Root Canals Of Teeth Research Articles

A novel artificial intelligence-powered tool for automated root canal segmentation in single-rooted teeth on cone-beam computed tomography.

To develop and validate an artificial intelligence (AI)-powered tool based on convolutional neural network (CNN) for automatic segmentation of root canals in single-rooted teeth using cone-beam computed tomography (CBCT). A total of 69 CBCT scans were retrospectively recruited from a hospital database and acquired from two devices with varying protocols. These scans were randomly assigned to the training (n = 31, 88 teeth), validation (n = 8, 15 teeth) and testing (n = 30, 120 teeth) sets. For the training and validation data sets, each CBCT scan was imported to the Virtual Patient Creator platform, where manual segmentation of root canals was performed by two operators, establishing the ground truth. Subsequently, the AI model was tested on 30 CBCT scans (120 teeth), and the AI-generated three-dimensional (3D) virtual models were exported in standard triangle language (STL) format. Importantly, the testing data set encompassed different types of single-rooted teeth. An experienced operator evaluated the automated segmentation, and manual refinements were made to create refined 3D models (R-AI). The AI and R-AI models were compared for performance evaluation. Additionally, 30% of the testing sample was manually segmented at two different times to compare AI-based and human segmentation methods. The time taken by each segmentation method to obtain 3D models was recorded in seconds(s) for further comparison. The AI-driven tool demonstrated highly accurate segmentation of single-rooted teeth (Dice similarity coefficient [DSC] ranging from 89% to 93%; 95% Hausdorff distance [HD] ranging from 0.10 to 0.13 mm), with no significant impact of tooth type on accuracy metrics (p > .05). The AI approach outperformed the manual method (p < .05), showing higher DSC and lower 95% HD values. In terms of time efficiency, manual segmentation required significantly more time (2262.4 ± 679.1 s) compared to R-AI (94 ± 64.7 s) and AI (41.8 ± 12.2 s) methods (p < .05), representing a 54-fold decrease. The novel AI-based tool exhibited highly accurate and time-efficient performance in the automatic root canal segmentation on CBCT, surpassing the human performance.

Isolation and molecular detection of Enterococcus faecium from infected root canals: for progressing towards sustainability

Background and objectives. Enterococcus is a lactic acid bacterium that, according to the Lancefield method of serology-based classification, was formerly classified as a group D Streptococcus until 1984. The current study aimed to isolate and molecularly detect E. faecium (EF) from the infected root canal, and to assess the antimicrobial susceptibility of the isolates. Material and methods. Samples were collected from 50 people who had a single root canal tooth with radiographic evidence of apical periodontitis. The transport media were preincubated at 37°C for 30 minutes and vigorously agitated for 60s before use and were then cultured on primary media. Aerotolerance, Gram-staining, synthesis of catalase, trypsin, and indole were used in the preliminary characterization stage. For species-level identification after preservation at 37°C, a variety of biochemical tests were used, including motility tests, carbohydrate fermentation, and the detection of enzymes. DNA extraction was achieved using the PrestoTM Mini gDNA bacteria kit. Amplification of ddI chromosomal genes from EF was accomplished using DNA extracted from these isolates. Antimicrobial sensitivity tests were conducted to investigate the sensitivity and resistance of the target bacteria against 7 antimicrobial agents. Results. The analysis of data revealed that the prevalence of EF was 70% (in 35 of the samples collected). 74% of the Enterococcus isolates tested positive for EF according to PCR findings. The antibiotic sensitivity test results showed that vancomycin and erythromycin resistance was observed in all samples of EF. As many as 94.3% of isolates were resistant to amikacin, 88.7% were resistant to gentamycin, and 91.4 % were resistant to azithromycin. Doxycycline (94.3%) and nitrofurantoin (97.1%) were more effective against the E. faecium isolated from the root canals. Conclusions. The study concludes that the EF bacteria is an important pathogen of root canal infection which is resistant to many antibiotics.

