Mothanna Alrahabi

Evaluation of root canal morphology of maxillary molars using cone beam computed tomography.

Objectives: The success of endodontic treatment is based on cleaning and shaping of the root canals. The root canals have complex morphology and wide individual variations. The objective of this study was to analyze root canals morphology and existence of extra canals in maxillary molars in Saudi subpopulation. Methods: Freshly extracted maxillary first molars (n=100) were included in this study. All teeth were examined for morphology of roots, root canals and apical foramen by Cone Beam Computed Tomography (CBCT). The root canals configuration was classified using Vertucci’s classification. Results: The majority of maxillary first molars (94%) were having three distinctly separated roots and 6% had four roots. Palatal and distobuccal roots were observed to contain one root canal (100%) and Vertucci’s type I configuration. The mesiobuccal root had one (29.4%; type I) or two canals (70.6%; type II, III or IV). Conclusions: The occurrence of second canal in the mesiobuccal root of upper first molar is very much likely (>70%). The mesiobuccal roots are more likely to have Vertucci’s type I or II configuration (>76%). The palatal and distobuccal roots always have a Vertucci’s type I canal configuration.

Knowledge regarding technical aspects of non-surgical root canal treatment in Al-Madinah Al-Munawarah private dental centers

Objective: We evaluated knowledge of technical aspects of non-surgical root canal treatment among general dentists in private dental clinics in Al-Madinah Al-Munawarah, Saudi Arabia. Materials and Methods: A questionnaire was distributed randomly to 70 general dental practitioners who were working in private dental centers. The response rate was 88.6%. Results: The results showed that only 3% of dentists were using rubber dams for isolation during endodontic treatment. The majority (59.7%) were using radiographs to determine the length. Also, 37% were using nickel-titanium (NiTi) rotary instruments to prepare the root canal. The lateral condensation technique with gutta percha points to fill the root canal was used by most respondents (77.5%). Conclusions: This study provides important data on endodontic treatment by general dental practitioners in Al-Madinah Al-Munawarah private dental centers. It shows a general lack of knowledge regarding the importance of using rubber dams as well as the new endodontic materials and methods. Continuing education programs to update their knowledge in the field of endodontics are essential.

Antibiotic abuse during endodontic treatment in private dental centers

Objectives: We evaluated antibiotic prescription practices during root canal treatments among general dentists in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia. Methods: A self-administered, questionnaire about antibiotic used during root canal treatment was distributed to 75 randomly selected general dental practitioners working in private dental clinics in Al-Madinah Al-Munawarah, Saudi Arabia, between March and April 2016. The questionnaires were collected one week later. To compare results of the collected data, Chi-square test was used. Results: The results revealed that 60% of the dentists prescribed amoxicillin with clavulanic acid as the first choice treatment for endodontic pathosis. Clindamycin (51.6%) was the first choice for patients who were allergic to penicillin. Forty-five percent of the general practitioners prescribed antibiotics for 5 days. Approximately 83.3% of general practitioners prescribed antibiotics for acute apical abscesses. Prophylactic antibiotics were prescribed for cases with a history of infective endocarditis (65.5%), non-controlled diabetes (60.3%), placement of a prosthetic joint in the previous 2 years (46.6%), congenital heart disease (36.2%), and kidney dialysis shunts (34.5%). Conclusion: This study reveals antibiotic abuse in endodontic treatment practice in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia. General dental practitioners are lacking knowledge regarding the prescription of antibiotics in endodontic treatment and situations requiring prophylactic antibiotics.

A cross-sectional study of the quality of root canal treatment in Al-Madinah Al-Munawwarah

Objective: This study evaluated the quality of root canal treatment (RCT) and determined the prevalence of apical periodontitis (AP) in Al-Madinah Al-Munawwarah, Saudi Arabia. Materials and Methods: Panoramic radiographs of 630 patients (316 males and 314 females) who attended clinics at the Dental College of Taibah University seeking dental care for the first time between 2010and 2013 were assessed for the adequacy of RCT and presence of AP. Results: RCT of at least one tooth was found in 52.8% of the patients, with a significantly higher prevalence in females (28.4 vs. 24.4%; P = 0.012), and AP was found in 53.5% of the patients, with a significantly higher prevalence in females (31.9 vs 21.6%; P = 0.000). Conclusions: There was a significant correlation between AP and inadequate endodontic treatment. This study reveals the importance of improving RCT in Al-Madinah Al-Munawwarah.

Cone beam computed tomography for exploring morphology of Mandibular first molar.

Aims: The root canals have complex morphology and vary widely among individuals variations. The objective of this research was to analyse the morphology of root canals and existence of extra canals in mandibular first molar in subpopulation of Al-Medina Al-Munawarah. Study Design: Experimental/Analytical. Place and Duration of Study: College of dentistry, Taibah University, Madinah Munawwarrah, Saudi Arabia, 2014. Methodology: This study was conducted using freshly extracted mandibular first molars (n=100). All teeth were examined for morphology of roots, root canals and apical foramen by Cone Beam Computed Tomography (CBCT). The root canals configuration was classified using Vertuccis classification. Results: All mandibular first molars (100%) had two distinct and clearly separated roots. There was a high probability of two canals (92.5%) in mesial root compared to the distal root that contain two canals only in 20% of teeth. There was no occurrence of more than two roots or more than two canals in any of the roots in the selected teeth. The majority of distal roots (80%) had single canal with type I canal configuration followed by type III (10%), type V (7.5%) and type II (2.5%). The mesial roots presented comparatively complex canals configuration. Type I canal configuration was Original Research Article Zafar and Alrahabi; BJMMR, 6(5): xxx-xxx, 2015; Article no.BJMMR.2015.228 515 observed in only 7.5% teeth. The incidence of C shaped canals was very low (2.5%). Conclusion: The occurrence of single rooted mandibular first molars as well as supernumerary roots is very unlikely. The incidence of two distinct canals in mesial root is high (>92%), however distal roots mainly represented one canal (80%).

