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Background: The educational process in the field of endodontics commences with preclinical exercises to enhance students' proficiency in cleaning, shaping, and performing root canal fillings. Therefore, this study aimed to radiographically evaluate the technical quality of root canal fillings performed by preclinical students on extracted teeth at the College of Dentistry, University of Ha'il, Saudi Arabia. Methods: A total of 788 extracted human teeth received root canal treatment by undergraduate students. The samples were then gathered and radiographically assessed using the three quality criteria of length, density, and taper. The category of root canal fillings was classified as either acceptable or unacceptable. The criteria for evaluating the acceptability of filling quality were defined based on the presence of adequate length, density, and taper. The effectiveness of root canal fillings was also evaluated in relation to the tooth type, sex, and treatment year. The agreement between the examiners was evaluated using Cohen's kappa test, and the relationship between the research variables was determined using the chi-squared test. The significance threshold was set at 0. 05. Results: The overall quality of root filling was determined to be satisfactory in 532 (67.5%) of 788 endodontically treated extracted teeth. The majority of the research sample (88.1%) had enough length, 89.6% had adequate density, and 86.4% had acceptable taper. The quality of anterior teeth was substantially better than that of posterior teeth (p < 0.001). Our findings showed that the quality of root canals was better in 2022 than it had been in earlier years (p = 0.001). The three RCT quality criteria differed significantly when compared between sexes (p = 0.002). Conclusions: The quality of the root canal fillings completed by undergraduate students was rated as acceptable. The findings of the research suggest that the implementation of routine assessments to evaluate the technical competence of undergraduate dental students performing root canal treatments could provide significant insights into the efficacy of the curriculum requirements. [ABSTRACT FROM AUTHOR]

Licorice (Radix glycyrrhizae) is a plant root extract widely used in various applications, including cosmetics, food supplements, and traditional medicine. It has a long history of medicinal use in different cultures due to its diverse pharmacological properties. Licorice has traditionally been used for treating gastrointestinal problems, respiratory infections, cough, bronchitis, arthritis, and skin conditions. In recent years, the potential therapeutic benefits of licorice for oral health have gained significant interest. This paper aims to provide a comprehensive review of the effects of licorice extracts and their bioactive components on common oral diseases such as dental caries, periodontitis, halitosis, candidiasis, and recurrent aphthous ulcers. The chemical composition of licorice has shown the presence of several bioactive compounds such as glycyrrhizin, glabridin, isoliquiritigenin (ISL), and licochalcone exhibiting various pharmacological activities, including anti-inflammatory, antimicrobial, antioxidative, and immunomodulatory effects. Interestingly, in certain patients, licorice has shown a promising potential to inhibit the spread of viruses, prevent biofilm formation, reduce inflammation, boost immune responses, alleviate pain, and exert antioxidative effects. In this review, we provide a brief overview of the current understanding of licorice's therapeutic benefits in the treatment of oral ailments, emphasising its potential as an alternative treatment option for oral diseases. Further research is warranted to explore its efficacy, safety, and clinical applications using placebo-controlled clinical trials. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cone-beam computed tomography (CBCT) could be more beneficial in clinical situations that involve the determination of root canal morphology. AIM: The aim of the study was to ascertain the prevalence of radix molaris (paramolaris-RP and entomolaris-RE) in a subpopulation of Saudi Arabia using CBCT. METHOD: A total of 700 CBCT scans of mandibular permanent first molars were included in this study. All CBCT scans were interpreted by two trained dentists and an endodontist. Mandibular permanent first molars with fully developed roots and closed apices were only included. Computed Tomography scans were obtained from the dental college record. The anatomic characteristics which were checked included: the prevalence of radix molaris in both RE and RP and the prevalence of radix molaris according to the patient's gender and age. All CBCT images were processed and reconstructed using OnDemand3D TM imaging software. RESULTS: Of the 700 patients included, 651 (93.0%) did not have radix molaris, 46 (6.6%) had radix entomolaris and 3 (0.4%) had radix paramolaris in the study group. There was no statistically significant difference between the genders and age in the incidence of RE and RP (P -value < 0.05). CONCLUSION: The study showed that RE prevalence is more compared to RP in the first lower molars in the population studied. It is important to identify extra roots and associated canals to perform successful root canal treatment and avoid failure. [ABSTRACT FROM AUTHOR]

