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

OBJECTIVE: This study aimed to identify and characterize root and canal morphology and the prevalence of C-shaped canals of mandibular second molars (MSMs) in a Yemeni population using cone-beam computed tomography (CBCT). METHODS: Three-dimensional digital images of 500 MSMs with mature roots were taken from 250 Yemeni individuals and analyzed for the following features: number of roots, shape and type of roots, type of canal configuration in each root, prevalence of C-shaped canal, and primary variations in the morphology of root and canal systems. Chi square and Fisher's exact tests were employed for statistical analysis. RESULTS: 89.6% of MSMs had two separate roots, 9% had two fused roots, 0.6% had three separate roots and 0.8% had one root. Mesial root was mostly ribbon-shaped (60.5%) and distal root was mostly kidney-shaped (50.7%). Type II and Type I canal configurations were the most frequent in mesial (56.9%) and distal (91.3%) roots, respectively. C-shaped canals were found in 9%. Six variants were found with variant 3 being the most common (71%). CONCLUSION: Yemeni MSMs are mainly two-rooted. The prevalence of three- and one-rooted MSMs was relatively low. Various canals configurations were found in MSMs among this sample of Yemeni population. The clinicians should consider C-shaped roots and canals when treating Yemeni MSMs and should be aware of their morphological variations to ensure successful root canal treatment. Although bilateral similarity of many anatomical features of MSMs was found, individual evaluation of each MSM is necessary while performing endodontic treatment on both sides.

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.

Perception and confidence levels among dental students and interns in performing various endodontic procedures / Niveles de percepción y confianza entre estudiantes de odontología y pasantes en la realización de diversos procedimientos de endodoncia

Aim: The present study aimed to collect information from senior students and new interns enrolled at the College of Dentistry, University of Science and Technology (UST), regarding their confidence levels in performing endodontic treatments. Materials and Methods: Anonymous surveys were distributed to 40 senior students and 37 new interns at UST, in Sana'a, Yemen. They were asked to indicate their self-confidence level using a Likert scoring system ranging from 1 and 5. Mann-Whitney U test and chi-squared test were used to determine statistical significance between the studied groups. Results: 37.5% of students and 35.1% of interns rated endodontic practice as difficult. Only 55% of students found that the number of treated cases were satisfactory, similar to that reported by interns (56.8%). There were no statistically significant differences between both groups regarding self-confidence levels for most endodontic procedures (p<0.05). Placing of a rubber dam, followed by managing inter-appointment flare-ups were procedures in which both groups reported the lowest confidence. On the other hand, both groups felt the lowest confidence in the treatment of maxillary followed by mandibular molars. Statistically significant differences were reported between the two groups for performing root canal treatments (RCT) (p< 0.05). Self-confidence levels on the management of most different indications showed no statistically significant differences between both groups (p>0.05) with exception to the management of irreversible pulpitis, necrotic pulp, asymptomatic apical periodontitis, chronic abscess, and traumatic cases, in which significant differences were noticed (p<0.05). Immature apices, root resorption, endodontic-periodontal (EP) lesions, trauma, symptomatic apical periodontitis and acute abscess were ranked as the cases in which both groups reported the lowest confidence. Canal blockage and ledge formation were the main mishaps encountered during practice among students and interns. Conclusion: Students and interns displayed neutral confidence in performing endodontic treatments.

Objetivo: El presente estudio tuvo como objetivo recopilar información de estudiantes de último año y nuevos pasantes inscritos en la Facultad de Odontología, Universidad de Ciencia y Tecnología (UST), con respecto a sus niveles de confianza en la realización de tratamientos de endodoncia. Materiales y métodos: se distribuyeron encuestas anónimas a 40 estudiantes de último año y 37 nuevos pasantes en UST, en Sana'a, Yemen. Se les pidió que indicaran su nivel de confianza en sí mismos utilizando un sistema de puntuación Likert que oscilaba entre 1 y 5. Se utilizaron la prueba U de Mann-Whitney y la prueba de ji al cuadrado para determinar la significación estadística entre los grupos estudiados. Resultados: el 37.5% de los estudiantes y el 35.1% de los pasantes calificaron la práctica de endodoncia como difícil. Solo el 55% de los estudiantes encontró que el número de casos tratados fue satisfactorio, similar al reportado por los pasantes (56.8%). No hubo diferencias estadísticamente significativas entre ambos grupos con respecto a los niveles de autoconfianza para la mayoría de los procedimientos de endodoncia (p<0.05). La colocación de una presa de goma, seguida de la gestión de brotes entre citas, fueron procedimientos en los que ambos grupos informaron la menor confianza. Por otro lado, ambos grupos sintieron la menor confianza en el tratamiento del maxilar seguido de los molares mandibulares. Se informaron diferencias estadísticamente significativas entre los dos grupos para realizar tratamientos de conducto radicular (ECA) (p<0.05). Los niveles de autoconfianza en el manejo de la mayoría de las indicaciones diferentes no mostraron diferencias estadísticamente significativas entre ambos grupos (p>0.05) con excepción del manejo de pulpitis irreversible, pulpa necrótica, periodontitis apical asintomática, absceso crónico y casos traumáticos, en los cuales se notaron diferencias (p<0.05). Los ápices inmaduros, la reabsorción radicular, las lesiones endodóncicas-periodontales (EP), los traumatismos, la periodontitis apical sintomática y el absceso agudo se clasificaron como los casos en que ambos grupos informaron la menor confianza. El bloqueo del canal y la formación de repisas fueron los principales percances encontrados durante la práctica entre estudiantes y pasantes. Conclusión: los estudiantes y los pasantes mostraron una confianza neutral en la realización de tratamientos de endodoncia.

