Endodontic Specialists Research Articles

The pattern of antibiotics prescription for endodontic infections in Malaysia: Cross sectional survey study.

This study aimed to assess the antibiotic prescribing pattern for endodontic infections among general dental practitioners (GDPs) and endodontic specialists in Malaysia. A 22-questions survey on demographic and general information on antibiotic prescribing patterns for endodontic infection was delivered to the email addresses of general dentists and specialists via the Dental Practitifoner Information Management System database. Collected data were analysed using multivariate logistic regression tests at the significance level of 0.05. A total of 372 responses were collected. 94% of respondents were GDPs, and 6% endodontists. Clinical experience and frequency of endodontic treatment performance were the significant factors in prescribing antibiotics (p < 0.05). The common reasons for antibiotic prescription were to control the spread of infection and fever (88%). Endodontists have better knowledge of antibiotic prescription than GDPs. The majority of GDPs had inappropriately prescribed antibiotics. Improving the knowledge of GDPs in Malaysia regarding antibiotics-indications in endodontics is mandatory.

Influence of operator's experience on the quality and success rate of root canal treatment with new nickel-titanium instruments

Objective: To analyze the influence of operator's experience on the quality and success rate of root canal treatment with new nickel-titanium instruments, providing support for improving the success rate of root canal treatment with new nickel-titanium instruments in clinic. Methods: Cases of root canal treatment and non-surgical root canal retreatment with 6-12 months recall performed by residents (resident group) with experience of 1-3 years and endodontic specialists (specialist group) with experience of 5-7 years were collected from the electronic medical system of the Department of Endodontics, School of Stomatology, Capital Medical University, from September 2020 to August 2021. All cases were prepared by engine-driven glide path files and controlled memory nickel-titanium finishing files. Chi-square test and logistic regression were used to analyze the differences and influencing factors of complications, filling quality and success rate of root canal treatment between the two groups. Results: A total of 277 cases performed by 24 residents and 3 specialists were included, 169 in the resident group and 108 in the specialist group. The clinical incidence of flare-ups was significantly higher in the resident group [3.6% (6/169)] than in the specialist group [0(0/108)] (P=0.048). There were no significant differences in ledges, root canal transportations, perforations, or instrument separations between the two groups (P>0.05). The prevalence of satisfactory fillings was 62.7% (106/169) in the resident group, which was significantly lower than that in the specialist group [86.1% (93/108)] (P<0.05). The success rate of root canal treatment was 91.7% (155/169) and 94.4% (102/108) in the resident group and the specialist group, respectively, with no significant differences (χ2=0.73,P=0.392). Multivariate analysis showed that the success rate of root canal treatment was related to complications and quality of root fillings (P<0.05). Conclusions: Higher success rate of root canal treatment could be achieved by residents and endodontic specialists with engine-driven glide path files and controlled memory nickel-titanium files.

Accuracy and Consistency of Gemini Responses Regarding the Management of Traumatized Permanent Teeth.

The aim of this cross-sectional observational analytical study was to assess the accuracy and consistency of responses provided by Google Gemini (GG), a free-access high-performance multimodal large language model, to questions related to the European Society of Endodontology position statement on the management of traumatized permanent teeth (MTPT). Three academic endodontists developed a set of 99 yes/no questions covering all areas of the MTPT. Nine general dentists and 22 endodontic specialists evaluated these questions for clarity and comprehension through an iterative process. Two academic dental trauma experts categorized the knowledge required to answer each question into three levels. The three academic endodontists submitted the 99 questions to the GG, resulting in 297 responses, which were then assessed for accuracy and consistency. Accuracy was evaluated using the Wald binomial method, while the consistency of GG responses was assessed using the kappa-Fleiss coefficient with a confidence interval of 95%. A 5% significance level chi-squared test was used to evaluate the influence of question level of knowledge on accuracy and consistency. The responses generated by Gemini showed an overall moderate accuracy of 80.81%, with no significant differences found between the responses of the academic endodontists. Overall, high consistency (95.96%) was demonstrated, with no significant differences between GG responses across the three accounts. The analysis also revealed no correlation between question level of knowledge and accuracy or consistency, with no significant differences. The results of this study could significantly impact the potential use of Gemini as a free-access source of information for clinicians in the MTPT.

