Root and canal configurations of mandibular molars using CBCT, with an emphasis on middle mesial canals

Introduction: An extensive knowledge of dental root and canal anatomy is essential to clinicians performing endodontic treatment. It is well-known that dental anatomy may be complex and display significant variation. Aim: The aim of the present study was to classify the root number and the root canal configurations of human mandibular first and second molars in a South African sub-population using CBCT. Materials and methods: The study design was a retrospective cross-sectional descriptive study. The sample size included 753 molars. The CBCT images of each individual mandibular first and second molar were evaluated in coronal, sagittal and axial views. Classification of the canal configurations of each root was made using the Vertucci classification system, including the additions proposed by Sert and Bayirli. Classification of root number was described as one, two, three, or four-roots. Results: Root anatomy: Two-rooted configurations were demonstrated in the majority of first and second molars (98.7% and 94%). One- and three-rooted molars were rare with a prevalence ranging from 0.3% to 2.9%. Half of all three-rooted molars presented with two distinct mesial roots. Four-rooted molars were found in second molars only (0.5%). Canal anatomy: The most common canal type in the mesial roots of mandibular first and second molars was Type IV (50% and 38%) followed by Type II (21% and 24%). The most common canal configuration in the distal roots of the first and second molars was Type I (50% and 81%) followed by Type V (20% and 10%). More than two mesial canals in mandibular first and second molars were present in 21% and 17% of the sample. More than two distal canals were demonstrated in first and second molars in 7% and 2% of the sample. C-shaped canal systems were found in 0.5% of first molars and 7.7% of second molars. Sex and age had no correlation to root or canal configurations. Conclusion: More than two mesial canals were found in about one-fifth of the sample. It is important for clinicians to be aware that a number of mandibular molars may present with more intricate anatomy than expected during endodontic treatment and that this may affect treatment outcomes.Dissertation (MSc (Dent))--University of Pretoria, 2020.OdontologyMSc (Dent)Unrestricte

Sterilisation and single-use of endodontic files - a short report

INTRODUCTION: In many countries, endodontic files continue to be sterilised and reused in multiple clinical cases as the alternative of single-use of these instruments is avoided due to financial reasons. METHODS: A survey was performed including South African general dental practitioners and specialist prosthodontists to determine the current endodontic file sterilisation methods in place and the adoption rate of single-use protocols of both hand and engine-driven instruments. RESULTS: The majority of respondents (76.6%, n=141/184) indicated autoclaving endodontic files prior to reuse. Almost a quarter of the respondents (23.4%, (n=43/184) used only cold sterilisation. Some respondents (2,8%, n=5/181) indicated not sterilising their files at all. A low number of respondents had adopted the single-use of endodontic hand files (10.9%, n=20/184). Engine-driven files were used only once and discarded by 18.5% (n=34/184) of respondents. CONCLUSION: It appears that, at times, acceptable infection prevention and control practices regarding the sterilisation these instruments are not necessarily being adhered to. The adoption of single-use protocols of endodontic files in a South African dental setting is higher than previously reported

Complications of head and neck radiotherapy : a dental perspective

For the treatment of head and neck cancers radiotherapy is frequently and successfully performed by medical specialists. However, a number of complications may occur following such therapy. Many of these complications are diagnosed and treated primarily by dental practitioners and specialists. Whilst some are easily managed, others, such as osteoradionecrosis of the jaw, may be very difficult to treat and have a significant impact on a patient’s quality of life. The following report documents a case where several complications occurred following radiotherapy. Comprehensive dental assessment and treatment prior to, during and after radiotherapy may lead to a reduction of complications. Greater cooperation and understanding between the medical and dental professionals is required during radiotherapy of head and neck cancer patients.http://www.onk.ns.ac.rs/archive/home.aspam2020Maxillo-Facial and Oral SurgeryOdontologyOral Pathology and Oral Biolog

