Prevalence of Fusobacterium Species in Endodontic Infections Detected With Molecular Methods: Systematic Review and Meta-Analysis.

INTRODUCTION: Endodontic infections are polymicrobial; however, investigating the role of bacterial species is critical because they may influence pathogenesis, the development of symptoms, or the persistence of disease. This systematic review aimed to determine the prevalence of Fusobacterium species and its association with different types of endodontic infections. METHODS: MEDLINE (Ovid), PubMed, Scopus, Web of Science, and Cochrane Library databases were used as electronic databases to retrieve relevant studies. The studies were evaluated for eligibility criteria, and the certainty in evidence and risk of bias were evaluated using critical appraisal tools for prevalence studies from the Joanna Briggs Institute. Forty studies were selected for meta-analysis and statistically analyzed for the relationship between the prevalence of Fusobacterium species and both the presence of symptoms and the type of infections (primary vs secondary/persistent) using meta-regression analysis. RESULTS: The prevalence of Fusobacterium spp. in endodontic infections ranged from 3%-100% (mean = 42.51%) in the 40 included studies. Calculated confidence intervals indicated that the presence of Fusobacterium spp. was not statistically associated with the presence of symptoms or with the type of infections (the set of 2 predictors was not significant; P < .05). CONCLUSIONS: The prevalence of Fusobacterium infection, which was identified with molecular methods, was not significant for overall regression using both predictors (ie, symptoms [symptomatic vs asymptomatic] and types of infections [primary vs secondary/persistent]).

Antibacterial and anti-inflammatory efficacy of N-acetyl cysteine in endodontic treatment: a scoping review.

BACKGROUND: This scoping review systematically summarized the available evidence about the efficacy of N-acetyl cysteine (NAC) as an intracanal antibacterial and/or anti-inflammatory. METHODS: PubMed, Scopus, Web of Science, and Google scholar search engines/databases were searched up to February 2022 to retrieve relevant studies. The studies were evaluated for eligibility criteria, and identifying relevant studies. RESULTS: Out of 193 studies, 15 fulfilled the inclusion criteria and were processed for data extraction. Thirteen in vitro studies assessed antibacterial/antibiofilm efficacy of NAC, and reported good and promising efficacy: NAC was found as efficacious as the comparators (chlorhexidine, sodium hypochlorite, calcium hydroxide), or even showed higher efficacy. Regarding the anti-inflammatory efficacy of NAC, one in vitro study found it equivalent to, while one clinical trial revealed it more efficacious than calcium hydroxide. CONCLUSIONS: There is accumulating evidence on the anti-microbial and anti-inflammatory efficacy of NAC in context of endodontics. However, further clinical trials with robust methodology and objective and reliable clinical, biological and microbial outcomes are warranted to translate its use for clinical practice on humans.

Association between dental diseases and history of stroke in the United States.

OBJECTIVE: This study aimed to determine the potential association between the dental diseases and self-reported history of stroke in the United States based on data from the Third National Health and Nutrition Examination Survey (NHANES III). METHODS: Data were extracted from NHANES III. Dental variables were carious tooth surfaces, number of missing teeth, gingival bleeding, and periodontal pockets. Multiple logistic regression modeling was used to estimate the effect of these dental diseases on the self-reported history of stroke with intent to adjust for the other potential determinants: age, sex, race, marital status, health insurance, education, exercise, body mass index, smoking, alcohol, hypertension, high serum cholesterol, and diabetes. RESULTS: Number of missing teeth was found to be significantly associated with the self-reported history of stroke. Associations between the self-reported history of stroke and caries, gingival bleeding, or periodontal pockets were not statistically significant. CONCLUSIONS: Number of missing teeth was an independent determinant of the self-reported history of stroke.

Management of cracked tooth using simvastatin as intracanal medicament.

Cracked tooth syndrome is presented as pain associated with biting and sensitivity. Intracanal medication with simvastatin stimulates hard tissue formation at crack line, and the tooth was functioning on the follow-ups.

Histologic Evaluation of Artificial Floors Under MTA and Nano-Filled Resin-Modified Glass Ionomer Used to Repair Furcation Perforations in Dogs.

Objective: This study aimed to compare the tissue reaction of two repair materials for furcation perforations, nano-filled resin modified glass ionomer (Nano-FRMGI) and mineral trioxide aggregate (MTA), used with or without an artificial floor. Methods: A total of 96 teeth in 6 dogs were used for this study. After access cavities, root canals were prepared and obturated with gutta percha using cold lateral condensation technique. Perforations were then created on the floors of the pulp chambers. The perforations divided into four groups n=24/group that were sealed with MTA alone, MTA with calcium sulphate artificial floor (CSAF), FRMGI alone and Nano-FRMGI with CSAF. All access cavities were filled with composite resin. Two dogs were sacrificed at 1, 3, and 6 month. The experimental tooth along with the surrounding alveolar bone were cut in block sections and histologically evaluated for tissue response. Data were analyzed by Chi-square (P≤0.05). Results: MTA and MTA with CSAF showed more bone and cementum apposition when compared to Nano-FRMGI at 6-month interval. MTA and MTA with CSAF showed less bone resorption, epithelium proliferation and inflammation compared to Nano-FRMGI at 6-month interval. Conclusion: MTA with CSAF or MTA-alone show better outcomes in the repair of pulp chamber floor perforation.

Root and Canal Configuration of Mandibular First Molars in a Yemeni Population: A Cone-beam Computed Tomography.