Impact of Calcium Hydroxide Particle Size on the Intracanal Medicament Penetration Efficacy

Calcium hydroxide (Ca (OH)2) is an intracanal medicament used as a disinfectant in cases of tooth inflammation with ad dubia prognosis. The success of root canal treatment depends on the ability of intracanal medicaments to eliminate pathogenic bacteria present in the walls of narrow and complex root canals by releasing calcium and hydroxyl ions at the closest contacts. This study aimed to evaluate the effect of particle size on the ability to penetrate Ca (OH)2 in the coronal, middle, and apical root canals. Fifteen mandibular premolars extracted for orthodontic and periodontal purposes were collected and cut to produce root canals with a length of 12 cm. The root canals were then prepared with a Protaper SX-F3 needle and irrigated using a solution of 2.5% NaOCl, NaCl, and 17% EDTA as lubrication at each needle change. Ca (OH)2 with different particle sizes in paste form was manipulated with distilled water at a concentration of 0.8 g/mL then the paste was applied to the prepared tooth root canals and covered with a temporary filling. The samples were then stored in an incubator at 37 °C for 7 days. Scanning Electron Microscopy-Energy Dispersive X-ray Spectroscopy (SEM-EDX) was performed on the transverse surfaces of the coronal 1/3, middle 1/3 and apical 1/3 of the tooth. The maximum penetration depth was evaluated by measuring the maximum distance between the dentin canal wall and Ca (OH)2 present in the dentinal tubules. In all three zones, the Ca (OH)₂ nanoparticles had a greater penetration depth than the Ca (OH)₂ nanoparticles (P&lt;0.001). In both groups, the penetration depth increased from the apical to the coronal section. All differences in the penetration test ability of the Ca (OH)₂ nanoparticles and Ca (OH)₂ microparticles at all depths of the surface. Ca (OH)₂ nanoparticles penetrate deeper into the dentinal tubules than Ca (OH)₂ microparticles do.

Exploring maxillary molar root morphology: A case of extra palatal canal

: A fundamental requirement for successful endodontic treatment is understanding the tooth's root canal anatomy. The pulp chamber represents the most intricate part of the tooth. Effective treatment depends on accurately diagnosing and identifying all canals, performing thorough cleaning and shaping, and completing a three-dimensional (3D) filling while preserving the natural structure of the root canal system.: A 35-year-old male patient presented with apical periodontitis in relation to maxillary first molar. Radiographic examination revealed widening of periodontal ligament. Following local anaesthesia via PSA nerve block and infiltration, rubber dam isolation was done. An access cavity was created, and upon locating the canal orifices, an additional, separate palatal canal was identified. Cone Beam Computed Tomography (CBCT) was advised to confirm. Using a microscope, the MB2 orifice was carefully exposed by troughing along the groove between the MB1 and palatal canals with long-shank burs and a DG-16 explorer. All five canals were meticulously cleaned and shaped with NiTi rotary files, followed by 3D obturation. The significance of identifying anatomical changes, such as the extra-palatal canal in maxillary first molars with MB2, is highlighted in this case report. Endodontic results are improved by successful management using precise procedures and modern imaging, highlighting the importance of careful evaluation in complex cases.

Disinfection of dental root canals by cold atmospheric plasma: a systematic review and meta-analysis of dental biofilm.

