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Background: Changes in healthy and inflamed pulp on periapical radiographs are traditionally so subtle that they may be imperceptible to human experts, limiting its potential use as an adjunct clinical diagnostic feature. Aim: This study aimed to investigate the feasibility of an image‐analysis technique based on the convolutional neural network (CNN) to detect irreversible pulpitis in primary molars on periapical radiographs (PRs). Design: This retrospective study was performed in two health centres. Patients who received indirect pulp therapy at Peking University Hospital for Stomatology were retrospectively identified and randomly divided into training and validation sets (8:2). Using PRs as input to an EfficientNet CNN, the model was trained to categorise cases into either the success or failure group and externally tested on patients who presented to our affiliate institution. Model performance was evaluated using sensitivity, specificity, accuracy and F1 score. Results: A total of 348 PRs with deep caries were enrolled from the two centres. The deep learning model achieved the highest accuracy of 0.90 (95% confidence interval: 0.79–0.96) in the internal validation set, with an overall accuracy of 0.85 in the external test set. The mean greyscale value was higher in the failure group than in the success group (p =.013). Conclusion: The deep learning‐based model could detect irreversible pulpitis in primary molars with deep caries on PRs. Moreover, this study provides a convenient and complementary method for assessing pulp status. [ABSTRACT FROM AUTHOR]

Periapical radiography is a regular radiographic procedure performed by dentists. However, at times, it may not be possible to position the image receptor into a patient's mouth in an optimized or practical way. For these cases, some dentists advocated the use of extraoral periapical radiography (EOPA). This literature review aimed to review the dental literature on the use of EOPA. In October 2023, PubMed, Web of Science, and Scopus were searched to identify papers that reported on the use of EOPA, supplemented by manual reference tracing and Google Scholar searches. After screening, 18 papers published between 2003 and 2022 were identified, including 14 original articles and 4 reviews. From very limited and conflicting evidence, it was found that root length/working length measurements between EOPA and IOPA did not significantly differ or EOPA showed inferiority. No data were available to compare EOPA with other extraoral modalities such as panoramic radiography. The technique used in EOPA to visualize posterior teeth in the maxilla and mandible varied across studies, such as the vertical angulation of the primary beam, whether mouth should be opened or closed, and whether a holder should be used or not. At the current time, EOPA probably should not be advocated for regular use. [ABSTRACT FROM AUTHOR]

Since electronic apex locators (EALs) were developed and innovated, they offered the property of being a determinant for the termination or end point of root canal treatments. Multiple studies have evaluated the efficacy of EAL. These studies suggested that EALs are accurate and reliable for determining working length more than radiographs alone. Two databases have been searched for topics related to EALs: PubMed and Google Scholar. To find out the most relevant articles related to the study's aim, search was done to review articles between 2004 and 2022. Since many brands have different EALs with different generations, the study has been done using Root ZX and Raypex 5 of EAL, concluding that both the Root ZX and Raypex 5 give accuracy up to 96.6% and 93%, respectively, for detecting the apical constriction. In addition, the systematic review results revealed no significant difference among the four generations of apex locators for the determination of working length. EALs can measure working length control and determine apical constriction, even in the presence of blood or irrigants. In addition, this device is a reliable tool for detecting perforations, whether small or large. Therefore, EALs are an essential tool in endodontics and should be combined with radiographs to achieve a higher level of prognosis and success. [ABSTRACT FROM AUTHOR]

Background : Introducing artificial intelligence (AI) into the medical field proved beneficial in automating tasks and streamlining the practitioners' lives. Hence, this study was conducted to design and evaluate an AI tool called Make Sure Caries Detector and Classifier (MSc) for detecting pathological exposure of pulp on digital periapical radiographs and to compare its performance with dentists. Methods : This study was a diagnostic, multi-centric study, with 3461 digital periapical radiographs from three countries and seven centers. MSc was built using Yolov5-x model, and it was used for exposed and unexposed pulp detection. The dataset was split into a train, validate, and test dataset; the ratio was 8–1-1 to prevent overfitting. 345 images with 752 labels were randomly allocated to test MSc. The performance metrics used to test MSc performance included mean average precision (mAP), precision, F1 score, recall, and area under receiver operating characteristic curve (AUC). The metrics used to compare the performance with that of 10 certified dentists were: right diagnosis exposed (RDE), right diagnosis not exposed (RDNE), false diagnosis exposed (FDE), false diagnosis not exposed (FDNE), missed diagnosis (MD), and over diagnosis (OD). Results: MSc achieved a performance of more than 90% in all metrics examined: an average precision of 0.928, recall of 0.918, F1-score of 0.922, and AUC of 0.956 (P<.05). The results showed a higher mean of 1.94 for all right (correct) diagnosis parameters in MSc group, while a higher mean of 0.64 for all wrong diagnosis parameters in the dentists group (P<.05). Conclusions: The designed MSc tool proved itself reliable in the detection and differentiating between exposed and unexposed pulp in the internally validated model. It also showed a better performance for the detection of exposed and unexposed pulp when compared to the 10 dentists' consensus. [ABSTRACT FROM AUTHOR]

