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Evaluation of Root Canal Morphology in Mandibular Premolars in an Iraqi Subpopulation Using Cone-beam Computed Tomography (Retrospective study)
Full text linkObjective: The effectiveness of root canal therapy relies on a thorough study of root canal anatomy, with mandibular premolars exhibiting a notable degree of diversity in this regard. The objective of this research was to utilize cone-beam computed tomography in order to determine the prevalence of mandibular premolar root canal configuration within a specific subpopulation in Iraq. Methods: Using cone-beam computed tomography scans, 404 mandibular premolars from 101 patients were evaluated retrospectively. The Vertucci classification and its subsequent modifications were employed to document and categorize the morphology of root canals and examine its relationship with gender, age of the patients, and unilateral/bilateral symmetry. The statistical analysis was performed using the Chi-square test or Fisher exact test, with a predetermined significance level of 5% (p≤0.05). Results: Around half (45%) of the first premolar teeth were of type I, 22.8% were of type V, 11.4% were of type III, and 10.4% were of type IX. No significant difference was detected between males and females regarding the types of canal configuration in mandibular first premolar teeth. Meanwhile, more than half (53%) of the second premolar teeth were of type I, 16.3% were of type V, 12.9% were of type III, and 10.4% were of type IX, the difference being significant between males and females. The differences in the distribution of types of canal configuration in both first and second premolars among the age groups were significant, however no statistically significant difference was observed between the right and left. Type I was the predominant root canal configuration in permanent mandibular premolars. Conclusions: Mandibular premolars had the greatest prevalence of type I root canal configurations, and there was a notable discrepancy in the number of canals between the MFP and MSP teeth in relation to age
Evaluation of Gutta-Percha Removal by Orange Oil Solvent and Eucalyptus Solvents Using Protaper Universal and XP-Endo® Rise Retreatment Instrument (An Invitro Comparative Study)
Full text linkObjective: This study evaluated the effectiveness of two rotary retreatment file systems with two gutta-percha solvents using Cone Beam Computed Tomography (CBCT) with Civil 3D 2020 metric software program during the root canal retreatment procedure. Methods: Forty extracted human permanent premolars had roots filled with guttapercha and were divided into four groups. The first two groups were retreated using the ProTaper universal rotary system with orange oil or eucalyptus solvent (A1, A2), while the other two groups were treated with Xp endo retreatment with the same solvents (B1, B2). A CBCT scan was taken before and after the root canal retreatment procedures to measure the amount of residual gutta-percha filling materials in the apical, middle, and coronal thirds. The amount of removed guttapercha was calculated by subtracting the before from the after measurements. The data was subjected to statistical analysis; P-values below 0.05 were considered statistically significant. Results: The amount of filling material removed at the coronal third was statistically nonsignificant between study groups (p= 0.544); in the middle third, there was a statistically significant difference between the groups (p= 0.043), and according to Tukey HSD, significance between A1 and B2 groups. Regarding the apical third there was a statistically significant difference between the groups (p= 0.017) and the significance was found between A1 and B1 groups. Conclusions: The ProTaper endo shaper rotary retreatment files are more efficient in removing root-filling materials than the Xp endo shaper. However, the type of solvent had no impact on the current study's results
Cephalometric Assessment of Skeletal Class II Malocclusion in a Sample of Kurdish Population in Sulaimani City (Retrospective Study)
