Effectiveness of different root-end filling materials in modern surgical endodontic treatment: A systematic review and network meta-analysis.

Background/purpose: There is controversial evidence on the best choice for root-end filling materials in follow-up periods and treatment protocols. The purpose of this study was to evaluate the effectiveness of different root-end filling materials in modern surgical endodontic treatment. Materials and methods: A total of 16 studies with a minimum follow-up of 12-months were qualified to be reviewed, involving randomized control trials and observational studies in PubMed, Cochrane library and Scopus until September 1, 2021. The outcome of modern surgical endodontic treatment was assessed based on clinical and radiographic success. Direct comparisons were combined to estimate indirect comparisons, and the estimated effect size was analyzed using the odds ratio (OR). The comparative effectiveness of all materials for target outcomes were shown as P-score. Results: Within this network meta-analysis, mineral trioxide aggregate (MTA) had superior effects among all root-end filling materials at 12-months follow-up. (MTA: OR, 2.03; 95% CI, 0.84-4.91; P-score, 0.86; reference material, gutta-percha). In further sensitivity analyses, MTA, calcium silicate-based root repair material (RRM) and super EBA cement (Super EBA) were associated with significantly higher success rates at 12-months follow-up. (MTA: OR, 5.62; 95% CI, 1.58-19.99; P-score, 0.88; RRM: OR, 5.23; 95% CI, 1.05-25.98; P-score, 0.74; Super EBA: OR, 3.99; 95% CI, 1.06-15.04; P-score, 0.54; reference material, gutta-percha). Conclusion: MTA remains the best choice for root-end filling materials of modern surgical endodontic treatment at the 12-month follow-up. Comparative randomized clinical trials in the long-term follow-up are warranted in future investigations.

A bibliometric analysis of top 100 most-cited articles in dentistry with author(s) affiliated with Taiwan institutes.

BACKGROUND: Citation analysis can provide a historical perspective in the advancement of research, evolution, and areas of research. Taiwan exhibits rigorous academic and scientific activities in dentistry; however, based on its empirical contribution in research, there is no report in the literature analyzing the top-cited articles published by authors affiliated with Taiwan institutes. The purpose of this study was to analyze the citation characteristics of the top 100 most-cited articles published in dentistry with author(s) affiliated with Taiwan institutes. METHODS: The Scopus database was used to search the qualified articles with authors from Taiwan published in journals. The bibliometric parameters, including year of publication, study design, research fields, citation half-life, self-citation, institute of origin, and international collaboration were analyzed. Multivariable linear regression in generalized linear model was used to find associate factors related to trends of citation counts. RESULTS: The top 100 most-cited articles were determined by analyzing 7667 articles from the Scopus database. The steadily increasing trends were observed in the number and percentage of articles of author(s) affiliated with Taiwan institutes to the world. The most common study design was the in vitro research (55 %). The majority citation half-life is 3-5 and 6-8 years, and self-citation counts were between one to five times (n = 26). The percentage of international collaboration of these most-cited articles was 32%, and the main collaboration country was the United States. By using multivariable linear regression in the generalized linear model, the associated factors, study design, and self-citation were significantly associated with the escalating trends of citation counts. CONCLUSION: This is the first study that provides valuable information in the dentistry regarding the academic activity, and empirical contribution of author(s) affiliated with Taiwan institutes in the world. The trends of citation characteristics were significantly correlated with study design and self-citation of these articles.

Citation Characteristics of H-Classics Articles in Implant Dentistry: A Citation Analysis Using H-Classics Method.

PURPOSE: Citation-based metrics, such as the H-classics method, have been used as an indicator to assess academic performance in the scientific community. However, information addressing issues regarding self-citation, citation half-life, and subject area of origin in implant dentistry is lacking. The purpose of this study was to investigate the citation characteristics of H-classics articles in implant dentistry throughout different time periods. MATERIALS AND METHODS: H-classics implant dentistry articles were searched and selected by applying the H-classics method from the Scopus database. Bibliometric analysis was conducted to evaluate the citation characteristics, including institutional and journal self-citation, citation half-life, and subject area of origin of identified H-classics articles. RESULTS: The International Journal of Oral & Maxillofacial Implants and Clinical Oral Implants Research are the leading journals contributing the majority of citations to the retrieved H-classics articles. Articles published in the United States cited the most H-classics articles. Journal self-citation was 12.41% on average, while institutional self-citation was approximately 7.81%. Citation half-life decreased significantly across time periods, with an average decreasing ratio of 43.95%. Research on Scope III, bioengineering interventions, had the most prominent distribution citation frequency in the subject area "Others." CONCLUSION: This study provides insightful views regarding citation characteristics of H-classics articles in implant dentistry (eg, interdisciplinary publications on bioengineering interventions) during the investigation periods, which may foster the translation of preclinical research into clinical applications in the future.

