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Introduction: The purpose of this study was to analyze the canal configuration of mesiobuccal root (MBR) of the maxillary molars in the Saudi subpopulation using cone-beam computed tomography (CBCT) and to compare if there is any gender and arch variation. Methodology: In this cross-sectional retrospective evaluation study, analysis of CBCT scans of MBRs of 400 maxillary first and second molars was done that has undergone CBCT scanning for diagnostic/treatment purposes in the private clinic of Jeddah, KSA. Statistical analysis was performed using Student's t-test and Chi-square test. Results: Type I, II, and III canal configurations have been reported to be the most common morphologies in the MBR in both first and second molars, with the incidence of 20.25% (81), 17.25% (69), and 17.25% (69), respectively. Type I canals were significantly (P < 0.001) more common in tooth #17 and #27, Type II canals were significantly (P < 0.001) more seen in tooth #26, Type 3 canals were more seen in tooth #27, but there is no statistically significant association. Supplemental canal configurations which were classified by Gulabivala as Type I, Type II, and Type IV were also seen. Furthermore, 93 additional unclassified canal configurations were also found. Conclusion: The data indicate high prevalence of MB2 canals with varying canal configurations. Preoperative CBCT imaging should always be done in tooth-like maxillary molars, to understand the complex configurations and variations and to achieve higher success while performing root canal treatment.
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Objective: The purpose of this prospective, randomized study was to evaluate and compare the anesthetic efficacy of 0.8 ml of 4% articaine and 1.6 ml of 2% lidocaine administered through buccal infiltration (submucosal) only in adult male and female patients with irreversible pulpitis of maxillary 1st molar. Study Design: Two hundred patients with irreversible pulpitis of the maxillary first molar were divided into four study groups and received only buccal infiltration of either 0.8 ml of 4% articaine or 1.6 ml of 2% lidocaine. Endodontic access was begun 7 min after the solution deposition. The success was defined as "no pain (0 mm)" or "weak/mild pain (>0 mm and ≤54 mm)" during access opening, and during the first file insertion till working length. Results: The compiled data of the number of failed cases were analyzed by two sample proportion test and of mean pain scores were analyzed by Student's unpaired t-test. P < 0.05 was taken as statistically significant. No significant difference was found in the number of failed cases on using 4% articaine and 2% lidocaine (P > 0.05). Moreover, no significant difference was found in the number of failed cases between the genders in Group I (4% articaine with 1:100,000 epinephrine) and also in Group II (2% lidocaine with 1:80,000 epinephrine). On comparing the mean pain scores of failed cases, it has been found that females experience more pain than males in Group I (not significant) and Group II (significant). Conclusion: The efficacy of 4% articaine with 1:100,000 epinephrine has been found to be better than 2% lidocaine with 1:80,000 epinephrine, as only 0.8 ml of 4% articaine with 1:100,000 epinephrine was effectively used as compared to 1.6 ml of 2% lidocaine with 1:80,000 epinephrine. Furthermore, females experience more pain as compared to males.
RESUMEN
Dental therapists encounter patients with various systemic diseases of which cardiovascular disease (CVD) patients form a significant segment. Relation between oral health and cardiac diseases has been well established. Common cardiac disorders encountered in a dental practice include arterial hypertension, heart failure, ischemic heart disease, cardiac arrhythmias, infective endocarditis, stroke, and cardiac pacemaker. Patients with CVDs pose a significant challenge to dental therapy. These patients need special considerations and an adequate understanding of the underlying cardiovascular condition to provide safe and effective dental treatment. Based on the cardiac condition, an appropriate modification in dental care is crucial. A multidisciplinary approach including the patient's cardiologist can potentially reduce complications and improve dental treatment results. This review aims at unfolding the risks associated with the dental management of a cardiac patient and outlines the measures to be undertaken for optimum dental treatment.