Lama Awawdeh

Root and canal morphology of mandibular first and second molar teeth in a Jordanian population

AIM To examine the root and canal morphology of mandibular permanent first and second molar teeth in a Jordanian population. METHODOLOGY A total of 685 extracted mandibular first and second permanent molar teeth were collected from dental clinics within north Jordan. The teeth were examined visually and the root number and morphology were recorded. After that, access cavities were prepared, pulp tissue dissolved by sodium hypochlorite and the root canals injected with Indian ink. Stained teeth were decalcified with 10% nitric acid, dehydrated with ascending concentrations of alcohol and rendered clear by immersion in methyl salicylate. The following observations were evaluated: (i) number of canals per root; (ii) number of root canals per tooth; (iii) canal configuration in each root; (iv) number and location of lateral canals and (v) presence of intercanal communications. RESULTS Of 330 mandibular first molars, the majority had three (48%) or four (46%) canals, whilst 4% had a third disto-lingual root. Of 355 mandibular second molars, 58% had three canals, 19% two and 17% had four canals, whilst 10% had C-shaped roots. The most prevalent canal configuration in the mesial root of both first (53%) and second (40%) molars was type IV, and in distal roots was type I (54% in first and 79% in second molars). CONCLUSIONS Jordanian mandibular first and second molar teeth exhibit features close to the average Caucasian root and canal morphology.

Root Form and Canal Morphology of Jordanian Maxillary First Premolars

This study was conducted to investigate root canal morphology of maxillary first premolars in a Jordanian population. Six hundred maxillary first premolars were collected, stained, and decalcified. Cleared teeth were examined and the following features were evaluated: (1) number of roots, (2) presence of furcation grooves, (3) location of apical foramina, (4) number and types of root canal, (5) number of lateral canals and isthmi, and (6) frequency of apical deltas. Of the six hundred maxillary first premolars 30.8% has one root, 63.2% has two, and 5.2% has bifid roots. Concerning root canal morphology, 79.7% had two canals with two separate apical foramina, whereas 3.3% of the teeth possessed type I canal systems. All two rooted maxillary first premolars showed furcation groove in the buccal roots. Maxillary first premolars are mainly two rooted and mostly have two canals. The presence of furcation groove should be kept in mind during both endodontic and prosthodontic procedures.

Effectiveness of propolis and calcium hydroxide as a short-term intracanal medicament against Enterococcus faecalis: a laboratory study.

The aim of this study was to investigate the antimicrobial activity of propolis-based intracanal medicament against Enterococcus faecalis using infected dentine models, and to compare its antimicrobial efficacy with that of the non-setting calcium hydroxide paste when used as a short-term medication for 1 and 2 days. A total of 50 dentine discs of 7-mm length was obtained from extracted human teeth. Five dentine discs were kept sterile to serve as a negative control. The remaining 45 were contaminated with E. faecalis and divided into two groups (n = 20) in addition to five discs that served as a positive control. The discs were treated as follow: 20 discs were filled with propolis, while the other 20 discs were filled with non-setting calcium hydroxide. Microbiological sampling was performed utilising sterile paper point, headstrom file and disc immersion. Results showed that propolis was significantly more effective than non-setting calcium hydroxide against E. faecalis after short-term application, which made comparison from this prospect unlevelled. The most effective microbiological sampling technique was abrading the lumen with headstrom file. Propolis is very effective as intracanal medicament in rapidly eliminating E. faecalis ex vivo.

Adhesion of Epiphany Self-etch Sealer to Dentin Treated with Intracanal Irrigating Solutions

INTRODUCTION This in vitro study assessed the adhesion of Epiphany self-etch (SE) root canal sealer to dentin treated with different irrigation regimens. METHODS Flat dentin surfaces were obtained from human third molar teeth; smear layer was created on each sample. Five groups of 10 samples each were conditioned with one of the following regimens: (1) deionized water for 10 minutes; (2) 5% sodium hypochlorite (NaOCl) for 10 minutes; (3) 5% NaOCl for 10 minutes and then 10% sodium ascorbate (Na-Ascr) for 10 minutes; (4) 5% NaOCl for 10 minutes and then 2% chlorhexidine (CHX) for 5 minutes; or (5) 5% NaOCl for 10 minutes and then 10% Na-Ascr for 10 minutes, followed by 2% CHX for 5 minutes. The conditioned dentin surfaces were dried with absorbent paper points. The Epiphany SE sealer was placed on each dentin surface with the use of hollow stainless steel tubes with specific diameter and height. The samples were stored in 100% humidity at 37°C for 7 days and then tested for shear bond strength in a universal testing machine. RESULTS Shear bond strength data were analyzed by one-way analysis of variance and Tukey post hoc tests (P < .05). There were statistically significant differences among the groups. CONCLUSIONS NaOCl decreased the bond strength of Epiphany SE sealer to dentin, whereas the use of Na-Ascr reversed this negative effect of NaOCl. CHX had neither negative nor positive influence on the bond strength.