Background : Introducing artificial intelligence (AI) into the medical field proved beneficial in automating tasks and streamlining the practitioners' lives. Hence, this study was conducted to design and evaluate an AI tool called Make Sure Caries Detector and Classifier (MSc) for detecting pathological exposure of pulp on digital periapical radiographs and to compare its performance with dentists. Methods : This study was a diagnostic, multi-centric study, with 3461 digital periapical radiographs from three countries and seven centers. MSc was built using Yolov5-x model, and it was used for exposed and unexposed pulp detection. The dataset was split into a train, validate, and test dataset; the ratio was 8–1-1 to prevent overfitting. 345 images with 752 labels were randomly allocated to test MSc. The performance metrics used to test MSc performance included mean average precision (mAP), precision, F1 score, recall, and area under receiver operating characteristic curve (AUC). The metrics used to compare the performance with that of 10 certified dentists were: right diagnosis exposed (RDE), right diagnosis not exposed (RDNE), false diagnosis exposed (FDE), false diagnosis not exposed (FDNE), missed diagnosis (MD), and over diagnosis (OD). Results: MSc achieved a performance of more than 90% in all metrics examined: an average precision of 0.928, recall of 0.918, F1-score of 0.922, and AUC of 0.956 (P<.05). The results showed a higher mean of 1.94 for all right (correct) diagnosis parameters in MSc group, while a higher mean of 0.64 for all wrong diagnosis parameters in the dentists group (P<.05). Conclusions: The designed MSc tool proved itself reliable in the detection and differentiating between exposed and unexposed pulp in the internally validated model. It also showed a better performance for the detection of exposed and unexposed pulp when compared to the 10 dentists' consensus. [ABSTRACT FROM AUTHOR]

The primary objective of this paper is to explore the diverse range of radiographic imaging techniques available for implant diagnosis and treatment planning. Pre-placement examination heavily relies on the utilization of these imaging modalities, as they play a critical role in ensuring the success of dental implant restorations by providing comprehensive diagnostic information about the patient's orofacial bony structures. Advancements in radiographic imaging have revolutionized the field of implant dentistry, offering dental professionals a wide array of imaging options to assess and plan implant procedures accurately. Having access to a variety of radiographic imaging techniques empowers dental practitioners to make well-informed decisions during implant treatment planning. It ensures that the implant procedure is tailored to the patient's unique anatomy and increases the chances of long-term success for dental implant restorations. [ABSTRACT FROM AUTHOR]

Furcation defects pose a significant challenge in the diagnosis and treatment planning of periodontal diseases. The accurate detection of furcation involvements (FI) on periapical radiographs (PAs) is crucial for the success of periodontal therapy. This research proposes a deep learning-based approach to furcation defect detection using convolutional neural networks (CNN) with an accuracy rate of 95%. This research has undergone a rigorous review by the Institutional Review Board (IRB) and has received accreditation under number 202002030B0C505. A dataset of 300 periapical radiographs of teeth with and without FI were collected and preprocessed to enhance the quality of the images. The efficient and innovative image masking technique used in this research better enhances the contrast between FI symptoms and other areas. Moreover, this technology highlights the region of interest (ROI) for the subsequent CNN models training with a combination of transfer learning and fine-tuning techniques. The proposed segmentation algorithm demonstrates exceptional performance with an overall accuracy up to 94.97%, surpassing other conventional methods. Moreover, in comparison with existing CNN technology for identifying dental problems, this research proposes an improved adaptive threshold preprocessing technique that produces clearer distinctions between teeth and interdental molars. The proposed model achieves impressive results in detecting FI with identification rates ranging from 92.96% to a remarkable 94.97%. These findings suggest that our deep learning approach holds significant potential for improving the accuracy and efficiency of dental diagnosis. Such AI-assisted dental diagnosis has the potential to improve periodontal diagnosis, treatment planning, and patient outcomes. This research demonstrates the feasibility and effectiveness of using deep learning algorithms for furcation defect detection on periapical radiographs and highlights the potential for AI-assisted dental diagnosis. With the improvement of dental abnormality detection, earlier intervention could be enabled and could ultimately lead to improved patient outcomes. [ABSTRACT FROM AUTHOR]

Periapical radiography is a routine radiographic procedure performed by dentists on a daily basis. It can be taken with two techniques, the paralleling technique (P tech) and the bisecting angle technique (B tech). This systematic review aimed to identify the relevant literature, compare the use of P and B techs across various dental specialties, and determine the most appropriate technique to be used for different purposes in taking periapical radiographs. In January 2023, we searched PubMed, Web of Science, Scopus, and Google Scholar to identify the studies that compared the two radiographic techniques. The search string was: (paralleling AND ("bisecting angle" OR "bisected angle")). Manual reference tracing was also performed to identify the studies potentially missed. After screening, 26 studies were included for the qualitative review. The 26 included studies were published between 1976 and 2021. Ten of the studies were about general dentistry (dental radiology in general applications), whereas another ten studies were related to endodontics, such as working length estimation. Most studies advocated the use of the P tech for general, endodontics, implantology, and other indications. B tech was advocated for patients with a low palatal height. More future studies are needed to evaluate their performance in different scenarios with standardized equipment and radiographic positioning. [ABSTRACT FROM AUTHOR]

