd molars. The number of retromolar foramina was 1 on 56 sides, 2 on 15 sides, and 3 on 4 sides. Forward canal without confluence was more common in edentulous patients than in dentulous patients, while the dental canal was more common in dentulous patients. The main canal diameter was 3.53 ± 0.97mm and the bifid MC diameter was 1.82 ± 0.70mm. Distance of the bifid MC to the lingual wall was higher in the > 64years group than in the 18-39years group (p = 0.022). Distance of the bifid MC to the alveolar crest was lower in the > 64years group compared to the 18-39years group and 40-64years group (p = 0.015). The main canal diameter was higher in the 40-64years group than in the 18-39years group (p = 0.012). Bifid MC has a high prevalence, occurring in almost one in two patients. Dental and retromolar types, which are close to the teeth, are more common, and this increases the possibility of complications. CBCT is the most accurate imaging technique used to detect and define these variations.

On the Possibility of Using 5-Aminolevulinic Acid in the Light-Induced Destruction of Microorganisms.

Antimicrobial photodynamic inactivation (aPDI) is a method that specifically kills target cells by combining a photosensitizer and irradiation with light at the appropriate wavelength. The natural amino acid, 5-aminolevulinic acid (5-ALA), is the precursor of endogenous porphyrins in the heme biosynthesis pathway. This review summarizes the recent progress in understanding the biosynthetic pathways and regulatory mechanisms of 5-ALA synthesis in biological hosts. The effectiveness of 5-ALA-aPDI in destroying various groups of pathogens (viruses, fungi, yeasts, parasites) was presented, but greater attention was focused on the antibacterial activity of this technique. Finally, the clinical applications of 5-ALA in therapies using 5-ALA and visible light (treatment of ulcers and disinfection of dental canals) were described.

Assessment of bifid mandibular canals using cone beam computed tomography in general population: a retrospective evaluation.

To evaluate the prevalence of bifid mandibular canals (BMC) using cone-beam computed tomography (CBCT) in the Saudi population subset. In the study, three hundred and forty-three CBCT scans (661 sides) were evaluated for the presence of BMC, involving 162 males and 181 females. Tomographic acquisitions were performed on the device Planmeca®. The image analysis was performed on the Planmeca Romexis® software, aided by image filters associated with transverse, oblique, and panoramic reconstruction cuts for analysis of the BMC. Naitoh's classification (2009) was employed to classify mandibular canals. The prevalence of BMC was determined according to location, gender, and age of participants. The data were analyzed with Chi-square and one-way ANOVA tests at a significance level of 95%. The BMC was observed in 37 (12.34%) out of 343 participants, of whom 20 (54.05%) were males and 17 (45.94%) were females. There was no significant difference in the proportion of bifid canals in both genders and various age groups. The most common BMC was the retromolar canal type, with 56.75% occurrence. The dental canal type was observed in 18.91% of BMC participants. The presence of a forward canal without confluence was observed in 16.21% of participants in the BMC, whereas a forward canal with confluence was noted in 8.10% of participants. The prevalence of bifid mandibular canals (BMC) within a subset of the Saudi population was 12.3%. The retromolar canal was identified as the most frequently occurring type, accounting for 56.7% of cases. No significant variations in BMC prevalence were observed concerning age and gender. Consequently, it is strongly advised to conduct a thorough assessment of the mandibular canal and its potential variations using CBCT imaging before undertaking mandibular surgical procedures, in order to minimize the risk of complications.

The Patterns of Impacted Third Molars and Their Associated Pathologies: A Retrospective Observational Study of 704 Patients.

