Assessment of the prevalence of radix entomolaris and distolingual canal in mandibular first molars in 15 countries : a multinational cross-sectional study with meta-analysis

AIM : The aim of this study was two-folded: i) to assess the prevalence of Distolingual Canal (DLC) and Radix Entomolaris (RE) in Mandibular First Molars (M1Ms), using Cone Beam Computed Tomography (CBCT) images and ii) to assess the impact of sociodemographic factors on the prevalence of these conditions worldwide. METHODS : CBCT images were scanned retrospectively and the ones including bilateral M1Ms were included in the study. The evaluation was performed by 1 researcher in each country, trained with CBCT technology. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating axial sections from coronal to apical. The presence of DLC and RE in M1Ms (yes/ no) was identified and recorded. RESULTS : Six thousand three hundred four CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries regarding the prevalence of both RE and DLC (P , .05). The prevalence of DLC ranged from 3% to 50%, and the overall prevalence was 22% (95% CI: 15%–29%). RE prevalence ranged from 0% to 12%, and the overall prevalence was 3% (95% CI: 2%–5%). There were no significant differences between left and right M1Ms or between genders for either DLC or RE (P ..05). CONCLUSION : The overall prevalence of RE and DLC in M1Ms was 3% and 22%. Additionally, both RE and DLC showed substantial bilaterally. These variations should be considered by endodontic clinicians during endodontic procedures in order to avoid potential complications.https://www.sciencedirect.com/journal/journal-of-endodonticsam2024OdontologySDG-03:Good heatlh and well-bein

Assessment of the prevalence of radix entomolaris and distolingual canal in mandibular first molars in 15 countries: a multinational cross-sectional study with meta-analysis

Aim: The aim of this study was two-folded: i) to assess the prevalence of Distolingual Canal (DLC) and Radix Entomolaris (RE) in Mandibular First Molars (M1Ms), using Cone Beam Computed Tomography (CBCT) images and ii) to assess the impact of sociodemographic factors on the prevalence of these conditions worldwide. Methods: CBCT images were scanned retrospectively and the ones including bilateral M1Ms were included in the study. The evaluation was performed by 1 researcher in each country, trained with CBCT technology. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating axial sections from coronal to apical. The presence of DLC and RE in M1Ms (yes/no) was identified and recorded. Results: Six thousand three hundred four CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries regarding the prevalence of both RE and DLC (P .05). Conclusion: The overall prevalence of RE and DLC in M1Ms was 3% and 22%. Additionally, both RE and DLC showed substantial bilaterally. These variations should be considered by endodontic clinicians during endodontic procedures in order to avoid potential complications

EurOP2E – the European Open Platform for Prescribing Education, a consensus study among clinical pharmacology and therapeutics teachers

Purpose Sharing and developing digital educational resources and open educational resources has been proposed as a way to harmonize and improve clinical pharmacology and therapeutics (CPT) education in European medical schools. Previous research, however, has shown that there are barriers to the adoption and implementation of open educational resources. The aim of this study was to determine perceived opportunities and barriers to the use and creation of open educational resources among European CPT teachers and possible solutions for these barriers. Methods CPT teachers of British and EU medical schools completed an online survey. Opportunities and challenges were identified by thematic analyses and subsequently discussed in an international consensus meeting. Results Data from 99 CPT teachers from 95 medical schools were analysed. Thirty teachers (30.3%) shared or collaboratively produced digital educational resources. All teachers foresaw opportunities in the more active use of open educational resources, including improving the quality of their teaching. The challenges reported were language barriers, local differences, lack of time, technological issues, difficulties with quality management, and copyright restrictions. Practical solutions for these challenges were discussed and include a peer review system, clear indexing, and use of copyright licenses that permit adaptation of resources. Conclusion Key challenges to making greater use of CPT open educational resources are a limited applicability of such resources due to language and local differences and quality concerns. These challenges may be resolved by relatively simple measures, such as allowing adaptation and translation of resources and a peer review system