Background: Due to tooth structure loss from caries, trauma, fracture, prior restorations, and endodontic therapy, all of which lower the tooth’s fracture resistance, restoring teeth that have had endodontic therapy presents a number of challenges. To evaluate the attitude and practice of dentists and specialists in Southern Saudi Arabia regarding the restoration of endodontically treated teeth. Materials and Methods: A cross‑sectional questionnaire‑based study was carried out in Southern Saudi Arabia with a sample of general dentists as well as dental specialists. The questionnaire consisted of 12 items (questions), of which the first few inquired about participants’ demographic data such as age, years of practice, and the rest of the questions were intended to ask regarding their choice and use of restorative options of endodontically treated teeth. Data hence obtained were subjected to statistical analysis using SPSS version 20. Results: A majority of the study dentists (33.8%) prefer tooth‑colored crowns to use for endodontically treated anterior teeth when more than 50% of the tooth structure is remaining. Nearly 29.7% believed to use of prefabricated post and tooth‑colored crowns for endodontically treated anterior teeth when <50% of the tooth structure is remaining. Most of the study participants (75.7%) preferred composite core material and (64.9%) placed the “post” after waiting for 1 week. It was observed that the majority of the specialists used prefabricated post and tooth‑colored crown (29.3%) as a restorative material for endodontically treated anterior teeth when <50% of tooth structure was remaining. A statistically significant difference (P = 0.011*) was found between the responses of specialists and general dentists for their preferred restorative material post root canal treatment (RCT). Conclusion: The survey revealed a clear predisposition among respondents to tapered prefabricated metallic posts. This result demonstrates a consensus among dentists, indicating a preferred option for postdesign in their clinical practice. Different views were expressed by general dentists and specialists for the questions related to restoration options, depending on their choices. [ABSTRACT FROM AUTHOR]

Introduction: Thorough knowledge of the teeth's root and root canal morphology is vital before obtaining access to endodontic therapy. This study aimed to undertake a comprehensive literature review of the root and root canal anatomy of the mandibular premolars in several provinces of Saudi Arabia. Materials and Methods: The PubMed and Scopus databases were screened for relevant literature. Included studies reported data on the number of roots, root canals, canal configurations, and anatomical variations of mandibular premolars in the Saudi population. Gender morphological differences and bilateral symmetry have also been reviewed, along with case reports of anomalies. Results: Fifteen studies that fulfilled the inclusion criteria were included. The weighted average of single-rooted teeth is 91.4% of the mandibular first premolar and 96.7% of the second premolar. Studies of the internal canal morphology revealed that two or more canals were found in 21.5% of the first premolar and 7.1% of the second premolar. Type I Vertucci canal configuration is the most prevalent in mandibular premolars. The multi-rooted or multi-canalled system variants were frequently reported in the clinical case reports. Conclusion: Mandibular first premolars have a higher incidence of multi-canal system than second premolars, hence clinicians should be attentive to the possibility of an extra canal in these teeth. Few studies are available that discuss the root canal morphology of mandibular premolars in the Saudi population, and further studies with a larger sample size covering Saudi Arabia's provinces are indicated. [ABSTRACT FROM AUTHOR]

Introduction: This study was conducted to assess the effect of magnification devices (MDs) during nonsurgical root canal treatment (RCT) on quality of life (QOL) among dental professionals of the Kingdom of Saudi Arabia. The dental practitioners performing endodontic treatment were evaluated for ergonomic, postural, psychological, and financial issues associated with and without the use of MDs. Materials and Methodology: A total of 1650 dental professionals (general dentists and endodontists) were recruited from public and private sectors of Saudi Arabia from October 2021 to December 2021. The World Health Organization's QOL assessment questionnaire (WHOQOL-BREF) was administered to conduct the study. The questionnaire addressed four domains of QOL which included physical, psychological, procedural, and financial. Statistical analysis was done by SPSS software® version 23.0. Descriptive analysis, ANOVA test, and unpaired t-test were used. Results: All dental professionals completed the survey. 41.5% reported the use of MDs out of which dental loupe was most commonly used. Work-related musculoskeletal disorders were the most frequent physical difficulty which was faced by 61.5% of dental practitioners while performing RCT. 80% of DPs revealed that MDs improve manual abilities while performing RCT. MDs also relieved psychological, physical, and postural stress by 49.2%, 64.6%, and 63%, respectively. Further 72% of the dental professionals reported improved quality of work after the usage of MD. Conclusion: MDs are commonly used by dental professionals during RCT in Saudi Arabia. It is believed that its use can lead to a better ergonomic, postural, and psychological state of these dental professionals. [ABSTRACT FROM AUTHOR]

Objective: The aim of this retrospective study was to assess the prevalence of apical periodontitis (AP) in root canal-treated maxillary and mandibular posterior teeth in a Saudi Arabian population based on findings from images taken using cone-beam computed tomography (CBCT). Methods: The sample included 300 CBCT images from patients (150 females and 150 males) aged between 18 and 80 years old and they were analyzed to detect AP in endodontically treated maxillary and mandibular premolars and molars. Also, the correlation between the prevalence of AP and gender along with location (right/left side of jaw) were analyzed. Periapical lesions were defined as lamina dura gaps appearing disrupted around the width of periodontal ligament and apex at the apical third of the roots. Results: There was higher prevalence of AP in maxillary (19.1%) when compared to mandibular posterior teeth (17.3%). Mandibular first and maxillary second molars were the most affected teeth with AP (P = 0.05 and P = 0.04, respectively). Also, there was higher prevalence of AP cases with a predilection toward males (Maxillary P = 0.005; Mandibular P = 0.00) and on the right side of the mandibular jaw (P = 0.03). Conclusion: In this study, the prevalence of AP had a significant association between gender with a predilection in males and location with a tendency to occur on the mandibular right side as observed in endodontically treated maxillary and mandibular posterior teeth using CBCT. [ABSTRACT FROM AUTHOR]