As the popularity of dental implants continues to grow at a rate of about 14% per year, so do the risks associated with the procedure. Complications such as sinusitis and nerve damage are not uncommon, and inadequate cleaning can lead to peri-implantitis around the implant, jeopardizing its stability and potentially necessitating retreatment. To address this issue, this research proposes a new system for evaluating the degree of periodontal damage around implants using Periapical film (PA). The system utilizes two Convolutional Neural Networks (CNN) models to accurately detect the location of the implant and assess the extent of damage caused by peri-implantitis. One of the CNN models is designed to determine the location of the implant in the PA with an accuracy of up to 89.31%, while the other model is responsible for assessing the degree of Peri-implantitis damage around the implant, achieving an accuracy of 90.45%. The system combines image cropping based on position information obtained from the first CNN with image enhancement techniques such as Histogram Equalization and Adaptive Histogram Equalization (AHE) to improve the visibility of the implant and gums. The result is a more accurate assessment of whether peri-implantitis has eroded to the first thread, a critical indicator of implant stability. To ensure the ethical and regulatory standards of our research, this proposal has been certified by the Institutional Review Board (IRB) under number 202102023B0C503. With no existing technology to evaluate Peri-implantitis damage around dental implants, this CNN-based system has the potential to revolutionize implant dentistry and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: To report the radiographic preferences during dental implant therapy in Palestine. Materials and Methods: Fourteen multiple-choice questions were delivered in electronic and hardcopy formats questionnaires during the Sixth International Implantology Conference (Palestine). The questions investigated the radiographic techniques that are mostly used based on various clinical scenarios and treatment phases. Results: One hundred and thirty-seven responses were captured. The majority of the participants were general dentists with implant experience (79.6%). Less than a third of the participants (27.2%) were members of the Palestinian Association of Dental Implantology. The majority (85.9%) of them have their practice in a city zone. Panoramic radiograph (PAN) combined with cone beam computed tomography (CBCT) was the most preferred radiographic technique during the planning stage. Conclusion: PAN and CBCT was the preferred choice during the planning stages. A PAN was preferred postoperatively and if no complications were associated. In the case of symptomatic patients, CBCT was the radiograph of choice. [ABSTRACT FROM AUTHOR]

Periapical Inflammation (PI) is one of the most popular diseases in adults due to complication of endodontitis or dental trauma with corresponding consequences to quality-of-life like tiredness and signs of infection. Specifically, patients having severe PI are often tiredness and high fever accompanied by signs of infection such as dry lips, dirty tongue, lymph node reaction in the area under the jaw. In X-Ray images, PI could be recognized by vague boundaries with signs of periapical ligament extensions. It is necessary to design a computerized diagnosis system based on the Deep Learning models for supporting clinicians in diagnosis of PI from X-Ray images. In this paper, we propose a new medical system called VNU for diagnosis of PI from X-Rays images. The VNU system uses Deep Learning to classify whether X-Ray images being PI or not. The Residual Neural Network (ResNet) with 34 layers is utilized with proper data augmentation and learning algorithms. The system is designed based on 7-layer enterprise architecture (User, Business, Application, Data, Technology, Infrastructure, and Security). It is used by both the clinicians and IT operators. The system has been validated on real data from Hanoi Medical University, Vietnam consisting of 900 images with PI and 500 normal images. Two scenarios of validation namely hyperparameter selection and performance comparison with other CNN-based Deep Learning models have been performed. It has been found from the experiments that the proposed system has better performance than the others in terms of sensitivity and specificity with the corresponding values of 96.70% and 93.87%. The system is deployed on the web interface that offers flexibility for clinicians in diagnosis and training. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate the performance of convolutional neural networks (CNNs) that were trained with small datasets using different strategies in the detection of proximal caries at different levels of severity on periapical radiographs. Small datasets containing 800 periapical radiographs were randomly categorized into a training and validation dataset (n = 600) and a test dataset (n = 200). A pretrained Cifar-10Net CNN was used in the present study. Different training strategies were used to train the CNN model independently; these strategies were defined as image recognition (IR), edge extraction (EE), and image segmentation (IS). Different metrics, such as sensitivity and area under the receiver operating characteristic curve (AUC), for the trained CNN and human observers were analysed to evaluate the performance in detecting proximal caries. IR, EE, and IS recognition modes and human eyes achieved AUCs of 0.805, 0.860, 0.549, and 0.767, respectively, with the EE recognition mode having the highest values (p all < 0.05). The EE recognition mode was significantly more sensitive in detecting both enamel and dentin caries than human eyes (p all < 0.05). The CNN trained with the EE strategy, the best performer in the present study, showed potential utility in detecting proximal caries on periapical radiographs when using small datasets. [ABSTRACT FROM AUTHOR]

