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

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

Influence of heat treated files on conserving the remaining dentin thickness during endodontic retreatment – An invitro CBCT study

Objectives: Non-surgical endodontic retreatment is to be a conservative option over endodontic surgery in case of recurrent infections. Root canal retreatment procedures needs to be initiated faster and proficiently with proper root canal retreatment files. The main aim of this study is to evaluate the remaining root dentin thickness post Gutta Percha (GP) retrieval from the root canal after using two different rotary instruments. Materials and methods: A total of sixty extracted single rooted teeth were chosen. Shaping and Cleaning was done Step Back (Telescopic) technique with apical preparation of size 40 k File. Irrigation was carried out using NaOCl (3 %) and Ethyelenediamine tetraacetic acid (EDTA) to clear the smear layer. The canals were dried using paper points and obturation was completed using lateral compaction technique with AH plus resin sealer. Upon completing the obturation, it was categorized into two groups: Group I- ProTaper retreatment files (PTR) and Group II- Solite RS3 (S-RS3) Retreatment files. Cone Beam Computed Tomography (CBCT) was used to assess the remaining dentin thickness post gutta-percha retrieval at 3,5 and 7 mm respectively. To test the significance between groups independent t test was used. Results: It can be noted from the results that more amount of remaining dentin thickness was seen after using Solite RS3 files at 3 mm, 5 mm and 7 mm on the mesial side compared to ProTaper retreatment files (p  0.05). Conclusion: Within the limitations of the study, it can be concluded that Solite RS3 files have the potential to preserve the remaining dentin thickness. However, more studies including various other parameters should be performed to arrive at a definitive conclusion

Attitude and practice of regenerative endodontic procedures among endodontists and paediatric dentists:A multinational survey from 13 countries

Background: Regenerative endodontics (RET) refers to biologically based procedures that aim to restore damaged tooth structures and reinstate the pulp–dentine complex to its normal physiological state. Aim: The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET. Design: A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period. Results: Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%–3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period. Conclusion: According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes.</p

Assessment of the Prevalence of Middle Mesial Canal in Mandibular First Molar: A Multinational Cross-sectional Study with Meta-analysis

Background: An additional canal found in the mandibular first molar (M1M) is the middle mesial canal (MMC), which is often missed during root canal treatment. In this study, the prevalence of MMC in M1M on cone-beam computed tomography (CBCT) images was evaluated in 15 countries, along with the effect of some demographic factors on its prevalence. Methods: Deidentified CBCT images were scanned retrospectively, and the ones including bilateral M1Ms were included in the study. 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 three planes (coronal, sagittal, and axial) after a 3-dimensional alignment of the long axis of the root(s). The presence of an MMC in M1Ms (yes/no) was identified and recorded. Results: In total, 6304 CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries (P .05) or between genders (odds ratio= 1.07, 95% CI: 0.91, 1.27; P > .05). As for the age groups, no significant differences were found (P > .05). Conclusions: The prevalence of MMC varies by ethnicity, but it is generally estimated at 7% worldwide. Physicians must pay close attention to the presence of MMC in M1M, especially for opposite M1Ms, due to the prevalence of MMC being significantly bilateral

Factors Affecting the Decision-making of Direct Pulp Capping Procedures among Dental Practitioners:A Multinational Survey from 16 Countries with Meta-analysis

Introduction: Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had 3 purposes: (1) to investigate the factors that affect clinicians’ decisions in DPC cases, (2) to determine which method of caries removal is preferred, and (3) to evaluate the preferred capping material for DPC. Methods: The questionnaire comprised 3 sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure, and patients’ age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. Results: A tendency toward more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR = 2.86, 95% CI: 2.46, 2.32; P &lt; .001) as opposed to the clinical scenario with 2 pulp exposures (RR = 1.38, 95% CI: 1.24, 1.53; P &lt; .001). Complete caries removal was significantly preferred to selective caries removal (RR = 4.59, 95% CI: 3.70, 5.69; P &lt; .001). Among the capping materials, calcium silicate-based materials were preferred over calcium hydroxide-based materials (RR = 0.58, 95% CI: 0.44, 0.76; P &lt; .05). Conclusions: While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of calcium silicate-based materials appears to have replaced calcium hydroxide-based materials.</p

Repair versus replacement of defective direct dental restorations:A multinational cross-sectional study with meta-analysis

Objectives: When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore international preferences for repair procedures and the clinical steps taken during the repair process. Method: An 11-question survey was distributed to dentists across 21 countries via different platforms. The survey comprised two sections: the first included five questions aimed at gathering demographic information, while the second consisted of six questions focusing on participants' practices related to the repair of composite or amalgam restorations A meta-analysis was employed to ascertain the pooled odds ratio of repairing versus replacement. The statistical analysis was carried out using the RevMan 5.3 program and forest plots were generated using the same program to visualize the results. Results: The survey was completed by 3680 dental practitioners. The results indicated a strong tendency to repair defective composite restorations (OR: 14.23; 95 % CI: 7.40, 27.35, p &lt; 0.001). In terms of amalgam, there was a significant tendency to replace the restorations (OR: 0.19; 95 % CI: 0.12, 0.30, p &lt; 0.001). When repairing restorations, the most common protocols were etching with orthophosphoric acid and creating an enamel bevel, regardless of the restorative material used. Conclusion: The findings of this study indicate that there exists a knowledge gap among dental practitioners regarding restoration repair. It is imperative that dental practitioners receive proper education and training on restoration repair, to ensure the usage of adequate protocols and restoration survival. Clinical significance: A significant portion of dental practitioners lack the necessary knowledge and education required for the repair of restorations. Therefore, it is imperative to establish guidelines aimed at enhancing the management of defective restorations, along with protocols for clinical interventions. This includes the incorporation of proper courses in undergraduate, graduate, and continuing education programs.</p