Comparison of Charge-Coupled Devices and Photostimulable Phosphor Storage Plates for Detection of Vertical Root Fractures in Endodontically Treated Teeth: An In Vitro Study

Objective: Vertical root fracture (VRF) is among the most common causes of endodontic treatment failures. This study aims to compare charge-coupled devices (CCD) and photostimulable phosphor plates (PSP) for detection of vertical root fractures in endodontically treated teeth.Methods: In this diagnostic in vitro study, 40 maxillary anterior teeth were selected and after preparation and root canal filling, their crowns were cut 2mm above the cementoenamel junction (CEJ). The teeth were embedded in a piece of dried bone and radiographed using CCD and PSP with equal geometry at zero and 15° horizontal angles. VRFs were then induced and the fractured fragments were reattached. The teeth were radiographed again. Three observers evaluated the radiographs for detection of fracture line. Data were analyzed using the Proportion test and Wilcoxon’s Signed Ranks test.Results: No significant difference was found between the two sensors in detection of VRFs [p-value (complete)= 0.592, p-value (absolute)= 1]. The sensitivity of the two sensors for detection of buccolingual and mesiodistal fractures was not significantly different [p-value BL (absolute)= 0.109, p-value BL (complete) 0.180] [p-value MD (complete)=0.593, p-value MD (absolute)= 0.102]. The sensitivity of both sensors for detection of buccolingual fracture was higher than for mesiodistal fractures (p<0.001).Conclusion: CCD and PSP had equal efficacy for detection of VRFs in endodontically treated teeth

Knowledge and clinical judgment of Iranian general dentists on vertical root fracture

BACKGROUND AND AIM: This study was conducted with the aim to investigate the knowledge and clinical judgment of Iranian general dentists and related factors on the diagnosis and treatment plan of vertical root fracture (VRF). METHODS: A questionnaire was distributed among 300 general dentists who attended in Iranian General Dentists Association (IGDA) congress in 2015. The questionnaire comprised of demographic information and nine closed-end questions on the knowledge on VRFs and different treatment options and seven photographs for clinical judgment evaluation. The answers to all questions were assessed and data were analyzed by chi-square test. RESULTS: 271 individuals (50.7% men and 49.3% women) participated in the study and responded the questions of the questionnaire correctively. Of the subjects, 88.3% and 76.3% had low to moderate clinical judgment and knowledge about vertically fractured teeth, respectively. The correlation between knowledge of participants attending in short endodontic courses was higher than that of those not attended in these courses; the difference between these two groups was statistically significant (P = 0.0005). The correlation between clinical judgment, gender, past clinical activity, attendance in short endodontic courses, and field of clinical interest among participants was not significantly different (P = 0.1900). CONCLUSION: It seems that knowledge and clinical judgment are weak among general dentists requiring serious improvement. Fortunately, short endodontic courses may improve their knowledge of diagnosis and interventions related to teeth undergoing VRF. KEYWORDS: Surveys and Questionnaires; Judgment; Dentists; Tooth Fractures; Tooth Roo

Comparative study of the apical microleakage of three root canal sealers

Introduction: The aim of this study was to examine and compare the apical sealing ability of AH26, AH plus and AH plus Jet using a fluid filtration model. Materials and Methods: 70 single-rooted teeth were dissected from the Cement-enamel junction. Canals were prepared with protaper rotary system and manual K files and irrigated with 5.25% Naocl and 17% EDTA. Ten teeth were assigned as control group and divided into 5 positive and 5 negative controls. Remaining specimens were divided into 3 groups of 20 samples and filled with gutta-percha points by lateral condensation technique. Each sample group was filled with either AH26, AH plus or AH Plus Jet. Micro leakage was assessed in the 2nd and 30th days by the mobility of air bubble in a capillary glass tube connected to the root. Results: No statistically significant difference was found in the apical micro leakage of the 3 studied sealers at any observation period. However, in the 2nd and 30th day, AH plus Jet had the least micro leakage values compared to AH plus and AH 26 (P>0.05). AH plus presented the highest micro leakage rate (P>0.05). Conclusion: Under the conditions of this study, all three studied sealers provided satisfactory seal in the mentioned period. Considering low microleakage rate of AH plus jet and its simplicity of use, the application of this sealer is recommended in endodontic therapy

Comparative study on the microleakage of three root canal sealers

 INTRODUCTION: The aim of this study was to examine and compare the apical sealing ability of AH26, AH Plus and AH Plus Jet using the fluid filtration model. MATERIALS AND METHODS: In this experimental study, 70 single-rooted teeth were dissected from the cement-enamel junction. Canals were prepared with ProTaper rotary system and hand K-files and irrigated with 5.25% NaOCl and 17% EDTA. Ten teeth were assigned to the control group and divided into 5 positive and 5 negative controls. Remaining specimens were divided into 3 groups of 20 samples each and filled with gutta percha by lateral condensation technique. Each sample group was filled with either AH26, AH Plus or AH Plus Jet. Microleakage was assessed on the 2(nd) and 30(th) day by the amount of air bubble movement within the capillary glass tube connected to the root. One-way ANOVA test was used for analysis. RESULTS: AH Plus Jet had the least microleakage value and AH Plus presented the highest rate; however, the differences were not statistically significant. CONCLUSION: Under the conditions of this study, all three studied sealers provided satisfactory seal within the two time intervals. AH Plus Jet demonstrated slightly lower microleakage values; therefore, its application can be recommended in endodontic therapy

Reverse contrast enhancement in digital radiography in detection of vertical root fracture (in vitro)

Background and Aims: Diagnosis of vertical root fractures often poses a clinical dilemma. Diagnosis of VRF in intraoral radiographs, except in cases where the beam is perpendicular to the direction of fracture is difficult. Misdiagnosis often leads to wrong decisions about the design of teeth future treatment plan. The aim of this study was to determine the diagnostic accuracy of reverse contrast enhancement options in digital radiography, and to compare it with the original images to find a suitable method to detect vertical root fracture.   Materials and Methods: In this experimental study, digital radiography with phosphor plate detector was taken from 40 extracted single root teeth. From each intact and fractured tooth, the original and reverse contrast images captured and stored. Two expert observers viewed the images twice with an interval of two weeks. Diagnostic criteria (Accuracy, PPV, NPV, Specificity and Sensitivity) in form of absolute and complete for each observer and each images was calculated. Inter and intra observer reliability was obtained using Mc-Nemar test.   Results: No significant differences in inter-observer reliability between the initial appearance and reverse contrast was observed (P>0.05), but in view of the intra-observer reliability in two cases, the difference was significant (P0.05), whereas significant difference between the two images was found in NPV index (P<0.05).   Conclusion: The use of reverse contrast enhancement option for detection of vertical root fracture did not show significant difference from initial view