Background: The study aims to investigate parameters in patients attending Fujairah Dental Center, including assessing the prevalence of impacted teeth, determining the frequency of associated pathological conditions, and evaluating the patterns and angulations of impacted third molars. Methods: It is a retrospective descriptive study of the panoramic radiographs of patients who attended Fujairah Dental Center for dental care between January 2011 and December 2017. The minimum age for inclusion was 17 years. Clinical records were used to obtain the demographic details of patients, such as age, gender, nationality, medical history, and smoking history. Seven hundred and four panoramic radiographs and clinical records of patients were analyzed. The age range was between 17 and 112 years old, with a mean age of 34 years (S.D 13.5). Results: Of the 704 panoramic radiographs evaluated, 236 (33.6%) X-rays showed teeth impaction with a total of 562 impacted teeth in the upper and lower jaws. Five hundred and twenty-five (93.4%) were impacted third molars, and 37 (6.5%) teeth were other kinds of impacted teeth. Females showed a higher frequency of impacted teeth (62.6%) compared to males (37.4%). The highest prevalence of impacted teeth was found in the 17-25 year age group (61%), and the prevalence declined with advancing age. Impacted third molars were more likely to occur in the mandible (57.3%) than in the maxilla (42.7%). Most of the impacted third molars were in the mesioangular position, followed by the vertical position. The evaluation of the depth of impacted third molars demonstrated that level C impaction was the most frequently seen, followed by level B impaction. Impacted third-molar teeth often presented with two roots (60.7%), followed by a single root (31.3%). An evaluation of the relationship between lower third molars and the inferior dental canal (IDC) revealed that the most frequently observed relation was interrupted (61.5%), followed by a distant relation to the ID canal, and 13% were superimposed. The most common morphological pattern of roots of the impacted third molars was either straight-type or curved and dilacerated roots (5.7%). Additionally, the most noticed pathological conditions associated with impacted teeth were carious second molars adjacent to impacted third molars (42%), which was more likely to be seen in the 17-25-year age group, with females having a higher prevalence than males.

Identifying the Anatomical Variations of the Inferior Alveolar Nerve with Magnetic Resonance Imaging.

The inferior alveolar nerve (IAN) is located in the mandibular canal (MC). It is critical to evaluate the position of the MC during treatment planning to prevent intra or postoperative complications. This retrospective study aimed to identify the anatomy and anatomical variations of the IAN using soft tissue imaging (pulse sequence magnetic resonance imaging [MRI]). This study was designed as a retrospective Consolidated Standards of Reporting Trials (CONSORT) study. In total, 220 MR images were obtained. Nutrient canals (NCs) were classified as intraosseous and dental NCs, while bifid MCs (BMCs) were classified as forward, retromolar, and buccolingual canals. IBM SPSS Statistics 22 was used. Kolmogorov-Smirnov and Shapiro-Wilk tests, descriptive statistical methods (means, standard deviations, and frequencies), and the Chi-square test were used. Statistical significance was set at P < 0.05. In total, 220 patients (172 females and 48 males) were evaluated. NCs were present in 92.3% of all MCs and were significantly higher in patients aged <25 years. BMCs were observed in 106 patients (24.1%). The most common BMC of MC/IAN was in the forward canal (14.4%), followed by the retromolar canal (7.5%). Although previously, the dental canal was considered as an anatomical variation, this study revisited the classification and suggested that dental canals are anatomical structures.

From teeth to pad: tooth loss and development of keratinous structures in sirenians.

Sirenians are a well-known example of morphological adaptation to a shallow-water grazing diet characterized by a modified feeding apparatus and orofacial morphology. Such adaptations were accompanied by an anterior tooth reduction associated with the development of keratinized pads, the evolution of which remains elusive. Among sirenians, the recently extinct Steller's sea cow represents a special case for being completely toothless. Here, we used μ-CT scans of sirenian crania to understand how motor-sensor systems associated with tooth innervation responded to innovations such as keratinized pads and continuous dental replacement. In addition, we surveyed nine genes associated with dental reduction for signatures of loss of function. Our results reveal how patterns of innervation changed with modifications of the dental formula, especially continuous replacement in manatees. Both our morphological and genomic data show that dental development was not completely lost in the edentulous Steller's sea cows. By tracing the phylogenetic history of tooth innervation, we illustrate the role of development in promoting the innervation of keratinized pads, similar to the secondary use of dental canals for innervating neomorphic keratinized structures in other tetrapod groups.

Study of the Effect Age and Gender of the Bone Height on the Position of the Inferior Dental Canal Using Cone Beam Computed Tomography