Background: The second premolar is one of the teeth which are crucial both aesthetically as well as functionally and one of the most commonly endodontically treated tooth. Aim of the study was to assess the number of canals in maxillary second premolar by clinical and radiographic evaluation in Pakistani sub population. It was a cross sectional study conducted in Endodontic Department of Rehmat Memorial Dental Teaching Hospital, Abbottabad, from January 2019 to January 2020. Method: One hundred and five patients were selected for the study, based on nonprobability sampling technique. All patients were examined clinically by exploration of pulp chamber followed by intra oral peri-apical radiograph to verify the clinical exploration of canals. Result: One hundred and five patients (46 males (43.8%) and 59 females (56.2%)} were selected for the study. Out of total 105 patients 47 (44.8%) had one canal and 58 (55.2%) had two canals. Out of 46 males 25 (54.3%) had two canals and out of 59 females 33 (56.9%) had two canals. Statistical analysis showed no significant difference (p=0.1871) of canals arrangements between genders. Conclusion: Clinicians should be careful whenever doing root canal treatment of maxillary second premolars because of the extreme variability of the anatomy of those teeth, there is always risk of missing the second canal. Frequency of two canals was high, which is not age or gender dependant. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT), periapical radiograph, and intrasurgical linear measurements in the assessment of molars with furcation defects. Materials and methods: This parallel, single-blinded, randomised controlled trial (RCT) consisted of 22 periodontitis patients who had molar with advanced furcation involvement (FI). All patients followed the same inclusion criteria and were treated following the same protocol, except for radiographic evaluation (CBCT vs. periapical). This study proposed and evaluated five parameters that represent the extent and severity of furcation defects in molars teeth, including CEJ-BD (clinical attachment loss), BL-H (depth), BL-V (height), RT (root trunk), and FW (width). Results: There were no statistically significant differences between CBCT and intrasurgical linear measurements for any clinical parameter (p > 0.05). However, there were statistically significant differences in BL-V measurements (p < 0.05) between periapical and intrasurgical measurements in maxillary molars. Meanwhile, the sensitivity were 62.8% and 56.9% for CBCT and periapical, respectively. Conclusions: Overall, when compared to the intrasurgical measurements, CBCT provided better diagnostic, sensitivity, and quantitative information on CAL, height, depth, and width of the furcation defects than periapical radiograph. Clinical relevance: An accurate presurgical furcation diagnostic can guide the clinicians from the stage of diagnosis to definitive management so that unnecessary periodontal surgical interventions can be prevented. [ABSTRACT FROM AUTHOR]

For any dental implant procedure that is being carried out, the success will depend on a thorough preoperative investigation. The quality, quantity and the volume of available bone at the planned implant site has to be assessed properly when planning a dental implant placement. When we speak of the forementioned aspects pre-surgical imaging and its co-relation to clinical findings help assess the relation to the amount of bone available from underlying vital parts namely the sinus cavities, nasal floor, nerves, teeth and vessels. Different radiographic modalities have been advocated for its assessment. Intra Oral Periapical radiograph (two-dimensional) is one such modality that has lost its importance after the introduction of more advanced techniques like Cone Beam Tomography (three-dimensional). This article will help us understand how two-dimensional and three-dimensional imaging modalities go hand in hand while treating dental patients. It will also explain why the conventional imaging technologies are still required in this era of modern methods of imaging. [ABSTRACT FROM AUTHOR]

Dentists and oral and maxillofacial radiologists have used periapical, occlusal, panoramic, and cephalometric radiographs for many years for diagnosing dental anomalies, especially before orthodontic or surgical treatment. Cone beam computed tomography was developed in recent years especially for the dental and maxillofacial region. Thus it has become the imaging modality of choice for many clinical situations, such as the assessment of dental impaction and structural teeth anomalies or other associated diseases and disorders (e.g., Gardner's syndrome, cleidocranial dysplasia). This article reviews different aspects of dental impaction and its possible effects on adjacent structures such as external root resorption, marginal bone loss, as well as describing structural dental anomalies. It provides a systematic analysis of their characteristic features and imaging findings for general radiologists to achieve a precise diagnosis and an optimal interpretation. [ABSTRACT FROM AUTHOR]

Purpose: This randomised double-blind placebo-controlled trial was carried out to investigate the effect of a one-week post-operative course of 600 mg of ibuprofen taken four times a day on marginal bone level around dental implants. Materials and methods: A total of 61 patients were allocated to the ibuprofen (31 patients) or placebo group (30 patients). Overall, 132 implants were inserted, 67 implants in the ibuprofen group and 65 implants in the placebo group. Preparation of the implant sites was carried out with an intermittent drilling sequence adapted to the fixture diameter and the local bone quality according to the Astra Tech implant installation guide. The primary outcome measure was the change in marginal bone level around dental implants from the baseline (2 weeks post-placement) to the 3- and 6-month radiographic examinations. The paralleling technique and a film holder coupled to a beamaiming device were used to take the periapical radiographs. Measurement of changes in bone level was made using a viewing box and ×8 magnifier. Results: Two patients from the ibuprofen group were unable to complete the prescribed course of ibuprofen owing to a minor self-reported stomach upset. A patient from the control group did not attend any of the scheduled appointments following implant placement. A total of three patients dropped out. All implants survived in either group during the 6-month observation period. The mean marginal bone level changes from the baseline were (-0.33 mm) at the 3-month and (-0.29 mm) at the 6-month follow-up for the ibuprofen group while the corresponding values for the placebo group were (-0.12 mm) and (-0.30 mm). There were no statistically significant differences between groups for mean marginal bone level changes at 3 months (P = 0.27) or 6 months (P = 0.97). Conclusions: Administration of a short course of systemic ibuprofen for post-operative pain management subsequent to implant placement may not have a significant effect on the marginal bone around dental implants in the early healing period. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to compare vertical and horizontal periodontal measurements of posterior teeth on standardized panoramic and intraoral radiographs. Methods and materials: Standardized panoramic and periapical radiographs were made of 16 human skulls using ball bearings placed on the maxillary first molars to allow adjustment for horizontal and vertical magnification. Results: At 14 of 19 measurement sites there was no significant difference between measurements on the 2 radiographic film types. At 4 sites vertical measurements on panoramic radiographs were significantly larger than on periapical radiographs (0.80 to 1.37 mm). At one site horizontal measurements were significantly greater on periapical radiographs (0.88 mm). Conclusions: If there is adjustment of the raw data for magnification as suggested in this study, panoramic radiographs may be used for measurement studies in the posterior region once the patients are positioned appropriately within the focal trough of the machines and the magnification range for the posterior focal trough is used for adjustment of data. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effect of defect morphology, bone thickness and examiner experience on the accuracy to detect the presence, the type and the depth of peri‐implant defects with digital periapical radiographs (PAs) and cone beam computed tomography (CBCT) in an in vitro model. Methods: Thirty six implants were placed in fresh porcine rib bone with different types of standardized defects while sites with no defect served as control. Fourteen masked examiners evaluated 324 PAs and 108 CBCT images. The presence and type of defect, the location of the bottom of the defect and the location of first bone‐to‐implant contact were recorded. The sensitivity, specificity, accuracy, positive and negative predictive values were calculated for each type of defect using actual measurements as the gold standard. Results: The diagnostic accuracy for PAs was affected by defect morphology, exposure time, thickness of bone walls and the level of experience of the examiner. The overall diagnostic accuracy of CBCT was high (>96%) for all types of defects. Conclusion: Cone beam computed tomography showed better diagnostic accuracy in the detection of peri‐implant defects, this can be attributed to the fact that CBCT seems to be less affected by variables that contribute to the poorer performance of PAs. [ABSTRACT FROM AUTHOR]

