Intraoral Periapical Radiographs Research Articles

COMPARISON IN ANXIETY LEVELS AMONG DENTISTS/ DENTAL STUDENTS AND NON-DENTAL PATIENTS UNDERGOING MANDIBULAR THIRD MOLAR SURGICAL REMOVAL

Objective:
 To compare the age, reasons for surgical removal, awareness about impacted mandibular third molar, anxiety & panic factor, and the type of dental setup preferred among the patients when they are dentists/dental students or otherwise, nondental patients in Peshawar.
 Materials and Methods:
 A sample of ten dentists and forty non dental patients was selected using stratified sampling techniques. The data was collected in local hospitals and dental clinics from January 2017 to January 2018. Preoperative factors such as depth of impaction, tooth position, and bony coverage were considered using orthopantomograms and intraoral periapical radiographs.
 Results:
 The results showed that anxiety and panic factor is high among dentists/dental students when undergoing surgical removal of the impacted mandibular third molar. The results further suggested that dentists themselves believe in the quality and techniques of the hospitals, as 50% of the dentist/dental students opted for dental hospitals for their impactions.
 Conclusion:
 The finding concluded that 100% of the nondental patients did their surgical removal after facing problems because of the impacted mandibular third molars.

Accuracy in the Dimension of Extracted Tooth with Intraoral Periapical Radiograph: A Comparative Study

Introduction: Because of its simplicity, cheaper cost, lower radiation exposure, and easy availability in a dental clinical setting, intraoral periapical radiographs (IOPAR) are frequently utilised for preoperative planning and evaluation for most minor oral surgical procedures.
 Aim: The Aim of this study is to Assess the Accuracy and Reliability of Intraoral Periapical Radiograph with the extracted teeth.
 Methodology: The study is comprised of 54 patients. For each extracted tooth, the actual measurements for tooth length will be measured with a Vernier caliper with a least count of 0.01mm. After obtaining the actual length of the tooth with the Vernier Caliper, the Length of the tooth will be measured from the Intraoral Periapical Radiograph using a Vernier caliper.
 Results: By comparing the length of the actual tooth with that of an IOPAR, it was found out that the difference that was obtained is statistically significant.
 Conclusion: There is significant overestimation in the dimension of the tooth.

Age Estimation Using Monoradicular Teeth by comparing Pulp/Tooth Area Ratios between Bucco-lingual and Mesio-distal Periapical Radiographs

Age estimation is an integral tool in identification of the victims when visual identification is not possible. Secondary dentin deposition is a regular ageing process and can be utilized in dental age estimation when development and eruption parameters cannot be utilized. In total, 38 monoradicular teeth of Nepalese subjects were assessed for tooth pulp ratio. Intraoral periapical radiographs of these teeth were taken, and pulp tooth ratio was calculated and dental age was estimated. The mean chronological age was 46.79 years and the mean estimated age was 44.32 years. The pulp/tooth area ratios calculated were in the range of 0.012 to 0.195, and 0.052 to 0.256 for mesio-distal and bucco-lingual planes respectively. Pulp tooth ratio of maxillary lateral incisors and mandibular lateral incisors showed the highest correlation with values of 90% and 76% respectively. Mesio-distal assessment was more accurate in dental age estimation than bucco-lingual view.

The application of intraoral radiography to assess the success of prosthodontic treatment

Background: Intraoral radiography is a radiographic technique that is often used in dentistry. Almost all dental and oral care re-quires radiographic examination data to support optimal results. Intraoral periapical radiographs can be helpful and very import-ant in estimating the mesiodistal dimensions of the potential area for implant placement and for obtaining an initial estimate of the vertical dimension. Objective: to understand the use of intraoral radiography in prosthodontics. Conclusion: the use of in-traoral radiography has enormous benefits for rehabilitation treatment, especially in prosthodontics, be it the use of periapical, bitewing and occlusal techniques.

Use of 3-D Printed Models for Implant Placement - A Case Series

Long-term stability of a dental implant depends on various factors, one among them is proper position within the alveolar bone. Pre-operative thorough examination of the surgical site is preliminary step while planning dental implants. Conventional techniques such as Intra-Oral Periapical Radiograph and Ortho Pantamogram sometimes not sufficient and clinical scenario always surprises the surgeon. Later advent of Cone-Beam Computed Tomography alleviated this problem to some extent but there are some clinical situations such as resorbed ridge where better visualisation is needed. This led to the innovation of rapid prototyping techniques for the fabrication of three-dimensional complex structures. This technology has numerous applications from the development of an instrument, 3-D printed anatomical models to the fabrication of 3-D printed tissues for regeneration procedures. A 3-D printed model is much more useful than plaster models in many aspects such as demonstrating anatomical structures, better treatment planning, and better understanding for the patient. Hence, this case series focuses on the use of 3-D printed models in the placement of dental implants.

