Intraoral Radiographs Research Articles

Prosthesis Emergence Angle Influences Marginal Bone Level for External Connection Implants: A Cross-Sectional Study.

To retrospectively evaluate the influence of prosthetic features on marginal bone level changes around bone-level implants with an external hex connection. A total of 100 patients with 166 implants and cemented crowns were included. Demographic and clinical data were collected. Prosthetic features were radiographically evaluated, including emergence angle (EA), emergence profile (EP), crown-implant ratio (CIR), and abutment height. Marginal bone levels were measured on intraoral radiographs taken at baseline and after at least 1 year. The correlation between prosthetic features and marginal bone loss (MBL) was then investigated. The mean follow-up time was 43.94 months. Implant length varied between 5 and 13 mm. The mean height of the abutments used was 1.55 mm. EA measured an average 30.62 degrees (± 13.20) mesially and 29.45 degrees (± 13.07) distally. The CIR was 0.99 (± 0.26). The mean MBL was 0.19 mm on the mesial side and 0.20 mm on distal side of the implants. Significant positive associations emerged between MBL and implant length (P < .005) and with EA (P < .05). A convex profile of the crown was shown to be associated with a higher distal MBL (P = .025) compared to concave and straight profiles.

The Use of Extra-oral Bitewing Radiographs for Treatment Planning in Paediatric Patients

The extra-oral bitewing is becoming increasingly popular among clinicians to help overcome some of the challenges posed when taking intra-oral radiographs for paediatric patients. When combined with clinical examination, this radiographic view provides important diagnostic information in the management of caries in the posterior dentition. In this article, the use of extra-oral bitewings will be explored. The introduction of a decision tree provides the dental practitioner working in either a primary or secondary care setting, a pathway to assist with deciding the optimal radiographic prescription. CPD/Clinical Relevance: Extra-oral bitewings can be a useful radiographic tool for dental caries diagnosis in the mixed dentition.

Clinical evaluation of corono-radicular restorative design with fibre post restoration for fractured endodontically treated maxillary incisors: A randomised control trial

ABSTRACT Aim: The primary aim was to evaluate and compare the survivability of corono-radicular direct composite (CRDC) restoration and fiber-reinforced composite post (FRC) followed by coronal restoration for fractured root canal-treated maxillary incisors with a tooth structure loss of 50%–70%. Methods: A total of 56 teeth from 49 patients with fractured maxillary central and/or lateral incisors due to trauma were recruited for the study. The teeth were randomly allocated to two groups randomly by lot method. The two treatment groups were as follows: Group I – CRDC and Group II – FRC followed by coronal restoration. The postoperative review was performed at 3-, 12-, 18-, and 24-month period using intraoral periapical radiographs and clinical photographs. The Patient Satisfaction Questionnaire was administered during 24-month review visit. Kaplan–Meier survival analysis was used to assess the longevity of the restorations. Results: There was no significant difference (P &gt; 0.05) in the survivability of the restorations among the two treatment groups. The mean survival period for CRDC was 24 months and FRC followed by coronal restoration was 23.74 months. The patient’s satisfaction assessed using the questionnaire was higher in CRDC (100%) than FRC followed by coronal restoration (81.5%). Conclusion: Within the limit of the present study, both CRDC and FRC followed by coronal restoration were equally effective in the management of fractured maxillary incisors with 50%–70% tooth structure loss.

Influence of Crown-to-Implant Ratio on Crestal Bone Loss at Implants with Single Crowns and Bridges: A 5- to 20-Year Long-Term Cohort Study in Patients with Periodontal Disease.