Background: Success in modern orthognathic surgery is based on the close association between the oral maxillofacial surgeon and the orthodontist during various phases of the treatment, starting from the preoperative treatment planning to obtain the ideal occlusion. Orthodontic and endodontic treatments are commonly studied. Although studies revealed that orthodontic treatment could cause an impact on endodontically treated teeth, and vice versa, to date, no study has been conducted revealing the incidence of root canal treatment (RCT) in patients who underwent orthognathic surgery. Thus, the present study was conducted to evaluate the incidence of root canal therapy among patients subjected to orthognathic surgery. Materials and Methods: The present retrospective study was done on 814 patients who underwent orthodontic treatment. The clinical and radiographic records were assessed for all patients, and evidence of RCT was calculated. The data were obtained about gender, type of teeth involved, and diagnosis of the condition. Results: Out of those 57 patients who underwent orthognathic surgery in the past 5 years, 11 (1.35%) had undergone RCT, with the mean age being 21.72 years. A statistically significant difference (P < 0.05) was found between both genders in diagnosis. A maximum of 27.27% of cases subjected to RCT were left maxillary first premolar, followed by right maxillary first premolar, and right maxillary first molar, with a statistically insignificant difference (P > 0.05) between both genders to the type of tooth involved. Conclusion: A significant rate of prevalence of RCT was observed among the patients undergoing orthognathic surgery (19.29%), mainly involving premolars. Males showed a higher incidence of RCT in the left mandibular molar, whereas in females, first maxillary premolars were mainly involved among patients subjected to orthognathic surgery. Thus, there is a need to evaluate patients for the requirement of RCT after orthognathic surgery. [ABSTRACT FROM AUTHOR]

Background: Identify the objectives and the instructional design of undergraduate endodontics in dental schools in Saudi Arabia. Methods: The online questionnaire was developed from an original survey conducted in the United Kingdom. The questionnaire was modified for purpose of the study and the region of interest. Then it was directed and emailed to the undergraduate endodontic program directors in twenty-six dental schools in Saudi Arabia. The results were analyzed using descriptive statistics and the Chi-square and Fisher's exact tests. Results: The response rate was 96.15%. The number of credit hours for preclinical endodontic courses was up to four credit hours (84%). Students were clinically trained to do vital pulp therapies (92%), root canal treatment (100%), and root canal retreatment (68%). The majority of dental schools define the minimum clinical requirements (92%). Practical and clinical competency exams were used to evaluate students' performance (92% and 84% respectively). The students were trained to treat cases of minimal (52%) to moderate complexity (48%). Endodontic treatment consent and difficulty assessment form were used by 32% and 60% of dental schools respectively. There was no significant difference in the instructional design between public and private dental schools (P > 0.05). Conclusion: The endodontic undergraduate objectives were to graduate competent clinicians who acquired basic science of endodontics and who know their limitations as it is necessary for a safe general dental practice. The use of endodontic treatment consent and case difficulty assessment should be wisely considered in clinical training. [ABSTRACT FROM AUTHOR]

Objectives: The current study aims to investigate the morphology and symmetry of root canals of mandibular second premolar teeth via Cone-Beam Computed Tomography (CBCT) among a sample of the Saudi population. Methods: A total of 1200 CBCT images were examined in the study. The number of roots in the mandibular second premolars was identified, and canal configurations were classified according to Vertucci classification. Bilateral symmetry and association between gender and number of roots and root canal configuration were investigated using a chi-square test was utilized for data analysis and p value was set at 0.05 for significance. Results: Of the total 2400 Mandibular second premolars, 98.33% were single rooted and 1.67% were double rooted. The prevalence of double roots in females on the right side was significantly higher than that on the left side (p = 0.017), but the opposite was found among males. Only Type I and II canal configurations showed significant differences regarding gender and sides. 98.0% of teeth showed the symmetrical number of roots in both genders. The symmetry in canal configuration was 96.7% in males and 97.3% in females and 99.1% was Type I in both sides, 0.5% Type III, and 0.3% Type IV in both sides. Conclusions: The root morphology of mandibular second premolars in the Saudi population demonstrated a high degree of variability. The vast majority of mandibular premolars have a single root with one canal and a low prevalence of two rooted teeth. Contralateral mandibular second premolars exhibited great symmetry of roots and root canal configuration. [ABSTRACT FROM AUTHOR]

