Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review.

INTRODUCTION: Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population. METHODOLOGY: An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies. RESULTS: The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 µm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 µm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology. CONCLUSION: This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.

Assessment of the Efficacy of Different Desensitizing Agents on Dentinal Tubules Occlusion- An In vitro Study.

Aim: The aim of the current research was to evaluate the effectiveness of three desensitizing agents on the occlusion of dentinal tubules. Materials and Methods: Eighty human maxillary and mandibular permanent premolar teeth that were subjected to extraction in the course of orthodontic treatment were utilized in this study. The teeth were subjected to sectioning by employing a double-sided diamond disk. A block was procured from every even cervical dentinal surface with dimensions of 4 mm × 4 mm × 3 mm (L × B × H) by sectioning the tooth transversely. Further, 35% phosphoric acid was utilized for 30 s to cause dentinal etching, thereby exposing the dentinal tubules. The blocks of dentin were assigned at random to one of the following four groups (n = 20): group I: control, group II: bioactive glass containing desensitizing agent, group III: 1% nano-hydroxyapatite containing desensitizing agent, group IV: tri-calcium phosphate-containing desensitizing agent. The exterior of the specimens was scanned and evaluated using a scanning electron microscope. Results: 1% nano-hydroxyapatite-containing desensitizing agent (2.04 ± 0.08) exhibited higher mean dentinal tubular blockage, followed by the bioactive class-containing desensitizing substance (2.26 ± 0.19), tri-calcium phosphate desensitizing agent (2.84 ± 0.10), and the control group (4.18 ± 0.12) in that order. Amid the experimental groups employing the various desensitizing substances, there were significant differences statistically with P < 0.001. Conclusion: The current research concluded that each of the three desensitizing agents was efficient in dentinal tubular occlusion regardless of their different chemical constitution. However, it was noted that 1% nano-hydroxyapatite-containing desensitizing agent was marginally superior to the bioactive glass- and tri-calcium phosphate-containing desensitizing agents.

A Conservative Management Approach for Unusual Presentation of Oral Actinomycosis.

Actinomycosis is gram-positive saprophytic infection that is characterized by chronic suppurative and granulomatous lesion. It could be found in the oral cavity, lungs, colon, and genital area. In the oral cavity, it is commonly associated with infected root canals presented as persistent infections. This case reports demonstrate an atypical presentation of actinomycosis in the lower left mandibular canine/premolar area showing painless soft tissue lesion associated with bone sequestration. Nonsurgical curettage of the lesion followed by nonsurgical root canal treatment and retreatment to the offended teeth was determined as the treatment modality for this case.

Comparative evaluation of push-out bond strength of ProRoot MTA, bioaggregate and biodentine.

OBJECTIVE: To evaluate the push-out bond strength of Biodentine (BD) in comparison with two available calcium silicate based materials, bioaggregate (BA) and ProRoot MTA (WMTA). MATERIALS AND METHODS: One hundred and twenty-three Root dentin slices of freshly extracted single Rooted human teeth were randomly divided into three groups (n = 41) according to the used test material: WMTA, BA, BD. After canal space preparation, the filling materials were placed inside the lumen of the slices. After 72 hours, the maximum force applied to materials at the time of dislodgement was recorded and slices were then examined under a stereomicroscope at ×40 magnification to determine the nature of bond failure. Analysis of variance (ANOVA) test was used to compare means of push-out bond strength. Post-hoc test was then accomplished for multiple comparisons. Chi-square test was used to determine if there is significant association between the type of material and type of failure. RESULTS: The mean push-out bond strength ± standard deviation in MPa values of WMTA, BA and BD were 23.26 ± 5.49, 9.57 ± 3.45, 21.86 ± 6.9, respectively. There was no significant difference between the means of WMTA and BD (p = 0.566), but the mean of BA was significantly lower than those of WMTA and BD (p = 0.000). Under stereomicroscope, WMTA and BA showed a majority of mixed type of failure than cohesive failure, while BD showed the opposite. No adhesive failure was observed in any specimen. CONCLUSION: The findings of the present study imply that the force needed for BD displacement is similar to WMTA and significantly higher than the force required to displace BA.