Cone-Beam Computed Tomographic Evaluation of Artifact Effects of Three Different Sealers

Introduction: Cone-beam computed tomography (CBCT) is one of the most important diagnostic tools in maxillofacial imaging. Nowadays different sealers are used in root canal therapy and some of them can create artifact in CBCT images. The aim of this study was to evaluate the effect of different sealers including AH-26, Diadent, and Anyseal in creation of artifact bands in the CBCT images based on voxel size. Methods and Materials: A total of 44 single rooted extracted teeth were selected. The canals were prepared by crown-down technique. All teeth were manually filed up to master apical file (MAF) size 45 and 1 mm shorter than the apical foramen. The teeth were divided into 4 equal groups. The canals were filled with gutta-percha and either of sealers AH-26, Diadent or Anyseal by lateral condensation technique. The control group were filled just with gutta-percha without any sealer. The CBCT images were taken in voxel sizes of 0.3 and 0.15. The Fisher exact and McNemar tests were used for statistical analysis. Results: Although, the control group had the lowest ratio of presence to absence of artifact, the ratio of presence to absence of artifact in voxel size of 0.3 and 0.15 mm were significantly lower in Anyseal than AH-26 (P=0.031, P=0.020) and Diadent (P=0.001, P=0.002). No significant difference was detected between two voxel sizes (P>0.05). Conclusion: In this in vitro study, all evaluated sealers induced artifacts in the CBCT images. Anyseal sealer had the lowest artifact in both evaluated voxel sizes.Keywords: Artifacts; Canal Sealer; Cone-Beam Computed Tomography; Root Canal Filling Material; Root Fractur

The relationship of mandibular radiomorphometric indices to skeletal age, chronological age and skeletal malocclusion type

The present study was performed with the following aims: (1) to assess the relationship between skeletal age, measured using the cervical vertebral maturity (CVM) method, and chronological age; (2) to determine the correlation of skeletal and chronological age to the cortical thickness of the lower border of the mandible using the linear radiomorphometric; and (3) to explore the relationship between these indices and skeletal malocclusion type. The data were collected from the records of 180 patients, including 57 males (31.7%) and 123 females (68.3%). The data were based on the panoramic and lateral cephalograms of each patient. The CVM stages were determined on the basis of the patients? lateral cephalograms. Three radiomorphometric indices were measured: AI, MI and GI. The patients were divided up into three groups of skeletal malocclusion: Class I, II, and III. For all the tests, statistical significance was set at P 0.05). Lastly, the relationship between GI and skeletal malocclusion type proved significant. AI and MI were found to increase significantly with increasing age, so the assessment of mandibular radiomorphometric indices could be clinically useful in estimating of the growth and maturation of the mandible

Prevalence of Taurodont Molars in a Selected Iranian Adult Population

Introduction: Taurodontism is an anomaly characterized by elongated crowns and consumedly apical location of the bifurcation area. This study aimed to determine the prevalence of taurodontism in molars based on digital panoramic radiographies in eight cities of Iran. Methods and Materials: This descriptive cross-sectional study was conducted on 2360 digital panoramic radiographs taken for different treatment purposes. Demographic information of patients was recorded and radiographs were evaluated for presence of taurodont molars. The prevalence rates were calculated and the data were analyzed using SPSS software version 18 via paired t-test, chi square test and ANOVA. Results: A total of 2360 panoramic radiographs (from 51.4% male and 48.6% female patients) were evaluated and the prevalence of taurodontism was reported 22.9% (22.6% in males and 23.3% in females) (P>0.05). Its prevalence was 51.67% in the right and 48.33% in the left quadrants (P>0.05), 34.1% in the mandible and 65.9% in the maxilla (P=0.000) and 79.52% in the second and 20.48% in the first molar (P=0.000). The prevalence of hypotaurodontism, mesotaurodontism and hypertaurodontism was 84.13%, 11.07% and 4.8%, respectively. Conclusion: The prevalence of taurodont molars was high in Iran and it was more common in the second molars and in the maxilla. Hypotaurodontism had the highest prevalence.Keywords: Molar; Panoramic; Prevalence; Radiography; Taurodontis

Evaluation of dentin penetration of three different endodontic sealers in the presence and absence of the smear layer