Introduction. Coronal leakage is detrimental to the long-term success of root canal treatment (RCT). While much emphasis is being placed on the quality of the final restoration, little attention is given to the temporary restoration placed in between root canal treatment appointments. The aim of this study was to survey temporization techniques practiced in Saudi Arabia and the frequency of observing temporary material breakdown or complete loss. Materials and Methods. An online questionnaire was distributed among general dentists, dental specialists, and clinical trainees in undergraduate and postgraduate dental programs. The sample size was estimated at 370 participants. Data were analyzed using descriptive statistics and chi-square tests. Results. The total number of participants who met the inclusion criteria was 525. The majority of them (94.6%) were practicing two-visit RCT. The most common temporization materials were Cavit (50.3%) followed by glass ionomer cement (32%). The majority (72.6%) of participants claimed they allow a thickness of 2-3 mm for temporary restorations. Many participants (60.4%) used a spacer material during temporization, and the cotton pellet was the most common spacer material. Temporary restoration breakdown or complete loss was a common observation. Although the duration between the two RCT visits was 2 weeks or less for 83.6% of participants, only 19.6% of participants claimed that they rarely observed temporization breakdown. Conclusion. Two-visit RCT is commonly practiced in Saudi Arabia, and endodontists performed significantly more single-visit procedures. Temporization practices may lack uniformity; however, clinicians were more likely to use calcium sulfate-derived material for two weeks or less. They allow for 2-3 mm thickness restoration and use a cotton pellet as a spacer. According to their clinical observation, temporary material breakdown or complete loss was frequent. This mandates further attention in research and education. [ABSTRACT FROM AUTHOR]

Purpose: To assess the prevalence of apical periodontitis (AP), as determined by orthopantomograms (OPGs), and its correlation with the quality of root fillings and coronal restorations.Materials and Methods: This cross-sectional study evaluated a random sample of 193 patients--112 (58%) females and 81 (42%) males--who presented as new patients at the Division of Endodontics. Digital OPGs were independently examined by two reliability-calibrated endodontists. The total number of teeth present, the location of the root canalfilled teeth, and the presence or absence of AP were recorded for each radiograph. The results were statistically analysed using the chi-square test followed by model building using multiple logistic regression.Results: A total of 324 endodontically treated teeth from the 193 selected radiographs were analysed. The mean number of teeth per patient was 25.5 ± 4.6, with an average of 1.64 root canal treatments per subject. Radiographically detected AP was associated with 190 (58.6%) root canal-treated teeth. The logistic model shows that the quality of endodontic treatment (adjusted odds ratio [ORa] = 1.82; 95% confidence interval [CI]: 1.40-3.17), status of coronal restoration (ORa = 1.77; 95% CI: 1.20-2.61) and the type of material used for coronal restorations (ORa = 1.39; 95% CI: 1.03-1.87) were significantly related to the periapical health of the teeth.Conclusions: The quality of endodontic treatment, status of coronal restoration and the type of coronal restorative material were found to be the most important factors influencing the health of periradicular tissue. [ABSTRACT FROM AUTHOR]

Background: There are very few studies comparing dentists' knowledge in relation to their clinical approach despite the existence of a possible gap between what they know and what they do. Aim: To measure the agreement between knowledge and practice methods related to a selected clinical scenario involving the placement of an indirect post in endodontically treated teeth (ETT) among different types of practitioners. Methods: An electronic questionnaire was emailed to members of the Saudi Dental Society. The questionnaire presented a clinical scenario of restoring a posterior ETT with an indirect post, core unit, and crown, followed by specific questions regarding knowledge and practice related to ten different treatment aspects such as who prepares the post space, technique, isolation, time, gap between gutta-percha, and time to cementation of the crown. Each question was presented twice for each aspect, once asking about their practice method and then what they thought was the correct practice (knowledge). The relationship between the participants' responses and their specialty and the agreement between the responses of knowledge and practice for each participant were analyzed by Pearson's chi-square test and Kappa. Results: 203 completed questionnaires were analyzed. Most participants were 30 years old or younger (62.6%), and general dental practitioners (59%). When comparing the knowledge to the practice methods of each participant, nine out of ten aspects were of a "weak" level agreement or below (kappa < 0.59, p < 0.001). Only one aspect demonstrated a "strong" level of agreement (Kappa = 0.804), which was related to the duration of time between obturation and post space preparation in the presence of a periapical lesion. However, this strong agreement in the responses was not aligned with current evidence. There was also a significant difference among the responses of endodontists, restorative dentists and general practitioners in most of the aspects. Conclusion: Overall, there was a weak agreement between what practitioners know and do in most aspects of a selected clinical scenario involving the placement of an indirect post in posterior ETT. Moreover, the participant's specialty influenced their responses regarding both knowledge and clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine the role of clinical audit in improving endodontic treatment outcomes. Materials and Methods: An audit at the department of endodontics at dental specialty centre kingdom of Saudi Arabia was carried out. The audit was conducted by developing endodontics treatment and success predictors based on evidence, that can be measured for endodontic care. A total of 12 months' data was examined from the previous dental records. Ten clinical cards were which included root canal treatment were selected. The audit was carried out for a minimum of 50 teeth and a maximum of 200 teeth. The radiographs of record cards were studied and a single dentist completed the audit tool. Results: The vitality test was performed in 1.98% cases, intra-canal medicament was used and named in 3.96% cases, 3.96% the teeth were extracted due to endodontic failure. Further, in 6.93% of the cases that were identified had certain spaces but overall root canal filling was evaluated as satisfactory. Conclusion: The vitality test, type of intracanal medicament, and assessment of root canal filling were not done, but there was an overall performance of predictors for endodontic treatment. [ABSTRACT FROM AUTHOR]