Knowledge of the internal and external root anatomy is essential for accurate determination of working length which often is taken as the apical terminus during endodontic therapy. The objective of this study is to determine the distance from the anatomical root apex to the major apical foramen in relation to radiographic findings and the position of the major foramen on the root apex by using micro-CT. A total of 100 extracted teeth for which a pre-extraction periapical radiograph available was analysed in this study. Each tooth was scanned using microcomputed tomographic (micro-CT) machine and images were constructed using software (NRecon version 1.6.3.3, SkyScan N.V, Belgium). Three-dimensional volume rendering of each specimen was performed using the MeVislab 2.1 freeware (Mevis Research, Bremen, Germany). The distance between the anatomical root apex to the mid-point of the apical foramen was measured in software (ImageJ 1.44; National Institutes of Health, MD, USA). The data were correlated to the presence of periapical radiolucency, if any. When resorption or an eroded apical area was observed in the 3- dimensional reconstructed images, the tooth was processed for histological confirmation. Mean distance between major apical foramen and anatomical root apex ranged from 0.391 mm for mandibular incisors to 0.798 mm for the mandibular premolars. T-test (p>0.05) showed no significant difference of foramen-to-apex distance between two periapical statuses. Major apical foramens of maxillary incisors (57.1%) were in a central position at the root apex. Radiographic findings showed no significant influence on the foramen-to-apex distance, which distance did not exceed 1 mm. The majority of the apical foramen seemed to be located in the centre of the root apex. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the present study was to evaluate the radiographic quality of RCTs performed by undergraduate clinical students of Dental School of Isfahan University of Medical Sciences. Methods and Materials: In this cross sectional study, records and periapical radiographs of 1200 root filled teeth were randomly selected from the records of patients who had received RCTs in Dental School of Isfahan University of Medical Sciences from 2013 to 2015. After excluding 416 records, the final sample consisted of 784 root-treated teeth (1674 root canals). Two variables including the length and the density of the root fillings were examined. Moreover, the presence of ledge, foramen perforation, root perforation and fractured instruments were also evaluated as procedural errors. Descriptive statistics were used for expressing the frequencies of criteria and chi square test was used for comparing tooth types, tooth locations and academic level of students (P<0.05). Results: The frequency of root canals with acceptable filling was 54.1%. Overfilling was found in 11% of root canals, underfilling in 8.3% and inadequate density in 34.6%. No significant difference was found between the frequency of acceptable root fillings in the maxilla and mandible (P=0.072). More acceptable fillings were found in the root canals of premolars (61.3%) than molars (51.3%) (P=0.001). The frequency of procedural errors was 18.6%. Ledge was found in 12.5% of root canals, foramen perforation in 2%, root perforation in 2.4% and fractured instrument in 2%. Procedural errors were more frequent in the root canals of molars (22.5%) than the anterior teeth (12.3%) (P=0.003) and the premolars (9.5%) (P<0.001). Conclusion: Technical quality of RCTs performed by clinical students was not satisfactory and incidence of procedural errors was considerable. [ABSTRACT FROM AUTHOR]

Introduction: Detection of root fracture is challenging both clinically and radiographically. Root fractures occur in different planes with unpredictable presentations. Aim: The aim of the study was to evaluate the diagnostic accuracy of selected digital image enhancement tools in the detection of horizontal Root Fracture (RF). Materials and Methods: Fifty three roots, of single and multirooted teeth, in eight dentate human cadaver mandibles were selected for this study. Following minimally traumatic extraction of the teeth, horizontal fractures were induced in 23 roots and remounted in the empty sockets of their respective human dry mandibles. The remaining teeth with no fractures were used as the control group. Twenty two periapical radiographs were obtained by using the paralleling technique and using Complementary Metal Oxide Semiconductor (CMOS). Image J software was used to enhance the original images with the Inversion (IN), Histogram-Equalization (EQ), and Polynomial (Poly) tools. A total of 88 periapical images (original and three enhanced images) were reviewed independently by three Oral and Maxillofacial Radiologists and two Endodontists. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the accuracy of fracture detection and the kappa statistic was used to assess agreement among reviewers. results: The diagnostic accuracy for one of the observers was significantly different in detection of RF with only EQ enhancement tool. Sensitivity and specificity were not significantly different. Interobserver agreement showed no significant difference between imaging methods. Intra-observer agreement was high to moderate. conclusion: There was no significant difference between the different imaging modalities. No statistical difference for the agreement was found among or between the endodontists and radiologists in this study. [ABSTRACT FROM AUTHOR]