RETRATAMENTO ENDODÔNTICO NÃOCIRÚRGICO EM MOLAR INFERIOR COM INFECÇÃO SECUNDÁRIA: CINCO ANOS DE ACOMPANHAMENTO

This study reported the repair of a periapical lesion after endodontic retreatment. A 42-year-old female patient was referred to an endodontic specialist for endodontic retreatment of tooth 36. Clinically, she was asymptomatic, and the periapical radiographic examination revealed radiopaque material similar to gutta percha and an inadequate filling of the canal (sub -root canal filling, in addition to a radiolucent image present in the apical region of the tooth. After anesthesia, the coronal opening was performed using ProDesign Logic RT #30/10, #.25/08, #.20 rotary instruments. /06 At that moment, the instrument fracture occurred in the mesio-lingual canal, which was removed with ultrasonic tips and a microscope. , Belo Horizonte, Brazil) at CRT. The foraminal debridement was performed with a Logic 25.01 instrument along the actual length of the tooth. Root canal filling was performed using the #30.05 single cone technique and Bio-C Sealer bioceramic endodontic cement. At the 5-year follow-up, the patient was asymptomatic and the radiographic examination confirmed complete repair of the periapical lesion.

Knowledge of Dentists regarding Antibiotic Prescription in Endodontics in Tripoli

The aim of this study was to assess how well dentists understand and follow guidelines for prescribing antibiotic in endodontics in Tripoli. A questionnaire link was sent to all participants via various social media platforms. All answers from the online form were automatically imported in an Excel file and were then appropriately analyzed. Descriptive statistics (such as frequencies and percentages) were calculated, and Chi-square test were used to compare between the groups. The majority (67.6%) of the respondents were general dental practitioners and most of them were females (80.4%). A smaller group (10.8%) were endodontic specialists while 21.6% belong to other specialties. Diffuse swelling was the most common condition for which antibiotics were prescribed (81.4%) and in patient with swelling &amp; difficulty in swallowing (73.5%). Antibiotics were always prescribed by 65,7% of respondents for patient exhibiting systemic symptoms such as fever and malaise and 6.9% of respondents always prescribed antibiotics in prolonged root canal treatment. The Majority of respondents selected Amoxicillin with Clavulanate as the first choice for patients without medication allergies (72.7%) and Amoxicillin ranked as the second most preferred antibiotic (39.4%) (Table 3). On the other hand, the majority of respondents preferred clindamycin as the first choice for patients with penicillin allergy (43.6%). The majority of the participants believe that the typical duration of antibiotics course is five to seven days (98%). The majority (95.1%) of respondents were aware of drug resistance, while a very small percentage (4.9%) were not aware. The data reveal that critical importance of selecting antibiotics based on patient-specific factors, such as allergies, to ensure effective and safe management of endodontic infections. The knowledge and attitude of dentists regarding antibiotic prescription for endodontic treatments require further improvement.

Diagnostic accuracy of artificial intelligence-assisted caries detection: a clinical evaluation

ObjectiveThis clinical study aimed to evaluate the practical value of integrating an AI diagnostic model into clinical practice for caries detection using intraoral images.MethodsIn this prospective study, 4,361 teeth from 191 consecutive patients visiting an endodontics clinic were examined using an intraoral camera. The AI model, combining MobileNet-v3 and U-net architectures, was used for caries detection. The diagnostic performance of the AI model was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, with the clinical diagnosis by endodontic specialists as the reference standard.ResultsThe overall accuracy of the AI-assisted caries detection was 93.40%. The sensitivity and specificity were 81.31% (95% CI 78.22%-84.06%) and 95.65% (95% CI 94.94%-96.26%), respectively. The NPV and PPV were 96.49% (95% CI 95.84%-97.04%) and 77.68% (95% CI 74.49%-80.58%), respectively. The diagnostic accuracy varied depending on tooth position and caries type, with the highest accuracy in anterior teeth (96.04%) and the lowest sensitivity for interproximal caries in anterior teeth and buccal caries in premolars (approximately 10%).ConclusionThe AI-assisted caries detection tool demonstrated potential for clinical application, with high overall accuracy and specificity. However, the sensitivity varied considerably depending on tooth position and caries type, suggesting the need for further improvement. Integration of multimodal data and development of more advanced AI models may enhance the performance of AI-assisted caries detection in clinical practice.

