Endodontic management of a fused left maxillary second molar and two paramolars using cone beam computed tomography: A case report.

BACKGROUND: Fused teeth usually involve several complications, such as the development of caries in the groove between fused crowns, tooth impaction, diastemas, aesthetic and periodontal problems, and pulpal pathosis, due to the complex anatomical structure of fused teeth. A thorough diagnosis is paramount to forming an accurate treatment plan and obtaining a favourable prognosis. With the advent of cone-beam computed tomography (CBCT), accurate 3-dimensional images of teeth and their surrounding dentoalveolar structures can now be readily obtained, and the technology can accurately provide a minimally invasive approach to acquire detailed diagnostic information. Therefore, we utilize CBCT data herein to generate a digital model for the infected region in a patient, and this model enables us to better plan the management of his case. CASE SUMMARY: This report details the diagnosis and endodontic treatment of a rare case involving a fused maxillary second molar and two paramolars with apical periodontitis. The patient experienced pain upon biting and cold sensitivity in the area of the maxillary left molar. No caries or other defects were identified in these teeth, and a normal response to a pulp electric viability test was observed. With the aid of CBCT and digital model technology, we initially suspected that the infection originated from the isthmus between the maxillary second molar and two paramolars. Therefore, we only treated the isthmus by an endodontic approach and did not destroy the original tooth structure; furthermore, the vital pulp was retained, and good treatment outcomes were observed at the 24-month follow-up. CONCLUSION: This finding may provide new insights and perspectives on the diagnosis and treatment of fused teeth.

Multiple Cervical Root Resorption Involving 22 Teeth: A Case with Potential Genetic Predisposition.

A rare case of extensive multiple idiopathic cervical root resorption with potential genetic predisposition was presented. A heathy 19-year-old Chinese male with no contributory medical or family/social history complained of pain during mastication that lasted for several months. Oral examination identified 7 missing teeth and external cervical root resorption involving 9 teeth. Comparison of orthopantomograms taken in May 2021 and February 2022 identified that cervical root resorption occurred in 22 teeth. Resorption commenced at the cementoenamel junction and progressed rapidly over the 9-month period. Laboratory test results were within normal limits. Trio-based whole-exome sequencing showed a missense mutation c.5630 C > T in the filamin A (FLNA) gene at chromosome X of the subject. This is suggestive of the possibility of sex-linked recessive inheritance. This is the first study to report FLNA mutation in human subjects with cervical root resorption involving multiple teeth.

Role-play in Endodontic Teaching: a Case Study.

Objective: To investigate the role of the application of role-play in endodontic study in improving the communication skills of Chinese dental undergraduates prior to their direct interactions with patients at the Fourth Military Medical University's School of Stomatology, China. Methods: Students were recruited from the 5-year bachelor's programme (n = 36) and randomly divided into six groups, and from the 8-year DDS programme (n = 10) and randomly divided into two groups to participate in the role-play training. Cases selected randomly from the case pool were distributed to the groups. The teacher gave an outline of the roles in the simulation. Each member of each group randomly selected their own role for the role-play. Four types of surveys were distributed to students and faculty members at different points after the role-plays had taken place, to evaluate their attitude towards the use of role-plays in endodontic study. Frequency analysis and a one sample t test were used to describe and analyse students' acceptance of role-play as a teaching technique. The level of statistical significance was set at P < 0.05. Results: Students' performance and satisfaction as well as the supporting faculty responses were very favourable towards role-playing. In total, 93.5% of students responded favourably to the role-play, answering 'strongly agree' or 'agree' to the positive statements about their role-play performance. A total of 95.1% of students stated that they had benefited psychologically and technically from the role-play ('strongly agree' or 'agree') after their 1-year rotating internship. Conclusion: The application of role-play in endodontic study is an effective way of educating Chinese dental undergraduates and can be beneficial for their transition from students to dentists.