Prevalence of Untreated Canals and Their Association with Periapical Periodontitis Using Cone-beam Computed Tomography

Introduction: Untreated canals represent the primary cause of treatment failure in molars and the second leading cause in other dental groups. This study determined the prevalence of untreated canals and their relationship with periapical periodontitis using cone-beam computed tomography (CBCT) images. Materials and Methods: 385 CBCT images with at least one treated canal were selected from the oral and maxillofacial radiology center. The number of roots and canals, presence, and size of periapical pathology, and presence of untreated canals were recorded. The study used descriptive statistics and Chi-square, Fisher's exact, and odds ratio tests to analyze data. Results: Of the 2053 teeth examined, 14.9% had at least one untreated canal. Untreated canals in teeth increase the chance of having a periapical lesion, raising the prevalence by 11 times. Of these, 91.8% had both untreated canals and periapical lesions. This was more than teeth without untreated canals (35.8%). Most untreated canals were in maxillary molars (65.3%), and mandibular molars (12.54%). There was a statistically significant relationship (P<0.001) between the number of roots, canals, expansion, destruction, and jaw type with the prevalence of untreated canals. The maxillary first molar (68.66%) and second mesiobuccal (MB2) canal (63.27%) had the highest percentages of untreated canals. Conclusions: The MB2 had the highest prevalence of untreated canals. The presence of untreated canals significantly increased the risk of expansion and/or destruction. Therefore, identifying these conditions can also be useful in diagnosing untreated canals. Dentists should assess the anatomy of the tooth and the structure of the root canal to minimize the possibility of an untreated canal. CBCT can assist in this process

Comparative Evaluation of Herbal and Commercial Toothpaste on Salivary pH and Streptococcus Mutans Count: A Randomized Crossover Clinical Trial

Objectives Enhancing dental health and oral hygiene is essential for preventing dental caries. Recently, there has been significant interest in using natural ingredients in oral care products. This study aimed to compare the effects of herbal toothpaste containing Saqqez oleo-gum resin essential oil with Sensodyne toothpaste on the colony count of Streptococcus Mutans (S. mutans) and salivary pH levels. Methods A randomized double-blinded clinical trial with a crossover design was conducted with 40 students aged 18-35 years who were caries-free. Initially, unstimulated saliva samples were collected to determine the baseline mutans streptococci count and salivary pH levels. In the first phase, participants were randomly divided into two groups: Group I received herbal toothpaste containing Saqqez oleo-gum resin essential oil, while Group II used Sensodyne toothpaste. After supervised tooth brushing, saliva samples were collected again to assess pH levels and S. mutans counts. Following a 72-hour washout period, the procedures were repeated with the groups switching toothpastes according to the crossover design. Data were analyzed using the Mann-Whitney U test and Wilcoxon matched pairs signed-rank test, at a significance level of p<0.05. Results A significant reduction in the S. mutans colony count and a significant increase in salivary pH levels were observed in both groups compared to their baseline values (P<0.05). However, no significant difference was found between the efficacy of the two toothpastes (P>0.05). Conclusion The effect of herbal toothpaste containing Saqqez essential oil on salivary pH and S. mutans level was comparable to that of commercial toothpaste evaluated in this study

Advanced Drug Delivery Platforms for the Treatment of Oral Pathogens

The oral cavity is a complex ecosystem accommodating various microorganisms (e.g., bacteria and fungi). Various factors, such as diet change and poor oral hygiene, can change the composition of oral microbiota, resulting in the dysbiosis of the oral micro-environment and the emergence of pathogenic microorganisms, and consequently, oral infectious diseases. Systemic administration is frequently used for drug delivery in the treatment of diseases and is associated with the problems, such as drug resistance and dysbiosis. To overcome these challenges, oral drug delivery systems (DDS) have received considerable attention. In this literature review, the related articles are identified, and their findings, in terms of current therapeutic challenges and the applications of DDSs, especially nanoscopic DDSs, for the treatment of oral infectious diseases are highlighted. DDSs are also discussed in terms of structures and therapeutic agents (e.g., antibiotics, antifungals, antiviral, and ions) that they deliver. In addition, strategies (e.g., theranostics, hydrogel, microparticle, strips/fibers, and pH-sensitive nanoparticles), which can improve the treatment outcome of these diseases, are highlighted