Assessment of the Difference Between General Practitioners and Specialists in Antibiotic Prescription for Emergency Patients

Background:Endodontic emergencies are one of the most common emergencies that dentists face during their career. Objectives: This study aimed to evaluate and assess the difference between general dentists and endodontists in managing endodontic emergency cases. Also, it highlights the risk of bacterial resistance due to an inappropriate antibiotic prescription. Methods: A cross-sectional study conducted at King Abdul-Aziz University Dental Hospital, a self-administered survey was distributed to 521 dental patients. The response rate was 82.9% (432 out of 521). The survey, available in both paper and electronic formats, comprised 24 questions organized into three main sections: the first section collected demographic and medical history data, the second focused on the patients' dental history related to emergencies, and the third detailed the treatment received during emergencies and the methods employed. A Fisher's exact test was utilized to assess significant differences between general dental practitioners and endodontic specialists regarding their initial steps, reasons for treatment, swelling conditions, biting and chewing conditions, and final treatments. Data analysis involved simple descriptive statistics, including percentages, frequency distributions, pie charts, and bar graphs. Statistical significance was determined with a p-value set at ≤ 0.05. Results: The study revealed that decay was the most prevalent reason for endodontic treatment, with immediate treatment being the preferred choice among dentists. Despite the well-documented issue of endodontic treatment failure due to inadequate coronal sealing, the majority of general dentists performed root canal treatments followed by either temporary or permanent restorations. Additionally, the study found that general dentists prescribed antibiotics more frequently than endodontists. Conclusion: The study findings indicate the need to develop intervention programs targeting clinicians to enhance knowledge about prescribing antibiotics for endodontic emergencies.

The use of 0.5% or 3% NaOCl for irrigation during root canal treatment results in similar clinical outcome: A 6-year follow-up of a quasi-randomized clinical trial.

To evaluate the 6-year outcome of root canal treatment irrigated with 0.5% or 3% sodium hypochlorite (NaOCl). The baseline trial was designed as a quasi-randomized clinical trial. Patients referred for root canal treatment to an endodontic specialist clinic were recruited to the study (n = 298). The concentration of NaOCl was allocated quasi-randomized to 271 subjects (0.5% [n = 139], 3% [n = 132]). Bacterial sampling was performed immediately before root canal filling. Samples were cultured and evaluated as growth or no growth. Patients were invited to a clinical and radiological follow-up >5 years postoperatively. The clinical outcome measurements were tooth survival, cumulative incidence of endodontic retreatments, patients' assessment of pain, clinical findings and radiological signs of apical periodontitis (AP). Tooth survival was 85.6% in the 0.5% NaOCl group and 81.1% in the 3% NaOCl group (p = .45). There was no record of retreatment in 94.4% in the 0.5% NaOCl group and in 92.2% in the 3% NaOCl group (p = .76). The percentage of asymptomatic cases were 87.8% in the 0.5% group and 85.3% in the 3% NaOCl group (p = .81). Absence of clinical signs of AP was seen in 86.6% in the 0.5% NaOCl group and in 83.6% in the 3% NaOCl group (p = .80). Absence of radiological signs of AP was seen in 74.0% in the 0.5% NaOCl group and 64.1% in the 3% NaOCl group (p = .20). Subjects with positive culture before root filling reported subjective pain with a significantly higher frequency as compared to negative-culture subjects (p = .014). The use of 0.5% or 3% NaOCl for irrigation during root canal treatment resulted in similar clinical outcomes 5-7 years postoperatively. Persisting bacteria immediately before root filling may predict future episodes of subjective pain.