The intricate structure of the tooth root canals has a role in the colonization and biofilm formation in hidden areas that are hardly reached by standard endodontic treatments. This review aims at summarizing data from in vitro and ex vivo studies for a better understanding of the application of cold atmospheric plasma (CAP) for the disinfection of dental root canals. PubMed, Scopus, and Web of Science databases were screened. Characteristics of the included studies were extracted, and a meta-analysis on ex vivo studies was carried out to evaluate the effect of CAP on colony forming unit assay of Enterococcus faecalis (E. faecalis). The study was performed following the PRISMA 2020 guidelines. A total of 31 studies fulfilled the selection criteria. Only 2 investigations reported an indirect plasma treatment, 28 trials used direct CAP administration, while 1 study applied both methods. Most of the studies were conducted on E. faecalis using as carrier gas Helium or Argon alone or in combination with Oxygen as well air. A considerable heterogeneity among studies was found regarding treatments which varied for source type, settings, and protocols of application. Despite this, CAP showed effectiveness in reducing E. faecalis colony forming unit with a standardized mean difference of 4.51, 95% C.I. = 2.55-6.48, p-value < 0.001. The data demonstrated the antimicrobial effect of direct CAP application against microorganisms. In-vitro studies showed an effect that depended on the time and distance of treatment, while the meta-analysis performed on ex vivo studies showed that the effect of CAP was independent of time and distance. https://doi.org/10.17605/OSF.IO/BJ59V, identifier OSF registries.

Comparative Evaluation of Crack Propagation During Root Canal Preparation in Primary Molar with Manual Instrumentation, ProTaper Universal and ProTaper Next Rotary File Systems: An in vitro Study.

Root canal preparation with rotary files causes dentinal cracks in root canals of primary teeth affecting their longevity. Nickel-titanium rotary files have been widely used for root canal preparation in primary teeth. The present study compared occurrence of dentinal microcracks in root canals of extracted primary molar teeth prepared using Hedstrom (H) files, ProTaper Universal rotary files, and ProTaper Next rotary file systems. In this in vitro experimental study, 80 primary molar mesial root canals were randomly divided into four groups of 20 canals each (n=20). Group I was prepared with H files. Group II was prepared with ProTaper Universal rotary files using shaping files SX and S2. Group III was instrumented with ProTaper Next rotary files X1 and X2 while Group IV was left unprepared and served as control. Roots were stained with 1% methylene blue solution and sectioned perpendicular to the long axis at 2mm, 4mm, and 6mm from the apical foramen. Slices obtained were examined under the stereomicroscope. Data obtained were subjected to statistical analysis using chi square tests. Dentinal microcracks were observed in groups prepared using H files, ProTaper Universal, and ProTaper Next rotary files. Highest percentage of cracked root canals (20%) was seen in Group I, prepared by H files. These cracks were complete in nature, found in apical sections and statistically significant (p= 0.016). Group III prepared with ProTaper Next showed 10% dentinal cracks, followed by ProTaper Universal group with 5% cracked root canals. H files may be considered more aggressive at apical third due to complete cracks produced.

Exploring the Influence of Genetic Single-Nucleotide Polymorphism (SNPs) on Endodontic Pathologies: A Comprehensive Review.

A considerable portion of the global population is affected by pulpitis and periapical lesions. While the impact of infections caused by various microbes and host effector molecules in pulpal and periapical diseases is widely recognized, disease susceptibility and progression are also influenced by the dynamic interaction between host genetic factors and environmental influences. Apical periodontitis occurs as an inflammatory response to microorganisms present in the root canals of infected teeth. Initially functioning as the body's defense mechanism, this response often progresses to chronic inflammation. Several studies have established associations between genetic polymorphisms and various dental conditions, including temporomandibular joint (TMJ) disorders, dental caries, orthognathic surgeries, open bite malocclusion, periapical periodontitis, pulp stones, pulpitis, periapical abscesses, local anesthesia complications, and endodontic treatment outcomes. Key findings from this review highlight the role of specific single-nucleotide polymorphisms (SNPs) in genes such as matrix metalloproteinase (MMP)1, MMP2, MMP3, interleukin (IL)-1β, IL-6, IL-17, and tumor necrosis factor-alpha (TNF-α), which influence inflammatory pathways and tissue remodeling. For example, SNPs in interleukin genes, such as IL-1β (-511 C/T), have been linked to an increased risk of apical periodontitis, while MMP gene polymorphisms contribute to tissue degradation in periapical lesions. This review underscores the importance of identifying genetic markers that drive disease progression and inflammatory processes in pulpal and periapical pathologies. A better understanding of these mechanisms can inform strategies for disease prevention, personalized treatment approaches, and improved endodontic outcomes.

