Cone-beam computed tomography study of root and root canal morphology using new classification in three ethnic groups in Kelantan, Malaysia

Adequate knowledge and comprehensive understanding of the root canal system is an essential pre-requisite for endodontic treatment. It is a general conviction that both maxillary and mandibular anterior teeth have single roots encasing single canals. However, literature shows higher prevalence of two canals in mandibular incisors which varies according to ethnicity, gender and age. Hence the aim of this study was to evaluate the root and canal morphology in Malaysian sub-population using cone beam computed tomography (CBCT) interpreted using two different classification systems. CBCT images of 856 patients with age ranging from 14 to 70 years, having 10080 anteriors were examined using software Romexis ver.2.9 (Planmeca Promax 3D). The number of roots and the root canal morphology of permanent anterior teeth were determined in different planes [coronal, axial and sagittal] and classified using Vertucci’s and Ahmed et al classification systems. Pearson Chi-square/Fisher’s exact tests were used for statistical analysis (P=0.05). According to Ahmed et al and Vertucci’s classifications, code 1MA1(MA- maxillary anteriors) and Type I were the most common in maxillary anteriors (98.2%), mandibular central incisors (64.7%) and canines (90.5%) respectively, whereas code 1MD1-2-1 (MD- mandibular anteriors) and Type III were the most common in mandibular lateral incisors (51%). Several Vertucci’s non-classifiable variations were identified which were classified using the new system. These include codes 1MD2-1-2-1(2.1%), and 1MD2-1-2-1-2-1 (0.1%). Two-rooted mandibular canines were identified in six samples. The prevalence of root canal variations in mandibular incisors was higher in males compared to females (P<0.001), Malay followed by Chinese and Indians (P<0.001), and in 20-30 age group as compared to other age groups (P<0.001). No significant difference was found in maxillary anteriors. Mandibular anteriors show a wide range of root and canal anatomical variations. The complexity of the root canal configuration is significantly affected by sex, ethnicity and age. The new classification system provides a simple and accurate presentation of the root canal morphology, especially in cases where complex root canal morphology is present

Computer Vision Syndrome: Will the Pandemic Lead to Eye Problems for Dentists?

Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features

A Multicultural Demographic Study to Evaluate the Impact of the SARS-CoV-2 Pandemic on the Job Satisfaction across the Dental Industry

Objective:&nbsp;To evaluate the difference in working conditions as perceived by dentists during the pandemic and their professional satisfaction levels.&nbsp;Material and Methods:&nbsp; An online survey was conducted using the convenience and snowball sampling methods. Two hundred seventy-two respondents across various countries answered information related to socio-demographic data and work satisfaction levels during the SARS-CoV-2 pandemic.&nbsp;Results:&nbsp;40.1% of dentists reported dissatisfied with their current work, while another 13.6% of dentists fell in the extremely dissatisfied category. 22.8% of dentists were significantly dissatisfied with their current income. Furthermore, 38.4% of the dentists were dissatisfied with physical working conditions, while 33.5% reported dissatisfaction with the freedom of working methods.&nbsp;Conclusion:&nbsp;This study was focused on the connection between various intrinsic and extrinsic factors affecting working conditions, social interactions, and psychological stresses. From the findings of this multicultural study, we can see that dentists across different countries have been affected and have varying levels of dissatisfaction. Therefore, regulatory authorities must plan for support and interventional programs to help dental professionals pass this difficult period

Synthesis of Silver Nanoparticles from Extracts of Wild Ginger (Zingiber zerumbet) with Antibacterial Activity against Selective Multidrug Resistant Oral Bacteria

Antibiotic resistance rate is rising worldwide. Silver nanoparticles (AgNPs) are potent for fighting antimicrobial resistance (AMR), independently or synergistically. The purpose of this study was to prepare AgNPs using wild ginger extracts and to evaluate the antibacterial efficacy of these AgNPs against multidrug-resistant (MDR) Staphylococcus aureus, Streptococcus mutans, and Enterococcus faecalis. AgNPs were synthesized using wild ginger extracts at room temperature through different parameters for optimization, i.e., pH and variable molar concentration. Synthesis of AgNPs was confirmed by UV/visible spectroscopy and further characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy analysis (EDXA), and Fourier-transform infrared spectroscopy (FTIR). Disc and agar well diffusion techniques were utilized to determine the in vitro antibacterial activity of plant extracts and AgNPs. The surface plasmon resonance peaks in absorption spectra for silver suspension showed the absorption maxima in the range of 400–420 nm. Functional biomolecules such as N–H, C–H, O–H, C–O, and C–O–C were present in Zingiber zerumbet (Z. zerumbet) (aqueous and organic extracts) responsible for the AgNP formation characterized by FTIR. The crystalline structure of ZZAE-AgCl-NPs and ZZEE-AgCl-NPs was displayed in the XRD analysis. SEM analysis revealed the surface morphology. The EDXA analysis also confirmed the element of silver. It was revealed that AgNPs were seemingly spherical in morphology. The biosynthesized AgNPs exhibited complete antibacterial activity against the tested MDR bacterial strains. This study indicates that AgNPs of wild ginger extracts exhibit potent antibacterial activity against MDR bacterial strains

