A comparative analysis of periapical status by using cone beam computed tomography and periapical radiography.

OBJECTIVE: The aim of this study was to compare the periapical status of different teeth by using the Periapical (Pa) and the cone beam computed tomography (CBCT) radiographs. PATIENTS AND METHODS: Pa and CBCT radiographs were obtained from the patients who required Endodontic treatment. The absence and presence of periapical lesions were investigated using both Pa and CBCT radiographs. Periodontal conditions other than periapical lesions were also observed by using both radiographs and recorded. Cohen's Kappa analysis was performed to observe the inter-rater and intra-rater reliability. Descriptive statistics including frequency and percentages of presence and absence of periapical lesions were analyzed. Independent t-test was conducted to compare the Pa and CBCT for the detection of periapical lesions. Chi-square test was used to investigate the distribution of gender and periapical lesions by both radiographs. RESULTS: A total of 204 teeth from 72 patients (29 female and 43 male) were assessed via CBCT and Pa radiographs. Inter-observer and intra-observer reliability showed the absolute level of agreement. T-test showed there is significant difference between Pa and CBCT radiographs regarding detecting periapical lesions. Chi-square test showed no significant differences between the gender and apical pathosis. CONCLUSIONS: CBCT is more reliable to detect periapical lesions compared to the Pa radiographs.

CBCT based study to analyze and classify root canal morphology of maxillary molars - A retrospective study.

OBJECTIVE: The study aims to evaluate maxillary molars' root and root canal morphology among the Saudi population using Cone-Beam Computed Tomography scanning (CBCT). SUBJECTS AND METHODS: Retrospectively, the CBCT scans of 483 Saudi nationals were evaluated to identify the number of roots and root canals in maxillary first and second molars. The records were tabulated and classified according to Vertucci and a new system for root and canal classification given by Ahmed and Dummer. Fisher's exact test was used to analyze the data statistically. To check for symmetry, comparisons were made between all the maxillary first molars (MFM's) and maxillary second molars (MSM's) on opposing quadrants. Inter Observer variability was seen using Cohen's Kappa test. RESULTS: MFM's presented with three roots with Type II Vertucci canal configuration (VC) commonly seen among them. MSM's had more variations in the number of roots and canals, although three roots and Type I VC were predominantly seen. When comparing the two genders statistically significant difference was observed in both maxillary molars at a 5% level using Fisher's exact test. Three roots with four canals (3R4C) were predominantly observed in the MFM's (85.6%) and three roots with three canals (3R3C) identified in 51.95% were more common than 3R4C (43.55%) in MSM's. Both the maxillary molars bilaterally, exhibited a high percentage of symmetry in root and canal configurations. CONCLUSIONS: Identification of root canal morphology of molars would reduce the chances of root canal failures by making sure all canals are obturated. This study provides supplemental information about the root canals of maxillary molars in a Saudi Arabian subpopulation.

Labial alveolar bone thickness and its correlation with buccolingual maxillary incisors angulation: a CBCT based study.

OBJECTIVE: Understanding the labial alveolar bone thickness (ABT) and buccolingual teeth angulation may reduce the complication that might arise during or post-operative treatment. The operator could determine the precise method to ensure long-term treatment success. This study aimed to evaluate the ABT with buccolingual upper incisor teeth angulation based on the maxillary plane by using the cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 371 CBCT radiographs were initially assessed and 100 CBCT radiographs were included. On the maxillary incisors, the labial alveolar bone thickness is evaluated at three points (Point A: Four mm below from CEJ, Point B: Midpoint from the labial alveolar-palatal alveolar crest plane and root apex. Point C: Root Apex of the tooth). The distance from these points to labial alveolar bone was measured for the ABT. Moreover, buccolingual angulation of the tooth was measured by the angle formed by the maxillary plane and the long axis of the tooth. RESULTS: There is no significant difference observed between genders in the labial alveolar bone thickness. The labial alveolar bone thickness grew gradually from the cementoenamel junction (CEJ) level to the apical level. Moreover, there was a statistically significant positive correlation observed between labial alveolar bone thickness at the apical level (Point C) and angulation (p<0.05). CONCLUSIONS: The labial bone thickness was less than 2 mm in the majority of cases at the three points among maxillary incisors. In addition, there is a correlation between buccolingual angulation of the maxillary incisors and labial alveolar bone thickness.

Effect of honey dressing material on palatal wound healing after harvesting a free gingival graft: a prospective randomized case control study.

OBJECTIVE: The aim of this prospective randomized case-control study was to understand the clinical benefits and effect of honey as a dressing material on palatal wound healing after harvesting free gingival graft (FGG). PATIENTS AND METHODS: This prospective randomized case-control study was conducted on a sample of 20 patients with 10 patients in each group. Medihoney dressing material was applied to the donor site in the test group, whereas no dressing material was applied to the control group. All the patients received the same medication (Ibuprofen 600 mg) and post-operative instructions straight away after the surgical procedure. Patients were given the follow-up appointment at first, second and fourth week after the surgery during which the length and the width of the donor site was measured and recorded. RESULTS: At first week, a significant difference in the proportion of patients showing the healing of donor site percentage was found to be 56% (both in width and length) for test group vs. 44% (both in width and length) for the control group (p=0.001). At 4-week, the healing of donor site percentage was found to be 86% (in width) and 91% (in length) for test group vs. 14% (in width) and 9% (in length) for the control group, the difference being statistically significant (p=0.001). CONCLUSIONS: The result of this current study suggests that the honey dressing material accelerated the wound healing process of the palatal wound after harvesting FGG. It also showed a shorter recovery period along with less post-operative morbidity.

Comparative assessment of periodontal treatment needs among the electronic cigarette users and traditional smokers.

OBJECTIVE: It is currently presumptuous that electric cigarettes are less harmful than the conventional ones; this is increasing the consumption of electric cigarettes. Therefore, this study intended to evaluate the periodontal treatment needs among conventional smokers, electronic cigarette smokers and non-smokers. This cross-sectional designed study involved 150 patients with a mean age of 29.88±7.81 years. PATIENTS AND METHODS: Among all patients, 50 patients were recruited in each group. The periodontal condition and the treatment need for the patients were assessed using the community periodontal index treatment need (CPITN). Fisher exact test was used to find the significant association of all three groups with the periodontal status and the treatment need. Female patients (12.5%) showed better periodontal status than the male patients (87.5%) and required less complicated periodontal treatment independently from smoking type. RESULTS: Furthermore, deeper pocket depth ≥6 mm (75%) has been found among the conventional cigarette smokers whereas the majority of the electric cigarette smokers (50%) have calculus deposition. Thus, 50% of the electric smokers require professional scaling whereas 57.1% of conventional smokers prerequisite complex periodontal treatment. CONCLUSIONS: Besides, there was a significant difference (p≤0.05) observed among all groups in periodontal health index and treatment need. Conventional cigarette consumers need more complicated periodontal treatment compared to the patients who consume electric cigarettes.