To evaluate how the crown-to-implant (C/I) ratio affects the loss of crestal bone at single-crown implants and bridges in patients with periodontal disease. A total of 39 patients treated for periodontitis were rehabilitated with 108 implant-supported single crowns and bridges. Each patient was examined over a 5- to 20-year period on a 3- to 6-month recall schedule. At each session, we recorded periodontal clinical parameters. In addition, intraoral radiographs were taken after superstructure insertion (baseline) and then at 1, 3, 5, 10, 15, and 20 years. The study population was divided by anatomical C/I ratio (Group 1: C/I ≤ 1, Group 2: C/I > 1). Implants had a 96.2% 5-year survival rate and 92.6% 20-year survival rate. The overall prevalence was 10.1% for mucositis and 1.1% for peri-implantitis. The survival rate (P = .68), incidence of mucositis (P = .325), and incidence of peri-implantitis (P = .077) did not significantly differ in the group comparison. The mean annual peri-implant bone loss was 0.09 ± 0.41 mm and was not significantly different between the groups. Mean bone loss was not significantly different until the 10th year of observation, during which Group 2 presented significantly less bone loss. The correlation of annual bone loss and clinical C/I ratio showed a small but significant negative effect throughout the entire study period (R = -0.217; P < .01). Increased crestal bone loss was not observed with implants with higher C/I ratios, both anatomical and clinical, and they even showed signs of less crestal bone loss.

X-ray features and diagnostics of purulent-necrotic lesions of the jaws

X-ray data of 750 patients with odontogenic and non-odontogenic osteomyelitis of the jaws aged 18 to 65 years were studied. The results of orthopantomography, panoramic zonography of facial bones, telerentgenography of the skull, intraoral radiography, computed tomography of the maxillofacial region are analyzed.&#x0D; The radiological characteristics of odontogenic acute, subacute, chronic and primary chronic osteomyelitis, hematogenic and posttraumatic osteomyelitis, radiation, bisphosphonate and phosphorus necrosis of the jaws are presented, taking into account differential diagnosis.&#x0D; The radiological semiotics of osteomyelitis of the jaws is diverse, since the features of the manifestation of osteomyelitis depend on the etiology, stage of the course and form of the bone inflammatory process.&#x0D; Orthopantomography is a method of primary diagnosis of osteomyelitis of the jaws. The use of computed tomography contributes to the accurate identification of the structure of the affected area, the magnitude of the destruction of anatomical details of the jaws and the boundaries of the spread of the purulent-necrotic process.

Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis.

Periodontal disease is a broad term given when the periodontium is affected by inflammation. There are several methods to diagnose periodontitis, but no method to quantify the cancellous bone is presently used. For this purpose, a non-invasive tool that is efficient in analyzing bone quality called fractal analysis can be employed. The objective of the study was to utilize fractal dimension (FD) to evaluate cancellous patterns of interproximal alveolar bone using a digital intraoral periapical radiograph (IOPAR) in different clinical presentations of periodontitis classified according to the latest classification by the World Workshop for Periodontal and Peri-Implant Diseases and Conditions, 2017 (WWDC, 2017). The study aimed to numerically calculate the periodontitis changes in the cancellous bone around the affected tooth on an IOPAR using fractal analysis and to provide an additional criterion for the staging of periodontitis. In this cross-sectional observational study, 75 patients were selected and equally allotted to five groups based on the staging system proposed by the WWDC, 2017. The region of interest was selected on the IOPA radiograph of the tooth with the site having the most significant clinical attachment loss, and FD was calculated using Image J analysis. The association of gender and age with stages of periodontitis was studied using the chi-square test of independence. A comparison of % bone loss and fractal dimension among stages was studied by using the non-parametric Kruskal Wallis test. The relationship between % bone loss and fractal dimension within stages and gender was studied by using the Karl Pearson correlation. A receiver operating characteristic (ROC) curve analysis was performed for FD value as a marker of periodontitis patients. We demonstrated that the FD values decreased significantly with the increase in stages (p < 0.0001). The overall relationship between % bone loss and FD showed a significantly strong negative correlation of -0.739 (p < 0.0001), except for stages III and IV. FD can be utilized as a quantitative method for detecting cancellous bone changes in different stages of periodontitis, aiding in diagnosing periodontitis.

Measurement of the Dentin Wall Thickness of the Maxillary Central Incisor in Relation to the Stage of Root Development: A Pilot Study.