CONDUTA DO ESPECIALISTA EM ENDODONTIA FRENTE AO RETRATAMENTO ENDODÔNTICO

Failure cases represent a significant percentage within endodontic practice. It is then necessary, in most cases, to carry out endodontic retreatment, which requires the search for a quick, safe and efficient technique. The objective of this study was to analyze the clinical conduct of the Endodontic Specialist in relation to endodontic retreatment through the completion of a questionnaire. To this end, 40 dental surgeons specializing in Endodontics, registered with CRO-PE, were selected. The results demonstrated that 97.5% of those surveyed indicated retreatment in the presence of a periapical lesion with symptoms, 50% in the absence of a periapical lesion with symptoms. Both in root canals treated endodontically and exposed to the oral environment for 30 days (75%) and in canals exposed for 40 days (82.5%) Specialists recommended retreatment in teeth that required a restoration with the presence of an intra-radicular post. 90%. Still in relation to how they use the Association of K, H and Gates-glidden files. The most used solvent was Eucalyptol (62.5%), followed by orange peel oil (55%), Xylol (7. 5%) and chloroform (7.5%). 5% do not use any solvent. 56.4% of those surveyed introduce the solvent up to the middle third in cases of overfilling of the root canal. 62.5% of those surveyed recommend a limit for canal preparation and filling of 1mm below the radiographic vertex. Using foraminal patency in 97.5% of cases. The most used irrigating solution was Chlorinated Soda (60%), followed by labarraque solution (25.0%), Dankin's liquid (17.5%) and saline solution (7.5%). 97.5% stated that they performed retreatment in two sessions and in these cases they used Callen (45.0%) and Callen associated with PMCC (42.5%) as intra-canal medication. The products tricresol formalin, calcium hydroxide P.A and formocresol were mentioned respectively by 15.0%, 12.5% ​​and 5.0%, 80% of those surveyed responded that in cases of flare-up they would not leave the tooth open to the oral environment . And 20% responded that they would leave it. Still in relation to flare-up, the intra-canal medication of choice when not leaving the canal open to the mouth was Callen (37.5%), followed by tricresol formalin (31.1%), callen + PMCC (25% ), calcium hydroxide P.A. (9.4%) and formocresol (3.1%). The drug of choice in cases of acute endodontic treatment was Amoxicillin associated with Clavulanate (92.5%).

Need for dentists with post-graduate training in endodontology according to members of the Swiss Dental Association

This questionary-based study was financed by the Swiss Society for Endodontology (SSE). At the time of this survey (2022) there were merely 20 board-certified endodontists in Switzerland, and 239 other members of the SSE, i.e. general practitioners with some form of post-graduate endodontic training or a keen interest in the field. The aim of this investigation was to evaluate the need for a higher number of trained endodontists as viewed by the general population of dentists in Switzerland. An electronic questionary in either German, French, or Italian was sent to all 4072 active members of the Swiss Dental Association (SSO). The questionnaire focused on the background of the surveyed dentists, their willingness to refer endodontic cases to a specialist or colleague with a focus on endodontics, their propensity to do so, and their perceived need for endodontists in their region. The response rate was 21%, and was similar between the different regions and cantons. Seventy-nine (9%) of the dentists participating in the survey were members of the SSE, while 16 (2%) were board-certified. Merely 7% of the participants received endodontic referrals themselves, while 81% referred cases in some instances. However, only 13% of participants referred endodontic cases always or regularly. The main reason for not referring was the belief by the surveyed dentists that they could perform the endodontic treatments themselves. Long distance to the next endodontic specialist or expert was the second most frequently given reason not to refer cases. A total of 58% of the participants believed that there were enough endodontists in Switzerland to cover the encountered clinical problems.

Influence of operator’s experience on complications of root canal treatment using contemporary techniques: a retrospective study

BackgroundEndodontic treatment has benefited from the development of new techniques and equipment. Few clinical studies have been published on the complications associated with root canal preparations performed by doctors with different working experiences using contemporary techniques. This study aimed to analyze the complications of endodontic treatment performed by residents and endodontic specialists in a teaching stomatology hospital using contemporary techniques.MethodsCases of root canal treatment (RCT) and non-surgical root canal retreatment (ReRCT) performed by residents with 1–3 years of experience and endodontic specialists with 5–7 years of experience were collected from the electronic medical system of the Department of Endodontics, Beijing Stomatology Hospital, from September 1, 2020 to August 31, 2021. The cases were examined in terms of patient age, sex, type of tooth, diagnosis, treatment modality (RCT or ReRCT), number of appointments, whether an operating microscope was used, presence of ledges, canal transportation, perforations, missed canals, separated instruments, flare-ups and clinical incidence of second mesiobuccal (MB2) root canal in the maxillary molars.ResultsIn total, 859 teeth from 820 patients were included in the analysis. The overall incidence of complications in the resident group was significantly higher than that in the specialist group. More ledges and flare-ups were observed in the resident group (p < 0.05). The clinical incidence of MB2 was significantly higher in the specialist group (p < 0.05). There were no significant differences in root canal transportation, perforation, or instrument separation between the two groups (p < 0.05). Multivariate analysis showed that the incidence of root canal preparation complications was related to operator experience, tooth type and treatment modality.ConclusionsTechnical advancements could reduce the effect of working experience on RCT complications between residents and endodontic specialists in a teaching stomatology hospital.