Efficacy of chitosan root canal medicament against cross-kingdom dual-species biofilm of Candida albicans and Enterococcus faecalis in an in vitro root-canal model.

Infection of the root canals with cross-kingdom biofilm of Candida albicans (C. albicans) and Enterococcus faecalis (E. faecalis) causes more inflammation and is resistant to conventional medication. This study aimed to evaluate the efficacy of chitosan paste (chitosan + propylene glycol (PG)) against this dual-species biofilm in comparison to calcium hydroxide (Ca(OH)2) in the root canals of human teeth. Fifty extracted single-rooted human teeth were prepared and inoculated with C. albicans and E. faecalis, and incubated for 3days for biofilm formation. Four experimental groups (N = 10 each) were applied with different root canal medications for 7days, including (1) No medication (negative control); (2) Ca(OH)2 + distilled water; (3) PG (vehicle control) and (4) chitosan + PG. The efficacy of root canal medicaments was assessed by determining the percentage of remaining colony-forming units (CFUs) of viable microorganisms in intracanal dentin. The dentin was collected, serially diluted, and spread on solid media for colony count. The biofilm structure in root canals at 3days and 10days (ie. before and after treatments) were observed with scanning electron microscopy (SEM) at 5000× and 10,000× magnifications. Data were analyzed using Welch's ANOVA and Games-Howell post-hoc test (α = 5%). The results show that Chitosan + PG group had a significantly lower percentage of remaining microorganisms when compared to PG, Ca(OH)2, and negative control groups (P-value = 0.015, 0.005, and < 0.001, respectively). Consistently, SEM showed the lowest amount of remaining biofilm in Chitosan + PG group. Thus, Chitosan + PG paste was the most efficacious root canal medicament against dual-species biofilm of C. albicans and E. faecalis in this model.

Evaluation of the physicochemical properties of intracanal medications used in traumatized teeth

Aim: The aim of the present study was to evaluate the solubility, flow and radiopacity of Calen (SS White Artigos Dentários Ltd, Rio de Janeiro, Brazil), Calen with zinc oxide (Calen/ZnO), calcium hydroxide + zinc oxide + 2% chlorhexidine (CH/ZnO/CHX), Calplus and Ultracal XS. Methods: 28 bovine incisor specimens were standardized, instrumented and filled with pastes with the aid of a centrix syringe. To assess solubility, the root canals of acrylic teeth (N = 10) were filled with the previously mentioned pastes and scanned by using micro–computed tomography before (initial) and after 7 days of immersion in ultrapure water. The solubility of each specimen was the difference between the initial and final volume. Flow properties were analysed according to the ISO 6876/2012 standard. Radiopacity was radiographically analysed by using Image J software. Data were submitted to analysis of variance and Tukey’s test (alpha 5%). Results: CH/ZnO/CHX and Calplus presented similar values regarding radiopacity. The group composed of Calen paste showed higher flow values. As for solubility, CH/ZnO/ CHX showed lower volume loss, but there was no statistical difference compared to other medications. Conclusion: The medication composed of calcium hydroxide, zinc oxide and 2% chlorhexidine is a suitable alternative for use in traumatized teeth.

Retreatment and aesthetic restoration of maxillary incisor with calcified root canal using a dynamic navigation system: a case report