The aim of this study was to determine the average dentin wall thickness (DWT) of the maxillary central incisor (MCI) required for performing finite element analysis (FEA) models of root development. A total of 137 intraoral periapical radiographs of MCI in children aged 7 to 11 years were examined and then classified into 5 groups according to root development stages, which included 1/2 of root development (S1), 3/4 of root development (S2), more than 3/4 of root development (S3), complete development with wide-open apex (S4) and complete development with closed apex (S5). DWT was measured at three reference (horizontal) lines: at a distance of 1 mm from the apex (M), 4 mm from the apex (L) and at the cervical line (K). The distal dentin wall thickness (M1, L1, and K1), the pulp thickness (M2, L2, and K2), the mesial dentin wall thickness (M3, L3, and K3), and the apex thickness (N) were measured using the diagnostic software Soredex Scanora 5.1.2.4. Statistical analysis compared the values of the parameters K, L, and M between developmental stages (multivariate ANOVA) and the linear correlations between the parameters (Pearson's correlation analysis). All analyses were performed at significance level α = 0.05. There were statistically significant differences between the developmental stages for parameters L and M, while no significant differences were found for parameter K. Most of the correlations between the parameters were statistically significant, with the values of the Pearson correlation coefficient R > 0.6 considered practically significant. All parameters on the same reference line for distal and mesial dentin wall thickness and for pulp thickness correlated well with each other (R = 0.46 - 0.68), but there was no statistically significant correlation with total root thickness on the same reference line (parameters K, L, or M), except for parameter K3 (R = 0.42). Despite the limitations of this study, the mean values of the selected parameters for the 5 groups of developmental stages of the maxillary central incisor could be used to model dentin wall thickness using finite element analysis.

Comparative evaluation of periapical healing in response to calcium hydroxide, polydimethyl siloxane and calcium silicate based endodontic sealers using radiograph

Background: Success of root canal treatment depends upon 3-D seal obtained after obturation without any presence of post-operative symptoms. The focus of this investigation is on ability of a sealer to form 3D seal and to reduce periapical lesion. The study aims to evaluate periapical healing of teeth treated with calcium hydroxide, polydimethyl siloxane and calcium silicate based endodontic sealers using radiograph. The objectives of this study will be to evaluate periapical healing ability of root canal treated teeth with Sealapex, Nanoseal-S and Bio-ceramic sealers over the time period of 3, 6 and 9 months; and to compare the periapical healing ability of a root canal treated tooth. Methods: A total of 60 subjects having periapical radiolucencies will be divided into 3 groups of 20 subjects each; Group I- Calcium hydroxide based, Group II- Polydimethyl siloxane based and Group III- Calcium Silicate based sealers. Root canal procedure will be done. Patients will be recalled after 3, 6, 9 months for the evaluation of periapical healing and PAI score check-up using intraoral periapical radiograph. Expected results: It is expected that among the material used in the study Bio-Ceramic and Nanoseal-S sealer may give better results as compared to Sealapex used in routine practice due to its ability of anti-microbial properties, optimal biocompatibility and excellent sealing ability. Conclusion: Comparison amongst the three sealers would provide us with the information about the best material which offers better periapical healing to get the best outcome of the root canal treatment by clinician.

Assessment of Digital Intraoral Periapical Radiograph for the Detection of Apical Root Resorption in Inflammatory Periapical Pathologies: A Radiovisiography Study.

Introduction Resorption often takes the form of external inflammatory root resorption. Apical periodontitis or an apical cyst is the most typical cause of external inflammatory root resorption. Failure of endodontic treatment can occur if severe apical root resorption occurs.This is due to the difficulty of reaching these sites.Apical root resorption is usually discovered during routine radiographs and is usually in its later stages. If the lesion is advanced, extraction is the only viable solution. An accurate diagnosis of incipient root resorption is essential.This research is designed to analyze the effectiveness of digital intraoral periapical radiographs in assessing apical root resorption (ARR) related to periapical pathologies. Material and methods Thiscross-sectional radiographic observational researchwas conductedin a dental college and hospital in central India. Radiovisiography (RVG) images of 190 patients' teeth with inflammatory periapical pathologies were evaluated to determine the presence or absence of resorption in the apical area of the root. After the radiographic assessment of the apical root resorption, the extraction of the affected teeth was done under all aseptic conditions. The periapical tissue was sent for histological analysis and the extracted tooth sample was examined for the presence or absence of apical root resorption. Results In comparison to apical periodontitis, the proportion of severe root resorption patients was significantly higher in abscess and periapical granuloma. Using Pearson's Chi-square test, the difference in patient proportions according to the kind of resorption in the three radiological diagnosis groups was statistically significant with a p-value of 0.0058. Conclusion It was concluded that on radiographic examination, digital intraoral periapical radiographs were found to be accurate in determining periapical apical pathologies and apical root resorption.