Full text linkObjective: This retrospective comparative cephalometric study aims to identify the cephalometric features of skeletal class IImalocclusion in a sample of the Kurdish population, the result of this study willl be useful in diagnosing and treating orthodontic andjaw surgery.Methods: A total of 85 pre-treatment lateral cephalometric radiographs with skeletal class II malocclusion (ANB =4) and 81 withskeletal class I malocclusion (1= ANB 4) were obtained from the pre-orthodontic patient records in a private orthodontic clinic inSulaimani city. The patients were between 18 and 35 years old. The lateral cephalometric radiographs were analyzed digitally usingFACAD cephalometric software. Twenty-two variables were measured from each cephalometric radiograph. The correlation betweenClass I and II was analyzed using the Mann-Whitney Test.Results: The result showed that the values of SNA, ANB, Y-axis, Convexity angle, Gonial angle, Intermaxillary angle, facial angleand FMA, posterior cranial base, effective maxillary length, LAFH were higher in skeletal Class II than in Class I cases, which indicatesthat skeletal class II Kurdish population have more vertical mandibular growth and prognathic maxilla, retrognathic mandible, andlonger face than class I. Meanwhile, SNB, Mandibular length, TFH, UAFH, Maxillary length, UI-Palatal plane angle, IMPA, andeffective mandibular length values were lower and the difference was statistically significant in the majority of cases.This illustratesthat the incisors are more proclined in class I than skeletal class II, whereas the mandible is shorter in skeletal class II patients. Theseresults summarize the characteristic features of skeletal class II patients in a sample of the Kurdish population in Sulaimani City, whichare caused by etiological factors (genetic, congenital). This information is useful for enabling orthodontists and maxillofacial surgeonsto attain a diagnosis and treatment plan for skeletal class II patients in a shorter period.Conclusions: Skeletal class II malocclusion in the Kurdish population is characterized by a prognathic but short maxilla, retrognathic,short, backward, and downward rotated mandible, and a prominent chin
Comparing Occlusal and Maxillofacial Features of Orthodontic Patients with and without Hypodontic Permanent Dentition: (A Retrospective Cross- Sectional Study)
Full text linkObjective: This study compared the occlusal and maxillofacial features of a sample of Kurdish orthodontic patients with and without hypodontic permanent dentition. Methods: This retrospective cross-sectional study included two groups of patients: a hypodontia group (n=35 patients, 17 males,18 females) and a control group (without hypodontia) (n=34 patients,16 males,18 females) with all teeth other than third molars present. Pretreatment orthodontic records of all patients who visited a private orthodontic center between 2017 and 2021 were examined. Hypodontia group was subdivided into three groups and compared to the control group according to the severity, distribution, side, and location of missing teeth in jaws. Occlusal features, including overjet and overbite, were assessed using the 3shape Ortho system and all standardized lateral cephalometric radiographs were imported to FACAD Cephalometric Software to analyze craniofacial morphology. Results were compared using Mann-Whitney U, Friedman test) and Kruskal-Wallis H test at p = 0.05. Results: The results showed significant differences in dentofacial features between the two groups. Mandibles were retrognathic, chin angle, and upper facial height to lower facial height ratio decreased significantly when compared to the control group at p=0.04,0.03,0.01 respectively. Common dental characteristics were significant increase of the interincisal angle, decreases of the mandibular incisor angles, retroclination of mandibular incisor relative to the N-B line, and overjet showed a remarkable reduction in the anterior group compared to either posterior or anteroposterior group. Conclusions: Hypodontia has little impact on dentofacial structures. Generally mean values were within normal range, however, there were statistically significant differences between groups
Evaluation of Developmental Dental Anomalies in an Adult Dentate Iraqi Sub-Population of Sulaimani City by Using Panoramic Radiographs