Estimation of Surface Radiation Dosage to Thyroid Gland and Lower Abdomen While Using Intraoral Periapical Radiography: A Phantom Study.

Background and objectiveEvery dose of radiation has the potential to cause biological harm. Quantitative assessment of radiation doses to radiosensitive organs can aid dental professionals in taking the appropriate protective measures against radiation. This data may also be used among the general public to alleviate fears of radiation exposure in dental radiography. This study aimed to estimate the surface radiation dose at the level of the thyroid and lower abdomen during intraoral periapical radiography (IOPAR).Materials and methodsA total of 80 calcium sulfate (CaSO4) discs were utilized in this cross-sectional in vitro study to estimate the surface radiation dose at the level of thyroid and lower abdomen on a phantom model while using an IOPAR. After exposure, the discs were submitted to the Radiation Laboratory's "Personnel Monitoring Service" to measure the surface radiation dose. Mean and standard deviations were calculated using descriptive statistics for continuous variables. The Mann-Whitney U test was used to compare bi-variate samples of independent groups. All statistical analyses were performed using SPSS Statistics version 21.0 (IBM, Armonk, NY).ResultsThe results showed a statistically significant difference in radiation exposure between the maxillary anterior and mandibular anterior regions when the thermoluminescent dosimeter (TLD) was placed in the lower abdomen (p=0.000). When the maxillary and mandibular posterior regions were compared, there was a statistically significant difference in radiation exposure when the TLD was placed in the lower abdomen (p=0.000).ConclusionWhen the cone was positioned in the maxillary region, there was an increase in surface radiation dosage to the lower abdomen and thyroid.

Healing after surgical retreatment at four time points: A retrospective study.

To evaluate the outcome of surgical retreatment at four time points, that is 6, 12, 24 and 48months post-operatively, and to search for prognostic factors that may affect the outcome. Clinical records and intraoral periapical radiographs were collected from patients who had undergone surgical retreatment between 2009 and 2015 and attended 6-, 12-, 24- and 48-month follow-up visits. Surgical retreatment was performed by one endodontist and involved minimal root-end resection and maximal length root-end preparation using prebent ultrasonic files. Outcomes were categorized as complete, incomplete, uncertain or unsatisfactory healing, based on clinical and radiographic findings. The complete and incomplete categories were pooled and considered successes, while uncertain and unsatisfactory outcomes were considered failures. Changes in healing outcome were analysed using the McNemar-Bowker test, and prognostic factors were analysed using univariate analysis. The study cohort included 297 patients with 384 teeth. The overall success rate after 48months was 90.6% compared with 88.5%, 93% and 92.4% after 6, 12 and 24months respectively. Age, gender, presence of isthmus and length of canal preparation had no significant influence on the outcome. Lesion size and tooth type had a significant influence only after 6 and 12months, respectively, with no significant differences at other time points. Fifty per cent of the teeth classified as unsatisfactory or uncertain healing at the 6months follow-up improved to incomplete or complete healing after 12months. None of the cases classified as unsatisfactory healing after 12months subsequently improved, and only 2 cases that were classified as uncertain healing after 12months improved after 24months. Surgical retreatment was found to be a predictable procedure with a high success rate of 90.6% after 4years. Over the follow-up periods, only a minor regression in the success rate was found. The 12months follow-up results closely indicated the long-term outcome of surgical retreatment.