Effect of Coconut Water Concentration on Survival of Bench-Dried Periodontal Ligament Cells

ABSTRACT Background : Coconut water is a biological and sterile liquid. It contains a variety of electrolytes, sugars and amino acids. The purpose of this study is to evaluate the effect of concentration and maturity of coconut water on its ability to preserve human PDL cell viability after exposure to dry time of up to 120 minutes using an in vitro cell culture model. Methods : PDL cells were obtained from sound permanent first molars which were cultured in Dulbecco’s Modified Eagle’s Medium (DMEM). Cultures were subjected to 0, 30, 60, 90 and 120 minutes dry periods then incubated with 100 and 50% young and mature coconut water for 45 minutes at room temperature (18-26°C). Untreated cells at 0 and 120 minutes, and cells incubated in DMEM served as controls. PDL cell viability was assessed by MTT assay. Statistical analysis of data was accomplished by using one-way analysis of variance complemented by Tukey test, and the level of significance was 5% (p < 0.05). Results : 100% mature coconut water (MCW) was better than 50% dilutions obtained from mature or young coconuts. However, no significant benefit to the cells was noticed from the addition of the soaking step prior to 30 minutes dry time. Conclusion : Avulsed teeth which are left dry for > 30 minutes may be benefited from soaking in 100% mature coconut water; further studies on simulated avulsion in animal models are needed to verify the above results.

Higher Maximal Occlusal Bite Force in Endodontically Treated Teeth Versus Vital Contralateral Counterparts

Introduction Decreased sensitivity to occlusal load could lead to a greater risk of damage to endodontically treated teeth. Therefore, this study aims to test whether root canal treatment reduces the sensitivity of the treated teeth to occlusal load. Methods This is a comparative cross‐sectional study of 124 patients who received root canal treatment. Treated teeth were compared with vital teeth on the contralateral side. After interviews with participants, their maximal bite forces (MBFs) of their root canal–treated and contralateral untreated teeth were measured using a digital bite fork force transducer. Data were analyzed by comparing the mean MBF of root canal–treated and control teeth. Results The mean MBF (± standard deviation) was 226.6 N (±168.7) for root canal–treated teeth and 207.93 N (±158.08) for control teeth. Root canal–treated teeth had a significantly higher difference in the mean MBF than the control group (P < .0001) using the paired sample t test. A univariate analysis test showed that differences in the MBF were affected by molar relationship, overbite, and the quality of root filling. Conclusions The difference in the MBF was significantly higher in root canal–treated teeth, which is consistent with the function of dental pulp as a highly sensitive sensor. Therefore, the reduction in the sensitivity of teeth to an applied load after pulp removal may increase the risk of overloading. This may, in turn, increase the frequency of tooth damage after root canal treatment.

The Antifungal Effect of Propolis Endodontic Irrigant with Three Other Irrigation Solutions in Presence and Absence of Smear Layer: An In Vitro Study

Introduction: The aim of this in vitro study was to compare the antifungal effect of propolis as an endodontic irrigant agent with a mixture of doxycycline, citric acid, and a detergent mixture (MTAD), 2% chlorhexidine (CHX) and 3% sodium hypochlorite (NaOCl) against Candida albicans in presence and absence of smear layer. Methods and Materials: Extracted teeth with single canals (n=104) were prepared and randomly distributed into four experimental groups; 30% propolis, MTAD, 2% CHX and 3% NaOCl. Each group had two subgroups; with and without smear layer. The antifungal effectiveness was evaluated. The Kruskal-Wallis and Mann-Whitney tests were used to compare the overall effectiveness of different treatments at significance level of 0.05. Results: Propolis, CHX and NaOCl had similar levels of effectiveness to each other against C. albicans, and these levels were not affected by the presence or absence of the smear layer. Each irrigant was significantly more effective than MTAD or saline solution. MTAD was less effective in the presence of the smear layer than in its absence. Conclusions: Propolis irrigation can produce root canals that are free of C. albicans, even in the presence of the smear layer.

Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial

Introduction: Mineral trioxide aggregate (MTA) has been used in pulp capping of cariously exposed mature permanent teeth with promising results. The search for alternative materials that seal better and set faster than MTA and do not stain is ongoing. Biodentine (Septodont, St Maur‐des‐Fossés, France) exhibits these advantages but has not been tested yet for a prolonged duration in mature teeth. This study aimed to evaluate the clinical performance of Biodentine and white MTA (Angelus, Londrina, Brazil) in cariously exposed mature permanent teeth. Methods: This was a prospective longitudinal randomized controlled study of 68 vital permanent teeth with deep caries. Patients were randomly allocated into 2 study arms: Biodentine and MTA. Teeth were assessed clinically and radiographically before the procedure. Caries were excavated under local anesthesia; hemostasis was achieved after pulp exposure using sodium hypochlorite and capped with Biodentine or MTA. Clinical and radiographic follow‐ups were performed by a blinded calibrated evaluator after 6 months and 1, 2, and 3 years. Results: There were no significant differences in the overall success rate between Biodentine and MTA; it was 93.3% (Biodentine = 93.1% and MTA = 93.5%) at 6 months. The overall success rate increased to 96.2% (Biodentine = 96.0% and MTA = 100%) at 1 year and to 100% at 2 years. At the 3‐year follow‐up, it decreased to 93.8% (Biodentine = 91.7% and MTA = 96.0%). Conclusions: Biodentine and MTA have favorable and comparable success rates when used as direct pulp capping or pulpotomy material in permanent mature teeth with carious exposure. The remaining tooth structure and durability of coronal restoration might affect significantly the long‐term success of vital pulp therapy.