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The Relationship Between Crown Shape and Root Canal Morphology of Maxillary Second Molars in an Iraqi Sub-population Using Cone Beam Computed Tomography (CBCT)
Full text linkObjective: This study aimed to look into how crown shape affected the architecture of the root canals. Methods: Nine hundred and fifty-four CBCT scans of maxillary second molars were evaluated. The relation between the crown shape and sex, root number, and root canals was determined. The frequency of the second canal in the mesiobuccal root (MB2), its age relation, and the symmetry of the concurrence of anatomical variations in contralateral molars were analyzed. The chi-square test was used for the analysis of the outcomes. It was deemed significant at P 0.05. Results: Overall, rhomboidal-shaped crowns comprised 60.1% of all crowns, while heart-shaped crowns made up 39.9%. Three-rooted teeth were the most common (74.5%), followed by two-rooted teeth (11.9%) and one-rooted teeth (8.5%), while four-rooted teeth made up only 5% of all samples. The most prevalent result in terms of the canal number was three canals (67%), followed by four canals (24.8%), two canals (7.3%), one canal (0.6%), and five canals (0.4%). Males were less likely to have crowns with a heart-shaped structure than females. The rhomboidal crown (22%) had a higher occurrence of MB2 canals when compared to the heart-shaped crown (2.8%). Conclusions: Given the constraints of this research, it would seem that the rhomboid form of the upper second molar crown is more prevalent, with a greater tendency to have three and four roots and the presence of MB2 than the heart-shaped form
Anatomical Relationship between the Roots of Erupted Maxillary Posterior Teeth and Maxillary Sinus using CBCT in Sulaimani City (A Retrospective Study)
Full text linkObjective: Cone beam computed tomography (CBCT) may be recommended as a dose-sparing technique and 3D imaging that providesthe clinician more details for examining the maxillary sinus and its relation to the root apices of upper posterior teeth, as comparedwith standard medical computed tomography.Methods: A total of (340) CBCT images were examined, images were analyzed by using (Galileos Viewer Software Version 1.9,Dentsply). The distance was measured from the molar and premolar teeth; the closest tooth to the sinus was considered for both sidesusing the software measuring tool.Results: A total of 340 CBCTs were examined. One hundred and forty-seven CBCTs were included that matched the criteria. Afterexamination of the CBCTs, the most common relation between the roots of the upper posterior teeth with the maxillary sinus was Type2: the apices of the upper posterior teeth touching the sinus floor. The result shows no statistical difference between the age groups (pvalue = 0.135); also, the relationship between sex and the relation of the teeth with the maxillary sinus was not significant (p value =0.075).Conclusions: The most common relation between the apices of maxillary posterior teeth and the maxillary sinus was close contact.We also concluded that the use of CBCT is essential in diagnosing the type of relation, especially during procedures where oro-antralcommunication and trauma to the maxillary sinus is possible
Impact of Immunohistochemical Expression of Collagen III and MMP-14 in Odontogenic Keratocyst
Full text linkObjective: Immunohistochemical expression of collagen III and MMP14 was evaluated in odontogenic keratocyst, and correlated to the clinicopathological parameters to remark on the role of these markers in the biological behavior of the cyst.Methods: Twenty-three odontogenic keratocysts samples were collected from three pathological laboratories in Sulaimani. Demographic information and the available radiographic investigation were recorded. The immune expression of collagen III and MMP14 was evaluated and related to the clinicopathological variables. Chi-square test was used for analysis and a p-value of 0.05 was cut off point for significance.Results: Males were predominantly affected by odontogenic keratocysts lesions (69.6%), which were mainly detected in the 35 years age groups. Keratocyst lesions were seen more frequently in the mandible (82.6%), with well-defined borders, and unilocular appearance. Collagen III was oriented more commonly in a parallel direction (70.8%), with moderate intensity (45.8%). MMP14 revealed cytoplasmic expression in the epithelial lining of the keratocyst (100%), score 3 was the most prevalent expression (54.2%) in the cystic wall, and prominent inflammation and epithelial separation were detected with high scoring of MMP14, which were (57.1%) and (56.3%) respectively.Conclusions: Both markers had independent combined roles in the cyst s biological behavior, including the prevalent parallel direction of the collagen III, while overexpression of the MMP14 might have an impact role in the aggressive behavior of the lesion
Marsupialization as an Organ Preservation Measure in Management of Odontogenic Cyst