Triple antibiotic paste in the treatment of a necrotic primary molar

This paper reports a case of an eight-year-old male who presented with a primary molar which had previously undergone a pulpotomy. Subsequently pulpal necrosis, internal resorption and mobility of the tooth occurred, complicating the case. A repeat pulpotomy was performed together with the use of triple-antibiotic paste (TAP). At the 10-month follow-up no clinical signs of disease were found. Complete healing of the furcal radiolucency was demonstrated, with bony infill, no mobility and resolution of the previous widening of the periodontal ligament. It appears that TAP may be a viable treatment modality to enable retention of necrotic primary teeth with a poor prognosis.https://www.sada.co.za/the-sadjam2019Odontolog

Root and canal configurations of mandibular first molars in a South African subpopulation

PURPOSE: This study investigated root number and canal configurations, including morphological variations, of mandibular first molars in a subpopulation of South Africans. METHODS: Two calibrated examiners retrospectively evaluated 371 mandibular first molars by using high-resolution cone-beam CT images and the Vertucci classification system with the additions of Sert and Bayirli. Internal and external configurations were recorded, and correlations of sex and age with root number and canal configuration were determined with the chi-square and Fisher exact tests (P < 0.05). RESULTS: Among mandibular first molars, 0.3% were single-rooted, 98.7% were two-rooted, and 1% were three-rooted. The most frequent configuration was Vertucci Type IV in mesial roots and Vertucci Type I in distal roots. Middle mesial canals were found in 20% and middle-distal canals in 7% of samples. The prevalence of third canals increased in mesial and distal roots as age increased (P > 0.05). Canal configuration and sex were not correlated (P > 0.05). CONCLUSION: Mandibular first molars exhibited diverse anatomic characteristics in this subpopulation. Clinicians should be aware of the possibility of additional canals in mandibular first molars, as treatment outcomes may be worse if canals are left untreated.https://www.jstage.jst.go.jp/browse/josnusd/pm2021Odontolog

Allergic contact dermatitis from resin‑modified glass ionomers

Monomers in a variety of dental materials may cause allergic contact dermatitis. While resin materials have been implicated in the onset of this condition, there is a paucity of evidence linking the condition to the resin‑modified glass ionomers (RMGIs). This report documents a rare case of a dentist who developed allergic contact dermatitis following exposure to a RMGI. Contact dermatitis occurred despite the use of latex gloves, which were worn during the procedure. Both the acute and chronic stages of the condition were clinically represented. Patch testing was conducted to confirm the diagnosis. A no‑touch technique and the routine use of nitrile gloves were subsequently adopted, which resulted in an overall decrease of the condition.Dentists, auxiliary personnel, and students should be aware of the possibility of sensitization to, and the development of allergic contact dermatitis not only from conventional resin materials, but also from the RMGIs.http://www.jcd.org.inam2021Maxillo-Facial and Oral SurgeryOdontolog

Endodontic trends by South African Dental Association members : an online survey

AIM: The aim of the study is to determine the techniques and materials used by South African dental practitioners who perform endodontic treatment in private practice and evaluate their compliance to the 2006 European Society of Endodontology (ESE) quality guidelines. MATERIALS AND METHODS: An online survey was distributed to all dentists registered with the South African Dental Association (n = 3191) and prosthodontists registered with the Academy of Prosthodontics (n = 61), practicing in South Africa. Fourteen subject areas related to endodontic materials and techniques were assessed. Responses were evaluated using simple descriptive and analytical statistics. RESULTS: The overall response rate was 7% (n = 215/3252; specialist prosthodontists 18% and general dentists 6%). Sixty-three percent of respondents (n = 122/193) did not routinely use rubber dam. The use of rubber dam and magnification was positively correlated with postgraduate endodontic qualifications (P < 0.05). Antibiotic prescription for irreversible pulpitis without systemic involvement was reported in an average of 31% of cases. Formaldehyde-containing sealers were used by 5% (n = 9/193). The majority of respondents (89%, n = 171/191) used sodium hypochlorite as a primary irrigant. Cold obturation techniques (82%, n = 159/193) were preferred over warm techniques (18%, n = 34/193), with the single-cone technique the most popular (58%, n = 112/193). Almost half preferred steroid-containing medicaments (48%, n = 92/193). CONCLUSION: Surveyed practitioners largely complied with the 2006 ESE guidelines. Notable exceptions including low rubber dam use, inappropriate antibiotic prescription, and the continued use of formaldehyde-containing medicaments and sealers were reported. Improved compliance to established guidelines may be achieved through the use of these results when planning ducational activities.http://www.saudiendodj.compm2020OdontologyCommunity DentistryMaxillo-Facial and Oral Surger