Global cone-beam computed tomography adoption, usage and scan interpretation preferences of dentists and endodontists.

This study investigated the adoption of cone-beam computed tomography (CBCT) by dentists and endodontists around the world, including their preferences in endodontic CBCT usage. An online questionnaire surveyed dental association members in Australia and New Zealand, and endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA, about their CBCT training history, considerations in acquisition/interpretation, access to and usage of CBCT, preferred scan interpreter, and preferred endodontic scan settings. Data were analysed with Chi-squared, independent sample t-tests, Cochran's Q and McNemar's tests. Responses from 578 endodontic specialists or postgraduates (Group E) and 185 non-endodontic dentists (Group NE) were included. Continuing professional education (CPE) was the most common source of CBCT training (69.2%). Factors considered in CBCT acquisition/interpretation included beam hardening (75.4%), radiation exposure (61.1%) and patient movement (58.3%). Group E reported higher CBCT usage (90.8%) than Group NE (45.4%, p < .001) and greater workplace access to CBCT (81.1% vs. 25.9%, p < .001). Scans were interpreted by the respondent in most workplace scans (83.3%) and externally taken scans (60.5%); Group E were significantly more likely to interpret themselves than Group NE. Small field of view (83.6%) and high resolution (86.6%) were most preferred as settings for endodontic CBCTs; Group NE were less likely to choose these settings. There were some geographic variations within Group E. CBCT training was most commonly acquired via CPE. Endodontic respondents reported very high CBCT usage and access in the workplace. There are educational implications regarding CBCT limitations, appropriate applications and interpretation.

Dose-response association of smoking with delayed healing of apical periodontitis after endodontic treatment.

A prospective cohort study aimed to assess the inhibitory effect of cigarette smoking on the rate of periapical bone healing after root canal treatment (RCT). Examination included both clinical and radiographic parameters to define healing status at baseline, 6 months, and 1 year after RCT. To examine and compare the healing rate of apical periodontitis (AP) after RCT between smokers and nonsmokers, and to evaluate how the intensity and duration of smoking affect AP healing up to 1-year follow-up. Study hypothesis was that smoking habits could delay or deteriorate AP healing. The study protocol was approved by the local ethics committee and all of the participants signed a consent form. Included were adult patients with a radiographically confirmed AP in a single tooth with a favorable periodontal prognosis and adequate coronal restoration, with no previous RCT. Excluded patients were those diagnosed with a systemic disease or on medications affecting bone metabolism, former and occasional smokers, pregnant patients, and those who refused to participate. Smokers were defined as those who consumed at least 100 cigarettes in their lifetime and currently smoke. Smoking intensity was classified according to cigarette consumption per day (CPD) into: heavy smoking (≥20 CPD) and mild smoking (˂20 CPD). Tobacco exposure over time was assessed by smoking index (=CPD ˟ duration of tobacco smoking in years) and categorized into: nonsmoker, <400, 400-799, and ≥800. The control group included healthy nonsmokers and matched the smoker group in termsof age and gender. All RCTs were performed by endodontic specialists following a standardized protocol. Clinical examination involved percussion and palpation tests, periodontal probing and examination of the coronal restoration; while the periapical healing was radiographically assessed using the periapical index (PAI) scoring. A total of 110 patients (55 smokers and 55 nonsmokers) were included. The two groups were comparable regarding age, gender, tooth type, socioeconomics, and periapical index scores at the baseline. The mean CPD among smokers was 12.22, and most of them were "mild smokers". At 12-month follow-up, nonsmokers showed a significantly higher healing rate compared to smokers (90.9% vs. 58.2%; χ2 = 13.846; p < 0.001). Conversely, smokers had significantly higher PAI when compared to the control group (p = 0.024). Regression analysis demonstrated that the risk of AP persistence increases with an increase in the smoking index [OR = 7.66; 95% CI: 2.51-23.28; p < 0.001, for smoking index <400 and (OR = 9.65; 95% CI: 1.45-64.14; p = 0.019, for smoking index 400-799]. Smoking was significantly associated with delayed AP healing after RCT. The likelihood of AP persistence rises as smoking exposure increases. These results could impact clinical decisions and guidelines concerning smokers.