Association between the presence of distolingual root in mandibular first molars and the presence of C-shaped mandibular second molars: a CBCT study in a Taiwanese population.

OBJECTIVES: The purpose of this study was to assess the prevalence of C-shaped canals in permanent mandibular second molars (SMs) and to determine whether its appearance was associated with the presence of distolingual root (DLR) in permanent mandibular first molars (FMs). METHOD AND MATERIALS: Three hundred and eighty patients were qualified for evaluation of their FMs and SMs using cone beam computed tomography. The prevalence, distribution pattern, external root morphology, and the internal root canal anatomy of the examined molars were recorded and analyzed. Furthermore, the association between the root canal configurations of SMs and the appearance of DLR in FMs was also assessed. RESULTS: The prevalence of SMs with C-shaped root canals was 44.7%. The most common root canal configuration type of the one-rooted SMs with C-shaped anatomy was C3 (45.6%), followed by C2 and C1. The frequency of C-shaped canals in SMs was 45.4% in Non-DLR group, 52.8% in unilateral DLR group, and 33.9% in bilateral DLR group, respectively. Moreover, the prevalence of C-shaped root canals in SMs with the presence of bilateral DLRs in FMs was significantly lowered. CONCLUSION: The association between the presence of DLR in FMs and C-shaped canal configurations in neighboring SMs was surveyed, and the prevalence of C-shaped root canals in SMs with the presence of bilateral DLRs in FMs was found to be significantly lowered.

Detection and location of second mesiobuccal canal in permanent maxillary teeth: A cone-beam computed tomography analysis in a Taiwanese population.

OBJECTIVES: The aim of this study was to analyze the incidence, symmetry, concurrence of second mesiobuccal canal (MB2) and determine geometric relationships between each orifice of maxillary first and second molars by cone-beam computed tomography (CBCT) analysis. METHODS: A total of 216 qualified individuals' (503 teeth) CBCT image were enrolled in the present study. The consistency of bilateral symmetry and concurrent appearance of MB2 canals were analyzed among individuals with contralateral and adjacent molar teeth. The inter-orifice distances and angulations of first and second molars were also measured. RESULTS: The overall incidence of MB2 canal of maxillary molars was 39.2%, in which 45.9% and 32.3% in the first and second molars, respectively. The distribution of MB2 canal in contralateral molar teeth has significant gender difference in second molars (p = 0.024) while analyzing the frequency of MB2 canal appearing in contralateral molar pairs. The simultaneous occurrence of MB2 canal was 22.4% for contralateral molars, and the prevalence of concurrent appearance of MB2 canal in the adjacent molars was 43.4%. After adjusting for gender, age, and tooth type, the inter-orifice distances of mesiobuccal to palatal (odds ratios = 1.891) and to distobuccal (odds ratios = 1.448) canals, demonstrated significant differences between molars with and without MB2 canals. CONCLUSIONS: The clinical significance of the results presents critical information on the geometric features, including inter-orifice distances and angulations between each orifice in maxillary molar teeth. Further studies should be conducted to investigate the exact anatomic coordination between each orifice and its impact on access preparation and external crown morphology.

Relationship of the Incidence of C-shaped Root Canal Configurations of Mandibular First Premolars with Distolingual Roots in Mandibular First Molars in a Taiwanese Population: A Cone-beam Computed Tomographic Study.

