Pulp stones in unerupted teeth: a retrospective analysis using cone-beam computed tomography.

BACKGROUND: A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity's environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation. METHODS: The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15-76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use. RESULTS: Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05). CONCLUSIONS: The results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications.

Bioceramics utilization for the repair of internal resorption of the root: A case report.

BACKGROUND: The objective of this work is displaying a successful treatment for an internal resorption case under operating microscope using bioceramic material. CASE SUMMARY: Periapical radiograph showed radiolucent lesion representing large internal resorption of the root. The respective defect was obturated using endoscquence bioceramic material follow up at the month 18 after treatment revealed no abnormal finings clinically and radiographically. CONCLUSION: New generations bioceramics have many advantages that internal root resorption cases can benefit from. The use of operating microscope helps to apply obturating materials with precision. However, long term study on a large sample is required in future studies.

Cyclic Fatigue Comparison of TruNatomy, Twisted File, and ProTaper Next Rotary Systems.

TruNatomy (TN; Dentsply Sirona, Maillefer, Ballaigues, Switzerland) is a newly released system that was not tested in any previous studies. The objective of this work is to evaluate cyclic fatigue resistance of the new file and compare it with the Twisted Files (TF) and ProTaper Next (PTN). Forty-five files were distributed into 3 groups: PTN X2 (size 25 and taper 0.06), TF (size 25 and taper 0.06), and TN prime file (size 26 and taper 0.04). Each group included 15 files. Lengths of all files were 25 mm. Cyclic fatigue testing was done using artificial stainless-steel canals with 60-degree curvature and 5 mm radius. Continuous rotation movement at 300 rpm was used until the file fractures. Time for file separation was recorded in seconds. The number of cycles to failure (NCF) mean and standard deviation for each group was calculated. For statistical analysis of data, ANOVA and Tukey's multiple comparison test were used. Mean and standard deviation (SD) of NCF were 259 ± 37.2, 521.67 ± 63.07 and 846.67 ± 37.16 for PTN, TF, and TN respectively. TN on average had significantly the highest NCF compared with PTN (p < 0.05) and TF (p < 0.05). TruNatomy file showed superior cyclic fatigue resistance. With its potential to preserve tooth structure, this file offers a good cyclic fatigue advantage. However, future studies are required to evaluate other properties of this file and to examine its clinical performance.

Lower First Permanent Molar with an Additional Root Diagnosis and Management.

Three rooted lower first permanent molar represents one of the main anatomical variants which is a treatment challenge of clinicians. This study is aimed at presenting a case of a lower first molar with an additional root that was diagnosed and managed successfully using new techniques in endodontics. Tooth #46 was diagnosed as a necrotic pulp with symptomatic apical periodontitis. Different angle radiographs were obtained, and they clearly showed three roots. The procedure was completed under magnification and illumination using an operating microscope. The access cavity was modified to achieve straight line access for all the canals. Careful step-by-step instrumentation was performed using flexible NiTi rotary files. The canals were irrigated using 6% sodium hypochlorite. Afterwards, three-dimensional obturation was completed using warm vertical compaction. Knowledge of the anatomy and an early diagnosis are required to achieve high-quality root canal treatment.

Prevalence of three-rooted mandibular permanent first and second molars in the Saudi population.

INTRODUCTION: This study aims to explore the frequency and factors affecting the prevalence of an extra root in the lower first and second permanent molars in the Saudi population. METHODS: Images of 379 Saudi patients who underwent CBCT for routine dental treatment were assessed. The CBCT images were evaluated on a 34-inch LED screen in a dark room and assessed by two examiners to count the prevalence of an additional root in the lower molars. Laterality and the gender factors were used to analyze that prevalence. Percentages represent categorical variables; Fisher's exact test and Chi square test were also used for the categorical variables. RESULTS: In the lower first molars, the prevalence of extra root in female patients was 5.7%, 3% in male patients and the overall prevalence was 3.05%; in lower second molars, the prevalence was 1.81% in female patients and 3.04% in male patients with an overall prevalence of 1.48%. A statistically significant difference was fond in the existence of an additional root with regard to laterality, to be more common on the right compared to the left side for both mandibular molars. The extra root prevalence was statistically significant in female patients at the first molar compared to male patients (p < 0.05). CONCLUSION: The overall of extra roots prevalence in the lower first and second molars in the Saudi population are 3.05% and 1.48%, respectively. Consideration and identification of this variation is essential to ensure successful endodontic treatment.

Effect of a combination of torsional and cyclic fatigue preloading on the fracture behavior of K3 and K3XF instruments.

INTRODUCTION: The purpose of this study was to evaluate the effect of various degrees of cyclic fatigue on torsional failure and torsional preloading on the cyclic fatigue life of heat-treated K3XF nickel-titanium (NiTi) instruments (SybronEndo, Orange, CA). METHODS: The mean number of cycles until failure (Nf) of K3XF and K3 NiTi instruments was examined in a 3-point bending apparatus with a 7-mm radius and 45° curve. Torque and distortion angles at failure of new instruments and instruments stressed to 25%, 50%, and 75% of the Nf were measured according to ISO 3630-1. Other new files were preloaded at 25%, 50%, and 75% of the mean distortion angles before the fatigue test. After torsional preloading, the Nf was examined. The fracture surface of each fragment was examined with a scanning electron microscope. RESULTS: The fatigue resistance of K3XF instruments was 2 times higher than that of K3 instruments (P < .05). The torque and angle of rotation at fracture of K3XF instruments were similar to those of K3 instruments. The 25%, 50%, and 75% torsional preloading significantly lowered the Nf of both K3 and K3XF instruments (P < .05). In the fatigue prestressed groups, K3 instruments with 75% preloading had significantly lower torque and distortion angles than unused K3 instruments (P < .05). The fractographic patterns corresponded to the pattern defined by the last stage test. CONCLUSIONS: A low amount of torsional preloading reduced the fatigue resistance of K3 and K3XF instruments. A high amount of precycling fatigue significantly reduced the torsional resistance of K3 instruments. The torsional resistance of K3XF instruments was less affected by previous load cycling even after extensive precycling.