Post-endodontic reconstruction of dental crown

Uspjeh endodontskog liječenja postiže se uklanjanjem ili značajnim smanjenjem broja bakterija, prevencijom ponovne bakterijske kontaminacije, zatvaranjem korijenskih kanala te kvalitetnom postendodontskom rekonstrukcijom zubne krune. Protokol kojim liječimo zub uključuje čišćenje i širenje korijenskih kanala zbog čega je narušena stabilnost samog zuba te su izmijenjena njegova mehanička i fizikalna svojstva. Upravo kako bi očuvali zubnu strukturu i osigurali joj dugotrajnost unutar stomatognatnog sustava koji je pod konstantnim opterećenjem vanjskih sila, bitno je provesti adekvatnu rekonstrukciju krune tog zuba. Uz temeljito provedenu dijagnostiku koja uključuje uzimanje anamnestičkih podataka pacijenta, detaljnu analizu radioloških snimki i provođenje intraoralnog i ekstraoralnog pregleda te određenih testova pristupamo kreiranju plana terapije. Ovisno o stanju preostalog zubnog tkiva, parodonta, smještaju zuba te ostalih zuba u ustima, suvremena stomatologija nam nudi brojne materijale kojima možemo opskrbiti krunu zuba. Također, bitan aspekt nam čine i pacijentove želje i mogućnosti koje svakako ne smijemo ignorirati. Kao postendodontsku opskrbu nude nam se izravne i neizravne restauracije te protetski nadomjesci. Od materijala možemo birati između kompozita, staklenoionomernog cementa, cirkona, keramike te drugih rjeđe zastupljenih u praksi. Nerijetko kod liječenih zubi je potrebno napraviti i nadogradnju radi povećavanja kliničke krune zuba koja može biti individualna ili konfekcijska. Postendodontska rekonstrukcija zubne krune predstavlja spektar brojnih postupaka i mogućnosti koje nam stoje na raspolaganju kako bi zubu vratili njegovu formu, funkciju, estetska svojstva te u konačnici i ulogu u stomatognatnom sustavu.The success rate of endodontic treatment is achived by removing or significantly reducing the number of bacteria, preventing repeated bacterial contamination, filling root canals, and highquality post-endodontic reconstruction of dental crowns. Protocol used to treat the tooth includes cleaning and enlargement of root canals, due to whichstability of the tooh itself is impaired and its mechanical and physical properties are changed. To preserve dental structure and ensure its longevity within the stomatognathic system, whichis under constant load from external forces, it is essential to carry out an adequate reconstruction of the crown of that tooth. Through thoroughly performed diagnosis, which includes obtaining the patient's anamnestic data, detailed evaluation of radiological images, and conducting intra- and extraoral examination as well as particulat tests, one approaches the creation of a therapy plan. Depending on the condition of the remaining dental tissue, periodontium, position of the tooth, and other teeth in the mouth, modern dentistry offers numerouos materials that can suppy the crown of the tooth. Moreover, the patient's wishes and possibilities are an imperative aspect that cannot be ignored. Direct and indirect restorations and prosthetic restorations are offered as post-endodontic care. One can choose from composite or glass ionomer resins, zirconia, ceramics, and others that are not common practice. Often in treated teeth, it is necessary to make the post-and-core system to increase the clinical crown of the tooth, which can be individual or ready-made. Post-endodontic reconstruction of the crown of the tooth represents a spectrum of numerous procedures and possibilities available to restore the tooth to its form, function, aesthetic properties, and, ultimately, its role in the stomatognathic system