BackgroundPulp canal occlusion (PCO) increases the difficulty of root canal treatment as well as tooth preservation and restoration. This is the first case report of successful localization of a calcified root canal under the guidance of a dynamic navigation system (DNS) for complete root canal retreatment and aesthetic restoration after a failed attempt to locate the calcified root canal with a traditional dental operating microscope (DOM).Case presentationThe patient was scheduled for root canal treatment for a labially inclined maxillary central incisor and post-core crown restoration with resin veneers in another hospital, but the calcified root canal could not be located with a microscope, so the patient was referred to our department. Root canal retreatment was planned for tooth #8, and the calcified root canal of tooth #9 was planned to be located and dredged under the guidance of a DNS. We used a DNS for successful positioning and to complete the root canal retreatment operation in the following 4 steps: preoperative CBCT imaging, preoperative plan design, calibration and registration, and real-time dynamic navigation. Three months later, teeth #8 and #9 presented no clinical symptoms, after which the fiber post-cores and zirconia all-ceramic crown restorations were completed. At the 12-month follow-up visit, the patient continued to be symptom­free, and satisfied with the final aesthetic restoration.ConclusionsThis case report suggests that DNS may be a promising technique with high accuracy and effectiveness to reduce the risk of iatrogenic errors and provide maximal preservation of dentin, when the traditional treatment of calcified root canals approaches failure (lateral perforation).

Controlling root canal infection in oncological patients with apical periodontitis

This study evaluated the effectiveness of chemomechanical preparation associated with intracanal medication in reducing the total bacterial load of infected root canals in cancer patients undergoing antineoplastic treatment. The prevalence, levels, and response to treatment of Streptococcus and Actinobacteria species were also assessed. The root canals of teeth with apical periodontitis from oncological and control patients were treated using rotary instrumentation, 2.5% NaOCl irrigation, and 2-week calcium hydroxide medication (n=23/group). Bacteriological root canal samples were taken before (S1) and after chemomechanical preparation (S2), and after intracanal medication (S3). DNA extracted from the samples was subjected to 16S rRNA gene-based quantitative real-time polymerase chain reaction assays for evaluation of the treatment effects on total bacteria, Streptococcus species, and members of the Actinobacteria phylum. All S1 samples were positive for bacteria. S1-S2 and S1-S3 bacterial reduction values were highly significant (P<.01). Although bacterial counts were reduced from S2 to S3, the decrease was not statistically significant (P>.05). Intergroup comparisons showed no significant differences in S1, S2 and S3 counts (P>.05). In the oncological group, 77% of the cases were positive for bacteria in S2, and 68% in S3. In the control group, corresponding figures were 65% for both S2 and S3. There were no significant differences between groups as for streptococci and actinobacteria prevalence, levels, and response to treatment (P>.05). Root canal treatment using rotary instruments, NaOCl irrigation, and calcium hydroxide medication was highly effective in reducing the bacterial populations in infected teeth with apical periodontitis from cancer patients, with no significant differences to controls.

Comparison of Debridement Efficacy of Two Irrigating Systems Endovac and Conventional Needle in Primary Tooth Root Canals: An In Vitro Study.

The purpose of the study is to evaluate how well the Endovac system and conventional needle irrigation work to remove smear layers (SR) from primary teeth root canals. Fifty extracted human primary teeth were divided into two equal sections vertically, then positioned within an acrylic model that was secured with screws. Group A (Endovac), n = 25, and group B (traditional needle), n = 25. Next, a uniform irrigation technique was used in every tooth embedded in the study model. Sections were examined with a 100× magnification stereomicroscope and electron microscope. Statistical tests were used to analyze the data. Endovac removed the SR from the apical third of the root canal system more successfully than a traditional needle (<0.05). Endovac has better performance than conventional needle irrigation in the removal of the SR in the deciduous teeth root canal system. (1) Removing the SR allows for more cleaning and disinfecting of root canal walls and better adaptation of root canal filling materials. (2) It is essential to remove the entire SR from the root dentin for successful endodontic treatment. Yadav P, Virdi MS, Saini C. Comparison of Debridement Efficacy of Two Irrigating Systems Endovac and Conventional Needle in Primary Tooth Root Canals: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(11):1219-1223.

Evaluation of apically extruded debris from root canal filling removal of the mesiobuccal canal of maxillary molars using XP shaper and protaper with two different irrigation.