Endodontic operative field asepsis: a comparison between general dentists and specialists

Objective The aim was to evaluate the establishment of an aseptic endodontic operative field in general dentistry by assessing general dentists’ ability to reduce the amount of contamination to a non-cultivable level, and to compare the operative field asepsis at a general dentistry clinic with that at an endodontic specialist clinic. Materials and Methods A total of 353 teeth were included in the study (153 in general dentistry, 200 at the specialist clinic). After isolation, control samples were taken, the operative fields disinfected with 30% hydrogen peroxide (1 min) followed by 5% iodine tincture or .5% chlorhexidine solution. Samples were collected from the access cavity area and buccal area, placed in a fluid thioglycolate medium, incubated (37°, 7 d), evaluated for growth/non-growth. Results Significantly more contamination was observed at the general dentistry clinic (31.6%, 95/301), than at the endodontic specialist clinic (7.0%, 27/386) (p <.001). In general dentistry, significantly more positive samples were collected in the buccal area than in the occlusal area. Significantly more positive samples were collected when the chlorhexidine protocol had been used, both in general dentistry (p <.001) and at the specialist clinic (p =.028). Conclusions The result from this study shows insufficient endodontic aseptic control in general dentistry. At the specialist clinic, both disinfection protocols were able to reduce the amount of microorganisms to a non-cultivable level. The observed difference between the protocols may not reflect a true difference in the effectiveness of the antimicrobial solutions, as confounding factors may have contributed to the result.

Current endodontic practice and use of newer technologies in Australia and New Zealand.

This study investigated endodontic clinical preferences, adoption of newer technologies and information sources among dentists and endodontists. Dental and endodontic society members in Australia and New Zealand were surveyed online regarding their endodontic treatment preferences, armamentarium, information sources and continuing professional education (CPE) attendance. Complete responses were received from 71 endodontic specialists or postgraduates (Group E) and 139 general dentists (Group D). Most of Group E used dental operating microscopes (95.8%), endodontic cone-beam computed tomography (CBCT; 98.6%) and calcium silicate-based materials (CSBMs; 97.2%), significantly more (P < 0.001) than Group D (86.3% used loupes, <32% used CBCT for endodontics or CSBMs). Most respondents used dental dam always for endodontics (94.3%), electronic apex locators (EAL; 81.0%) and engine-driven nickel-titanium (NiTi) instruments (91.4%); Group E had more experience with engine-driven NiTi (P < 0.001). Endodontic CPE attendance was highest at dental association programs (P < 0.001) while hands-on NiTi training attendance was highest via commercial companies (P < 0.05). Online information sources were commonly used (38.8% of Group D, 59.2% of Group E). Dental dam, EAL and engine-driven NiTi were almost universally used. The endodontic group reported high adoption of newer endodontic technologies. Endodontic CPE and information sources should be further surveyed as online engagement evolves. © 2023 Australian Dental Association.

In Vitro Evaluation of the Accuracy of Three Electronic Apex Locators Using Different Sodium Hypochlorite Concentrations.