Diagnostic reference levels for intraoral periapical and panoramic radiography

Objective: The objective of this study was to suggest the diagnostic reference levels for intraoral and panoramic radiography through the nationwide survey at regular intervals in South Korea.Study Design: One hundred twenty-six dental institutions from all regions of South Korea were visited. Information on radiographic equipment and clinical exposure parameter was recorded at 118 intraoral and 125 panoramic equipment. Patient entrance dose (PED) and dose-area product (DAP) in intraoral radiography and DAP in panoramic radiography were measured using a DAP meter.Results: Third quartile PED and DAP of intraoral radiography in adults were 1.5 mGy and 46.0 mGy cm2, those in 12-year-old children 1.2 mGy and 37.1 mGy cm2 and those in 6-year-old children 1.0 mGy and 29.9 mGy cm2. Third quartile DAP of panoramic radiography in adults, 12, and 6-year-old children were 227 mGy cm2, 175 mGy cm2, 163 mGy cm2, respectively. The median exposure parameters of intraoral radiography in adults were 60kV, 6mA, and 0.23 seconds and those in 12-year-old children 60kV, 6mA, and 0.16 seconds and those in 6-year-old children 60kV, 6mA, and 0.15 seconds. The median exposure parameters of panoramic radiography in adults were 74kV, 10mA, and 13.6 seconds and those in 12-yearold children 67kV, 10mA, and 13.2 seconds and those in 6-year-old children 67kV, 8mA, and 12.0 seconds.Conclusion: As the national DRLs for intraoral radiography and panoramic radiography in Korea, we recommended 1.5 mGy and 227 mGy cm2 for adults, 1.2 mGy and 175 mGy cm2 for 12-year-old children, and 1.0 mGy and 163 mGy cm2 for 6-year-old children, respectively.

Have conventional dental radiographs lost its charm to modern techniques?

For any dental implant procedure that is being carried out, the success will depend on a thorough pre-operative investigation. The quality, quantity and the volume of available bone at the planned implant site has to be assessed properly when planning a dental implant placement. When we speak of the fore-mentioned aspects pre-surgical imaging and its co-relation to clinical findings help assess the relation to the amount of bone available from underlying vital parts namely the sinus cavities, nasal floor, nerves, teeth and vessels. Different radiographic modalities have been advocated for its assessment. Intra Oral Peri-apical radiograph (two-dimensional) is one such modality that has lost its importance after the introduction of more advanced techniques like Cone Beam Tomography (three-dimensional). This article will help us understand how two-dimensional and three-dimensional imaging modalities go hand in hand while treating dental patients. It will also explain why the conventional imaging technologies are still required in this era of modern methods of imaging.

Prediction of nerve damage by comparing periapical radiographic signs of impacted mandibular third molars in close proximity to inferior alveolar nerve with their true tomographic relationship – An observational study

The purpose of the study was to correlate the accuracy of Roods and Shehab signs in an intraoral periapical radiograph (IOPAR) with Cone-beam computed tomography (CBCT) findings to indicate Cone-beam computed tomography only in high-risk conditions.70 impacted mandibular third molar teeth in 58 patients above 18 years with intraoral periapical radiographs presenting with one or more root and canal signs of Rood and Shehab criteria were included in the study. Winter's classification was recorded, and the patients were exposed to a Cone-beam computed tomographic scan. True canal – tooth relationship was assessed in the sectional images. Pearson Chi-square test was used to correlate periapical radiograph and tomographic findings, and an unpaired t-test was applied for descriptive analysis.Rood and Shehab canal criteria in the periapical radiographs were significantly correlated to direct contact of an impacted lower third molar with the canal (p< 0.05) and loss of cortication of Mandibular canal (p< 0.05) on the cone-beam computed tomography. Cone-beam computed tomography is recommended to assess the periapical radiographs with canal risk markers pre-operatively to help avoid iatrogenic complications.

1643 Quality Assessment of Intra-Oral Radiography Within Two Hospitals in South Wales, UK: A Two-Cycle Audit and Introduction to The Updated 2020 Public Health England Quality Grading System

Abstract Aim To evaluate the quality of intra-oral radiographs taken within two hospitals in South Wales, United Kingdom, and assess the impact of radiographer training, with the aim of reducing the percentage of undiagnostic radiographs to 10% or less in accordance with national performance targets. Method Details of intra-oral periapical and occlusal radiographs taken in the two hospitals between the 1st July 2015 and the 30th June 2016 were retrieved. 100 radiographs were randomly selected and assessed. Change was then implemented in the delivery of radiographer training workshops, which involved two hours of both didactic teaching and hands-on skills training. There were 10 workshops and 52 attendees. A second audit cycle was completed, with a further 100 radiographs randomly selected from the 1st December 2018 and 30th April 2019. Results There was a 33.2% reduction of undiagnostic radiographs, bringing the total down to 6.3%, meeting the standards of the audit. Feedback from the workshops were also extremely positive; 50% of radiographers grading the quality of the workshops at 10/10. Conclusions The workshops were successful in improving the quality of intra-oral radiographs, therefore improving the quality of this service. This blueprint can be shared amongst other hospitals, to sustainably improve the overall quality of dental radiography in the hospital setting. Recent updated guidance in 2020 introduced a new two-point scale radiograph grading system: ‘Acceptable’ and, ‘not acceptable’. Radiographs graded as, ‘not acceptable’, should account for no more than 5% of radiographs. Future audit cycles will follow this new grading system and standard.