INTRODUCTION: The aim of this study was to determine the prevalence of C-shaped canal configurations (CSs) and radicular grooves (RGs) in permanent mandibular first premolars (MPs) and to investigate the relevance of such complexities with the presence of distolingual roots (DLRs) in permanent mandibular first molars (MMs). METHODS: A total of 800 pairs of MPs and MMs were investigated using a cone-beam computed tomographic system (NewTom 5G; QR srl, Verona, Italy). The frequency and symmetry of DLRs in MMs along with the occurrence of RGs and CSs in examined MPs were evaluated. Multivariable logistic regression analysis was applied to examine the correlation between the CSs of MPs with the appearance of DLRs in MMs. RESULTS: In the examined teeth, 23.0% of MMs had a DLR, whereas 16.6% of MPs had RGs and 12.5% of MPs had C-shaped canals. Although the most common canal configuration in MPs is the single canal (74.1%), the other 25.9% still possess complicated root canals. Of these MPs that have different canal configurations, 54.6% had 2 canals, whereas 44.4% had CSs. Specifically, the CS showed a high prevalence of C3 morphologies at 98.9% followed by C1 at 1.1%. A corresponding and increasing frequency was noted in CSs and RGs of MPs and MMs with DLRs (P < .001). After adjusting for related categoric variables, the adjusted odds ratios for CSs of MPs in the bilateral DLR group compared with the non-DLR group was 3.294 (P < .001). CONCLUSIONS: This study showed an increased appearance of CSs in MPs when DLRs were present in MMs in the Taiwanese population.

Increasing prominence of implantology research: a chronological trend analysis of 100 top-cited articles in periodontal journals.

PURPOSE: To identify 100 top-cited articles published in periodontal journals and analyse the research trends by using citation analysis. MATERIALS AND METHODS: 100 top-cited articles published in periodontal journals were retrieved by searching the database of the ISI Web of Science and Journal Citation reports. For each article, the following principal bibliometric parameters: authorship, geographic and institute origin, manuscript type, study design, scope of study, and citation count of each time period were analysed from 1965 to 2015. RESULTS: The identified 100 top-cited articles were retrieved from five periodontal journals and citation counts were recorded between 262 and 1,693 times. For the institute of origin, the most productive institute, in terms of the number of 100 top-cited articles published, was the University of Gothenburg (Sweden) (n = 19), followed by the Forsyth Dental Center (USA) (n = 15). Most manuscripts were original research (n = 74), and the inflammatory periodontal disease (n = 59) was the most frequent topic studied. Interestingly, the trend of increase average citation reached significance for implantology (ß = 26.75, P = 0.003) and systemic interactions (ß = 29.83, P = 0.005), but not for inflammatory disease (ß = -10.30, P = 0.248) and tissue regeneration (ß = 9.04, P = 0.081). By using multivariable linear regression in a generalised linear model, suitable published journal (Journal of Clinical Periodontology), geographic regions (Europe), more intense international collaboration, adequate manuscript type (review article) and study design (systematic review) could be attributed to escalating average citation counts in implantology (all P < 0.05). However, for systemic interactions, only geographic region and study design were significantly associated with the increasing citation trend. CONCLUSIONS: These principal bibliometric characteristics revealed escalated trends in average citation count in implantology throughout time.

The Presence of Distolingual Root in Mandibular First Molars Is Correlated with Complicated Root Canal Morphology of Mandibular Central Incisors: A Cone-beam Computed Tomographic Study in a Taiwanese Population.

INTRODUCTION: The aim of this study was to assess the prevalence of complicated root canals in permanent mandibular central incisors (PMCIs) and its correlation with the presence of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone-beam computed tomographic imaging in a Taiwanese population. METHODS: A total of 400 patients (800 pairs of PMCIs and PMFMs) were qualified for further analysis. The prevalence of DLRs in PMFMs along with root canal configurations of PMCIs were assessed at subject and tooth levels. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMCIs with the existence of DLRs in PMFMs. RESULTS: The prevalence of PMFMs with DLRs and complicated root canal configurations in PMCIs was 23.0% and 15.6%, respectively. A significant difference in age (<50 years vs ≥50 years) was found for complicated root canal configurations in PMCIs. The most prevalent root canal system in PMCIs was Vertucci type I (84.4%) followed by type III (13.5%). A positive correlation between the presence of DLRs in PMFMs and complicated root canal configurations in PMCIs was noted. After adjusting for categoric variables including sex, age, and side, the odds ratios for the occurrence of complicated root canal configurations of PMCIs in the unilateral DLR group and the bilateral DLR group compared with the non-DLR group were 2.13 and 2.53, respectively. CONCLUSIONS: The concurrent appearance of DLRs in PMFMs and complicated root canal morphology in PMCIs is prominent in Taiwanese individuals.

Complicated Root Canal Morphology of Mandibular Lateral Incisors Is Associated with the Presence of Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in a Taiwanese Population.