Morphological variations can occur in primary and permanent teeth. Genetic and environmental factors could be responsible for various dental anomalies. Anomalous teeth are usually asymptomatic and are diagnosed during routine oral examination. These anomalies may increase caries susceptibility and complicate dental treatment procedures such as extraction or root canal treatment. We report a rare case of mandibular first molar with a single root and a root canal. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the preference of general dentists and dentists from various specialties regarding preservation of natural teeth vs. replacing it with an implant. METHODOLOGY: A survey in the form of an electronic scenario-based questionnaire was designed and the link was distributed among dentists from different specialties in Saudi Arabia over the duration of two months from the 28th July to 28th September, 2019. Following the demographic questions, participants were provided results of diagnostic aids for five clinical cases representing varying challenges, and participants were asked to either preserve the tooth or replace it with a dental implant. RESULTS: Total 203 participants completed the survey, 25% preferred implants over preserving the tooth in the first case, while 52% had the same preference in the second case, and 68% preferred extraction in the third case. The choice of extraction for cases 4 and 5 was 17% and 6% respectively. CONCLUSION: Many teeth are being extracted which could have been conserved. Ethically, the patient's benefit and interest should be considered first while presenting various treatment options. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the root configuration and prevalence of multiple canals in mandibular incisors among a Saudi subpopulation in the Al-Madinah Al-Munawara region using cone-beam computed tomography (CBCT). Materials and Methods: The study included imaging data from 929 CBCT scans. All scans were obtained using a CBCT device (Carestream SM 749, Rochester, NY, USA). Each scan was analyzed in two orthogonal planes (axial and sagittal) to explore information regarding tooth identification, the number of roots, and the internal morphology of the mandibular incisors. Vertucci's classification was used to categorize the canal configuration of the mandibular incisors. Statistical Analysis: Data interpretation was performed using SPSS software. Chi-square and one-way analysis of variance tests were applied for data analysis (P < 0.05). Results: Five hundred and twenty-three CBCT scans were excluded according to the set criteria. A total of 1624 mandibular incisors were inspected from 406 CBCT scans. In females, 275 (64.8%) teeth showed Type I configurations, and 125 (29.4%) showed Type III configurations. In males, 563 (46.9%) teeth showed Type III configurations, and 543 (45.2%) showed Type I configurations. In terms of the number of roots, all samples showed single-rooted mandibular incisors. Conclusion: All participants' mandibular incisors had single roots with a high incidence of single-canal configurations. The root canal configuration of the majority of lower incisors showed bilateral symmetry. [ABSTRACT FROM AUTHOR]

This study assessed the influence of cultural changes (known as acculturation) on pathways of fear and anxiety in Endodontics. A purposive sampling technique identified patients of Saudi Arabian descent living in Australia and Saudi Arabia. Only patients with root canal fillings (or treatment planned for endodontic treatment) were included. Patients with intellectual disabilities, surgical root therapy, and aged under 20 were excluded. Consenting patients attending the dental clinics of University of Griffith University, Australia and University of Dammam, Saudi Arabia completed the "My Endodontic Fear Questionnaire." Three hundred and twenty‐four patients (21–75 years) were included, 90% of participants reported more than one pathway. Australian Saudi Arabians mainly utilised vicarious pathway (94.9%), whilst Saudi Arabians utilised the verbal threat (93.5%) and parental pathway (78.3%). This study highlights the possible role of acculturation on the perception of fear and anxiety in Endodontics; however, further research with other ethnic groups is essential to enhance our understanding. [ABSTRACT FROM AUTHOR]