The main goal of three-dimensional obturation is to provide an impermeable fluid tight seal within the entire root canal system, to prevent oral and apical microlekage. There is substantial evidence that the quality of root canal filling has a significant effect on the outcome of root canal treatment. The objective of the study was to evaluate the radiographic technical quality of root canal fillings performed by under graduate dental students at College of dentistry, Aljouf University, Saudi Arabia. A total of 277 root canal fillings were studied. The quality of endodontic treatment was evaluated by periapical radiograph in relation to the length, density and taper of the root canal fillings. The iatrogenic errors were also recorded. The total no of root filled canals were 277 with the predominance of maxillary 173 followed by mandibular 104. Out of 277 canals 186 (67.2%) were straight and the highest number of straight canals were found in incisors 51 (27.4%) while 91 (32.8%) were curved, the most curved canals were observed in molars 56 (61.53%). There was significant difference (p=0.000), showing that shape of a canal effects the acceptable filling of root canal and there was also significant difference observed for adequacy of density between different canal shapes. Adequate taper was found in 259 root canal fillings while inadequate taper in 18 root canal fillings. The result was statistically significant (p=0.03). Separated instruments, ledge formation, strip perforation, furcal perforation and root perforation were present in 6 (2.2%), 18 (6.5%), 1 (0.4%), 1 (0.4%) and 4 (1.4%) root canals respectively. Overall the quality of root canal fillings performed by the students was satisfactory. [ABSTRACT FROM AUTHOR]

Objective: To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) and periapical radiographs (PR) for the detection of external root resorption (ERR). Material and Methods: An electronic search in databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, the China National Knowledge Infrastructure, and System for Information on Grey Literature in Europe (SIGLE), was performed until August 2016. A manual search of relevant journals and reference lists of enrolled studies was conducted. The studies investigating the diagnostic accuracy of CBCT or PR for ERR, with simulated ERR as the reference test, were considered eligible. The diagnostic accuracy of CBCT and PR was statistically pooled using a bivariate model. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was used to test the stability of the overall results in the meta-analysis. Results: A total of 15 studies were included in this systematic review. The pooled results showed that CBCT had significantly higher sensitivity (0.89; 95% confidence interval [CI]: 0.77-0.96) and area under curve (0.96; 95% CI: 0.77-0.96) than PR (sensitivity: 0.68; 95% CI: 0.56-0.78; area under curve: 0.88; 95% CI: 0.85-0.90). No difference in sensitivity, specificity, and area under the curve between conventional and digital PR was observed. Conclusions: Currently available evidence suggests that CBCT could be reliable to detect the presence of ERR in clinical practice and has a higher diagnostic efficacy than PR. [ABSTRACT FROM AUTHOR]

Aim: To radiographically evaluate the technical quality of root canal treatment performed by undergraduate dental students and compare the findings with other institution's work. Materials and Methods: A retrospective, crosssectional study was conducted at the Academy Dental Teaching Hospital involving postoperative periapical radiographs of patients who were endodontically treated by batch #14 undergraduate dental students of final year (2013-2014) from UMST, Sudan. The total number of the students was 21, while periapical radiographs fulfilling the required criteria were 173. The radiographs of each case were evaluated in terms of length, density, and taper of the root canal filling. Procedural errors such as presence of a ledge, perforation, and a separated instrument were also recorded. Chi-square test was used to determine statistically significant differences between variables, with the level of significance set at P = 0.05. Results: The overall quality of performed root canal treatment was adequate in almost half (55.5%) of the evaluated teeth. The length and taper of the root canal filling were found to be significantly associated with maxillary and mandibular posterior teeth with P = 0.018 and 0.006, respectively. No associations were found between the density and presence of separated instrument in the maxillary and mandibular posterior teeth, P = 0.314 and 0.480, respectively. Conclusion: The radiographic quality of root canal treatment performed by undergraduate students of batch #14 UMST was acceptable in 55.5% of the cases. Special emphasis must be placed on the educational methods and training of students for providing root canal treatment on molar teeth. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the degree of external apical root resorption (EARR) in patients treated with self-ligating Damon appliances and with conventional preadjusted appliances. Methods: The sample comprised 52 patients, divided into two groups. Group 1 consisted of 25 patients treated with self-ligating Damon appliances, with an initial age of 16.04 years, final age of 18.06 years, and treatment time of 2.02 years. Group 2 consisted of 27 patients, treated with conventional preadjusted appliances, with an initial age of 16.77 years, final age of 18.47 years and treatment time of 1.70 years. The groups were matched regarding the initial and final ages, treatment time, type of malocclusion, and treatment protocol without extractions. Root resorption was evaluated on periapical radiographs of the maxillary and mandibular incisors at the end of orthodontic treatment with the scores of Levander and Malmgren. Intergroup comparisons of root resorption were performed with Mann-Whitney tests. Results: No significant difference in the degree of root resorption between the two groups was found. Conclusions: Similar degrees of resorption can be expected after non-extraction treatment with Damon self-ligating or conventional preadjusted appliances. [ABSTRACT FROM AUTHOR]