A novel application of dynamic guided navigation system in immediate implant placement

Background/purposeImmediate placement in the esthetic zone has been a predictable treatment option. However, it requires the clinician to be experienced and knowledgeable about esthetic diagnosis, accurate 3-dimensional (3D) implant placement, and restoratively driven planning/placement. Therefore, this study aimed to investigate a novel workflow integrating dynamic navigation to immediate single-implant placement in the aesthetic zone. Materials and methodsWe included ten patients who required at least one implant in the esthetic area and were treated with post-extraction socket implant placement. Osteotomy and implant placement followed computer-assisted implant positioning and image-guided dynamic navigation. Treatment outcomes were implant success rates, surgical and prosthetic complications, marginal bone level (MBL), modified pink esthetic score, and white score. ResultsIn the consecutive clinical cases, patients were satisfied with implant therapy's function and esthetic outcome in the esthetic zone. No other surgical or biological complications occurred, which accounts for the 100% cumulative success rate. The mean MBL was −0.76 ± 0.15 mm assessed using standardized intraoral digital periapical radiographs. ConclusionThe novel application of a dynamic guided navigation system is a dependable clinical protocol to obtain optimal implant position/angulation and esthetics on immediate implant placement.

Evaluation of Dental Radiographic Imaging among Insured Population Reporting for Dental Treatment –A Retrospective Study

Aim: To evaluate various dental radiographic examination techniques carried out among insured population. Material and method: This was a retrospective study performed among patients reported to Department of Dentistry, ESIC Medical College, Hyderabad during a two year period from January 2017 to December 2018. Records of 11,535 patients who required radiographic investigations like intraoral periapical radiograph (IOPAR), Orthopantamogram (OPG), Computerized Tomogram (CT) and Cone beam computerized tomogram (CBCT) for diagnosis and treatment planning were analyzed. Results: Among the 11,535 patients, a total of 9,193 IOPAR, 1936 OPG, 348 CT, and 58 CBCT were taken. Among IOPAR, 6164 (67.05%) were advised to diagnose dental caries, 1514 (16.47%) for periodontal disease, and 636 (6.92%) for dental trauma. Regarding OPG, 485(25.05%) were advised to diagnose maxillofacial trauma, 338(17.46%) for periodontal disease, and 224 (11.57%).With regards to CT, 308(88.51%) were advised to diagnose maxillofacial trauma and 40(11.5%) were advised for Cysts and Tumours. In 58 instances where CBCT was advised 47(81.04%) were advised to diagnose Cysts and Tumours and 11(18.96%) were advised for maxillofacial trauma. Conclusion: About 17.07% (11,535 out of 67,551) of the Out-patients required radiological investigations. Among them IOPAR was most commonly advised while the least was CBCT. IOPAR was gold standard for Dental caries and its sequel, and for periodontitis. OPG was ideal for multiple teeth lesions; however had the drawback of ghost images. CT gives a good 3D view but has high radiation exposure and is expensive. CBCT is advanced and gave realistic anatomical picture with comparatively less radiation. However, its availability and standing posture are the drawbacks.

English

BACKGROUND Most common osseous destructive lesions effecting the jawbone are odontogenic cystic lesions, which are lined by epithelium, has been involved in the formation of teeth as the epithelial cell rest are present in jawbone after teeth formation. The three most common odontogenic cysts (OCs) are radicular cyst (RC), dentigerous cyst (DC) and the odontogenic keratocyst (OKC). Less common variety is the residual cyst. Odontogenic cysts are mainly developmental and inflammatory in origin. The objective of the present study was to find clinico-radiographic characteristics of odontogenic cysts in the mandible. METHODS This was a case series (descriptive) study on OCs of mandible conducted at Tripura Medical College and Dr BRAM Teaching Hospital, Hapania, Agartala, Tripura (W), India, over a period of 6 months from August 2019 to January 2020. Subjects showing clinico-radiographic features of OCs in mandible were included, subsequently confirmed by histopathological examinations. Usually orthopantomograms (OPGs) and intra oral peri apical radiograph (IOPAs) were done for radiological findings, computed tomography (CT) scan was required for examination of the size of lesion. Data were analysed using windows excel. RESULTS Diagnosis of OCs was confirmed in 20 patients, among them, males were (60 %) and female were (40 %). The age range of the patients was 17 - 65 years. Most common type of cyst diagnosed in the study was radicular cyst in 50 % cases followed by dentigerous cysts which were in 30 % cases, odontogenic keratocysts were in 15 % patients and others were 5 %. RCs were represented in higher percentage (50 %). Right side of mandible was the most effected side (60 %) than left side (40 %). Main finding of the study was, in every type of cystic lesions, males were recorded as predominant, and it occurred in early age group. CONCLUSIONS Main finding of the study was radicular cyst which was in higher percentage (50 %) and was being most common with association of carious tooth. KEYWORDS Odontogenic Cysts, Mandible, Finding