Background and Objectives: The aim of this study was to compare the accuracy of three types of electronic apex locators (EALs) when two different concentrations of NaOCl irrigation solutions are used by two operators. Materials and Methods: After creating the access cavities for 20 single rooted extracted teeth, the actual canal length (ACL) of each canal was determined visually using a #10 file and magnification. The teeth were subsequently inserted in plastic molds filled with alginate. The electronic measurement of root canal length (EWL) was performed using three different electronic apex locators: Root ZX II, Apex ID, and Dual Pex. Two independent operators, an endodontic specialist with 20 years practice and an undergraduate student in the final year of study, performed the irrigation procedures with two different concentrations of NaOCl (2% and 5.25%), and then measured the EWL using each of the EALs. The accuracy of all EALs, was determined in each case by subtracting the EWL from the ACL. Statistical analyses were performed using one-way ANOVA test. Results: In the presence of 2% NaOCl solution, for a margin error of ±0.5 mm, Root ZX II, Apex ID, and Dual Pex presented an accuracy of 90%, 80%, and 85% respectively. The increase in the concentration of the irrigation solution affected the accuracy of Root ZX II and Apex ID for both operators, diminishing it to 75% for the same margin error, but improved Dual Pex's accuracy to 100%. Conclusions: The best accuracy in working length determination was obtained by Root ZX II for 2% NaOCl solution and by Dual Pex for 5.25% NaOCl solution with no significant statistical difference when compared.

Nationwide Trends of Modern Endodontic Practices Related to Working Length, Instrumentation, Magnification, and Obturation: A Comparative Cross-Sectional Survey Comparing Endodontic and Non-Endodontic Specialties Practicing Root Canal Treatment in India.

The present study was designed to assess trends in contemporary endodontic practice regarding the techniques and materials used in endodontic therapy among dental practitioners from various regions of India. A cross-sectional questionnaire-based study was conducted amongst dentists who were pursuing postgraduates in endodontics (PG Endo) and other branches (PG-OB), specialists from other branches (MDS-OB) and specialists in endodontics (MDS-Endo) in various dental colleges representing East, West, North, South, and Central zones through an e-survey using Google forms. State-wise postgraduate dental college lists were obtained from the Dental Council of India (DCI) website. Using a multistage cluster random sampling method and considering the unanticipated response rate, emails were sent to 2100. A 29-item close-ended questionnaire, framed according to different aspects of endodontic treatment, was used to record the responses. When the distribution of the groups of dentists was compared, the central zone had the highest number of PG-OB (44.2%) and the lowest number of MDS-Endo (8.4%). The electronic apex locator (EAL) method of working length determination has been reported less among MDS-Endo than MDS-OB. The difference between the usage of various methods for working length determination was significant among the different groups in all the zones. (p < 0.0001) Most MDS-Endo preferred the rotary method of instrumentation over the combination method for different zones. The majority of dental practitioners preferred a combination method of instrumentation. Zone-wise comparisons among dentists showed the majority of general dental practitioners preferred the combination method (radiographs and electronic apex locator) for working length determination. Most MDS-Endo preferred the rotary method of instrumentation over the combination method for different zones. All dental practitioners did not so commonly use magnification in all the zones. The single cone technique was the most opted by dental practitioners of all the zones.

Current Trends in Irrigation Solution and Adjunct Use During Endodontic Therapy Among Dental Professionals in Jeddah, Saudi Arabia: A Cross-Sectional Study.

Introduction Chemical irrigation is a crucial component of endodontic therapy, and irrigation adjuncts increase the efficiency of non-surgical root canal system disinfection, reduce microbial loads, and enhance the penetration of irrigants throughout the root canal system. This study aimed to determine the current trends in chemical irrigation and its adjunct use during root canal therapy by general dental practitioners (GDPs) and endodontic specialists in both government and private sectors in the city ofJeddah, Saudi Arabia. Methods This cross-sectional study used a self-administered survey sent to GDPs and endodontic specialists in both government and private sectors in the city of Jeddah, Saudi Arabia. Responses were accepted from November 2019 till May 2020. The survey was randomly distributed to consenting participants. The results are presented using descriptive statistics. Results A total of 302 participants responded to the survey, with a 44% response rate. The majority of responses were from GDPs (54%), while 46% were from endodontic specialists. Regarding the workplace, 59% of respondents were public sector professionals, 25% were private sector professionals, and 16% were both public and private sector professionals. Around 30% of the respondents used sodium hypochlorite (NaOCI) as their primary irrigation solution during root canal treatment, with 52% using it at its full-strength concentration and 18% and 17% preferring to use it in combination with Ethylenediaminetetraacetic acid (EDTA) only or EDTA and saline, respectively. When asked to rank the reasons for choosing their irrigant of choice during therapy; antibacterial capability and tissue dissolution were the most crucial factors to 80% and 57% of participants, respectively. Half of the respondents irrigated the canal to 2 mm from the apex and 21% irrigated to 1 mm from the apex. Three-quarters of participants aimed to remove the smear layer during root canal treatment. Only 47% of respondents used adjuncts to irrigation, and 71% reported that their choice of irrigation solution would differ depending on whether the apex is open or closed. Conclusion Most respondents used full-strength NaOCI concentration as the main irrigation solution and routinely removed the smear layer during root canal treatment. Only 47% of respondents used irrigation adjuncts such as ultrasonics.

