The Uptake of Nickel-Titanium Rotary Files in Saudi Arabia

Aim. We surveyed the uptake of nickel-titanium rotary files (NTRFs) among all dentists in Saudi Arabia. Methodology. A questionnaire encompassing endodontic performance and NTRF uptake was e-mailed to all members of the Saudi Dental Society. Data were collected from participants during a three-month period and were analyzed using χ2 tests and correlation coefficients. Level of significance was set at P = 0.05. Results. The overall response rate was 30.6% (n = 490), and 82.9% were found to perform root canal treatment (RCT). Among the 406 RCT performers, general dentists formed the bulk (45%). Among endodontists, 91.5% were using NTRF (P < 0.001). Those who graduated between 1991 and 2000 used NTRF more than any other group did (78.4%, P = 0.05). Graduates from Europe and Australia used NTRF most frequently (100%, P = 0.001), followed by those from North America (87%, P = 0.001), and finally by Saudi Arabian graduates (68.7%). Male respondents performed more endodontic procedures and used NTRF significantly more often than female respondents did (males: 73%; females: 56.2%) (P = 0.001). The most significant reasons for not using NTRF were “unavailability” (64.7%, P ≤ 0.05) and “lack of experience” (54.1%, P ≤ 0.001). Conclusions. We found that NTRF usage was not as widespread in Saudi Arabia as in other developing countries. Therefore, we suggest an improved implementation of NTRF in undergraduate and postgraduate curriculums and the provision of educational courses with a greater focus on this development

Gaining more insight into the determinants of candida species pathogenicity in the oral cavity

Candida infection (candidiasis) is potentially life threatening and can occur in almost all anatomical sites, including the mouth. Candida species are in fact the most common fungal pathogens isolated from the oral cavity and frequently cause superficial infections such as oral candidiasis and denture-associated erythematous stomatitis. Whilst systemic dissemination of Candida from intraoral foci is rare and largely due to severe deficits of the host immune defenses, the development of localized oral candidiasis is most commonly related to a variety of non-immune determinants such as Candida virulence factors and permissive oral microenvironment. In particular, phenotypic switching and dental biofilm have emerged as major determinants for the pathogenicity of Candida and are currently the subject ofintense research. An understanding of the molecular aspects underlying the biological behavior of Candida will be the key to the development of effective preventive as well as therapeutic measures for invasive and oral candidiasis

Antimicrobial activity of ProRoot MTA in contact with blood

Dental materials based on Portland cement, which is used in the construction industry have gained popularity for clinical use due to their hydraulic properties, the interaction with tooth tissue and their antimicrobial properties. The antimicrobial properties are optimal in vitro. However in clinical use contact with blood may affect the antimicrobial properties. This study aims to assess whether antimicrobial properties of the Portland cement-based dental cements such as mineral trioxide aggregate (MTA) are also affected by contact with blood present in clinical situations. ProRoot MTA, a Portland cement-based dental cement was characterized following contact with water, or heparinized blood after 1 day and 7 days aging. The antimicrobial activity under the mentioned conditions was assessed using 3 antimicrobial tests: agar diffusion test, direct contact test and intratubular infection test. MTA in contact with blood was severely discoloured, exhibited an additional phosphorus peak in elemental analysis, no calcium hydroxide peaks and no areas of bacterial inhibition growth in the agar diffusion test were demonstrated. ProRoot MTA showed limited antimicrobial activity, in both the direct contact test and intratubular infection test. When aged in water ProRoot MTA showed higher antimicrobial activity than when aged in blood. Antimicrobial activity reduced significantly after 7 days. Further assessment is required to investigate behaviour in clinical situations.ERDF (Malta) for the financing of the testing equipment through the project: “Developing an Interdisciplinary Material Testing and Rapid Prototyping R&D Facility” (Ref. no. 012)

PRISMA for abstracts: best practice for reporting abstracts of systematic reviews in Endodontology

An abstract is a brief overview of a scientific, clinical or review manuscript as well as a stand‐alone summary of a conference abstract. Scientists, clinician–scientists and clinicians rely on the summary information provided in the abstracts of systematic reviews to assist in subsequent clinical decision‐making. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) for Abstracts checklist was developed to improve the quality, accuracy and completeness of abstracts associated with systematic reviews and meta‐analyses. The PRISMA for Abstracts checklist provides a framework for authors to follow, which helps them provide in the abstract the key information from the systematic review that is required by stakeholders. The PRISMA for Abstracts checklist contains 12 items (title, objectives, eligibility criteria, information sources, risk of bias, included studies, synthesis of results, description of the effect, strength and limitations, interpretation, funding and systematic review registration) under six sections (title, background, methods, results, discussion, other). The current article highlights the relevance and importance of the items in the PRISMA for Abstracts checklist to the specialty of Endodontology, while offering explanations and specific examples to assist authors when writing abstracts for systematic reviews when reported in manuscripts or submitted to conferences. Strict adherence to the PRISMA for Abstracts checklist by authors, reviewers and journal editors will result in the consistent publication of high‐quality abstracts within Endodontology

Comparing ProFile Vortex to ProTaper Next for the efficacy of removal of root filling material: An ex vivo micro-computed tomography study