Full text linkObjective: The present study attempts to evaluate the prevalence of developmental dental anomalies in patients aged 18 years and over by using panoramic radiographs among the Kurdish subpopulation in Sulaimani city. Methods: Seven hundred and ninety-four OPGs between 2010 and 2022 were evaluated retrospectively in this study. Using panoramic radiography to evaluate the frequency of dental anomalies in shape, structure, number, and size. Results: The prevalence of dental anomalies diagnosed by panoramic radiographs was 26.6% among the sample. Anomalies of shape were the most common abnormalities, followed by number, size, and structure. The most common anomaly seen in this study was dilaceration (18.52%), followed by hypodontia and microdontia (both 16.67%), taurodontism, and macrodontia (16.05.%). Less frequent sub-types were amelogenesis imperfecta, peg-shaped lateral incisors and ghost teeth, accounting for 0.62%. Conclusions: Tooth shape anomalies were the most prevalent forms of developmental dental defects among the Kurdish sub- population in Sulaimani city. Dilaceration, hypodontia, microdontia and taurodontism were the most prevalent categories of abnormalities. The study confirmed that racial variables play a role in the incidence of dental anomalies. In addition, digital panoramic radiography is a beneficial method for the detection of dental abnormalities. Importantly, patient management and the treatment design are dependent on an early diagnosis
A CBCT Study Comparing the Outcomes of Volumetric Bone Mass and Mini-Implant Success with Different Types of Malocclusions
Full text linkObjective: The present study aimed to determine the favorable site for orthodontic mini-implant insertion in both the maxilla and mandible in terms of cortical and trabecular bone thickness and density in different types of skeletal malocclusion using cone-beam computed tomography (CBCT). Methods: In this study, seventy-five CBCT examinations that were requested for different purposes were used, twenty-five in each malocclusion group (class I, class II and class III), class I (ANB: 2°-4°), class II (ANB 4°), and class III (ANB 2°) groups. RadiAnt Dicom Viewer was utilized, measurements were done at different sites in the jaws using standardized orientations, and the three malocclusion groups were compared for cortical bone thickness and density as well as the density of trabecular bone, using the Kruskal- Wallis and Mann-Whitney test for non-parametric data and one-way ANOVA for parametric data. Results: The highest cortical bone thickness was between 1st and 2nd molars at a 6 mm distance from the alveolar crest ranging from 1.03 mm to 1.2 mm in maxilla and 2.13 mm to 2.26 mm in the mandible. The difference between groups was only noticed between canine and 1st premolar which showed less buccal cortical bone thickness in class II cases with 1.07 mm. Cortical bone density was not significantly different between the three groups with maximum density between canine and 1st premolar with a density of 997.9 to 1078 HU in the maxilla and the mandible 1245.4 to 1329.3 HU. The trabecular bone density was also highest between canine and 1st premolar of both jaws, in maxilla 422.13 to 564.15 HU and mandible 509.81 to 799.04 HU. The difference between the groups was only in the anterior location between canine and 1st premolars which was less in class III cases with 509.81 HU Conclusions: Skeletal relations can have an impact on the thickness of the cortical bone, although all skeletal classes have the same pattern in the maxilla, in the mandible between the canine and the 1st premolar, variations in bone thickness and trabecular density may be seen in various skeletal malocclusions. So, it is important to properly consider the placement of mini-implants with the skeletal relation to achieve the maximum primary stability. Further researches are recommended, with long term follow up, on stability of mini- implants and its correlation with bone thickness and density
Comparison of Fracture Resistance of Endodontically Retreated Mandibular Premolar Roots using Two Obturation Techniques with Two Types of Sealers: An In Vitro Study
Full text linkObjective: This study aimed to evaluate the fracture resistance of endodontically retreated roots after obturation using two obturation techniques with two types of sealers. Methods: Eighty extracted single-rooted lower premolars with single-oval canals were selected for the study. After decoronation, the canals were instrumented with ProTaper Next rotary files and randomly split into two main groups according to the obturation techniques: Group A (n=40) Cold Lateral Condensation obturation techniques (CLC) and Group B (n=40) Warm Vertical Compaction obturation technique (WVC). Then, the main groups were divided into two subgroups according to different sealers: Subgroup A1: (n=20) using gutta-percha with AH Plus sealer, Subgroup A2: (n=20) using gutta-percha with MTA Fillapex sealer, Subgroup B1: (n=20) using gutta-percha with AH Plus sealer, Subgroup B2: (n=20) using gutta-percha with MTA Fillapex