Background: Perforations are the one of the greatest cause of failure in endodontics. Early diagnosis of root perforations is a critical factor in treatment outcome. The aim of this study was to compare the sensitivity, specificity, and accuracy of conventional periapical (PA) radiography with cone-beam computed tomography (CBCT) in detecting strip root perforations in filled and unfilled root canals. Methods and Materials: In this in vitro experimental study, mesial root canals of 100 extracted mandibular molar teeth were prepared. Distal wall of the mesiolingual canals were thinned by rotating a Gates Glidden. Then the mesial roots of 51 teeth were randomly perforated. All samples were examined with PA (3 horizontal angles) and CBCT before and after obturation. The images were evaluated for diagnosis of strip root perforations by two observers. Sensitivity, specificity, and accuracy of each technique for detection of strip root perforation were calculated. The data were subjected to statistical analysis using Chi-square and Fisher exact tests. Results: In unfilled canals, sensitivity, specificity, and accuracy of the techniques for detection of strip root perforation were significantly different (P < 0.05). After obturation, PA was significantly more sensitive than CBCT (P < 0.05). Conclusion: Under the conditions of this in vitro study, in the absence of root filling materials, CBCT was superior to PA for detection of strip root perforation but for perforation detection in obturated root canals, PA with three different horizontal angulations was more reliable. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the accuracy of two imaging methods in detecting the apical pathology in endodontically treated teeth. Material and Methods: A clinical examination from a sample of 156 teeth of patients treated by students of masters in endodontics at the Care Center of the Faculty of Dentistry at St. Joseph University, Beirut was done after 5 years of follow-up. Periradicular digital radiographs and a cone-beam computed tomography (CBCT)scans were taken and analyzed statistically using both the Exact Fisher tests and McNemar tests. Results: The prevalence of lesions was significantly higher with CBCT (34.8%), whereas for digital radiography (13.8%). The CBCT was revealed more precise to identify periapical lesions. As for the clinical success, the rate was 82.5%. Conclusion: Within the limitations of the present study, CBCT was more reliable in detecting periapical lesions compared with digital periapical radiographs. [ABSTRACT FROM AUTHOR]

Background: Periodontitis is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganisms, resulting in destruction of the periodontal ligament and alveolar bone. Progressive loss of alveolar bone is the salient feature of periodontal disease. Accurate detection of periodontal disease with the use of radiographs helps in diagnosis, treatment and prognosis. Aims: The present study aims to compare the efficacy of conventional intraoral periapical (IOPA) and direct digital radiographs (RVG) in detecting interdental alveolar bone loss using intrasurgical (IS) measurements as the gold standard. Materials and Methods: Thirty patients elected to undergo periodontal flap surgery with periodontitis computing to 60 interdental alveolar defects on mandibular first molars were considered. IOPA and RVG were captured using standardized techniques. Bone loss measurements in IOPA and RVG were compared to the IS measurements. Statistical Analysis: Statistical analysis was carried out using student t test and ANOVA with the help of SPSS software and p-value <0.05 was considered as significant. Results: Both IOPA and RVG underestimated the bone loss measurements when compared to IS measurements which was statistically significant (p<0.0001). Bone loss measurements in RVG were closer to IS measurements than IOPA. Conclusion: Both the radiographic techniques IOPA and RVG underestimated bone loss by 1.5-2.5 mm. RVG was superior to IOPA for the detection of interdental bone loss due to reduced time and radiation exposure to obtain the same diagnostic information. [ABSTRACT FROM AUTHOR]

Aims: To survey the current radiographic prescriptions in dental implant assessment among dentists in Libya. Settings and Design: Eighty dentists were interviewed during a dental meeting by two calibrated graduate students, using a 19-question questionnaire, considering imaging modality options for preoperative implant site assessment with respect to cost, patient radiation dose, and broad coverage of facial bones and teeth. Statistical Analysis Used: Epi-Info 6.04 software was used to analyze the database file. Results: The radiographic examinations more often prescribed for dental implant assessment were the panoramic radiograph (70%), followed by panoramic plus periapical radiographs (15%). Only 6.25% of the dentists prescribed computed tomography as a single examination. The most common reason for prescribing a specific radiographic examination was the desire for broad coverage of the facial bones and teeth (44.64%), cost (14.3%) was the second most common cause. Conclusions: The interviewed dentist in this study prescribed panoramic radiographs in dental implant assessment based on broad coverage and cost. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to investigate the quality of root canal obturation performed by 6th year undergraduate dental students at the Dental School, University of Mashhad, Iran. Materials and Methods: A random 200 sample records of patients who received endodontic treatment at the Dental School, University of Mashhad between 2009 and 2010 was investigated. The quality of root canal filling was determined in relation to the adequate density and length of root fi lling. Statistical analysis of the data was carried out using statistical package for the social sciences (SPSS 12.0, SPSS Inc., Chicago, IL, USA) with Chi-square test. P < 0.05 was considered as significant. Results: About 38% of teeth fulfilled the criteria of an acceptable root canal filling. Adequate length and density of root filling was found in 73% and 66% of teeth respectively. There was significant difference between maxillary and mandibular teeth according to the quality (P = 0.009), length (P = 0.039) and density (P = 0.005) of root filling. The frequency of root canals with an “acceptable” filling was significantly greater in the anterior teeth than in molars. Conclusion: The technical quality of root canal treatment performed by undergraduate dental students was found to be less than ideal. Thus, the training course of the students at the preclinic and clinic has to be revised. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Marmara University Institute of Health Sciences is the property of Marmara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this study was to determine the prevalence of aggressive periodontitis found in patients attending Altamash Dental Hospital. Aggressive periodontitis was diagnosed using standard protocol. Aggressive Periodontitis was evaluated on the basis of localized and generalized condition which was further examined by taking OPG and peri-apical radiographs. 1000 patients were examined and treated from February 2009 to March 2010 by completing periodontal evaluation proforma and by measuring pocket depth by periodontal probe. Results showed higher prevalence of localized aggressive periodontitis (71%) compared to generalized aggressive periodontitis (29%) and localized aggressive periodontitis group was found more in smaller age group patients when compared to generalized aggressive periodontitis. There was no statistically significant difference in male/female proportions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate maximal occlusal bite forces (MOF) and marginal bone level (MBL) changes in patients with implant–tooth-supported fixed partial prostheses (FPP). Material and methods: Twenty nine partially edentulous patients consecutively who received 34 three-occlusal unit FPP with terminal implant and tooth support were subjected to quantification of MOFs using a sub-miniature load cell connected to a data acquisition system and measurement of the MBL changes around implants in digitalized periapical radiographs obtained at prostheses delivery and 24-month follow-up. Results: MOFs for implant support (mean: 353.61 N) significantly differed from tooth support (mean: 275.48 N) ( P<0.05), while gender did not influence MOFs ( P>0.05). MBL changes at mesial and distal sites of the implants at 24 months of functional loading were 0.28 and 0.097 mm respectively. Conclusion: Although MOFs under functional loading might indicate an increase in load participation for supporting implant, the rigid connection between implant and natural tooth via three-occlusal unit FPP does not jeopardize the time-dependent MBL stability of the implant under functional loads. [ABSTRACT FROM AUTHOR]