Inferior alveolar canal considered as one from the most important vital structures exist in the mandible and any injury to the (IAC) during the surgical procedures should be avoided, knowing the exact position of the (IAC) can help in avoiding the injury of the (IAC). The sample was consist of 100 patients divided into 2 main groups 1st group consist of 50 males (25 males dentulous, 25 males edentulous), and the 2nd group consisted of 50 females (25 females before menopause &amp; 25 females after menopause). Two measurements were taken the 1st from the crest of alveolar ridge to the superior rim of the (IDC), and the 2nd from the inferior rim of (IDC) to the lower border of the mandible in both right and left sides of the mandible. Results: the stastical analysis of the distance from the crest of alveolar ridge to the superior rim of the (IDC) for both males &amp; females groups showed that there were highly significant difference between male (edentulous versus dentulous) the mean values less in edentulous groups ,and female ( before menopause versus after menopause) the mean values are greater in the ( before menopause ) groups, the stastical analysis of the distance from the inferior rim of (IDC) to the lower border of the mandible showed that the mean values in case of dentulous in males groups was less in edentulous group than dentulous group (right side) with non-significant difference while in the measurement of left side the mean value was higher in the edentulous group with non-significant difference and in females groups the mean values were greater in( before menopause) groups. Conclusion : it can be concluded that the position of the inferior dental canal heavy influenced by the due to the dental status ,due to the teeth loss , age and hormonal changes affect the bone height which is also affected by gender. the vertical distance from the crest of the alveolar ridge to superior rim of (IAC)., the vertical distance from the crest of the alveolar ridge to superior rim of (IAC) , and the distance from lower rim of (IAC) to the lower border of the mandible would be smaller due to the effect of bone height.

Eradication of Porphyromonas Gingivalis and Prevotella Intermedia Biofilms using the Chlorhexidine Gluconate and Matrica Mouthwash (Chamomile Extract)

Introduction: One of the critical pathogenic agents in oral and dental bacteria is biofilm formation. Porphyromonas gingivalis (P. gingivalis) and Prevotella intermedia (P. intermedia) biofilms critically contribute to the unsuccessful treatment of oral and dental illnesses, and their permanent presence in dental canals harms the recovery process after treatment. Today, dentists are seeking superior and more beneficial choices with less toxicity as appropriate disinfectants for the mouth and teeth. Objective: The current research aimed to investigate the effects of Chlorhexidine (CHX) gluconate and matrica mouthwash on one-, three-, and five-day-old P. gingivalis and P. intermedia biofilms. Method: The biofilm formation capabilities of P.gingivalis and P.intermedia were assessed using the microtiter plate method. Subsequently, the Minimum Inhibitory Concentration (MIC) of CHX gluconate and matrica mouthwash at various concentrations against biofilm formation in P. gingivalis and P. intermedia was specified using the microdilution method. Results: The biofilm formation capabilities of P. gingivalis and P. intermedia were approved on a quantitative scale. Both CHX gluconate and matrica mouthwash were effective in eradicating biofilm formation in P. gingivalis and P. intermedia strains. Notably, according to the results, CHX mouthwash exhibited a greater efficacy in eradicating P. gingivalis biofilm. Furthermore, the matrica mouthwash capability to eradicate biofilms in P. gingivalis and P. intermedia was equivalent, with no significant difference observed. Conclusion: The CHX mouthwash is recommended as a novel approach for controlling biofilm infections stemming from oral and dental bacteria, including P. gingivalis and P. intermedia

Prevalence and characteristics of accessory mandibular canals in an eastern Chinese population by cone beam computed tomography.

This retrospective study aimed to determine the prevalence and morphological characteristics of accessory mandibular canals (AMCs) in an eastern Chinese population to provide clinical guidance for reducing intraoperative and postoperative complications. Cone beam computed tomography (CBCT) scans of 300 Chinese patients were used to identify AMCs according to a modification of Naitoh's classification. The length of the branch (L0) and the upper and lower angles between the branch and mandibular canal were measured on sagittal images. Additionally, the branches were divided into narrow or wide types by calculating the ratio of the branch diameter to the main canal diameter. The location of the bifurcation point was characterized by measuring its distance to the buccal wall of the mandible (L1), lingual wall of the mandible (L2) and alveolar ridge (L3). The prevalence rate of AMCs was 40.7% (95% CI: 35.1-46.3), and the most common type was the retromolar canal, followed by the forward canal, dental canal, trifid mandibular canals (TMCs) or others, inferior canal and buccolingual canal. Twenty-one cases of multiple branches with unusual patterns were observed in the study. The average values of L0, L1, L2 and L3 were 15.05 ± 0.63mm, 5.79 ± 0.14mm, 4.40 ± 0.18mm and 14.61 ± 0.31mm, respectively. The mean upper angle and lower angle were 141.59° ± 2.44° and 50.64° ± 2.57°, respectively. Approximately 20.8% of the branches were defined as wide type, and no statistical significance was found between different types. AMCs are not rare anatomic variations of the mandibular canal in the eastern Chinese population; thus, CBCT examination is highly recommended for precise evaluation before surgeries involving the mandibles.