Single visit root canal treatment: Review

The main objective of performing root canal therapy is to eliminate bacteria from the infected root canal system or remove inflamed pulp tissue and close it with a biologically acceptable filling material. If this treatment managed well, regardless of the number of visits, it will create a favorable environment for healing. The recent advances in Endodontic technology, attracts the dental practitioners as well as the Endodontist to perform the root canal treatment in one visit. The question that we consider in this review article focuses on the long term prognosis of one-and multiple appointment endodontic therapy for teeth with vital pulp, necrotic pulp, and apical periodontitis .

Clinical impact of bisphosphonates in root canal therapy

Bisphosphonates are stable structural analogs of pyrophosphate, which suppress the activity of osteoclasts, leading to decreased bone resorption. They are essential medications in the treatment of osteoporosis. Osteonecrosis of the jaw is a serious adverse effect of bisphosphonate therapy. The prevalence of bisphosphonate-related osteonecrosis of the jaw varies from 0% to 28%, and it can be triggered by dental extraction and trauma. Root canal therapy can delay, or even eliminate, the need for tooth extraction, and therefore, may reduce the risk of bisphosphonate-related osteonecrosis of the jaw. We suggest that this might be the best treatment for teeth with pulpal and/or periapical disease.

Anatomical Variations of Mental Foramen: A Retrospective Cross-Sectional Study

Mental foramen is (MF) an important anatomical landmark that has clinical significance during dental treatments such as placing dental implants or endodontic treatment of mandibular premolars. The location and morphology of mental foramen varies among populations. The aim of this study is to determine the range of variations in the anatomical location and shape of ment l foramen. This is a retrospective study conducted using panoramic radiographic (OPG) data of patients. A total of 498 panoramic radiogr phic images showing erupted lower premolars and first molars were included. All OPGs data were sorted in six study groups and analyz ed statistically. The majority of cases (57 %) showed the presence of MF in line with the long axis of 2nd premolar. Only 3.2 % of MFs were in line with the long axis of first premolar. The shape of MF was round in majority (40 %) followed by oval shape (35.7 %). Irr egular shape mental foramens were observed in 24.3 % of cases. The p value < 0.05 was considered as statistically significant. The ana tomical location of mental foramen varies between first premolar to first molar. In terms of shape, the mental foramen ranged from roun /oval t irregular. Although, the position and shape varied with age of the patient, there is no predictable correlation between the age and position or shape of mental foramen.

Comparison of the shaping ability of various nickel–titanium file systems in simulated curved canals

Aim: The aim of this study was to compare the shaping time and shaping ability of the ProTaper Universal, ProTaper Next, WaveOne, and Twisted Files (TF) nickel–titanium (NiTi) systems. Materials and Methods: This study was conducted using simulated root canals (n = 40). The specimens were divided into four experimental groups (n = 10 each). Each group prepared by NiTi system as following: ProTaper Universal, ProTaper Next, and WaveOne, the canals were injected with black ink before instrumentation, a series of photographs of each canal was saved to a computer using a set protocol. The canals were reinjected using red ink postoperatively to define their outlines, and images were taken in the same standardized manner. Photoshop software was used to superimpose pre- and post-instrumentation images in two different layers. Each 1 mm step from the apical end was measured using ImageJ Software and evaluated by measuring the amount of removed resin. The data were analyzed using SPSS version 20.0. Significance was set at P< 0.05. Results: There were significant differences (P < 0.05) in shaping time (in seconds) among the NiTi systems where the shortest preparation time was with TF system. There were significant differences (P < 0.05) in canal transportation values among NiTi systems. Canal transportation at D1, D2, D3, D5, and D7 was greater for the TF system than for the other systems (ProTaper Universal, ProTaper Next, and WaveOne). The transportation with the TF System was toward the outside of the curvature, and it was greater than that with other systems at D1, D2, D5, and D7. Conclusions: ProTaper Universal, ProTaper Next, and WaveOne preserved the original curvature of the canal better than the TF system.

Evaluation of complications of root canal treatment performed by undergraduate dental students

ABSTRACT This study evaluated the technical quality of root canal treatment (RCT) and detected iatrogenic errors in an undergraduate dental clinic at the College of Dentistry, Taibah University, Saudi Arabia. Dental records of 280 patients who received RCT between 2013 and 2016 undertaken by dental students were investigated by retrospective chart review. Root canal obturation was evaluated on the basis of the length of obturation being ≤2 mm from the radiographic apex, with uniform radiodensity and good adaptation to root canal walls. Inadequate root canal obturation included cases containing procedural errors such as furcal perforation, ledge, canal transportation, strip perforation, root perforation, instrument separation, voids in the obturation, or underfilling or overfilling of the obturation. In 193 (68.9%) teeth, RCT was adequate and without procedural errors. However, in 87 (31.1%) teeth, RCT was inadequate and contained procedural errors. The frequency of procedural errors in the entire sample was 31.1% as follows: underfilling, 49.9%; overfilling, 24.1%; voids, 12.6%; broken instruments, 9.2%; apical perforation, 2.3%; and root canal transportation, 2.3%. There were no significant differences (p > 0.05) in the type or frequency of procedural errors between the fourth- and fifth-year students. Lower molars (43.1%) and upper incisors (19.2%) exhibited the highest and lowest frequencies of procedural errors, respectively. The technical quality of RCT performed by undergraduate dental students was classified as ‘adequate’ in 68.9% of the cases. There is a need for improvement in the training of students at the preclinical and clinical levels.