Prevalence of three-rooted primary mandibular first and second molars: clinical and radiographic findings in a Mexican population.

The aim of this study was to determine prevalence and describe the clinical and radiographic findings of three-rooted primary mandibular first and second molars in a Mexican population. Intraoral periapical radiograph, orthopantomogram or cone beam computed tomography (CBCT) were obtained. A total 2284 children from the state of Puebla, Mexico were examined, of whom 20 presented an anatomic variant in tooth crown shape. Of the total teeth with crown alterations, 10 first and 5 second primary mandibular molars were found to have supernumerary roots. In one case, it was possible to obtain micro-CT images. The study recorded prevalence, unilateral or bilateral occurrence, and ratio between sexes. Data were analyzed using descriptive statistics. Clinical findings were presence of an anatomical variation (tuberculum paramolare / right and/or left cervical convexity) in primary mandibular first molars. Second molars presented conventional crown morphology. Prevalence of three-rooted primary mandibular first and second molars was 0.44% and 0.22%, respectively. Male: female ratio for presence of threerooted primary mandibular first molars was 4:1, showing genetic predisposition in males, and for second molars it was 1.5:1, with no predisposition according to sex. The clinical and radiographic anatomical variants in primary molars should be considered by pediatric dentists during routine care because they may cause difficulties in restorations.

Endodontic Retreatment in Underfilled Root Canal of Maxillary First Molar with Chronic Periapical Abscess: A Case Report

Background:The failure of endodontic treatment commonly caused by imperfect obturation, periodontalperiradicularlesions, untreated root canals, and some other factors. The failure may trigger the occurrenceof secondary infections due to persistent. bacteria.One of the abnormalities that appear after endodontictreatment is a periapical abscess.Endodontic failure can be overcome by endodontic retreatment, apicalsurgery, or extraction. During an endodontic retreatment, endodontic instruments are used to remove theroot canal filling material and to repeat the steps of endodontic treatment to achieve the apical patency.Purpose: This case report presents management to overcome the failure of previous endodontic treatmentwith nonsurgical endodontic retreatment. Case: A 66 years old male patient came with a dull pain oftooth no 16 and uncomfortable when used for chewing since 2 months after endodontic treatment. Theepisodic swelling appeared since 3 months ago which then deflated.The objective examination showed apositive response to bite test and percussion test. Intraoral periapical radiograph confirmed an underfilledroot canal, and a periapical radiolucency with a diffuse border on palatal root. Case Management: Basedon the patient’s history taking, radiographic, and clinical examination,endodontic retreatment was doneand followed by porcelain fused to metal crown restoration. Conclusion: Endodontic retreatment is theappropriate treatmentoption to overcome the failure of the previous endodontic treatment that accompaniedwith a periapical lesion and to preserve its function in stomatognatic system.

A technical report on the hamular technique for radiographing maxillary anterior teeth using a digital sensor.