Diagnostic Accuracy of Pulp Vitality Tests and Pulp Sensibility Tests for Assessing Pulpal Health in Permanent Teeth: A Systematic Review and Meta-Analysis

he current systematic review and meta-analysis was carried out to compare the diagnostic accuracy of pulp vitality and pulp sensibility tests in assessing pulpal health. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar and Open Grey databases were searched and after assessing eligibility criteria the data were extracted. True-positive, false-positive, true-negative, false-negative, sensitivity and specificity values were extracted or calculated if not presented. Quality of studies was evaluated based on the QUADAS 2 tool. Metaanalysis was performed in MetaDTA (v2.0; Shinyapps, RStudio PBC, Boston, MA, USA) and Review Manager 5.3 (RevMan web; The Cochrane Collaboration, London, UK). Ten articles were included for qualitative synthesis and five for meta-analysis. The pooled diagnostic odds ratio for pulse oximeter (PO), electric pulp tester (EPT), cold test (CT) and heat test (HT) was 628.5, 10.75, 17.24 and 3.47, respectively. Pairwise comparison demonstrated a higher pooled mean sensitivity and specificity with PO compared with EPT. Comparison between PO and CT and between PO and HT also demonstrated a higher pooled mean sensitivity and specificity for PO. Summary points on receiver operating characteristic curves confirmed the ability of PO to correctly screen negatives in presenting patients as compared to EPT, CT and HT but no study was rated as good on quality assessment. PO can be considered as the most accurate diagnostic method as compared to EPT, CT and HT. This review provides information about the reliability and diagnostic accuracy of using pulp vitality and sensibility tests for assessing pulp status

Evaluation of bi-lateral co-infections and antibiotic resistance rates among COVID-19 patients

In addition to the pathogenesis of SARS-CoV-2, bacterial co-infection plays an essential role in the incidence and progression of SARS-CoV-2 infections by increasing the severity of infection, as well as increasing disease symptoms, death rate and antimicrobial resistance (AMR). The current study was conducted in a tertiary-care hospital in Lahore, Pakistan, among hospitalized COVID-19 patients to see the prevalence of bacterial co-infections and the AMR rates among different isolated bacteria. Clinical samples for the laboratory diagnosis were collected from 1165 hospitalized COVID-19 patients, of which 423 were found to be positive for various bacterial infections. Most of the isolated bacteria were Gram-negative rods (n = 366), followed by Gram-positive cocci (n = 57). A significant association (p 50% of COVID-19 patients were fever, fatigue, dyspnea and chest pain with a significant association (p < 0.05) in bacterial co-infected patients. The current study results showed a comparatively high prevalence of AMR, which may become a severe health-related issue in the future. Therefore, strict compliance of antibiotic usage and employment of antibiotic stewardship programs at every public or private institutional level are recommended

Rare non‐syndromic bilateral maxillary and mandibular permanent canine agenesis

Abstract Oligodontia or absence of teeth such as the Canines is rare and is often accompanied with several other missing teeth. This condition may also be accompanied with morphological and growth related changes in the teeth and the maxillofacial complex. Complete agenesis of the permanent canines in the maxilla and the mandible is extremely rare and occurs in association with syndromic oligodontia. Non‐syndromic absence of canines however, is extremely rare and has only been reported twice. Studies have shown that the incidence of missing canines is more in females. This report describes a sporadic case of congenital absence of maxillary and mandibular bilateral canines. The patient reported to the clinic with a chief complaint of crowding and wanted alignment. On intra‐oral examination it was observed that the patient had all permanent canines missing with no prior history of extractions, crowding in both the arches and class I molars on both sides. With no other symptoms fixed orthodontic therapy was planned for the patient with premolars substituted for the canines

Endodontic Clinical Diagnostic Skills amongst Undergraduate Dental Students: Cross-Sectional Study

The purpose of the study was to evaluate the clinical endodontic diagnostic skills amongst undergraduate dental students at pre-clinical and clinical levels at Cardiff University School of Dentistry. An online questionnaire containing eight questions about endodontic diagnosis and hypothetical clinical scenarios was sent to all year 3rd, 4th, and 5th-year undergraduate dental students who were divided into G1, G2, and G3 groups. The data were analysed descriptively and reported in percentages. Around 121 students out of 226 responded to the questionnaire with a response rate of 53.5%. The overall correct response from G1 (3rd year) was 31.6% to 65.8%, G2 (4th year) was 73% to 93%, and G3 (5th year) was 73.2% to 92.7%. The study concludes that the 4th and 5th-year undergraduate dental students&rsquo; responses to the hypothetical clinical scenarios were higher than the 3rd-year students. However, regarding questions about the endodontic diagnosis, the percentages of correct answers were similar among all the 3rd, 4th, and 5th-year students. Therefore, further studies assessing endodontic diagnostic skills amongst the same cohort of students during their progression in the undergraduate course are recommended

Crossover Analysis of the Astringent, Antimicrobial, and Anti-inflammatory Effects of Illicium verum/Star Anise in the Oral Cavity

Introduction. Illicium verum commonly known as star anise has been widely used in many Asian countries for pharmaceutical treatment for many diseases. The aim of the present study was to investigate the anti-inflammatory, astringent, and antimicrobial properties of an Illicium verum mouthwash. Methods. The present double blinded randomized clinical trial was conducted on fifty subjects, divided into groups A and B. Illicium verum mouthwash (group A) and placebo (group B) were provided to subjects for 21 days; after 14 days, washout period mouthwashes were switched as per crossover design between groups for 21 days. The gingival index (GI), papillary bleeding index (PBI), and oral microbial count were recorded at each stage of study. Results. The significant intragroup difference was observed, before crossover in group A and after crossover in group B for GI, PBI, and oral microbial count at different stages of study. On comparing both group A and group B at the first and second follow-up for GI, PBI, and oral microbial count, a statistically significant difference (p<0.05) was observed. A statistically highly significant mean intergroup and intragroup difference was seen for all the clinical parameters at different stages of study. Conclusion. The study revealed that the Illicium verum/star anise has potent antibacterial, anti-inflammatory, and astringent properties

Insights into Polymeric Materials for Prosthodontics and Dental Implantology

Nowadays, a large variety of prostheses both in medicine and dentistry are increasingly made of polymers and polymer-based materials [...