Endodontic Treatment Outcome of 45 Incisor Teeth in Dogs Determined by Intraoral Radiography.

A retrospective study was conducted to determine the outcome of endodontic treatment of incisor teeth in dogs. Medical and dental records from four private veterinary specialty practices over an 8-year period (2013-2021) were reviewed. Forty-five incisor teeth from 41 dogs with ages from 1 to 11-years-old were included in the study. The indications for endodontic treatment were complicated crown fracture in 23 incisors (51.1%), non-vital tooth in 15 incisors (33.3%) and complicated crown-root fracture in seven incisors (15.5%). Evaluation criteria included availability of complete medical and dental records, patient demographics, and at least one follow-up visit as recent as 6 months after the initial root canal therapy. Endodontic treatment outcome was defined as successful, no evidence of failure, or failure. Root canal therapy was successful in 42 teeth (93.3%), no evidence of failure was found in three teeth (6.6%), and none of the cases showed failure of the treatment. Duration of follow-up ranged from 6 to 64 months. Only three variables appeared to have statistical significance: presence of preoperative periapical lucency (PAL) (P = .01), postoperative PAL (P < .001) and postoperative external inflammatory root resorption (P = .014). Based on this study, following "loose criteria" (success and no evidence of failure combined), 100% of the treatments were successful, making this option an excellent therapy choice in a veterinary specialty dentistry practice.

Conventional root canal treatment of a mandibular second premolar with three roots and three canals performed by an undergraduate student: A case report with 8-year follow-up

Abstract In developing countries, such as Sudan, there is a lack of advanced endodontic technologies and specialized endodontists. Therefore, challenging endodontic cases are inevitability encountered by undergraduate students and general dental practitioners. Their ability to manage such cases can significantly impact the decision of whether a tooth is saved or extracted. Here, we report the case of a 24-year-old male patient who presented to our clinic with pain in the mandibular second premolar. Tooth #45 had caries and was tender to vertical percussion. An intraoral periapical radiograph (IOPR) revealed a wide periodontal ligament space and thickened lamina dura, with the deep occluso-distal decay reaching the pulp space. A radiograph obtained using the tube shift technique revealed the presence of three distinct roots and canals. The patient was diagnosed with symptomatic irreversible pulpitis and apical periodontitis. His root canal treatment (RCT) was performed by a 5th-year undergraduate student using the conventional radiography technique, hand file instruments, and lateral condensation obturation. At the 8-year follow-up visit, the tooth crown was lost, the patient was asymptomatic, and the IOPR revealed normal periapical bone. This case demonstrates the importance of training undergraduate students from developing countries to perform RCT for challenging endodontic cases using conventional techniques.

Accuracy of Intra-Oral Radiography and Cone Beam Computed Tomography in the Diagnosis of Buccal Bone Loss.

