Radiographic assessment of endodontic mishaps in an undergraduate student clinic: a 2-year retrospective study.

Objectives: The aim of this study was to compare the occurrence of instrumentation and obturation related endodontic procedural mishaps following the use of either, stainless steel hand or engine-driven rotary instrumentation techniques. Methods: From a computerized hospital database, a total of 730 dental patient records who had received endodontic treatment by undergraduate dental students between August 2018 to September 2020 were retrieved. The inclusion criteria were primary (non-surgical) endodontic treatment on permanent teeth with complete radiographic records. Following record screening, a final sample of n = 475 dental records were included. Radiographic records were evaluated for both instrumentation and obturation related mishaps. The data was analysed using multiple logistic regression analysis (α = 0.05). Results: Engine-driven rotary instrumentation resulted in a significant decrease in the overall occurrence of instrumentation related endodontic mishaps by 40% compared to hand instrumentation (Odds Ratio = 0.59 [0.36-0.97], p = 0.04). In particular, rotary instrumentation decreased ledge formation, perforation and obturation related mishaps, with minimal effect on the limitation of zipping. Conclusion: The use of rotary instrumentation techniques may reduce the incidence of instrumentation and obturation endodontic mishaps in the undergraduate dental clinic.

The prevalence of dental caries among Egyptian children and adolescences and its association with age, socioeconomic status, dietary habits and other risk factors. A cross-sectional study.

Background: Dental caries is a chronic, multifactorial disease, with limited data available for the Egyptian population. The aim of this study is to assess the prevalence of dental caries among Egyptian children and adolescents in correlation with age, gender, body mass index, socioeconomic status, parental education, biological risk factors and dietary habits. Methods: A total number of 369 Egyptian children and adolescents (age ranges from 3-18 years) were examined over the period from 15 th November 2017 to 13 th January 2018. Socio-demographic data, oral hygiene measures and dietary habits for children were recorded. Dental status was analyzed using decayed, missing and filled tooth index (dmft) for deciduous dentition and (DMFT) index for permanent dentition. For mixed dentition (deft) index was used, d (decayed tooth indicated for filling), e (decayed tooth indicated for extraction) and f (filled tooth). Results: 74% of the children had dental caries with mean dmft: 3.23±4.07; deft: 4.21±3.21; DMFT: 1.04±1.56. In primary dentition, dmft of the children was positively correlated with age, beans, candies, crackers, chocolates and inversely correlated with gender, socio-economic status (SES), parental education, brushing frequency of the parent, brushing frequency of the parent to the child teeth, brushing frequency of the child and consumption of eggs, fruits/vegetables, milk and milk products. In mixed dentition, deft was positively correlated with candies, crackers, citric juices, while negatively correlated with age, SES, parental education, brushing frequency of the parent to the child, brushing frequency of the child, fruits/vegetables. In permanent dentition, DMFT in children was positively correlated with age and chocolates while not correlated with any of the remaining risk factors. Conclusion: The present study clarifies the significant risk factors associated with dental caries amongst Egyptian children. This will help in planning strategies to prevent and treat such disease.

Three-dimensional assessment of proximal contact enamel using optical coherence tomography.

OBJECTIVE: The purpose of this study was to detect and investigate the association of enamel microcracks with demineralization at proximal contact areas of premolars, using 3D swept-source optical coherence tomography (SS-OCT). METHODS: Extracted maxillary and mandibular premolars (n=50 each), without any visible tooth cracks, were examined for demineralization of interproximal contact areas, using the International Caries Detection and Assessment System (ICDAS). SS-OCT was used to evaluate demineralization and detect microcracks. Demineralization progression was divided into 4 types by depth: 0 for sound enamel and Type I, II, and III for enamel demineralization penetrating into the outer third, the middle third, and the inner third of the enamel thickness, respectively. Enamel microcracks were classified according to the predominant crack pattern: Type O, no cracks; Type A, subsurface microdefects; Type B, enamel microcrack running along the direction of the enamel prism; Type C, enamel microcrack running transverse to the enamel prism direction; and Type D, a combination of patterns A, B, and C. SS-OCT findings were confirmed by confocal laser scanning microscopy observation. RESULTS: Microcracks confined within the superficial enamel in proximal contact areas were seen as bright lines on SS-OCT. There were significant positive correlations among ICDAS codes, demineralization levels, and microcrack distribution (p≤0.001). The mesial side of maxillary premolars showed significantly more demineralization (n=36) and microcracks (n=27) than that of the mandibular premolars (n=20 and n=14, respectively; p<0.001). SIGNIFICANCE: The presence of microcracks within the superficial enamel in proximal contact areas could be determined using SS-OCT, and correlated with the level of demineralization. 3D SS-OCT is a valuable diagnostic tool for comprehensive assessment of microstructural changes related to enamel demineralization and crack development.