Full text linkObjective: Odontogenic cysts are a category of intra-osseous lesions that occur frequently. Marsupialization can be the maintherapeutic option for patients with large cysts or lesions to preserve crucial anatomical structures. The goal of this study was to treatindividuals with odontogenic cystic lesions conservatively using the marsupialization method.Methods: Twenty-two patients participated in this research as part of a cross-sectional study designed for statistical purposes. Thestudy included males and females between the ages of 6 and 80 with biopsy-proven odontogenic cysts.Results: After the treatment of 22 patients, data were collected and analyzed statistically. The statistical analysis was performed withthe use of Microsoft Excel and SPSS (Statistical Package for the Social Sciences). The Spearman coefficient was used to evaluate thecorrelation between patient age and marsupialization duration and the correlation between cyst size and marsupialization duration,while the Kruskal-Wallis test was used to illustrate the link between cyst type and marsupialization duration. Moreover, the Mann-Whitney U test was used to assess statistical variations between variables.Conclusions: Marsupialization is a conservative, noninvasive procedure that is effective in reducing the cyst s size until it is fullyresolved or reaches a certain point suitable for excision by enucleation. The marsupialization treatment was also advantageous inpreserving teeth, bones, the inferior alveolar nerve, the maxillary sinus, and the nasal cavity. The main purpose of this study was topreserve the vital structures that were compromised by the different types of odontogenic cysts, and the treatment strategy successfullyachieved that goal
Influence of Different Thicknesses of Monolithic Crowns Made from Different Resin-Bonded Glass Ceramic on Their Load-bearing Capacity (An in vitro Comparative Study)
Full text linkObjective: To investigate the load-bearing capacity of the full-coverage crowns made from lithium disilicate glass-ceramic LDGC(IPS e.max , Ivoclar Vivadent) and 10% zirconia reinforced lithium silicate glass ceramic ZLS (Dentsply DeTrey) with differentthicknesses.Methods: Forty resin dies with supporting bases were duplicated from two prepared typodont teeth for all-ceramic crowns as amaxillary first molar. Forty crowns corresponding to each die were prepared and then they were divided into four groups: Group I (n10) made from ZLS with a restoration thickness of (1.0 mm occlusally and 1.0 mm radially) and Group II (n 10) made from LDGCwith a restoration thickness of (1.0 mm occlusally and 1.0 mm radially), and Group III (n 10) made from ZLS (1.5 mm occlusally and1.5mm radially) and Group IV (n 10) made from LDGC (1.5 mm occlusally and 1.5 radially). All crowns were fabricated by chair sideCEREC CAD/CAM and crystallized with Speed fire Dentsply Furness. The virolink resin cement (VariolinkII, Ivoclar Vivadent) wasused to bond the crowns to the corresponding dies. All samples were thermo-cycled (10000 cycles between 5c and 55c) and tested forfracture resistance using a Universal testing machine at 0.5 mm/minute speed until failure. ANOVA and Tukey HSD test were used tocompare the fracture resistance between groups.Results: The result demonstrates that the fracture resistance means and SD of ZLS with different thicknesses ranged from 572 N ±122.002 to 1171±217.432 N, and those of LDGC with different thicknesses ranged from 625 N ±151.676 N to 845 N ±388.222 N.Conclusions: The fracture resistance increased with increasing crown thickness using different glass-ceramic materials
Comparative Analysis of Conventional, Sonic and Laser Activated Irrigation Methods on Fracture Resistance of Endodontically Treated Roots: An in vitro Study
Full text linkObjective: To compare the effect of different irrigation activation methods on the fracture strength of endodontically treated roots.Methods: Sixty extracted single-rooted mandibular premolars with single canals were used. The specimens were instrumented with ProTaper Next rotary instruments up to size X3 and were randomly split into four groups (n=15) according to final irrigation procedures: Group I: Conventional syringe irrigation with distilled water, Group II: Conventional syringe irrigation with NaOCl and EDTA, Group III: Sonic-activated irrigation with EndoActivator and Group IV: Laser-activated irrigation with Er-Cr: YSGG. Using a single-cone technique, root canals were obturated with gutta-percha and AH Plus root canal sealer. All samples were embedded in self-curing acrylic resin and subjected to axial forces by mechanical compression testing in a universal testing machine at 1 mm/min until fracture occurred. The data were evaluated statistically by using analysis of variance (one-way ANOVA) (P 0.05).Results: Conventional syringe irrigation with distilled water showed the highest mean value of fracture resistance and Laser-activated irrigation with Er, Cr: YSGG showed the lowest mean value of fracture resistance. In general, statistical analyses showed a non-significant difference between all tested groups (P 0.05).Conclusions: The fracture resistance of roots treated endodontically was found to be unaffected by different activation methods. However, Laser-activated irrigation with Er-Cr: YSGG resulted in the greatest reduction of fracture resistance in comparison to the other groups
The Effect of Habitual Water Pipe and Cigarette Smoking on Clinical Gingival Status in Non- Periodontitis Sample
Full text linkObjective: The study aimed to investigate the effect of the water pipe and cigarette smoking on clinical gingival parameters of non- periodontitis individuals. Methods: This cross-sectional study recruited 176 men and 49 women aged 17–41, and they were divided into three groups (each with 75 participants): control, cigarette, and water pipe. Furthermore, a case sheet and a questionnaire were prepared to obtain the individual's demographic profile and details regarding cigarette smoking and habitual water pipe-taking data. The following gingival parameters: sulcular depth SD, bleeding index BI, plaque index PI, gingival phenotype Gph, recession R and gingival pigmentation, were recorded and assessed for the three study groups. The obtained data were analyzed statistically using SPSS for Windows version27.0, with P≤0.05 considered statistically significant. Results: Smokers had a higher prevalence of mild brown gingival pigmentation, tooth discoloration, and thick gingival biotype compared to non-smokers (P 0.05). Also, there was a statistically significant link between the type of record and the above indicators (SD, BI, and PI). Conclusions: Water pipe and cigarette smoking negatively influence gingival health measures in non-periodontitis individuals