Introduction. The aim of this study was to investigate the root canal morphology of maxillary first premolars in Saudi Arabian subpopulation by cone beam computed tomography (CBCT). Methods. One hundred maxillary first premolars were collected from the College of Dentistry at Jazan University and different dental centers in the southern region of Saudi Arabia. These teeth were cleaned thoroughly and were mounted in a plastic artificial mandible jaw to mimic soft tissue which was then placed in a water container. The 3D scan images were obtained with CBCT imaging (3D Accuitomo170) and evaluated on the basis of the number of roots, number of canals, and root canal configuration using Vertucci's classification. Results. Out of the 100 maxillary first premolars, the majority of teeth had 2 roots (61%) followed by (36%) one root. Two canals were the most predominant with 97% and then 3% three canals, and no tooth presented with one canal. Type IV canal configuration was most prevalent (75%) followed by Type V (13%). Conclusions. The CBCT provides enhanced and accurate information of root morphology, canal configuration, and its variations, thereby constituting an excellent alternative for radiographic diagnosis tool in the dental practice. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the quality of previous root canal treatment (RCT) among patients seeking retreatment in order to determine the actual reason for the failures. Materials and Methods: Survey was conducted between January and March 2018, among the patients seeking endodontic retreatment at the Dental Specialist Center in Najran City, KSA. Fifty patients with complaints to their RCT tooth were randomly selected for the study. All the patients were thoroughly examined clinically and teeth were radiographed. All the examinations were done by the same person. Attempt was made to correlate the presenting signs and symptoms to the quality of the past treatment. A well prepared questionnaire was used to record the details of the clinical and radiographic examination. The data collected was used to evaluate the qualification and competency of the clinician to provide RCT of acceptable international standards. Result: In the clinical part, 54% of cases reported with pain, 30% of intact fillings and sign of failure symptoms after few months from the RCT. In the radiographic part, most of cases presented with good obturation, high percentage of peri-apical radiolucency, overfilled, apical and internal resorption. Upto 6% were registered in cases with presence of broken instrument or perforations. All standard deviations were high. Conclusion: The survey revealed very strong correlation between failures of endodontic treatment (FET) and disregard for the fundamental basics among the clinicians. Proper clinical training in dental schools and continuing dental education programmes would certainly improve the quality of RCT provided to the public. [ABSTRACT FROM AUTHOR]

Aim and Objectives: A study was carried out among children to assess the incidence of endodontically treated first permanent molar (FPM) teeth during 4 years in Abha, Saudi Arabia. Materials and Methods: A convenient sample of 65 children, willing to participate was included in the study. Sixty-five children were selected for the study of age 6 years old, having erupted FPM teeth in all quadrants. The panoramic radiographs of the subjects were evaluated for sound, decayed, missing, filled teeth (DMFT), or endodontically treated FPM teeth. The same subjects were followed for 4 years and their orthopantomograms (OPGs) were taken at the age of 10 years. Their OPGs were again examined for sound, DMFT, and endodontically treated teeth. The mothers of these children were asked one question about their awareness regarding the importance of FPM teeth of their children. Data were put to statistical analysis. Results: It was found that all subjects at 6 years of age were having sound FPM teeth in all the 4 quadrants of their oral cavity. The overall incidence of endodontically treated FPMs was found to be 1.2% at age 10 years of the subjects. Conclusion: It was concluded that the incidence of endodontically treated FPM teeth was 1.2%. The incidence of root canal treatment was found to be more in the children whose mothers were not aware about the importance of FPM teeth. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the reasons for root canal treatment (RCT) done in the students' clinics of Prince Sattam Bin AbdulAziz University, Alkharj, Saudi Arabia (PSAU). METHODOLOGY: Information about Root Canal Treatments (RCT) was collected through specially designed forms. The forms were distributed to the 4th year students of the campus of PSAU. The participants were asked to record details of all root canal treatments carried out by them during a period of one academic year (2015-16), counter-checked by the faculty. The data were entered and analyzed using Statistical Package for Statistical Package for the Social Sciences (SPSS), version 22. Frequencies were calculated using simple arithmetical methods. RESULTS: The data were collected for 202root canal treatments. Irreversible pulpitis (59.9%), necrosis of pulp (22.8%), and previously initiated root canal treatments (13.8%) were the major reasons for RCT.67.6% of the cases had carious exposure. Only 1% of RCT were carried out due to failed RCT, a majority (60%) of which failed because of short obturation. Pre-Operative Radiographic examinations revealed that in 62.9% of the cases, the periapical tissues were normal, while 22.8% of the radiographs showed an evidence of chronic apical periodontitis. CONCLUSIONS: Irreversible pulpitis and Necrosed pulp were the most common reasons for initial root canal treatment while short obturation was the predominant reason for failed root canal treatment. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the use of NiTi rotary and stainless steel endodontic instruments for canal shaping by undergraduate students. We also assessed the quality of root canal preparation as well as the occurrence of iatrogenic events during instrumentation.Methods: In total, 30 third-year dental students attending Taibah University Dental College prepared 180 simulated canals in resin blocks with NiTi rotary instruments and stainless steel hand files. Superimposed images were prepared to measure the removal of material at different levels from apical termination using the GSA image analysis software. Preparation time, procedural accidents, and canal shape after preparation were analyzed using χ 2 and t-tests. The statistical significance level was set at P < 0.05.Results: There were significant differences in preparation time between NiTi instruments and stainless steel files; the former was associated with shorter preparation time, less ledge formation (1.1% vs. 14.4%), and greater instrument fracture (5.56% vs. 1.1%). These results indicate that NiTi rotary instruments result in better canal geometry and cause less canal transportation.Conclusions: Manual instrumentation using stainless steel files is safer than rotary instrumentation for inexperienced students. Intensive preclinical training is a prerequisite for using NiTi rotary instruments. These results prompted us to reconsider theoretical and practical coursework when teaching endodontics. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the reasons for and patterns of extraction of permanent teeth in a subset of the Saudi population. Methods: During a 3-month period, dentists were asked to record, using a specially designed survey form, the reasons for every extraction of a permanent tooth. The reasons for tooth extraction were assigned to different causes, ie, dental caries, periodontal disease, eruption problems, trauma, orthodontics, failed root canal treatment, and others. The data requested for each extraction were: patient age, gender, nationality, and type of tooth removed and the reason for its extraction. Results: The highest percentage of extractions was observed in young females aged 10-30 years. Presence of caries was observed to be the main reason for extraction (50.2%) followed by orthodontic problems (18.2%), eruption problems (17.5%), and periodontal problems (8.2%). The most frequently extracted posterior teeth were the third mandibular molar (19.4%), the third maxillary molar (16.4%), the first maxillary premolar (13.2%), and the first mandibular molar (10.9%). Conclusion: Dental caries was found to be the most common reason for extraction of teeth. Molar teeth were found to be the most frequently extracted, with an increased number of extracted first premolars as a result of orthodontic treatment. The highest percentage of extractions was observed in young females aged 10-30 years. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this study is to obtain data on the prevalence of bisphosphonate-associated osteonecrosis of the jaws (ONJ) among patients who received dental treatment in Riyadh. The study was conducted in five hospitals in the Riyadh area. All subjects were interviewed to collect data regarding their medical history, bisphosphonates usage, dental history, and possible complications after dental treatment. A total of 88 subjects under bisphosphonates therapy were interviewed, 25% were males and 75% were females. Bisphosphonates were taken orally by 89.7% of the subjects while 10.2% received bisphosphonate intravenously. All the subjects have had dental treatments after the beginning of bisphosphonate therapy. 79.5% of those patients had dental extraction, 13.6% root canal treatment, 4.5% oral surgery, and 4.5% received dental implants. No complications were reported after the dental treatment. In the present study, patients with bisphosphonates therapy did not develop complication after the dental treatment. However, it is recommended that patients receiving bisphosphonate therapy should be treated with precaution. Dental awareness programs should be provided to the physicians prescribing bisphosphonates to their patients. [Copyright &y& Elsevier]