Retrospective Evaluation of Mandibular Canal Anatomy and Variations by Cone-Beam Computed Tomography

Purpose: Determining the anatomical localization and variations of the mandibular canal is of great importance in determining the treatment method to be preferred during the treatment of the patient and having an idea before surgery for possible complications. In this study, it was aimed to evaluate the anatomy and variations of the mandibular canal using Cone Beam Computed Tomography(CBCT). Materials&amp;amp;Methods: CBCT images obtained from 300 jaws of 300 patients, 168 of whom were female and 132 male, were used. The examined mandibular canals were divided into four groups as retromolar, anterior canal, dental and buccolingual canals. Statistical analysis of the data was performed using descriptive statistics and chi-square tests. Results: Bifid duct was detected in 149(49.2%) of the patients, but trifid duct was not detected. 73 (48.99%) of bifid canals were detected on the right and 76 (50.01%) on the left. Considering the relationship between age and gender and the presence of mandibular canal variation, no statistically significant result was found according to the chi-square test.When the right-left distribution of the channel variations evaluated in the study was examined, no statistically significant relationship was observed.(p&amp;gt;0.005)(p=0.688) Conclusion: The prevalence of variation in the examined mandibular canals was found to be 49.66%. Anterior canal(35.6%) was most common, followed by retromolar canal(28.2%), dental canal(25.6%) and buccolingual canal(10.7%). According to the results obtained, the possibility of approximately 50 percent mandibular canal variation should be considered in prosthetic and surgical treatment interventions planned in the relevant regions.

FEATURES OF INCINAL ANESTHESIA IN THE TREATMENT OF ACUTE PERIODONTITIS OF THE FRONTAL TEETH OF MAXILLA IN ADOLESCENT CHILDREN

Actuality. Currently, the problem of treatment of acute forms of periodontitis, especially in children, is related to the use of anesthetic care against the background of increased stress factors and lability of the nervous system. The works of many authors have proven that after conducting incisor guide anesthesia, anesthesia occurs not only of the soft tissues of the anterior third of the palate, but also of the pulp of the incisors, which is especially important when extirpating the pulp and exposing the pulp chamber. Today, many authors recommend using incisive conductor anesthesia as a monomethod of pain relief for incisors, but this technique has not been widely used in practical health care. Some authors prove the effectiveness of the additional use of incisive conduction anesthesia when infiltration is insufficient. It should be noted that the data analysis has a contradictory character without the presence of a single dominant opinion regarding the combined method of using conductive and infiltration anesthesia, especially in adolescents with an odontogenic inflammatory process.&#x0D; The purpose of the study: to investigate the anesthetic effect with the combined use of infiltration and incisive conductor anesthesia in the treatment of acute periodontitis of the frontal group of teeth on the upper jaw in children of the adolescent period.&#x0D; Materials and methods. The archival data of cone-beam computed tomography of 25 patients on a Planmeca tomograph were studied. Outpatient treatment of 65 patients diagnosed with acute serous and acute purulent periodontitis was carried out. To anesthetize the central or lateral incisor from the side of the causative tooth, infiltration anesthesia with "Ultracain" (4% solution) was performed in the canine area of the maxilla, creating a depot of anesthetic 2-5 mm from the focus of inflammation and blocking the anterior upper alveolar nerves. The VAS (Visual Analog Scale) and the Numerical Rating Scale (NRS) were used to assess pain intensity.&#x0D; The results. According to the tomography results, we have found the following features: the incisive canal begins with two separate nasopalatine openings, which open in the front part of the bottom of the nasal cavity on both sides of the nasal septum, with the merging of the two canals into one incisive canal, which looks like a slingshot on the tomogram. The incisor foramen is located behind the central incisors of the upper jaw by 7-8 mm in girls and 8-9 mm in boys, immediately under the incisor papilla. Based on the results of X-ray studies, we established several forms of the channel. In 75-80% of cases, the incisive canal has the shape of an "eight", less often it is found in the form of a funnel and, in two cases, a cylinder. The length from the top of the incisive papilla to the narrowing of the incisive canal is 9.0-10.5 mm in girls and 10.0-11.7 mm in boys.&#x0D; In 58% of cases, on the tomogram, we have found the relationship between the alveolar canals and the incisive canal. At the level of the bottom of the nose, the microcanals of the anterior superior alveolar nerves connected with the incisor canal, in 22% of cases opening in the anterior third of the palate through independent openings. According to the obtained data, the combination of analgesia used allows the intervention to be completely painless in 82-87% of cases. In 4% of cases, patients complained of painful sensations, there was no need for additional analgesia. In 3% of cases (75% of cases in girls), endodontic treatment was painless, but at the same time, during the opening and drainage of the infiltrate in 5% of cases, additional infiltration anesthesia was performed. Immediately after incisive conduction anesthesia in 75% of cases, patients felt numbness of the nasal cavity, especially its lower third. When re-examining in 40% of cases, patients noted discomfort in the area of the incisor papilla.&#x0D; Conclusions. The use of a combination of infiltration anesthesia and incisive conductor anesthesia allows achieving full analgesia of the pulp and periodontal tissues in the treatment of acute periodontitis of the frontal group of teeth.