Periapical extrusion of debris for root retreatment will effectively improve the posttreatment inflammation and pain. The aim of this study was to investigate the extruded debris for root retreatment using XP shaper and ProTaper files. In his experimental laboratory study, 40 extracted human maxillary molars were used in this laboratory study. After disinfection and equalization of length, the samples were treated with a passive step-back technique and dressed. The samples placed in the tubes for retreatment were divided into four groups: (1) XP shaper file and hypochlorite, (2) XP shaper file and ethylenediaminetetraacetic acid (EDTA), (3) ProTaper file and hypochlorite, and (4) ProTaper file and EDTA. Then, the teeth were taken out of the tubes, and cleaned to collect the remaining apical debris. The weight of the tube and the extruded debris was measured again. Data were analyzed using the Kruskal-Wallis test (α =0.05). The highest average of extruded debris was related to the XP shaper file with EDTA solution, and the lowest average was related to the ProTaper file with hypochlorite solution. Between the two files used with EDTA and hypochlorite solution, the average debris extrusion of the XP shaper file with EDTA solution was significantly higher (P < 0.05) compared to the ProTaper and XP shaper files with hypochlorite solution (P < 0.05). Regardless of the type of irrigant material, the ProTaper file can be a more suitable option than the XP shaper file for retreatment of the tooth root canal with minimal debris extrusion.

Comparative Evaluation of Obturation Quality Using Three Different Obturation Techniques in Primary Teeth: A Conebeam Computed Tomography Analysis: In Vitro Study.

Pulpectomy is recommended for primary teeth when both the coronal and radicular pulp tissues are irreversibly damaged. Biomechanical preparation of root canals is essential for the success of endodontic treatment. Achieving the optimal length during obturation while minimizing voids and ensuring a hermetic seal is crucial for the success of pulpectomy procedures. The aim of this in vitro study is to compare the root canal obturation quality among Lentulo Spiral, Pastinject, and Dispo Van syringe in primary teeth using cone-beam computed tomography (CBCT) scanning. The selected extracted primary teeth were from the age-group of 4-7 years. Teeth indicated for pulpectomy with at least two-thirds of the total root length present were included. The study was conducted over a duration of 6 months. The study examined 60 primary tooth root canals, divided into three groups. Endoflas was used for obturation with Lentulo Spiral, Pastinject, and Dispo Van syringe. Postoperative CBCT was used to assess the presence of voids. The values were analyzed for the success rate of obturation using an independent t-test with MedCalc for Windows. In this study, three different filling techniques were evaluated and compared based on the presence of voids in the canals. Pastinject exhibited superior performance with the fewest voids, followed by the Lentulo Spiral and Dispo Van syringe. The findings indicated that the most effective technique for obturating primary teeth was the Pastinject method. Adhya S, Chakraborty S, Dey B, et al. Comparative Evaluation of Obturation Quality Using Three Different Obturation Techniques in Primary Teeth: A Cone-beam Computed Tomography Analysis: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(11):1248-1251.

Investigating the Antibacterial Ability of Sodium Hypochlorite Solution Activated with PUI and XPF File Against Enterococcus faecalis Using CFU, RT-PCR, and SEM.

Eradication of microorganisms present in the root canal system during endodontic therapy is one of the critical factors affecting the final outcome of endodontic treatment. However, even adequate technique of the root canal treatment and use of irrigants according to the established protocol does not lead to the complete elimination of microorganisms during endodontic treatment. The presence of Enterococcus (E.) faecalis inside the root canal system may be an important factor contributing to the failure of the treatment. Introducing agitation techniques in irrigation, such as passive ultrasonic irrigation (PUI) and the use of the activating instrument XP-endo Finisher (XPF), contribute to a better debridement and disinfection of the root canal. This study was conducted on 42 root canals experimentally inoculated with E. faecalis and exposed to three irrigation protocols. These have included a standard irrigation protocol using a syringe and needle, passive ultrasonic irrigation, and activation of the irrigant using an XPF instrument. The reduction in microorganisms was evaluated using the quantitative polymerase chain reaction in real-time (RT-PCR) as well as via the method of determining the number of colony forming units on nutrient medium (CFUs). The results of this study showed that the use of supplementary irrigation protocols, PUI, and XPF led to a significant decrease in the number of microorganisms inside the root canal of experimental teeth. These findings indicate a significant positive impact of these procedures on the disinfection of the root canal system.