The use of cone beam computed tomography (CBCT) in dentistry started in the maxillofacial field, where it was used for complex and comprehensive treatment planning. Due to the use of reduced radiation dose compared to a computed tomography (CT) scan, CBCT has become a frequently used diagnostic tool in dental practice. However, published data on the accuracy of CBCT in the diagnosis of buccal bone level is lacking. The aim of this study was to compare the accuracy of intra-oral radiography (IOR) and CBCT in the diagnosis of the extent of buccal bone loss. A dry skull was used to create a buccal bone defect at the most coronal level of a first premolar; the defect was enlarged apically in steps of 1 mm. After each step, IOR and CBCT were taken. Based on the CBCT data, two observers jointly selected three axial slices at different levels of the buccal bone, as well as one transverse slice. Six dentists participated in the radiographic observations. First, all observers received the 10 intra-oral radiographs, and each observer was asked to rank the intra-oral radiographs on the extent of the buccal bone defect. Afterwards, the procedure was repeated with the CBCT scans based on a combination of axial and transverse information. For the second part of the study, each observer was asked to evaluate the axial and transverse CBCT slices on the presence or absence of a buccal bone defect. The percentage of buccal bone defect progression rankings that were within 1 of the true rank was 32% for IOR and 42% for CBCT. On average, kappa values increased by 0.384 for CBCT compared to intra-oral radiography. The overall sensitivity and specificity of CBCT in the diagnosis of the presence or absence of a buccal bone defect was 0.89 and 0.85, respectively. The average area under the curve (AUC) of the receiver operating curve (ROC) was 0.892 for all observers. When CBCT images are available for justified indications, other than bone level assessment, such 3D images are more accurate and thus preferred to 2D images to assess periodontal buccal bone. For other clinical applications, intra-oral radiography remains the standard method for radiographic evaluation.

Evaluating cone cut in rectangular collimation in intraoral radiography: application of ALADA and radiation stewardship

ObjectiveRectangular collimation is a popular method used in intraoral radiography to reduce patient exposure to ionizing radiation. One of the perceived drawbacks of rectangular collimation is the possibility of an increase in cone cut errors ultimately impacting the diagnostic value of the radiographs. Thus, the aim of this study was to explore the frequency of cone cut errors in radiographs taken using a rectangular collimator.Materials and methodsRadiographs taken using PSP plates at Academic Center for Dentistry Amsterdam in the Netherlands by staff and students from January to December 2015 were assessed for cone cut errors. The radiographs were grouped as bitewings, front teeth, inferior premolars and molars, and superior premolars and molars and categorized as no cone cut, cone cut but diagnostically usable, and cone cut but diagnostically not usable. The results were entered into Microsoft Excel and analyzed thereafter.ResultsA total of 53,684 radiographs were assessed, 79% had no cone cut errors and consequently 21% had some degree of cone cut. However, the diagnostic value was unaffected in 18% of the radiographs with cone cut. Only 3% of the radiographs were deemed diagnostically unusable due to cone cut. The most common area of cone cut was in the premolar and molar areas while cone cut in the front teeth was least likely to be diagnostically unusable.ConclusionCone cut from the use of a rectangular collimator does not seem to result in an increase of diagnostically unusable radiographs. Thus, rectangular collimation should be preferred as it decreases the amount of radiation exposure to the patient while producing diagnostically usable radiographs and thus allowing the dental professional to adhere to the ALADA principle and practice radiation stewardship.Clinical relevanceScientific rationale for the study: rectangular collimation is a method used to reduce patient exposure to ionizing radiation; however, this benefit is negligible if radiographs must be retaken due to cone cut errors that make the radiograph diagnostically unusable. Therefore, the aim of this study was to explore the frequency of cone cut in radiographs taken using a rectangular collimator. Principal findings: cone cut was observed in 21% of the radiographs; however, only 3% of the radiographs were considered diagnostically unusable. Practical implications: rectangular collimation does not result in a high number of diagnostically unusable radiographs and should be used to reduce patient exposure to ionizing radiation.