Endodontic treatment of dentin dysplasia type I D

Dentin dysplasia (DD) Type I is a developmental condition affecting dentin, inherited in an autosomal‐dominant pattern or occurring due to a new mutation. Whilst the crowns of DD Type I affected teeth appear clinically normal, the roots are blunt and shortened. Pulp necrosis and periapical pathoses may be seen in the absence of obvious causes. Pulp stones and calcifications are frequently encountered. Endodontic management of DD may be challenging. A case of DD Type I, sub‐classification d, in which spontaneous irreversible pulpitis developed on three mandibular incisors is documented. The case was managed by conventional endodontic treatment. Knowledge of this uncommon dental condition may assist dentists to adequately diagnose and manage these cases. Extraction should not be considered the first‐line treatment option when sufficient root length is available to attempt endodontic treatment. Referral for medical evaluation is recommended to rule out systemic diseases which may mimic this condition.https://onlinelibrary.wiley.com/journal/174744772021-09-22hj2021Maxillo-Facial and Oral SurgeryOdontologyOral Pathology and Oral Biolog

Root and canal configurations of maxillary premolars in a South African subpopulation using cone beam computed tomography and two classification systems

This cone beam computed tomography (CBCT) study aimed to describe the maxillary premolar anatomy of a South African subpopulation using two classification systems. A total of 601 premolars were evaluated. For each tooth, the root number and canal configurations were described using the classification systems devised by Vertucci (1984) and Ahmed et al. (2017). Correlations between root number and sex were determined using the chi-squared test (P = 0.05). Two roots were present in approximately half of all maxillary first premolars (54.1%, n = 171/316). The majority of maxillary second premolars displayed one root (78.2%, n = 223/285). Single-rooted maxillary second premolars were more common in females (P < 0.05). The Vertucci type IV configuration was most prevalent in the maxillary first premolars. In contrast, maxillary second premolars showed a greater tendency toward Vertucci’s type I configuration. The classification proposed by Ahmed et al. indicated the most prevalent maxillary first premolar configuration to be 2MP B1P1. The most common configuration among the maxillary second premolars was 1MP1. Diverse root and canal anatomical presentations were found in this subpopulation. Both classification systems adequately describe maxillary premolar anatomy; however, the system proposed by Ahmed et al. may more accurately describe complex teeth.https://www.jstage.jst.go.jp/browse/josnusdam2020Maxillo-Facial and Oral SurgeryOdontolog

Double gemination or fusion of a permanent mandibular second molar : a case report

Gemination and fusion are developmental conditions affecting the shape of teeth in both primary and permanent dentition. A 12-year-old girl presented for clinical assessment and the examination revealed an unusually shaped mandibular right second molar with irreversible pulpitis. Correlation of the intraoral and radiological appearance of this tooth suggested a diagnosis of either double gemination or fusion. The favourable position of the developing third molar supported early extraction of the abnormal second molar. The present report documents the clinical and radiological presentation of a mandibular second molar with an unusual developmental alteration in shape. Well-timed extraction therapy and good communication may reduce the need for unnecessary, complex treatment.https://www.quintessence-publishing.com/deu/en/journal/chinese-journal-of-dental-researcham2022Maxillo-Facial and Oral SurgeryOdontologyOral Pathology and Oral Biolog