Introduction: A sealer’s ability to effectively and stably penetrate the dentinal tubules is an essential factor for selecting an effective root canal obturation material. Evaluation of the sealers’ penetration into the dentinal tubules provides valuable data in the endodontic treatment outcome.Aim: To compare the dentin penetration of AH Plus, Endoseal MTA, and Syntex endodontic sealers in the presence and absence of the smear layer.Materials and methods: Thirty single-rooted teeth were selected in the present in vitro study and randomly assigned to three experimental groups (n=10). Half of the samples were prepared by removing the smear layer in each group, and the remaining samples were prepared without removing the smear layer. Root canal preparation was carried out with the Perfect Rotary system up to file T3. The root canals were obturated with gutta-percha and AH Plus, Endoseal MTA, or Syntex endodontic sealers. The samples were incubated at 100% relative humidity at 37°C for one week. Each root was sectioned at 2-, 5-, and 8-mm distances from the apex, and sealer penetration depth at each section was determined under a scanning electron microscope (SEM). ANOVA was used to compare penetration depths.Results: There were significant differences in sealer penetration between the samples with and without smear layer removal in each group. The maximum and minimum sealer penetration was at the coronal and apical sections, respectively. The maximum sealer penetration depths in descending order were observed with AH Plus, Syntex, and Endoseal MTA sealers (p<0.05).Conclusions: Elimination of smear layer increased three sealers’ dentin penetration depth, with the deepest penetration for the AH Plus sealer in the coronal section without the smear layer

Review of Oral and Dental Consideration in the Patients with Head and Neck Radiotherapy and Chemotherapy

Objectives Aggressive cancer therapy places patients at a greater risk for oral complications. Cancer patients suffer from oral toxic effects secondary to antineoplastic therapy (radiotherapy and chemotherapy). The aim of this review is management of the head and neck   cancer patients that specifically emphasizes the prevention and treatment of oral and   dental complications associated with cancer therapy.Methods In this narrative review article, the specialized databases such as PubMed, PubMed Central, MEDLINE, EBSCO, Science Direct, Scopus from 2008 to 2018 were used to find relevant documents by using Mesh terms: Chemotherapy, Radiotherapy, oral consideration, head and neck.Results The data were categorized in: Complications of head and neck radiotherapy and its management (Xerostomia,  Oral Infection, Oral Mucositis, Osteoradionecrosis), Complications of head and neck chemotherapy and its management (Mucosal toxicity, Dental alterations, Neurological disorders, Salivary alterations, Dysgeusia, Infections, Bleeding tendency, Osteonecrosis of the jaws due to bisphosphonates).Conclusion In order to minimize   morbidity in the head and neck cancer patients, it is recommended for consulting to   dental health care providers   before, during and after cancer therapy

Relationship of Skeletal Class of Malocclusion with Radiomorphometric Indices of Mandible in Short-Face Patients

Objectives This study aimed to assess the relationship of skeletal class of malocclusion with some radiomorphometric indices of the mandible in short-face patients. Methods This cross-sectional study was conducted on 179 short-face patients between 17 to 30 years who sought orthodontic treatment during 2013 to 2020. The gonial and antegonial angles, and type and depth of antegonial notch were assessed bilaterally on traced panoramic radiographs. The correlation between radiomorphometric indices and class of malocclusion was analyzed using One-way ANOVA and Independent T-test by SPSS version 25 (alpha=0.05). Results The mean size of gonial angle was significantly different among the three classes of malocclusion (P<0.001), and the largest gonial angle was recorded in class III, and the smallest in class I patients. The mean size of antegonial angle and antegonial depth were not significantly different among the three classes of malocclusion (P=0.487). The difference in the mean size of gonial and antegonial angles was not significant between males and females (P=0.119, and P=0.176, respectively). However, the mean antegonial depth in males was significantly greater than that in females (P<0.001). Type I antegonial notch was more common in females than males at both sides. Age had no significant correlation with gonial angle, antegonial angle, or antegonial notch depth (P=0.422, P=0.737, P=0.392, respectively). Conclusion Facial growth pattern in short-face patients can be predicted with antegonial angle. Also there is significant correlation between skeletal class of malocclusion and the size of gonial angle

Digital Radiography with Computerized Conventional Monitors Compared to Medical Monitors in Vertical Root Fracture Diagnosis

Introduction: Vertical root fracture (VRF) is a complication which is chiefly diagnosed radiographically. Recently, film-based radiography has been substituted with digital radiography. At the moment, there is a wide range of monitors available in the market for viewing digital images. The present study aims to compare the diagnostic accuracy, sensitivity and specificity of medical and conventional monitors in detection of vertical root fractures. Material and Methods: In this in vitro study 228 extracted single-rooted human teeth were endodontically treated. Vertical root fractures were induced in 114 samples. The teeth were imaged by a digital charge-coupled device radiography using parallel technique. The images were evaluated by a radiologist and an endodontist on two medical and conventional liquid-crystal display (LCD) monitors twice. Z-test was used to analyze the sensitivity, accuracy and specificity of each monitor. Significance level was set at 0.05. Inter and intra observer agreements were calculated by Cohen’s kappa. Results: Accuracy, specificity and sensitivity for conventional monitor were calculated as 67.5%, 72%, 62.5% respectively; and data for medical grade monitor were 67.5%, 66.5% and 68% respectively. Statistical analysis showed no significant differences in detecting VRF between the two techniques. Inter-observer agreement for conventional and medical monitor was 0.47 and 0.55 respectively (moderate). Intra-observer agreement was 0.78 for medical monitor and 0.87 for conventional one (substantial). Conclusion The type of monitor does not influence diagnosis of vertical root fractures