Background: Endodontic treatment failure is one of the most common problems encountered in dentistry., Aims: This study aimed to evaluate the causes of failure of endodontic treatment among patients in the Saudi Arabian city of Al-Kharj., Subjects and Methods: A total of 250 patients of both genders were involved in the study. Criteria confirming the failure of the endodontic treatment were pain, tenderness on pressure, periapical radiolucency, and sinus tract. Patients were selected by convenience sampling methods. A diagnostic chart was prepared to complete the investigation in three different hospitals, during a six-month period (October 2018 - March 2019). The results were analyzed statistically using Chi-square test and use of simple arithmetical methods to determine percentage and frequencies., Results: The main cause for endodontic failure was poor quality adjunctive treatment. 147 out of 179 male patients and 53 out of 71 female patients received poor quality treatment. There was a statistically significant difference between gender versus adjunctive treatment (P = 0.009) and between hospital versus adjunctive treatment (P = 0.005), and quality of adjunctive treatment between private hospital as compared to government hospital which was also statistically significant (P = 0.008). In quadrant wise distribution, first molars were the most commonly involved teeth. Inadequate filling of the root canal was (36.8%), missed canals (14.4), over-extension root canal fillings (12.8%), perforations (9.6%), instrumentation related (8.8%), and endodontic access preparation related (2.4%) in the decreasing order of frequency were seen as the most common causes of failure of endodontic treatment., Conclusion: First molars were the most commonly affected tooth in the failure of endodontic treatment. Poor adjunctive treatment and inadequate filling of the root canals were the most common causes of endodontic failure, more commonly seen in male than female patients and in private clinics/hospitals than government hospitals., Competing Interests: None