Radiographic Evaluation of Errors during the Root Canal Treatment by 5th and 6th Year Undergraduate Students of Islamic Azad University of Isfahan (Khorasgan) from 2015 to 2018

Introduction: Quality of root canal treatment is considered as an important prognostic factor for endodontic therapy success. The aim of this study is to evaluate radiographic errors during the root canal treatment by 5th and 6th year undergraduate students of Islamic Azad university of Isfahan (Khorasgan) from 2015 to 2018.&#x0D; Materials &amp; Methods: In this study records of 860 cases of endodontic treatment of patients referred to the General Endodontics Department and the Comprehensive Treatment Department of Isfahan Azad University (Khorasgan) during 2015-2018 including 1903 root canals that had received root canal treatment were examined. Periapical radiography was used to evaluate errors during access cavity preparation, canal preparation, and canal filling by two endodontic specialists and it was recorded in pre-prepared forms. In the access cavity preparation: furcation perforation, low access cavity expansion, high access cavity expansion were evaluated. During the canal preparation phase, errors such as missing of canal, ledge, transport, perforation types and broken instruments were investigated. Length and density of root filing were the criteria evaluated at the canal filling stage. The analysis was performed at both descriptive and inferential levels. Statistical analysis was performed by Chi-Square test and exact Fisher's test.&#x0D; Results: Frequency of acceptable root canal treatment (without errors) was 37.5%. Lower first molars showed the highest error rate (40.7%). Furcation perforation was reported with 9.4% highest error of access cavity preparation. The highest error rate was reported transport (7.8%) in the preparation phase. Inadequate density (gap) of 36.9% and under filling of 31.1% had the highest error in filling stage.&#x0D; Conclusion: According to the results of this study, it can be stated that general endodontics department needs careful planning to increase the quality of root canal treatments performed by students.

Diagnosis consensus among endodontic specialists and general practitioners: An international survey and a proposed modification to the current diagnostic terminology.

This survey aimed to determine the consensus amongst endodontic specialists in North America and practitioners worldwide to diagnose the pulp and periapical conditions of selected case scenarios encountered in daily practice using the American Association of Endodontists (AAE) pulpal and periapical diagnostic terms. Secondly, an attempt was made to suggest modifications in terms accordingly. A survey designed by two endodontic educators was sent to endodontists in North America and clinicians worldwide through an electronic database. The survey included socio-demographic questions followed by the clinical and radiographic presentations of four clinical scenarios. The participants were then requested to provide the pulpal and the periapical diagnosis of 11 teeth presented in these cases (22 answers in total/participant) using the AAE diagnostic terminology. Cases were designed to include 12 pulpal/periapical conditions as control (non-controversial conditions) and ten so-called controversial conditions. A proportion threshold of 10% was required for any diagnostic term to be reported in this survey. The participants were divided into two groups based on the region of endodontic training and/or practice to 'Specialised North American' or 'International Practitioners,' and their results were statistically compared using chi-squared tests (p< .05). The survey included 421 participants. 74% were endodontists, and 46.1% were amongst the 'Specialised North American' group and 53.9% amongst the 'International Practitioners'. Eleven of 12 control conditions had an almost complete agreement amongst the participants regarding the diagnostic terms selected, ranging between 82% and 96%, with no other diagnostic term exceeding the 10% threshold. All the controversial conditions yielded more than one diagnostic term selected/condition that exceeded the 10% threshold for groups ('Specialised North American' and 'International practitioners'). There were no differences in the diagnostic terms selected between the two groups; however, the weight for each term varied between the groups in some cases. There is a lack of consensus amongst clinicians, regardless of their training and region of practice, on the appropriate diagnostic terms to be used in particular clinical conditions. More diagnostic terms and modifications in the current terms may be required to establish a more reliable diagnostic terminology.