Compound Odontoma Associated with Dentigerous Cyst

A 17-year-old female presented to the Department of Oral and Maxillofacial Surgery complaining of hard expansion with pain sensation in the posterior part of the left mandible for two weeks ago. She was healthy with an unremarkable medical history. Intra-oral examination revealed retained lower left deciduous molar (#75) with bony expansion on the left side of the mandible. Orthopantomograph (OPG) showed unerupted third molars as well as compound odontoma associated with dentigerous cyst include the cement-enamel junction of impacted lower left second premolar leading to mechanical obstacle of eruption and in turn impaction (Panel A). Under local anesthesia, two sided flap was raised, surgical removal of impacted tooth with cyst enucleation, and curettage of the surrounding odontoma tissues (Panel B) with preservation of the inferior dental canal (Panel C). Odontomas are hamartomas that presented as complex or compound odontomas; their etiology still unknown. Compound odontoma was a malformation having more orderly arranged dental tissue pattern that was rarely associated with dentigerous cyst of impacted premolars. The early diagnosis and management of odontoma and cyst are important for both surgeon and patient to avoid the need for surgical intervention and the need for future Prosthodontic restoration of extracted teeth. At the end of six weeks, results showed complete healing and the patient retained her normal sensation with good aesthetic outcome.

Prevalence and Characterization of bifid mandibular Canal Using Cone Beam Computed Tomography: A Retrospective Cross-Sectional Study in Saudi Arabia.

AimThe purpose of this study is to determine the prevalence and morphological characteristics of the bifid mandibular canal in a Saudi Arabian subpopulation, to aid in preventing surgical complications near the mandibular canal.Patients and MethodsUsing CBCT images obtained from the Radiology unit database in a University Hospital Clinics. A total of 488 CBCT images were investigated (244 Female – 178 Male). In the present study, the Naitoh classification was used to categorize the bifid mandibular canal into the following types: 1) Retromolar canal; 2) Dental canal; 3) Forward canal (with or without confluence); and 4) Buccolingual canal. Additional variation (Trifid canal) was included. All CBCTs were assessed in coronal, sagittal, axial, as well as panoramic views using specialized software.ResultsThe prevalence of BMC was 28.7% (95% CI, 24.5 to 33.2), Gender (p = 0.404) and age (p = 0.654) had no statistical significances, laterality of BMC, patients with unilateral BMC were significantly older than those with bilateral BMC (mean ± SD ages of 40.5 ± 13.5 and 32.9 ± 13.8, respectively, p = 0.009). About two-thirds (67.5%) of the investigated BMC cases were found unilateral. The most common reported type of BMC was retromolar canal.ConclusionThe incidence of bifid mandibular canal using CBCT is considered relatively high in Saudi Arabian subpopulation, with the most common type was the retro-molar canal.

Development of a biomimetic bioreactor for regenerative endodontics research.