Background: To investigate the complications associated with the use of nickel titanium rotary instruments (NiTi-RIs) for root canal treatments (RCTs), in Saudi Arabia dental practice, and to explore the influencing factors. Methods: After obtaining an ethical approval, two pilot studies were conducted to formulate the final questionnaire. The sample size was measured taking into consideration 60% expected response rates and confidence level of 99.9%. The questionnaire was emailed to 600 general dentists (GDs) randomly selected from the dental register and all of the endodontists (175). The email's introduction clarified objectives of the study and guaranteed that all of the collected information would remain confidential. A reminder was sent after 10 weeks. The data were collected and analyzed using the chi-squared test at a 0.05 significance level. Results: With a 51% overall response rate, 71.9% off the respondents used NiTi-RIs. The majority (83.1%) experienced complications while using NiTi-RIs; with the instruments' fracture being significantly the most common complication (52.7%) (p < 0.001). The majority (87.7%) experienced NiTi-RIs' fractureat least once; with more endodontists (94.3%) than GDs (83.3%) (p < 0.001). The greater the number of weekly performed RCTs and participants' experiences, the more NiTi-RIs fractures and the greater the number of fracture incidents (p < 0.001). While 60% of those who performed 1–3 RCTs per week experienced NiTi-RIs fractures, 100% of those who performed more than 12 RCTs per week did so. The highest percentage of those who experienced more than 10 fractured NiTi-RIs (60%) was within the group who performed more than 12 RCTs per week. Although fracture incidents decreased with a smaller number of reuses, there was no significant correlation between the number of fractured instruments and NiTi-RIs discard strategy (p ≥ 0.05). Conclusion: Fracture incidence was the most common complication while using NiTi-RIs, regardless of the clinicians' experiences and skills. While the single use may reduce NiTi-RIs fractures, to some extent, the greater number of RCTs performed per week was the most influential factor. [ABSTRACT FROM AUTHOR]

Background: To establish the extent of using nickel titanium rotary instruments (NiTi-RIs), to identify reasons for using / not using NiTi-RIs, to explore usage modalities and to identify factors and measures that can increase implementation of NiTi-RIs in general dental practice. Methods: Two pilot questionnaires were conducted on academic staff members at College of Dentistry, Taibah University, general dentists (GDs) and endodontists to finalise the questionnaire. A sample size was calculated considering the expected and minimum accepted response rates (60 and 48%, respectively) and a 99.9% Confidence Level. The online-questionnaire was sent to 600 GDs and all endodontists (175) working in Saudi Arabia. A reminder was emailed after 10 weeks to encourage non-respondents to complete the questionnaire. Responses, were collected and converted into numerical data which were analysed using the Chi-square test (p = 0.05). Results: Significantly most respondents (71.9%) used NiTi-RIs (p < 0.001); with more endodontists (96.9%) than GDs (60%). Most users (62.5%) had been using NiTi-RIs for More than 3 years (p < 0001). The trend of using NiTi-RIs increased as participants' experience and the number of root-canal treatments performed per week increased (p = 0.021). While most respondents (45.3%) used NiTi-RIs because of faster root-canal preparation, the majority of non-users (85.3%) didn't do so because of high cost. The highest proportion (43.3%) reported better undergraduate education as the most important factor that can significantly increase NiTi-RIs usage. The majority (91.8%) prepared glide-path before using NiTi-RIs; especially with stainless steel hand-files (63.3%). Conclusions: NiTi-RIs are relatively well adopted in Saudi dental practice. However, better education, especially during undergraduate training and lower cost can increase their usage. Overall, clinicians showed good awareness of NiTi-RIs usage aspects which reflected on usage modalities. [ABSTRACT FROM AUTHOR]

Background: This study aimed at investigating dental clinicians' preferences on management of necrotic pulp with acute apical abscess (NPAAA) cases. Methods: Following an ethical approval and two pilot studies, an electronic survey was emailed to 400 general dental practitioners (GDPs) and 56 endodontists. The email explained the study's methods and assured that participants' identities and information given would remain anonymous and confidential. A reminder email was sent after eight weeks. Responses were collected and data were analyzed using the Chi-square test at p = 0.05. Results: The majority of respondents (86.3%) would deal with NPAAA cases "differently" from vital-pulp ones (p < 0.001). More endodontists (40%) used two or three irrgants than GDPs (29.5%). Whilst the highest proportion of endodontists (29.7%) rarely prescribed antibiotics, the highest proportion of GDPs (26%) generally did so (p < 0.001). Whilst the highest proportion of GDPs (26.9%) over-instrumented the largest canal in the first visit, most endodontists (56.8%) performed complete cleaning & shaping (C&S) (p < 0.001). In cases of non-stopped exudates, whilst the highest proportions of endodontists would either let the patient wait till the exudates significantly reduce then continue their intended approach (40.5%) or insert ICMs and temporize the tooth (40.5%), the highest proportion of GDPs (30.8%) would insert only dry cotton pellet without temporizing the tooth (p = 0.002). Of those who would leave the tooth open if non-stopped exudates presents in the first visit, the majority (81.9%) would temporize the tooth if little exudates present after C&S (p < 0.001). Conclusions: Clinicians, especially GDPs, opted to treat teeth involved in NPAAA differently from those with vital-pulp, such as: were using different ICMs and irrigants, C&S to different apical size preparation. GDPs should improve their practice by implementing multi-irrigants protocol while C&S, limit prescribing antibiotics, perform complete debridement of the root canal system and not to leave the tooth open between visits. Clinicians, especially GDPs, relied on their own experiences in managing NPAA cases which necessitates scientific-based guidelines. [ABSTRACT FROM AUTHOR]