Assessment of Gingival Phenotype in Type 2 Diabetic Patients in Sulaimani City
Full text linkObjective: To determine the prevalence of gingival phenotype (GP) in type 2 diabetic patients in Sulaimani city and its relation withthe severity of periodontal diseases.Methods: A sample of 150 individuals with type 2 diabetes were selected with an age range of 40-65. Probe transparency methodinvolving a colorvue biotype periodontal probe was used to assess GP through the mid-labial gingival margin on the maxillary andmandibular central, lateral incisors, and canines. Clinical periodontal parameters including keratinized gingival width (KGW), probingpocket depth (PPD), plaque index (PI), bleeding index (BI), and clinical attachment loss (CAL) were recorded with a Williamsperiodontal probe. In addition, standardized HBA1C was assessed for each participant.Results: The majority of patients in this study had thin gingiva (42.7%), followed by medium, thick, and very thick gingiva (38%,14.7%, and 4.7%, respectively). The association between gingival thickness and severity of periodontal disease (gingivitis, periodontitisstage 1, stage 2, stage 3, and stage 4) was non-significant. However, significant differences were detected between the mean of KGWand the severity of periodontal disease. Furthermore, there was no statistically significant association with gingival thickness accordingto sex.Conclusions: Thin gingiva was the most common gingival phenotype among type 2 diabetes patients in Sulaimani city, followed bymedium gingiva, while thick and very thick gingiva were less common. Furthermore, there was no statistically significant associationbetween gingival phenotype and the severity of the periodontal diseases
Effect of Different Obturation Techniques on the Amount of Debris Extrusion During Endodontic Retreatment Using XP Endo Retreatment Set Files (In vitro Study)
Full text linkObjective: This study aimed to assess the effect of the cold and warm obturation techniques on the amount of apically extruded debris(AED) and time needed for the removal of filling material during endodontic retreatment using the XP endo retreatment files.Methods: Sixty single-rooted lower premolars with round-shaped canals were selected for the study. The canals were prepared andobturated with one of four obturation techniques (N=15): cold lateral compaction (CLC), single-cone (SC), thermoplasticized guttapercha injection (TGP), and gutta core (GC) obturation techniques. All the root canal fillings were removed using XP endodonticretreatment files. The mean weight of the AED was estimated with an analytical balance to an accuracy of 10-4 g. AED data weresubjected to Kruskal-Wallis and a one-way ANOVA, post hoc Tukey's test for the time factor, with a significance level ≤ 0.05.Results: AED data revealed significant differences among groups (p=0.039). The CLC technique was significant compared to TGP,with a significance level of p=0.018, and significant compared to the SC technique, with a significance level of p=0.034. Also, therewere highly significant differences between groups regarding the time needed for retreatment (p=0.000).Conclusions: The obturation technique influences AED, and time for root canal retreatment. CLC resulted in less debris extrusion,while SC resulted in higher debris extrusion and TGP required the least time for root canal retreatment
Retention Evaluation of Implant-Supported Mandibular Overdenture Using Two Different Attachment Systems: An in Vitro Study
Full text linkObjective: The purpose of this in vitro study was to evaluate the retentive behavior of implant-supported overdenture using two different attachment systems (locator and milled bar-clip attachment system).Methods: Six edentulous mandibular models were fabricated from cold‑cure PMMA; the denture-bearing area of the acrylic resin model was covered by an approximately 1.5 mm thick silicone resilient liner to simulate mucosa. The Study models were divided into three groups: Model A (locator), Model B (milled bar-clip attachment system without extension), and Model C (milled bar-clip attachment system with 1cm extension). However, for each study model, a complete mandibular denture was constructed. Anterior, posterior, and central dislodging forces were measured by digital force gauge at the beginning of the study (Initial retention) and after 540 courses of consecutive pulling and inserting the prosthesis (final retention), which was to simulate six months of overdenture use assuming three daily removals and insertions for oral hygiene practice.Results: There were statistically significant differences in retention between the group models, and milled bar-clips attachment systems revealed the highest retentive capacity. However, after six months of simulated use, there was a significant retention loss; retention of Model B recorded the highest percentage loss of 55.1%, while Model A recorded the most minor retention loss of 24%.Conclusions: The bar and clip attachment system offered higher retentive values than the locator attachment system. However, the retention loss was correlated to the particular attachment system, and the bar–clip attachment systems had the highest percent of retention loss. In contrast, the locator attachments were associated with acceptable retention, simplicity, and minimal retention