Obtaining an intraoral periapical radiograph of the maxillary anterior teeth can be quite challenging, especially in patients where a rigid digital sensor cannot adequately fit in the palatal vault. This technical report presents a periapical radiographic technique that places the sensor in the space surrounding the hamular notch to avoid the spatial restrictions of the hard palate, opening the possibility of parallel alignment of the sensor and the long axis of the tooth, perpendicular alignment of the tube-head to both, and a minimally distorted resultant radiographic image. Four adult patients demonstrated the quantitative and qualitative features of this hamular technique (HT). A human skull demonstrated relative magnification and image quality. While patient and equipment-specific, comparisons of magnification, distortion, and image quality illustrate the potential capabilities and limitations of the HT. The HT radiographs appeared to be less distorted than the variable-angle technique (VAT-a clinical approximation of the bisecting angle technique) but magnified 7.9-21.6%. A radiograph of an implant showed a 2.0% distortion over true aspect ratio. The HT radiograph from a human skull showed a slightly lighter and less sharp image than the VAT radiograph. Preliminary results showed that while the HT images were magnified, lighter, and less sharp that the VAT, they were diagnosable for caries. In all the HT images presented in this technical report, there was less distortion than comparable techniques. Notably, one HT periapical radiograph of a maxillary lateral implant showed virtually no distortion, suggesting that a nearly parallel projection was achieved using the technique. While further research is needed, this report shows that the HT has the potential to produce minimally distorted digital radiographs of anterior teeth in patients where the sensor cannot adequately fit into the palatal vault.

Deep learning for categorization of endodontic lesion based on radiographic periapical index scoring system.

The study aimed to apply convolutional neural network (CNN) to score periapical lesion on an intraoral periapical radiograph (IOPAR) based on the periapical index (PAI) scoring system. A total of 3000 periapical root areas (PRA) on 1950 digital IOPAR were pre-scored by three endodontists. This data was used to train the CNN model-"YOLO version 3." A total of 450 PRA was used for validation of the model. Data augmentation techniques and model optimization were applied. A total of 540 PRA on 250 digital IOPAR was used to test the performance of the CNN model. A total of 303 PRA (56.11%) exhibited true prediction. PAI score 1 showed the highest true prediction (90.9%). PAI scores 2 and 5 exhibited the least true prediction (30% each). PAI scores 3 and 4 had a true prediction of 60% and 71%, respectively. When the scores were dichotomized as healthy (PAI scores 1 and 2) and diseased (PAI score 3, 4, and 5), the model achieved a true prediction of 76.6% and 92%, respectively. The model exhibited a 92.1% sensitivity/recall, 76% specificity, 86.4% positive predictive value/precision, and 86.1% negative predictive value. The accuracy, F1 score, and Matthews correlation coefficient were 86.3%, 0.89, and 0.71, respectively. The CNN model trained on a limited amount of IOPAR data showed potential for PAI scoring of the periapical lesion on digital IOPAR. An automated system for PAI scoring is developed that would potentially benefit clinician and researchers.

Comparison of Two Methods in Estimating the Relation Between Dental Age and Chronological Age

Introduction: Personal identification is becoming increasingly important not only in legal medicine but also in criminal investigation, identification, and genetic research. Dental age (DA) estimation has gained acceptance because it is less variable when compared to other age indicators. Aim: This study aims to determine DA by radiographic methods in digital orthopantamogram using Willem's method and in intraoral periapical radiograph using Kvaal's method and also to find out the accuracy of two methods in determining the relation between DA and chronological age. Materials and Methods: The study sample consisted of 75 randomly selected subjects who referred to the Oral Medicine and Radiology department for the purpose to undergo orthodontic treatment, were selected. Orthopantmograph and one intraoral periapical radiograph of right mandibular first molar using paralleling cone technique were taken for each patient The DA was determined using orthopantamography by Willem's method and intraoral periapical radiograph by Kvaal's method. Results: The student's t-test was used to analyze the significance between the two different age estimation methods. In Demirjian's method, the overall mean difference between estimated DA and CA for males was 15.10 years, while for females was 11.88 years. Estimated DA assessment by Willem's method appeared to underestimate chronological age both in males and females. Conclusion: In this study, a significant relation was found between estimated DA and CA in the Willem method (p-0.00) and Kvaal's method (p-0.05). Both the methods seem to be applicable in estimating the age of both genders.

Root Canal Morphology of Maxillary Second Premolars for patients attending Ajman University

Background: The internal anatomy is a complex system and root canal morphology varies between teeth, especially in maxillary second premolars. Objective: The purpose of this present study is to identify the variations in root and root canal morphology of the upper second premolar. Methods: A retrospective study on 197 maxillary second premolars, which have had an endodontic treatment in Ajman University in the Academic Year 2018/2019. Intraoral periapical (IOPA) radiograph was reviewed for identifying the number of root canals. Results: The incidence of two canals in the maxillary second premolars was very high 78.7%, and the internal anatomy is complex and highly variable. Conclusion: A straightforward message to the clinicians to be careful in their evaluation and to take care whenever an upper maxillary second premolar is to be treated endodontically.