Effect of Er:YAG Laser-Activated Irrigation with Side-Firing Spiral Endo Tip on Dentin Mineral Composition of Tooth Root Canals

Background: Treating tooth root canal systems with Er:YAG laser together with irrigants has been shown to be effective in reducing biofilms formed by Enterococcus faecalis. This study investigated whether laser-activated irrigation (LAI) with side-firing Endo tip (LiteTouch™; Light Instruments, Yokneam, Israel) affects dentin mineral composition when used with common endodontic irrigants. Methods: Root canals of extracted human teeth were treated with Er:YAG laser using a side-firing Endo tip combined with 17% ethylenediaminetetraacetic acid (EDTA) and/or 2.5% NaOCl in continuous or intermittent mode for 60 s. Dentin mineral composition (Ca, P, O) in coronal, middle, and apical regions of root canals was examined by energy dispersive X-ray spectroscopy. Results: The use of LAI with continuous EDTA resulted in the largest reduction in Ca and P levels. A final NaOCl rinse mitigated the EDTA-mediated mineral loss in all root canal regions and increased the O content. Likewise, the reduced Ca/O and Ca/P ratios caused by continuous EDTA irrigation were reversed when combined with a final NaOCl rinse. Conclusions: LAI with Er:YAG Endo tip using continuous EDTA irrigation followed by NaOCl caused minimal dentin mineral loss and can therefore be considered to be a safe treatment module for cleaning root canals.

Radiculomegaly as a key clinical feature in oculo-facio-cardio-dental (OFCD) syndrome: a case report with a novel truncating variant in BCOR gene.

Radiculomegaly is a rare dental anomaly characterised by the enlargement of the root canals of teeth. It is usually associated with oculo-facio-cardio-dental (OFCD) syndrome due to truncating variants in BCL-6 transcriptional corepressor (BCOR) (MIM*300485). We present the case of a 21-year-old female patient who was referred to genetics for a polymalformative syndrome including bilateral glaucoma and dental anomalies, especially radiculomegaly. Some others dysmorphic features were right superior lip notch, ogival palate, long philtrum, difficulty in pronation, café-au-lait spots, II-III toe bilateral syndactyly, and macrocephaly. Cone-beam CT confirmed radiculomegaly. The genetic analysis identified a heterozygous pathogenic variant NM_001123385.1:c.2093del (p.Pro698Glnfs*17) in the BCOR gene. After genetic diagnosis of OFCD syndrome, cardiac CT-scan revealed a large asymptomatic atrial septal defect that was subsequently surgically closed. Reviews of the literature have previously highlighted the prevalence of radiculomegaly in OFCD syndrome with a positive predictive value of 88.23% and a sensitivity of 75.94%. This case report highlights the importance of radiculomegaly as a clinical sign of OFCD syndrome, emphasising the rarity of non-syndromic radiculomegaly and the benefits of its diagnosis in clinical management, especially in cardiac screening.

Three-dimensional assessment of root canal morphology of primary dentition using cone beam computed tomography.