INTRODUCTION: The aim of this study was to assess the root canal configurations in permanent mandibular lateral incisors (PMLIs) and the correlation between the root canal configurations of PMLIs with the appearance of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone-beam computed tomographic (CBCT) imaging. METHODS: A total of 1200 CBCT images (300 patients) of PMFMs and PMLIs were investigated. The frequency and distribution of DLRs in PMFMs along with root canal configurations of PMLIs were assessed ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMLIs with the appearance of a DLR in PMFMs. RESULTS: The prevalence of PMFMs with a DLR was 24.3%, and the incidence of complicated root canal configurations in PMLIs was 25.0%. The most prevalent root canal systems of PMLIs were Vertucci types I (75%) and III (23.0%). The incidence of complicated root canal configurations in PMLIs was 19.5% in the non-DLR group (ie, no DLR was found on either side of the PMFMs), 33.3% in the unilateral DLR (Uni-DLR) group (ie, a DLR was found in 1 of the PMFMs [the left or right side] and a DLR was not found on the other PMFM), and 39.8% in the bilateral DLR (Bil-DLR) group (ie, a DLR was found in both the right and left PMFMs). After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMLIs in the Uni-DLR and Bil-DLR groups compared with the non-DLR group were 2.12 (P = .003) and 2.707 (P < .001), respectively. CONCLUSIONS: The simultaneous appearance of DLRs in PMFMs and complicated root canal configurations in PMLIs is prominent in Taiwanese individuals. Clinicians should be aware of the correlation between the anatomic variants of PMFMs and PMLIs, which are important before endodontic treatment.

Complicated Root Canal Configuration of Mandibular First Premolars Is Correlated with the Presence of the Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in Taiwanese Individuals.

INTRODUCTION: The purpose of this study was to examine the frequency and bilateral consistency of distolingual roots (DLRs) in permanent mandibular first molars (PMFMs) and root canal configurations in PMFPs (permanent mandibular first premolars) and to determine the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs. METHODS: A total of 932 cone-beam computed tomographic images of PMFMs and PMFPs were collected from 233 patients. The frequency and bilateral consistency of DLRs in PMFMs along with root canal configurations (root number and canal number) of PMFPs were recorded and evaluated ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs. RESULTS: The prevalence of PMFMs with DLRs was 24.7%, and the incidence of complicated root canal configurations of PMFPs was 26.6%. The incidence of complicated root canal configurations of PMFPs was 19.6% in the non-DLR group, 37.2% in the unilateral DLR group, and 44.7% in the bilateral DLR group. After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMFPs in the unilateral DLR and bilateral DLR groups compared with the non-DLR group were 2.472 (95% confidence interval, 1.434-4.263; P = .001) and 3.392 (95% confidence interval, 1.976-5.823; P < .001), respectively. CONCLUSIONS: An increasing and corresponding trend between the presence of DLRs in PMFMs and complicated root canal configurations in PMFPs was noted in Taiwanese individuals. These results suggest that the clinicians should familiarize themselves with the anatomic variants of PMFMs and PMFPs before endodontic treatment.

Geometric features of second mesiobuccal canal in permanent maxillary first molars: a cone-beam computed tomography study.

BACKGROUND/PURPOSE: Inadequacy to locate the second mesiobuccal canal (MB2) canal leads to the highest probability of endodontic failure in permanent maxillary first molars (PMFMs) and still remains a constant challenge for many clinicians. The aim of this study was to characterize the geometrical features between MB2 and other orifices of examined PMFMs using cone-beam computed tomography images. MATERIALS AND METHODS: A total of 108 teeth qualified in the cone-beam computed tomography image archives were enrolled in the present study. The intersecting point (T) was determined as the perpendicular line (h, altitude of triangle) projected from the vertex of the MB2 canal orifice to mesiobuccal canal orifice-palatal canal orifice line (MB1-P). We measured the geometric features of PMFMs with the MB2 canal, including the interorifice distances, area, altitude, and the ratio between the canal orifices. RESULTS: The average interorifice distance was found to be 1.91 ± 0.59 mm for MB1-MB2, 5.73 ± 0.66 mm for MB1-P, and 4.11 ± 0.79 mm for MB2-P, with significant gender difference for MB1-MB2 distance. For the MB1-T distance, a significant difference was found between genders (P = 0.02), with males averaging 1.78 ± 0.07 mm, and females 1.48 ± 0.11 mm. For the MB1-P distance, the majorities of both genders were found in the 20-40% cut-off. A portion of the males exhibited a tendency towards the 40-80% cut-off, while females shifted in the reverse direction towards the 0-20% cut-off. CONCLUSION: In clinical scenarios, these anatomical characteristics of the root canals system could be beneficial to locating the MB2 canal.