Aim: This study compared the efficacy of ProFile Vortex (PV) with that of ProTaper Next (PTN) for the removal of root canal filling material. Materials and methods: Twenty-six mesial canals of extracted mandibular first molars were instrumented, obturated with gutta-percha and sealant, and randomly allocated to a PTN (X3, X2, or X1) or PV group. The percentage of remaining material, amount of dentin removed, and extent of transportation were assessed using micro-computed tomography. The total time required for removal of material was calculated. Results: Both systems were effective for material removal (p ≤ 0.001). Less time was required to remove material using PV (256.43 ± 108.95 s) than using PTN (333.31 ± 81.63 s; p ≤ 0.05). PV and PTN files removed approximately 84% and 78% of the filling material, respectively (p > .05). There was no significant canal transportation in either group. PV and PTN files removed 1.32 ± 0.48 mm3 and 1.63 ± 0.67 mm3 of the dentin, respectively (p = .18). Conclusion: Our findings suggest that PV is as effective as PTN for removal of root canal filling material. Therefore, PV can be considered for use in endodontic retreatment, although more effective files or techniques are still required. Keywords: Endodontics, Retreatment, Profile vortex, Root canal, Obturation, ProTaper Next, Rotary fil

A Micro-Computed Tomography Study of the Root Canal Morphology of Mandibular First Premolars in an Emirati Population

ObjectiveTo investigate variations in the root canal morphology of mandibular first premolars in a population from the United Arab Emirates using micro-computed tomography (micro-CT) and conventional radiography.Materials and methodsThree-dimensional images of 50 extracted human mandibular first premolars were produced using a micro-CT scanner, and conventional radiography was also used to record the number of roots, the root canal system configuration, the presence of a C-shaped canal system and lateral canals, intercanal communications, and the number and location of apical foramina. The interpretations of micro-CT and conventional radiography were statistically analyzed using Fisher's exact test.ResultsVariable root canal configurations based on Vertucci's classification were observed in the teeth (i.e., types I, III, IV, V, and VII). The examined teeth exhibited the following 2 additional root canal configurations, which did not fit Vertucci's classification: type 1-2-3 and type 1-3. A C-shaped canal configuration was present in 14 (28%) cases, and lateral canals were present in 22 (44%) cases. Apical deltas were found in 25 (50%) cases, intercanal communications were seen in 6 (12%) cases, and apical loops were seen in 2 (4%) of the samples. Micro-CT and X-ray imaging identified 39 (78%) and 34 (68%) apical foramina, respectively. A single apical foramen was detected in 33 (66%) samples, and 2 or 3 apical foramina were detected in 14 (28 %) and 3 (6%) samples, respectively. In 18.5 (37%) samples the apical foramina were located centrally, and in 31 (62%) they were located laterally.ConclusionA complex morphology of the mandibular first premolars was observed with a high prevalence of multiple root canal systems

Efficacy of the Rotary Instrument XP-Endo Finisher in the Removal of Calcium Hydroxide Intracanal Medicament in Combination with Different Irrigation Techniques: A Microtomographic Study

Objectives: This study aims to evaluate the efficacy of the rotary instrument XP-endo Finisher for the removal of Ca(OH)2 aided by different irrigation regimens. Methods: Sixteen double-rooted upper premolar human teeth were selected for the study. Thirty-two canals were prepared using a ProTaper Next rotary system up to X3. Then, the canals were filled with Ca(OH)2. The volume of Ca(OH)2 inside the canals was measured by microcomputed tomography (micro-CT). After that, the teeth were randomly allocated into two experimental groups, i.e., A and B (n = 16 canals). In group A, Ca(OH)2 was removed using the master apical file (X3). In group B, Ca(OH)2 was removed using a XP-endo finisher. In half of both groups (n = 8), syringe irrigation (SI) was used, while passive ultrasonic irrigation (PUI) was used for the other half. After removal, the remaining volume of Ca(OH)2 was measured. All data were statistically analyzed using two-way ANOVA with Tukey&rsquo;s post hoc test. Results: The percentages of remaining Ca(OH)2 in the apical thirds of all canals were significantly higher as compared with the middle and coronal thirds in all groups (p &lt; 0.05). There was no significant difference between different files and techniques (p &gt; 0.05). Clinical Significance: This study presents a new method for the removal of Ca(OH)2 from root canals

A Micro-Computed Tomography Study of the Root Canal Morphology of Mandibular First Premolars in an Emirati Population

ObjectiveTo investigate variations in the root canal morphology of mandibular first premolars in a population from the United Arab Emirates using micro-computed tomography (micro-CT) and conventional radiography.Materials and methodsThree-dimensional images of 50 extracted human mandibular first premolars were produced using a micro-CT scanner, and conventional radiography was also used to record the number of roots, the root canal system configuration, the presence of a C-shaped canal system and lateral canals, intercanal communications, and the number and location of apical foramina. The interpretations of micro-CT and conventional radiography were statistically analyzed using Fisher's exact test.ResultsVariable root canal configurations based on Vertucci's classification were observed in the teeth (i.e., types I, III, IV, V, and VII). The examined teeth exhibited the following 2 additional root canal configurations, which did not fit Vertucci's classification: type 1-2-3 and type 1-3. A C-shaped canal configuration was present in 14 (28%) cases, and lateral canals were present in 22 (44%) cases. Apical deltas were found in 25 (50%) cases, intercanal communications were seen in 6 (12%) cases, and apical loops were seen in 2 (4%) of the samples. Micro-CT and X-ray imaging identified 39 (78%) and 34 (68%) apical foramina, respectively. A single apical foramen was detected in 33 (66%) samples, and 2 or 3 apical foramina were detected in 14 (28 %) and 3 (6%) samples, respectively. In 18.5 (37%) samples the apical foramina were located centrally, and in 31 (62%) they were located laterally.ConclusionA complex morphology of the mandibular first premolars was observed with a high prevalence of multiple root canal systems