Post-endodontic reconstruction of dental crown

Uspjeh endodontskog liječenja postiže se uklanjanjem ili značajnim smanjenjem broja bakterija, prevencijom ponovne bakterijske kontaminacije, zatvaranjem korijenskih kanala te kvalitetnom postendodontskom rekonstrukcijom zubne krune. Protokol kojim liječimo zub uključuje čišćenje i širenje korijenskih kanala zbog čega je narušena stabilnost samog zuba te su izmijenjena njegova mehanička i fizikalna svojstva. Upravo kako bi očuvali zubnu strukturu i osigurali joj dugotrajnost unutar stomatognatnog sustava koji je pod konstantnim opterećenjem vanjskih sila, bitno je provesti adekvatnu rekonstrukciju krune tog zuba. Uz temeljito provedenu dijagnostiku koja uključuje uzimanje anamnestičkih podataka pacijenta, detaljnu analizu radioloških snimki i provođenje intraoralnog i ekstraoralnog pregleda te određenih testova pristupamo kreiranju plana terapije. Ovisno o stanju preostalog zubnog tkiva, parodonta, smještaju zuba te ostalih zuba u ustima, suvremena stomatologija nam nudi brojne materijale kojima možemo opskrbiti krunu zuba. Također, bitan aspekt nam čine i pacijentove želje i mogućnosti koje svakako ne smijemo ignorirati. Kao postendodontsku opskrbu nude nam se izravne i neizravne restauracije te protetski nadomjesci. Od materijala možemo birati između kompozita, staklenoionomernog cementa, cirkona, keramike te drugih rjeđe zastupljenih u praksi. Nerijetko kod liječenih zubi je potrebno napraviti i nadogradnju radi povećavanja kliničke krune zuba koja može biti individualna ili konfekcijska. Postendodontska rekonstrukcija zubne krune predstavlja spektar brojnih postupaka i mogućnosti koje nam stoje na raspolaganju kako bi zubu vratili njegovu formu, funkciju, estetska svojstva te u konačnici i ulogu u stomatognatnom sustavu.The success rate of endodontic treatment is achived by removing or significantly reducing the number of bacteria, preventing repeated bacterial contamination, filling root canals, and highquality post-endodontic reconstruction of dental crowns. Protocol used to treat the tooth includes cleaning and enlargement of root canals, due to whichstability of the tooh itself is impaired and its mechanical and physical properties are changed. To preserve dental structure and ensure its longevity within the stomatognathic system, whichis under constant load from external forces, it is essential to carry out an adequate reconstruction of the crown of that tooth. Through thoroughly performed diagnosis, which includes obtaining the patient's anamnestic data, detailed evaluation of radiological images, and conducting intra- and extraoral examination as well as particulat tests, one approaches the creation of a therapy plan. Depending on the condition of the remaining dental tissue, periodontium, position of the tooth, and other teeth in the mouth, modern dentistry offers numerouos materials that can suppy the crown of the tooth. Moreover, the patient's wishes and possibilities are an imperative aspect that cannot be ignored. Direct and indirect restorations and prosthetic restorations are offered as post-endodontic care. One can choose from composite or glass ionomer resins, zirconia, ceramics, and others that are not common practice. Often in treated teeth, it is necessary to make the post-and-core system to increase the clinical crown of the tooth, which can be individual or ready-made. Post-endodontic reconstruction of the crown of the tooth represents a spectrum of numerous procedures and possibilities available to restore the tooth to its form, function, aesthetic properties, and, ultimately, its role in the stomatognathic system

Cone-Beam Computed Tomography Analysis of the Root Canal Morphology of Lower Second Molars in the Croatian Subpopulation

The aim of this study was to investigate the root canal morphology of lower second molars in the Croatian subpopulation of the Zagreb region using cone-beam computed tomography (CBCT). We analyzed 3212 CBCT scans from the two radiology centers in Zagreb. The number of roots and root canals, the occurrence of C-shaped canals and additional roots were recorded. “C”-shaped roots were classified according to Melton classification. Canals in the mesial root were classified according to Vertucci. Lower second molars were found on 608 CBCT scans from a total number of 859. Among them, 78 (9.1%) had a “C”-shaped form. In the mesial roots, the frequencies of Vertucci types were: Type I in ninety-four cases (12.0%), Type II in three hundred and twenty cases (41.0%), Type III in six cases (0.8%), Type IV in three hundred and fifty-two cases (45.1%), Type V in three cases (0.4%), Type VI was found in four cases (0.5%) and Type VIII was found in one case (0.1%). Radix entomolaris and paramolaris were found in 29 (3.4%) lower second molars. The lower second molars in the Zagreb population show significant diversity in internal anatomy with a relatively high prevalence of “C”-shaped root canals and merged root canals in the mesial root

Harmonizing and improving European education in prescribing: An overview of digital educational resources used in clinical pharmacology and therapeutics.

AIM: Improvement and harmonization of European clinical pharmacology and therapeutics (CPT) education is urgently required. Because digital educational resources can be easily shared, adapted to local situations and re-used widely across a variety of educational systems, they may be ideally suited for this purpose. METHODS: With a cross-sectional survey among principal CPT teachers in 279 out of 304 European medical schools, an overview and classification of digital resources was compiled. RESULTS: Teachers from 95 (34%) medical schools in 26 of 28 EU countries responded, 66 (70%) of whom used digital educational resources in their CPT curriculum. A total of 89 of such resources were described in detail, including e-learning (24%), simulators to teach pharmacokinetics and/or pharmacodynamics (10%), virtual patients (8%), and serious games (5%). Together, these resources covered 235 knowledge-based learning objectives, 88 skills, and 13 attitudes. Only one third (27) of the resources were in-part or totally free and only two were licensed open educational resources (free to use, distribute and adapt). A narrative overview of the largest, free and most novel resources is given. CONCLUSION: Digital educational resources, ranging from e-learning to virtual patients and games, are widely used for CPT education in EU medical schools. Learning objectives are based largely on knowledge rather than skills or attitudes. This may be improved by including more real-life clinical case scenarios. Moreover, the majority of resources are neither free nor open. Therefore, with a view to harmonizing international CPT education, more needs to be learned about why CPT teachers are not currently sharing their educational materials