Objective: To describe root and canal morphology of mandibular first molars (MFMs) in a Yemeni population using cone-beam computed tomography (CBCT). Methods: CBCT images of 500 right and left untreated MFMs with fully developed roots from 250 Yemenis (125 male and 125 female) comprised the sample size of this study. The following characteristics were recorded: (1) number of roots and their type and morphology, (2) number of canals orifices per root, (3) type of canal configuration and (4) primary variations in the morphology of the root and canal systems. Results: 96.8% of MFMs are double-rooted. A third root was found in 3.2%, more in females than males. Mesial root was mainly ribbon-shaped (92.2%) and distal root was kidney-shaped in 56.2%. Two canals orifices were found in mesial root of 95.8% and one canal orifice was found in distal root of 96.4%. Vertucci type II canal configuration was the most frequent (57%), followed by type IV (35.6%) in mesial root. Type III canal configuration was the most prevalent (48.8%), followed by type I (41%) in distal root. Variant 3 represented the most common root and canal morphology (89.8%). Conclusion: MFMs in Yemeni population are mainly two-rooted with 3.2% having a supernumerary distolingual root. Cross section of mesial root was mainly ribbon-shaped and distal root was kidney-shaped. Vertucci type II and III configurations were the higher incidence in mesial and distal roots, respectively. The presence of two canals in mesial root and one canal in distal root of MFMs with two separate roots (variant 3) was the most common morphology.

Orthodontic-induced External Root Resorption of Endodontically Treated Teeth: A Meta-analysis.

INTRODUCTION: The difference in the amount of orthodontic-induced external root resorption (OIERR) of endodontically treated teeth (ETT) compared with vital pulp teeth (VPT) treatment is controversial. This systematic review and meta-analysis assessed the available evidence regarding OIERR of ETT compared with VPT. METHODS: PubMed, Scopus, MEDLINE, Web of Science, and Cochrane databases were searched up to May 2018 to retrieve relevant studies. The studies were evaluated for eligibility criteria, and the risk of bias was assessed using the Risk of Bias In Non-randomised Studies of Interventions tool (Cochrane Bias Methods Group, Odense, Denmark). Weighted means of OIERR in ETT and VPT were calculated using a fixed effects model, and a random effects model was used to assess the significance of treatment effects. RESULTS: Eight studies were identified, from which 7 were included in the meta-analyses. The funnel plot of the random effects model exhibited a symmetrical distribution, which indicates no publication bias of the included studies. Because of the significant heterogeneity between studies, a random effects model was used. Significantly less OIERR for ETT was identified compared with their contralateral VPT. CONCLUSIONS: Endodontic treatment does not seem to increase OIERR.

Root form and canal morphology of maxillary first premolars of a Yemeni population.

BACKGROUND: The purpose of this study was to investigate variations in the root canal systems of permanent maxillary first premolars in a Yemeni population using a clearing technique. METHODS: Two hundred fifty permanent maxillary first premolar teeth extracted from Yemeni individuals were collected. A small hole in the center of the occlusal surface of each tooth was prepared and pulp tissue was removed by immersion in 5.25% sodium hypochlorite. Teeth were stored in 5-10% nitric acid solution for 5-6 days. Next, teeth were rinsed, dried, and dehydrated using ascending concentrations of ethanol (70, 95, and 100%) successively for 12 h each. Waterproof black ink was injected into the dried dehydrated teeth. Stained teeth were then rendered clear by immersion in methyl salicylate solution (98%) until evaluation. Root canal morphology of each tooth was then examined. RESULTS: 54.8% of teeth were single-rooted, while 44.4% were double-rooted and only 0.8% had three separated roots. The most common canal system configuration was Vertucci type IV (55.6%). Eight specimens of the single-rooted premolars (3.2%) had new canal configurations that have not been recognized in previous published studies. Accessory canals and inter-canal communications were detected in a total of 52.8 and 34.4% of the specimens, respectively. The apical foramen was located centrally to the apex in 84.9% and apical deltas were found in 13.2% of the studied sample. CONCLUSIONS: Yemeni permanent maxillary first premolars are mainly single-rooted and predominantly present Vertucci type IV canal morphology. The finding of additional canal configurations in this study is low but should be kept in mind when performing endodontic therapy for these teeth.

Canal configuration of mandibular first premolars in an Egyptian population.

The purpose of this study was to investigate canal configuration of mandibular first premolars in an Egyptian population. Two hundred fifty human extracted mandibular first premolars were collected from Egyptian patients and a small hole in the center of the occlusal surface of each tooth was made perforating the roof of the pulp chamber. Teeth were decalcified by immersing in nitric acid and dehydrated in ascending concentrations of ethyl alcohol. A waterproof black ink was passively injected from the occlusal hole into pulp system and stained teeth were immersed in methyl salicylate solution for clearing. Standardized pictures of the cleared teeth were obtained and anatomical features of the root canal were observed. The average length of the mandibular first premolar teeth was 22.48 ± 1.74 mm, one-rooted teeth were 96.8% and the two-rooted were 3.2%. Vertucci Type I canal configuration represented the highest percentage (61.2%) followed by Type V (16.4%), Type IV (13.2%), Type II (5.6%) and Type III (2.8%). Vertucci Type VI canal configuration represented the lowest percentage (0.4%) and a complex configuration was found in one tooth. Accessory canals were detected in 22.8% and inter-canal connections were observed in 24.8% while 54% showed apical delta. Such knowledge is clinically useful for localization and negotiation of canals of mandibular first premolar, as well as their subsequent management in Egyptian population.