Radiographic assessment of root canal morphology of mandibular central incisors using new classification system: A cross-sectional study

Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review

INTRODUCTION

Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population.

METHODOLOGY

An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies.

RESULTS

The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology.

CONCLUSION

This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.

Cone-beam Computed Tomography Analysis of the Root Canal Morphology of Mandibular Incisors Using Two Classification Systems in a Spanish Subpopulation: A Cross-Sectional Study

OBJECTIVE

This study evaluated the root and canal morphology in permanent mandibular incisors teeth using cone-beam computer tomography imaging in a Spanish subpopulation, and compared these findings with ipsilateral (similarity) and contralateral (symmetry) incisors. In addition, the position of canal splitting was measured.

METHODS

A total of 229 datasets comprising four mandibular teeth each (n=916 incisors) were analysed using Vertucci and Ahmed et al. classifications, and, the similarity and symmetry were calculated. The distance from the cemento-enamel junction (CEJ), and the most coronal canal divergence was measured (if present). The role of sex was also assessed. The Cochran Q Test, LOGIS PROC in SUDAAN, Chi-square, and Kappa were used for the different comparisons. A p-value of less than 0.05 was considered significant.

RESULTS

All incisors were single-rooted and no significant differences regarding root canal morphology were found according to the sex of the subjects included in the database. The most common morphology was Vertucci type I/Ahmed et al. 1MI1(65.3% for central and 66.8% for lateral incisors respectively), followed by type III/1MI1-2-1 (31% for central and 30.6% for lateral incisors). 1.8% of the samples were considered as non-classifiable with Vertucci but were classified with codes using the Ahmed et al. system. Similarity values were 74.7% for the left side, and 74.2% for the right side, whereas symmetry values were 90% for central and 84.3% for lateral incisors. In the presence of divergences, the main (SD) distances from the CEJ were for type II/1MI1-2-1 3.8+-0.8 (centrals) 4.0+-0.7 mm (laterals); for type V/1MI1-2 this value ranged between 6.0+-1.8 and 5.5+-1.5 mm, whereas values for 1MI1-2-3-2-1 were 1.8 and 2.1 mm. No significant differences were found when the position of the most coronal divergence was compared between lateral and central incisors for the different morphologies.

CONCLUSION

A high prevalence of Vertucci I/Ahmed et al. 1MI1 configuration was present in mandibular incisors from Spanish individuals. Similarity and symmetry were common, particularly for central incisors. The position of the coronal splitting of the canals varied according to the root canal morphology.

Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study

BACKGROUND

Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation.

METHODS

This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance.

RESULTS

The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding.

CONCLUSION

The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

Critical analysis of a new system to classify root and canal morphology - A systematic review

A novel system to classify root and canal morphology was recently introduced (Ahmed et al. 2017). This systematic review aimed to answer the following research question: Does the Ahmed et al. system provide a more accurate and practical classification of root and canal anatomy compared to other classifications? A literature search was conducted in Google Scholar, Scopus and Wiley Online Library to identify the citation counts for the article entitled 'A new system for classifying root and root canal morphology; doi.org/10.1111/iej.12685'. After removal of duplicates and unrelated articles, 15 studies were included and analysed. All studies compared the Ahmed et al. system with the Vertucci classification. Results revealed that both systems were able to classify simple canal configurations in single-rooted anterior and premolar teeth, disto-buccal and palatal roots of maxillary molars. However, the Ahmed et al. system provided more accurate and comprehensive categorisations of single-rooted teeth with complex canal anatomy, multi-rooted maxillary and mandibular premolars and the mesio-buccal root of maxillary molars. Further evidence on the utility of the Ahmed et al. system is required using other diagnostic devices especially in molars.

Challenges of E-Learning: Behavioral Intention of Academicians to Use E-Learning during COVID-19 Crisis

The COVID-19 crisis demanded that all educational activities should be performed virtually to follow social distancing guidelines. Therefore, there was a need to perform a research study to assess the effects of external factors on the perceived usefulness, ease of use of e-learning, and the further effect of these perceptions on attitude and intent to use e-learning by using the technology acceptance model (TAM) among academicians at higher education institutions in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted, and data were collected from 263 academicians across Saudi Arabia through an online survey questionnaire using a non-probability purposive sampling technique and analyzed and tested using the SPSS and Smart PLS software. Results: This study found that self-efficacy was positively associated with perceived usefulness at β = 0.143 and p < 0.05, but it had no association with perceived ease of use at β = 0.057 at p > 0.05. System accessibility had a significant and positive relationship with perceived usefulness and perceived ease of use at β = 0.283, β = 0.247, and p < 0.01, respectively. Self-efficacy had a positive effect on perceived usefulness, whereas the subjective norm had no relationship with perceived usefulness and perceived ease of use at β = −0.065 and β = −0.012 at p > 0.05, respectively. Perceived ease of use and perceived usefulness were positively related to attitude towards use, which has a significant influence on intention to use e-learning. Conclusion: Perceived ease of application is the most significant factor (β = 0.556) in developing the attitude among academicians to practice e-learning, followed by perceived usefulness (β = 0.262). Moreover, it can be concluded that system accessibility has a stronger influence on developing perception among academicians about the expediency and ease of application of e-learning than self-efficacy.

Comparison between Restorative Materials for Pulpotomised Deciduous Molars: A Randomized Clinical Study

AIM

To evaluate and compare the clinical outcomes of Cention-N (CN) and stainless steel crowns (SSCs) as restorations for pulpotomised primary molars, and to study clinical and radiographic outcomes of pulpotomies restored with these materials.

METHODS

The study was conducted on 60 pulpotomised molars with occlusoproximal caries. These were randomly divided into two groups and restored with either stainless steel crowns or Cention-N. Clinical performance of restorations and clinical and radiographic success of pulpotomy was examined at 6, 9 and 12 months.

RESULTS

The mean scores for marginal integrity deteriorated significantly at 6, 9 and 12 months in both groups but in comparison were insignificant. The mean for proximal contact deteriorated significantly for the Cention-N group, whereas the mean for gingival health deteriorated remarkably for the stainless steel crown group at successive evaluations. No tooth in either group showed secondary caries or discomfort on biting, except for one tooth in Cention-N group which presented with secondary caries. The clinical success rate for pulpotomised molars was 100% for both groups until nine months, although this had reduced by the end of 12 months. Radiographically, the success rate was 79.3% for Cention-N, while it was 86.6% for stainless steel crowns at 12 months. There was no significant difference in clinical and radiographic success between either group.

CONCLUSION

Cention-N and stainless steel crowns are comparable for marginal integrity. However, crowns maintain significantly better proximal contacts while Cention-N was notably better for gingival health of the restored tooth. Both materials do not show secondary caries and discomfort on biting and are comparable in clinical and radiographic success of pulpotomy at the end of one year.