Association between Periodontitis and Chronic Rhinosinusitis Involving Maxillary Sinus Measured by Lund Mackay Staging System.

This study aimed to evaluate the association between periodontitis and chronic rhinosinusitis (CRS) via cone-beam-computed tomography (CBCT) using the Lund-Mackay staging system. CBCT images from different departments of the school of dentistry, at Prince Sattam University were evaluated for the presence of rhinosinusitis. All the CBCT scans were exposed for multiple indications, and no patients had a scan exposed solely for this study. The Lund-Mackay staging system was used to measure the CRS in the CBCT. Descriptive statistics for the frequencies and percentages were used to summarize the data. Logistic regression was used to examine the associations between periodontitis and CRS. Each variable was assessed individually by using multivariable analysis. Collinearity issues among the variables were solved to select a limited set of factors using a stepwise variable selection procedure. A total of 399 CBCT images were included in the current research. Logistic regression showed that only gender was significantly associated (p = 0.0001) with the presence of CRS. However, a stepwise variable selection procedure included gender and bone loss as significantly associated with CRS. No significant difference was observed between unilateral vs. bilateral CRS in gender, bone loss, medical status, and periodontitis. However, only gender showed a significant difference in both bilateral vs. no CRS and unilateral vs. no CRS. Periodontitis is not associated with CRS. However, gender has a significant influence on CRS.

A Prospective Clinical Study Evaluating the Efficacy of Intra-Ligamentary Anesthetic Solutions in Mandibular Molars Diagnosed as Symptomatic Irreversible Pulpitis with Symptomatic Apical Periodontitis.

Accomplishing painless endodontic treatment, especially in the mandibular molar region, is challenging. Hence, the aim of the study was to compare the efficacy of 2% lidocaine and 4% articaine when used as supplemental intra-ligamentary (IL) anesthesia in mandibular molars having symptomatic irreversible pulpitis with symptomatic apical periodontitis after failed Inferior Alveolar Nerve Block (IANB) injection. In this prospective study, one-hundred and forty-seven adult patients diagnosed with irreversible pulpitis in a mandibular tooth were included who received IANB with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. Patients who experienced pain were recorded using the Heft-Parker visual analog scale (HP-VAS score ≥ 55 mm) and received supplement intra-ligament injection with either4% articaine or 2% lidocaine with 1:100,000 epinephrine. Supplementary intra-ligament injections resulted in 82.6% and 91.3% of profound anesthesia in the first molar region for 2% lidocaine and 4% articaine, respectively. Similarly, an additional IL injection of articaine success percent (78.9%) in the second molar region was higher than lidocaine (63.1%). The overall success ratio revealed no significant difference in achieving profound anesthesia of either solution. In this study population, there was no difference in the success ratio of anesthesia between 2% lidocaine and 4% articaine when used as supplemental IL injection.

Variation in Hemodynamic Characteristics during Periodontal Crown-Lengthening Surgical Procedure: An Uncontrolled Cohort Study.

(1) Background: The purpose of this prospective study was to determine the changes in primary hemodynamic parameters and oxygen saturation in systemically healthy patients during the surgical procedure involving crown lengthening. (2) Methods: A total of 44 patients who required a crown-lengthening procedure in a single tooth in the maxillary arch were included in this study. Heart rate (HR), blood pressure (BP) and oxygen saturation (SpO2) were measured in all the subjects at three different intervals: before injecting the anesthetic (T1), after the anesthetic injection (T2) and after the procedure (T3). Descriptive statistics were computed, and observations were recorded as mean and standard deviation (SD). Analysis of variance (ANOVA) was used to compare the mean observation within parameters at different time intervals. (3) Results: All primary hemodynamic parameters were increased in the T2 phase over T1 and decreased in the T3 phase over T2. However, SpO2 decreased in both the T2 and T3 phases compared to the initial T1 phase. No significant differences were observed among the primary hemodynamic variables. However, SpO2 showed a significant difference (p = 0.013) among the T1, T2 and T3 phases. (4) Conclusions: Further study with larger sample size is required in order to analyze the accurate hemodynamic alterations.

Accuracy and Reliability of CBCT Compared to Clinical Probing in Detection of Trifurcation Defects: An In Vivo Study.

Background: Furcation defects are areas of pathological bone resorption in multirooted teeth. The aim of the study was to compare the measurements of trifurcation bone loss, measured using CBCT, versus clinical measurements in order to evaluate the efficacy of CBCT as an adjunctive diagnostic tool. Material and Methods. The included patients had both CBCT scans for maxillary molars and completed periodontal charts. Clinical examination consisted of probing and detection of vertical and horizontal furcation defects. These were measured and recorded. CBCT measurements were then evaluated using the linear measuring tool in Carestream imaging software (Carestream, Rochester, USA) and iCAT (Imaging Sciences, Hatfield, USA). These measurements of the CBCT images were then documented and compared to clinical findings. The two examiners were blinded to each other's measurements. Results: The most common tooth with a detected furcation defect was tooth #2 (31.7%), followed by tooth #15 (26.8%) and #3 (21.9%). The least common tooth with a detected furcation defect was #14 (19.5%). The mean values of buccal furcation for clinical and CBCT measurements were 3.01 mm and 2.6 mm, respectively. The measurements of mesial furcation were 2.5 mm and 2.2 mm for CBCT. The distal measurement of clinical examination was 2.7 mm and for CBCT was 2.44 mm. Conclusion: CBCT can be used as an adjunct to clinical furcation measurements and adds useful diagnostic information to assess trifurcation defects. In addition, CBCT limited field of view (FOV) can provide relatively high-resolution images at a reduced dose that is comparable to two-dimensional imaging.