Copyright of dentalTarget is the property of dentalTarget and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report two cases in which cone beam computed tomography (CBCT) was essential for the establishment of the diagnosis of periapical lesions. CBCT allows a three-dimensional assessment of a specific region with no superimposition of structures. Therefore, its use is recommended when radiographic images are not sufficient for the diagnosis. [ABSTRACT FROM AUTHOR]

Radiographic examination forms an integral part of clinical dentistry, with some form of radiographs necessary on the majority of patients. Intra-oral periapical (IOPA) radiographs form the backbone of imaging for diagnosis and follow-up of various dento-facial pathologies. However, certain patient populations are unable to tolerate intra-oral films/sensors due to various reasons. A not-so recent development called extra-oral periapical (EOPA) radiography may be a useful adjuvant to such a situation, at least in the near future. It is essentially a technique where the film is placed extra-orally overlying the tooth of interest. The following manuscript is an attempt to throw light on this technique and the impact it may have on various disciplines of dental practices. The advantages and disadvantages of EOPA radiography and it's comparison to IOPA radiography has been discussed. [ABSTRACT FROM AUTHOR]

Background: the aim of this study was to assess the 2-year pulp survival of deep carious lesions in teeth excavated using a self-limiting protocol in a single-blind randomized controlled clinical trial. Methods: At baseline, 101 teeth with deep carious lesions in 86 patients were excavated randomly using self-limiting or control protocols. Standardized clinical examination and periapical radiographs of teeth were performed after 1- and 2-year follow-ups (REC 14/LO/0880). Results: During the 2-year period of the study, 24 teeth failed (16 and 8 at T12 and T24, respectively). Final analysis shows that 39/63 (61.9%) of teeth were deemed successful (16/33 (48.4%) and 23/30 (76.6%) in the control and experimental groups, respectively with a statistically significant difference (z score = 2.3, p = 0.021). Of teeth with severe and mild symptoms at T0, 42.9% and 36.7% respectively failed at T24 (p > 0.05). Within the self-limiting group, there was a lower success in premolars compared to molars (p < 0.05). Conclusion: after 2 years, there was a statistically significant higher pulp survival rate of teeth with deep carious lesions excavated using self-limiting protocols in patients with reversible pulpitis. Molars showed higher success than premolars in teeth excavated using the self-limiting protocol. There was no statistically significant association between the outcome and the severity of symptoms at T0 (ClinicalTrials.gov NCT03071588). [ABSTRACT FROM AUTHOR]

This study aimed to develop new image receptor-holding instruments with appropriate horizontal X-ray beam angulation, based on the anatomical data of posterior region interproximal surfaces derived from archived CT images. CT images of 92 patients with sound upper and lower dental arches were collected from our CT database and analyzed to determine the angles between the tangential interproximal contact line and the central groove line of posterior teeth. The average angle for each site was calculated and used to modify instruments using a three-dimensional printer. The utilities of the conventional and the modified instruments for viewing proximal surfaces were compared using two dry skulls. The right and left sides of each site, except for the lower second premolar and first molar sites, did not differ significantly. The difference between the sites was 2.0°; hence, we calculated mean values for the two sides at each site. In the maxilla, the angles of the first and second premolar, second premolar and first molar, and first and second molar to the groove line were 83.9° (±5.4°), 84.4° (±3.9°), 81.6° (±5.1°), while those in the mandible were 85.0° (±9.2°), 85.0° (±4.0°), and 90.6° (±4.9°), respectively. The holding instruments modified to 80° demonstrated better proximal viewing ability in the upper molar region than conventional instruments. The mean angles of the interproximal surfaces were determined from CT data. The image receptor holding-instruments were modified according to these angles to allow appropriate X-ray angulation, which facilitated improved observation of the proximal surfaces of teeth in the posterior region in this pilot in vitro study. [ABSTRACT FROM AUTHOR]