How Brazilian oral health care workers face COVID-19

Aim: To investigate surveillance, biosafety, and education strategies of Brazilian oral health care workers (OHCWs) during the first wave of the COVID-19 outbreak. Methods: This was a cross-sectional study covering OHCWs from a single multicenter research centre. A self-administered and validated online questionnaire was used for data collection, including the following variables: sociodemographic, medical history, biosafety, professional experience, surveillance, and education. Results: The sample consisted of 644 OHCWs (82.5% dentists, 13.2% dental assistants and 4.3% technicians), most without comorbidities (84.8%), from the public (51.7%) and private (48.3%) health systems, in 140 cities of a southern state. The most prominent measures of surveillance were waiting room distancing and visual alerts, symptom assessment, and availability of guidelines on COVID-19. Regarding biosafety measures, the lowest adherence was related to intraoral radiographs (2.7±1.4; 95%CI: 2.6–2.9), use of dental dams (2.1±1.4; 95%CI: 2.0–2.2), and availability of high-power suction systems (2.5±1.7; 95%CI: 2.3–2.6). Among OHCWs, 52.6% received guidance on measures to take during dental care in the workplace. Continuing education was mainly through documents from non-governmental health authorities (77.4%). Conclusion: Surveillance and biosafety measures were adopted, but activities that reduce the spread of aerosols had less adherence. These findings underscore the importance of considering dental practices, and surveillance and education strategies to formulate policies and relevant support to address health system challenges during the COVID-19 pandemic. A coordinated action of permanent education by policymakers is necessary.

Artificial Intelligence Techniques for Automatic Detection of Peri-implant Marginal Bone Remodeling in Intraoral Radiographs

Peri-implantitis can cause marginal bone remodeling around implants. The aim is to develop an automatic image processing approach based on two artificial intelligence (AI) techniques in intraoral (periapical and bitewing) radiographs to assist dentists in determining bone loss. The first is a deep learning (DL) object-detector (YOLOv3) to roughly identify (no exact localization is required) two objects: prosthesis (crown) and implant (screw). The second is an image understanding-based (IU) process to fine-tune lines on screw edges and to identify significant points (intensity bone changes, intersections between screw and crown). Distances between these points are used to compute bone loss. A total of 2920 radiographs were used for training (50%) and testing (50%) the DL process. The mAP@0.5 metric is used for performance evaluation of DL considering periapical/bitewing and screws/crowns in upper and lower jaws, with scores ranging from 0.537 to 0.898 (sufficient because DL only needs an approximation). The IU performance is assessed with 50% of the testing radiographs through the t test statistical method, obtaining p values of 0.0106 (line fitting) and 0.0213 (significant point detection). The IU performance is satisfactory, as these values are in accordance with the statistical average/standard deviation in pixels for line fitting (2.75/1.01) and for significant point detection (2.63/1.28) according to the expert criteria of dentists, who establish the ground-truth lines and significant points. In conclusion, AI methods have good prospects for automatic bone loss detection in intraoral radiographs to assist dental specialists in diagnosing peri-implantitis.

Evaluation of 3D MRI for early detection of bone edema associated with apical periodontitis.

To detect and evaluate early signs of apical periodontitis using MRI based on a 3D short-tau-inversion-recovery (STIR) sequence compared to conventional panoramic radiography (OPT) and periapical radiographs in patients with apical periodontitis. Patients with clinical evidence of periodontal disease were enrolled prospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR sequence. The MRI sequences were assessed for the occurrence and extent of bone changes associated with apical periodontitis including bone edema, periradicular cysts, and dental granulomas. OPTs and intraoral periapical radiographs, if available, were assessed for corresponding periapical radiolucencies using the periapical index (PAI). In total, 232 teeth of 37 patients (mean age 62±13.9 years, 18 women) were assessed. In 69 cases reactive bone edema was detected on MRI with corresponding radiolucency according to OPT. In 105 cases edema was detected without corresponding radiolucency on OPT. The overall extent of edema measured on MRI was significantly larger compared to the radiolucency on OPT (mean: STIR 2.4±1.4 mm, dental radiograph 1.3±1.2 mm, OPT 0.8±1.1 mm, P=0.01). The overall PAI score was significantly higher on MRI compared to OPT (mean PAI: STIR 1.9±0.7, dental radiograph 1.3±0.5, OPT 1.2±0.7, P=0.02). Early detection and assessment of bone changes of apical periodontitis using MRI was feasible while the extent of bone edema measured on MRI exceeded the radiolucencies measured on OPT. In clinical routine, dental MRI might be useful for early detection and assessment of apical periodontitis before irreversible bone loss is detected on conventional panoramic and intraoral periapical radiographs.