sealer. All the root canal fillings were removed using XP endodontic retreatment files for retreatments. A universal testing machine was used for the fracture resistance test. The data were evaluated statistically by using analysis of variance (one-way ANOVA) (P 0.05). Results: Cold lateral condensation with AH Plus sealer showed the highest mean fracture resistance (984 N). Meanwhile, WVC with AH Plus sealer showed the lowest fracture resistance (879 N). Statistical analyses showed a non-significant difference between all tested groups (P 0.05). Conclusions: The highest fracture resistance was offered by CLC with AH Plus sealer. However, WVC using gutta-percha with AH Plus sealer resulted in the greatest decrease in fracture resistance compared to the other groups
Effects of 1,25-hydroxycholecalciferol on Initial and Secondary Stability of the Dental Implant An In Vivo Study
Full text linkObjective: This study aims to evaluate the efficacy of vitamin D levels on the stability of dental implants using the AnyCheck® device. Methods: Fifty-six units of implants were placed for 21 participants (10 male, 11 female). A new damping capacity method device (Anycheck) was used to test the stability of the implants in two periods, first at the time of implant insertion (initial stability) and second after 3-4 months from implant insertion (secondary stability). The implant stability index was set based on the implant stability quotient value (from 0 to 100. After that, all the participants were sent for a Vit D level test. As a result of this test, the participants were divided into two groups: those with Vit D 30 (Normal) and those with Vit D 30 (Deficient). A statistical analysis was performed by using (paired t-test and independent t-test) at a significant level of (p 0.05). Results: The initial stability tests showed a non-significant increase in the ISQ mean value for the normal vitamin D group compared to the deficient vitamin D group (73.133, 72.288). The secondary stability tests showed a significant decrease in the ISQ mean value for the normal vitamin D group compared to the vitamin D deficient group (69.3, 72.28). Conclusions: Within the limitations of this study, the vitamin D level does not significantly improve dental implants' initial and secondary stability. The efficacy of vitamin D on implant osseointegration remains controversial and requires further investigation
Efficiency of Canal Brush and Ultrasonic Activated Irrigation in Smear Layer Removal Using Two Different Chelating Agents (In Vitro Study)
Full text linkLateral Cephalometric Analysis of Maxillary Positional Changes Treated by Mini-implant Assisted Rapid Palatal Expansion vs. Hyrax Expansion: Comparative Prospective Study
Full text linkObjective: The aim of this study was to compare the skeletal, dental, and soft tissue evaluation of mini-implant-assisted rapid palatal expansion and hyrax expansion, most commonly used to treat maxillary transverse deficiency, on lateral cephalogram at two-time intervals. Methods: The research employed lateral cephalograms at two-time intervals in thirty-six patients treated with rapid maxillary expansion (RME). Depending on the type of expansion, patients were divided into two groups. The hyrax group (n = 18; ages = 16.33 ±2.3 years) had RME with tooth-borne appliance; the mini-implant-assisted rapid palatal expansion group (n = 18; ages = 18.3 ± 2.5 years) had RME with a tooth-bone-borne appliance. Pretreatment and posttreatment digital lateral cephalogram samples were analyzed with WebCeph. The two groups were compared for cephalometric differences using the Mann-Whitney test. Intragroup differences were assessed with the Wilcoxon Signed Ranks Test. Results: When inter-group differences were assessed, statistically significant differences in the mean changes were observed. The sella- nasion-point A angle increased more in the mini-implant-assisted rapid palatal expansion group, and the upper lip to E-line decreased more in the hyrax group. Intragroup differences, assessed by the Wilcoxon Signed Ranks Test, were found to be statistically significant for the upper lip to E-line and nasolabial angle decrease for hyrax group, while in the mini-implant-assisted rapid palatal expansion group, the sella- nasion-point A angle increased. Conclusions: MARPE expanders lead to more skeletal changes. An increase in the SNA angle caused the maxilla to move forward. However, in the Hyrax group, statistically significant differences were seen in soft tissue analysis