In the context of regenerative endodontics research with the development of biomaterials, this work aimed to develop and test a prototype biomimetic bioreactor of a human tooth. The bioreactor was designed to reproduce a shaped dental canal connected with a cavity reproducing the periapical region and irrigated through two fluidic channels intended to reproduce the apical residual vascular supply. A test biomaterial composed of polylactic acid/polycaprolactone-tannic acid (PLA/PCL-TA) was produced by electrospinning/electrospraying and calibrated to be inserted in a dental canal. This biomaterial was first used to evaluate its imbibition capacity and the oximetry inside the bioreactor. Then, Dental Pulp Stem Cells (DPSCs) were cultured on PLA/PCL-TA cones for 1-3weeks in the bioreactor; afterward cell adhesion, proliferation, and migration were histologically assessed. Complete imbibition biomaterial was obtained in 10min and oximetry was stable over time. In the bioreactor, DPSCs were able to adhere, proliferate and migrate onto the surface and inside the biomaterial. In conclusion, this bioreactor was used successfully to test a biomaterial intended to support pulp regeneration and constitutes a new in vitro experimental model closer to clinical reality.

Correlation between mandibular anatomy and bad split occurrence during bilateral sagittal split osteotomy: a three-dimensional study.

This study aimed to find out the correlation between different anatomical parameters of the mandible and the occurrence of a bad split in patients who had undergone bilateral split sagittal ramus osteotomy (BSSRO). At both the distal roots of the first molar (1) and the retromolar area (2), we measured the distance from the buccal margin of the inferior dental canal (IDC) to the buccal margin of the cortical bone (MCBC), the thickness of both buccal cortical (WBCB) and cancellous bone (WBCA), distance from the superior border of IDC to the alveolar crest (MCAC), buccolingual thickness (BLT), and thickness of cancellous bone (WCA). At the ramus, the distances between the sigmoid notch to the upper part of the lingula (SL) and the inferior border of the mandible (SIBM), the thickness of the ramus at the level of the lingula (BLTR), and the anteroposterior width of the ramus (APWR) were measured. The paired and independent t-tests were used when applicable, and a P-value < 0.05 was considered significant. MCBC1 showed a significant difference between bad and non-bad split sides (P = 0.037). Both WBCA1 and WBCA2 show the same significant difference (P = 0.023, 0.024). Similarly, WCA1 and WCA2 showed a statistical difference between the bad and non-bad split sides (P = 0.027, 0.036). There were no statistically significant differences between the compared sides of WBCB1, WBCB2, MCAC1, MCAC2, SIBM, APWR, SL, and BLTR. Narrow space between IDC and the buccal cortical margin, along with the decrease in the thickness of both buccal cancellous bone and total cancellous bone at the inferior border of the mandible along the course of SSRO, has been implicated in the occurrence of bad split intraoperatively.

Impact of Guidance and Multitasking on Manual Dexterity Skills in Dentistry.

This study investigated the effect of learning by observation on the development of fine motor skills related to endodontic manual instrumentation. We evaluated if learning by observation with guidance had any influence upon operator performance under tense or taxing conditions. Dental students prepared standardized simulated root canals of varying morphology. Learning involved silent video with hand guidance (n = 23), audiovisual combined with oral instructions (n = 23), or silent video (n = 13). Undergraduates who previously completed conventional preclinical endodontics provided comparative data as a control group (n = 16). During investigations, a root canal of a lower molar plastic tooth was shaped, beginning with a primary task, and followed by multitasking conditions. The performance of the students was assessed by evaluating the accuracy of dental canal shaping and time taken to complete the task. Differences were analyzed using ANOVA (p < 0.05). Performance was similar during learning between the three experimental groups. Accuracy of the performance did not differ within each group for the two tests nor between the groups at each test (p > 0.05). These findings demonstrated that performance subsequent to learning by observation without instructions was comparable to learning with instructed observation. The results also identified that the performance of the experimental group (1.5- to 2-hour practice) was comparable with the conventional control group (15- to 20-hour practice). Alternative approaches to learning dexterity skills in dentistry may provide improved outcomes, especially in demanding situations.

Maxillofacial Radiology 194

CBCT imaging and analysis was performed. Observe unilateral expansion by the distending soft tissue outline illustrated through 3D rendering (Figure 2). Sagittal oblique (Figure 3) and axial (Figure 4) slices depict a round heterogenous predominantly high-density lesion with an encompassing thin uniform less dense peripheral band. Irregular root resorption, displacement of the inferior alveolar nerve canal, buccal-lingual cortical expansion, thinning, and interruption was apparent. Irregular thickening at the inferior border and surrounding osteosclerosis were noted. A macroscopic view (Figure 5), photomicrograph (Figure 6), and conventional radiograph (Figure 7) of vertically sectioned surgical specimens of similar lesions. Note the intimate relationship with the tooth roots.