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.

Tensile stress distribution in maxillary central incisors restored with cast-made and prefabricated dental posts

AIM: To analyze and compare the tensile stress distribution in endodontically treated teeth restored with cast-made (Ni-Cr and gold) and prefabricated (titanium and glass fibre) dental posts. METHODOLOGY: Four threedimensional finite element (FE) models of a maxillary central incisor restored with Ni-Cr cast-made (Model Ni-Cr), gold cast-made (Model GO), prefabricated titanium (Model TI) and prefabricated glass fibre (Model FP) posts were constructed. An oblique loading of 100N was applied to each three-dimensional model. Tensile stress distribution within the root dentine and at the post and surrounding structure interfaces were analysed. RESULTS: In all the FE models studied, a higher magnitude of tensile stresses was observed on the palatal aspect of the cervical dentin as compared to the labial aspect and progressively decreases from the outer to the inner part of the root. The gold cast-made and glass fibre post models showed significantly less tensile stress concentration in the post-core component than the other experimental models. The maximum tensile stress was seen on the palatal aspect of the Ni-Cr compared to other posts. The higher magnitude interfacial tensile stress concentration was observed in a pulpless tooth restored with a Ni-Cr cast-made post, followed by titanium and gold castmade posts, respectively. However, the minimum interfacial tensile stress was noticed in a pulpless tooth restored with a glass fibre post. CONCLUSION: Glass fibre posts tend to transfer tensile stress more homogenously within the tooth and at interfaces than the other types of investigated posts.

Cross-sectional assessment of the periapical status as related to quality of root canal fillings and coronal restorations in a Yemeni population

Aim: the present study aimed to examine the influence of the quality of root canal fillings and coronal restorations on the prevalence of periapical lesions. Materials and Methods: Two hundred digital panoramic radiographs were obtained from the archive of Al‑HamziDental Center in Sana’a, Yemen. The final sample consisted of 120 radiographs, and 675 root filled teeth.The quality of root canal fillings was scored according to criteria of length, homogeneity and taper. Coronal status (type of restoration, signs of marginal leakage or decay) was also evaluated. The periapical status was categorized on the basis of presence or absence of radiographical signs of apical periodontitis. Chi-square test was used to determine statistical significance between different parameters. Results: We found that 93.6 percent of root filled teeth were associated with apical periodontitis. Only 9.2 percent of root filled teeth were found to have an acceptable standard of root canal fillings, of which 32.3 percent was also associated to signs of periapical disease. In roots with an unacceptable root canal filling, 95.4 percent had periapical disease. Teeth with good (14.4 percent) and poor (32.9 percent) intra-coronal restorations had apical periodontitis in 93.8 percent and 97.7 percent of cases, respectively. Crown restorations were present in 52.7 percent of root filled teeth, of which 91.0 percent were associated with periapical lesions. Conclusion: The poor technical quality of root canal fillings and coronal restorations is consistent with a high prevalence of apical periodontitis.

Radiographic evaluation of root canal fillings in a selected Yemeni population: a retrospective study / Evaluación radiográfica de tratamientos de endodoncia realizados en una población Yemení: estudio retrospectivo

Abstract: aim: to assess the root canal filling quality performed by general dental practitioners in Yemen through radiographic evaluation. Materials and Methods: Four hundred fifty-five digital panoramic radiographs were selected from the archive of the Dental Health Center in Sana'a, Yemen. The final sample consisted of 221 patients, 685 teeth, and 977 root canals. The criteria for overall radiographic adequacy of root canal fillings were defined as the presence of adequate length, density and taper, and absence of iatrogenic errors (ledges, transportations and perforations). Chi-square test was used to determine statistical significance between different parameters. Results: This study considered only radiographic criteria for evaluation of the root canal fillings. The percentage of root canal fillings with adequate length, density and taper was 30.8 percent, 29.6 percent and 20.7 percent, respectively. Considering the incidence of iatrogenic errors, perforations were present in 12 root canals (1.2 percent), while the presence of transportations was observed in 20 root canals (2.0 percent). However, ledges were no detected in any root canals. Conclusion: The root canal filling quality performed by general dental practitioners in Yemen is poor.

Resumen: objetivo: evaluar a través de la evaluación radiográfica la calidad de los tratamientos de endodoncia realizados por odontólogos generales en Yemen. Materiales y Métodos: Cuatrocientos cincuenta y cinco radiografías panorámicas digitales fueron seleccionados desde el archivo del Centro de Salud Dental en Sana'a, Yemen. La muestra final fue de 221 pacientes, 685 dientes y 977 endodoncias. Los criterios de adecuación radiográfica general de los tratamientos de endodoncia se definieron como la presencia de longitud adecuada, la densidad y la forma cónica y la ausencia de errores iatrogénicos (proyecciones, transportaciones y perforaciones). Se utilizó la prueba de chi-cuadrado para determinar la significación estadística entre los diferentes parámetros. Resultados: En este estudio se consideró sólo criterios radiológicos para la evaluación de las obturaciones del conducto radicular. El porcentaje de obturaciones del conducto radicular con la longitud adecuada, la densidad y la forma cónica fue del 30,8 por ciento, 29,6 por ciento y 20,7 por ciento, respectivamente. Teniendo en cuenta la incidencia de errores iatrogénicos, las perforaciones estaban presentes en 12 tratamientos (1,2 por ciento), mientras que se observó la presencia de transportaciones en 20 tratamientos (2,0 por ciento). Sin embargo, las proyecciones no fueron detectadas en ningún tratamiento. Conclusión: La calidad de los tratamientos de endodoncia realizados por dentistas generales de Yemen es pobre.