Root canal therapy in primary teeth is exceedingly complex due to the unique internal geometry of the pulp cavity. The purpose of this study was to evaluate variations in primary teeth root canal morphology and applicability of the Ahmed etal. (Int Endod J, 50, 2017, 761) alphanumeric system for classifying them. A retrospective analysis of 2024 primary teeth from an existing CBCT database was performed for assessing variations in root canal morphology. Descriptive statistics and the chi-squared test were used for data analysis. The maxillary canines exhibited splitting levels of 5.9% (right) and 6.6% (left), and merging levels of 1% (both sides); maxillary lateral incisors showed splitting levels of 2.6% (right) and 0.8% (left), with no merging observed; mandibular second molars had splitting levels of 1.5% (right) and 0.8% (left), with no merging observed; and mandibular lateral incisors exhibited a merging level of 0.9% (right), with no splitting observed. This study provides new insights into the variations in root canal morphology of primary teeth, particularly highlighting the variations found in primary canines. The Ahmed etal. (Int Endod J, 50, 2017, 761) classification system was found to be a useful tool for categorizing these variations.

Root Canal Morphology of Premolars in Population of Hyderabad, Pakistan: A Cone Beam Computerised Tomographic Analysis.

To investigate the mean tooth length and root canal configuration of human maxillary and mandibular premolars in the population of Hyderabad, Pakistan, using Cone Beam Computed Tomography (CBCT). Observational study. Place and Duration of the Study: Department of Operative Dentistry and Endodontics, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan, from December 2022 to March 2023. Using retrospective analysis of CBCT scans, tooth length, the number of roots, and root canal configuration of 536 mandibular and maxillary premolars were assessed in the subpopulation of Pakistan. The data were analysed employing descriptive statistics, Chi-square tests, and One-Way ANOVA to determine the association between various factors and root canal morphology. Vertucci Type 1 (one canal) was the most common configuration in maxillary premolars, with frequencies ranging from 46.3 to 52.2%. The mean length of all 8 premolars ranged from 20.56 mm to 21.58 mm. C-shaped canal configurations were observed in a small percentage of maxillary and mandibular premolars, with C1 being the most common. No significant association was found between gender and canal configuration or tooth length, and in tooth lengths among different canal configurations. Vertucci Type 1 was the most common configuration in maxillary premolars, followed by Vertucci Type 4. Single-rooted premolars were more prevalent, while two-root configurations were less common. C-shaped canal configurations were observed in a small percentage of premolars, with higher frequency in mandibular premolars. Cone beam computed tomography, Dental anatomy, Endodontics, Premolars, Root canal morphology.

Testing the Inhibitory Activity of Bajakah Tampala (Spatholobus littoralis Hassk) Wood Extract from South Kalimantan on the Growth of Pseudomonas aeruginosa Bacteria

Background: Dental root canal treatment aims to eliminate microorganisms that cause infection in the tooth root canal, one of which is Pseudomonas aeruginosa bacteria. Disinfection of dental root canals with 0.5% - 5.25% NaOCl irrigation solution is still constrained so it is necessary to look for alternatives. The bajakah tampala plant (Spatholubus littoralis Hassk) is known to contain antibacterial compounds, namely flavonoids, saponins, tannins, and polyphenols. Objective: To evaluate the inhibitory activity of bajakah tampala wood extract (Spatholobus littoralis Hassk) from South Kalimantan against the growth of Pseudomonas aeruginosa bacteria. Method: Post test-only with control group design. The test groups were 100%, 75%, 50% bajakah tampala wood extract solution and positive control 2.5% NaOCL solution. Extraction using maceration method. Bacterial growth inhibition was tested by well diffusion method. Inhibition zone was measured using a caliper. Results: The growth inhibition from the largest to the smallest was shown by 75%, 100% and 50% bajakah wood extracts with mean inhibition zone diameters of 5.05 mm, 3.84 mm and 2.02 mm respectively, meanwhile the positive control was 16.14 mm. One Way Anova test showed significant difference in inhibition (p&lt;0.05) in all groups. Post hoc test showed no significant difference in the inhibition of 75% bajakah tampala wood extract with 100% extract. The inhibition of 100% and 75% extracts was significantly greater than 50% extract. The inhibition of NaOCL 2.5% was significantly greater than all groups of test extracts. Conclusion: Bajakah tampala wood extract has inhibitory activity against the growth of Pseudomonas aeruginosa bacteria.