Outcomes of endodontic microsurgery using different calcium silicate-based retrograde filling materials: a cohort retrospective cone-beam computed tomographic analysis.

PURPOSE: To evaluate the outcomes of endodontic microsurgery (EMS) using mineral trioxide aggregate (MTA; Dentsply Sirona, Charlotte, NC, USA), EndoSequence root repair material (RRM putty; Brasseler, Savannah, GA), and injectable Bioceramic (BC) sealer (Brasseler USA) followed by the application of RRM putty (lid technique) as root-end filling materials. METHODS: One hundred and ten patients who underwent EMS between 2016 and 2020 at King Abdulaziz University Dental Hospital were recruited for clinical and radiographic follow-up after a minimum of 1 year. Radiographic assessment was performed using periapical radiographs (PAs) and cone-beam computed tomography (CBCT). Volumetric analysis of periapical radiolucencies (PARLs) was performed using Amira software. RESULTS: Seventy-nine patients (103 teeth: MTA group, n = 28; RRM putty, n = 41; lid technique, n = 34), attended the follow-up visit, with an average follow-up period of 24 months (recall rate = 74.5%). Of the 103 teeth, 40 were anteriors, 24 were premolars, and 39 were molars. All three groups of retrograde filling materials (MTA, RRM putty, and lid technique) showed high success rates on both PA (85.7, 85.4, 94.1%, respectively) and CBCT imaging (67.9, 75.6, 88.2%, respectively), without any significant difference among the success rates of different materials. Overall, a slight agreement was noted between the PA and CBCT outcomes, with a statistically significant difference (P = 0.029). None of the patient-, tooth-, or treatment-related factors significantly influenced the outcomes of EMS. Adequate density of root canal filling material was significantly associated with a high percentage of completely healed cases on CBCT (P = 0.044). PARL volumes were reduced significantly over 1-4 years follow-up after EMS (P < 0.001) CONCLUSIONS: EMS showed high success rates on both PA and CBCT when MTA, RRM putty or lid technique were used as retrograde filling materials. CBCT imaging is more precise than PA in detecting the healing outcomes of EMS.

Prevalence and Pattern of Idiopathic Osteosclerosis and Condensing Osteitis in a Saudi Subpopulation.

Background This study aims to investigate the prevalence and pattern of idiopathic osteosclerosis (IO) and condensing osteitis (CO) in the jaws of a Saudi Arabian subpopulation with regards to gender, age, shape, localization, and tooth relationship. Methodology Digital panoramic and periapical radiographs with clinical data of 1,000 patients at King Abdulaziz University Dental Hospital were analyzed to determine the incidence of IO and CO lesions in relation to age, gender, location in the jaws, and dental status of the associated tooth. Descriptive statistics and chi-square tests were used for data analysis. Results Out of the 752 patients (495 females, 257 males), IO was identified in 66 (8.8%) patients, while 44 (5.9%) patients had CO. IO occurred more in females (68.2%) than males (31.8%). CO had a statistically significant higher rate of occurrence in females (81.8%) than males (18.2%) (P ≤ 0.05). IO and CO lesions were observed to be higher in individuals in their third decade, and 100% were in the mandibular molar area. Almost half of the identified IO (48.5%) had a rounded shape radiopacity, while CO mostly appeared irregular (63.6%). Conclusions The prevalence of IO and CO in the studied Saudi subpopulation was low. Both lesions were more frequent in females in their third decade and were primarily found in the mandibular molar region.

Pulpal and periapical tissue response after direct pulp capping with endosequence root repair material and low-level laser application.

BACKGROUND: The study aims to investigate the pulp and periapical reaction and healing after capping with EndoSequence Root Repair Material (ERRM) combined with low-level laser application. METHODS: In 6 rabbits, pulps were exposed via class V, half of the samples received a low-level diode laser at 980 nm. Thereafter, cavities were capped with regular-set ERRM. The specimens were processed for histomorphological examination after 2 weeks and two months. RESULTS: After 2 weeks, images show mild inflammation and organized odontoblasts in lased group. The non-lased group shows more severe inflammation. The predentin thickness was thicker in the lased group with statistical significance (p < 0.05). After 2 months, inflammatory cells were sparse in both lased and non-lased groups. In the periapical area, group one showed dilated blood vessels and thick fibrous connective tissues. In group two, there were more numerous maturations of PDL fibers with scattered inflammatory cells and congested blood vessel. CONCLUSIONS: Using low-level laser therapy in combination with ERRM for pulp capping shortens the inflammatory phase and enhances healing.