Successful Root Canal Treatment of an Atypical Mandibular Canine with a Boomerang-shaped Root and Canal System with a Large Periapical lesion—A Case Report with 9-year Follow-up

AimThis report describes an atypical mandibular canine with a single boomerang-shaped root and root canal system with a large periapical lesion managed by root canal treatment. MethodsThe chief complaint of a 16-year-old male was acute pain and an abnormal sensation in the right mandibular canine (tooth #27). The clinical examination revealed that tooth #27 had an unusual coronal morphology. The buccal aspect of the tooth resembled that of a normal canine but was significantly broader than expected. On the lingual aspect of the crown; however, there was an unusual cusp-like structure with ridges that was slightly less prominent than the buccal incisal tip. The intraoral periapical radiographs revealed a complex root with an obvious cow horn-shaped canal mesially and distally, but with the suggestion of a root structure joining the mesial and distal extensions. A large periapical lesion was present. Computed tomography revealed the presence of a single root and canal system shaped like a boomerang. Root canal treatment was performed and the patient was followed-up for 9 years. ResultsFollowing root canal treatment, the patient had no symptoms, no mobility, no periodontal pockets, or root resorption. At 9 years, the cone beam computed tomography images confirmed that satisfactory healing of the periapical tissues had occurred. ConclusionThe mandibular right canine had a unique boomerang-shaped root and canal system. Effective shaping and cleaning of the complex canal shape plus thermoplastic root filling aided the successful healing of the periapical lesion.

Bioactive glass in the treatment of an infrabony defect in a dog

AbstractThis article describes a graft‐only approach to regenerate periodontal structures in a vertical infrabony defect around the mesial root of the mandibular second molar tooth of a dog. Bioactive glass material was used to fill this defect without coverage of a membrane. The grafted area was examined using periodontal probing and an intraoral radiograph 6 months after the procedure. Probing depth around the affected root had decreased to normal levels, and the intraoral radiograph of the affected area revealed new bone growth. Bioactive glass without a membrane appeared to be sufficient for alveolar bone regeneration in this canine patient.

Intraoral digital radiography- A way forward or risk of overexposure: A questionnaire-based study

: Digitization of intraoral radiography has revolutionized dentistry. It comes with plethora of advantages, such as quick image production elimination of processing chemicals, reduced patient exposure. With easy and instant image acquisition, the number and frequency of radiographs as well retakes have also increased. Therefore, making us think is there an actual reduction in the radiation exposure or not.: To assess clinical utilisation of intraoral digital radiography among practicing dental surgeons.It is a questionnaire-based study. Questionnaire was curated using google forms and divided into two sections. First section included personal data and second section was focused on the clinical practice. Questionnaire link was circulated through various social media platform. 112 responses were collected.Out of all responses, 78.6% are using intraoral digital radiography, among them 53.4% are using CCD sensors. Maximum number of practitioners (54.5%) take on an average 0-5 intraoral digital radiographs and 98.9% of them take 1-6 retakes per day. Errors in positioning the receptor and PID were the most common reasons for taking repeats.: It appears that there is an increase in number and frequency of radiographs and number of retakes which might be nullifying the dose reduction from intraoral digital radiography. Practitioners should not neglect the radiation exposure from intraoral digital radiography as it may have a cumulative effect in long run and should abide by the radiation protection protocol and ALADA principle.

ImageJ Software in Periodontics: An Insight

There are various conventional radiological parameters for measuring the periodontal pocket depth apart from clinical measurements such as intraoral periapical radiograph, orthopantomogram and digital such as radiovisiography (RVG), and cone-beam computed tomography (CBCT) to an extent. As CBCT is highly recommended in the field of dentistry, especially in periodontics for an accurate measurement of remaining alveolar bone present from crest to apical region three dimensionally. Many patients cannot afford CBCT due to its cost-effectiveness and time-consuming procedure, and hence, a software was introduced to limit radiation exposure, where all preoperative and postoperative RVGs were placed in a software to measure its osseous defect and bone formation. This technique is introduced to reduce the exposure time to patients as well as for diagnosis of osseous defects radiographically to clinicians. This software can also be used in other fields of dentistry also. The main objective of this short communication is to create awareness regarding the availability of such a tool and recommend its application in periodontal regeneration clinical trials.