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Objective: The study aimed to evaluate healing in apicomarginal defects with amniotic membrane (AM) using 2D periapical radiography and 3D cone beam computed tomography imaging. Method and materials: Thirty-four patients with symptomatic apical periodontitis and apicomarginal communication were allocated to either the AM or control group. Clinical and radiographic assessment was performed at baseline and at 12 months using Molven criteria, modified Penn 3D criteria, and RAC and B indices at resected plane, apical area, cortical plate, and combined apicocortical area, respectively. Results: There was no significant difference in the healing outcome in 2D imaging (93.3% control and 86.7% AM) and 3D imaging (80.0% control and 53.3% AM) between the groups. With RAC scoring, a greater percentage of unhealed cases was observed in cortical plate. Radiographic buccal bone formation in the 3D imaging was evident only in six cases. However, both the groups depicted significantly greater percentage reduction in the size of the lesion in 2D than the 3D analysis (AM group 91.69 ± 15.99 2D, 76.06 ± 47.62 3D, P = .020) and (control group 92.06 ± 14.36 2D, 85.12 ± 18.55 3D, P = .005). Conclusion: No significant difference in healing was observed between the AM and the control groups with the use of both periapical radiography and CBCT imaging. Despite good clinical healing and radiographic apical bone fill, buccal bone formation was not evident in 3D imaging in most of the cases. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate whether utilizing additional cone beam computed tomography (CBCT) imaging has any effect on quality of life and healing outcome following periapical surgery compared with periapical radiographs (PR). Methodology: The study was registered in ClinicalTrials.gov (NCT04333940). In this parallel group randomized controlled trial, 52 patients (88 teeth) with persistent apical periodontitis and periapical radiographic evidence of periapical lesion were randomly assigned to either PR or CBCT group. The primary predictor was the type of the imaging method (PR only or with additional CBCT). The primary outcome was patient's quality of life during the first week after periapical surgery and the secondary outcomes were duration of surgery and healing outcome at 12‐month follow‐up. Participants of both groups received periapical surgery based on the pre‐surgical plan provided by the radiographic imaging methods. Quality of life (QoL) was assessed using Modified Shugars questionnaire. Radiographic analysis for healing was conducted using Molven's criteria and modified PENN 3D criteria. The categorical data between groups were analysed using the Chi‐square test, whilst intragroup comparisons were analysed using the McNemar test. The average scores for each component of QoL (oral functions, general functions, pain, swelling and other symptoms), combined QoL scores (overall average of values of 13 variables) and analgesic usage on each day were calculated and analysed. Results: At 12 months of follow‐up, fifty patients were evaluated. Participants in PR group reported significantly more swelling on first three days compared with CBCT group. The analgesic use was higher in the PR group on 2nd and 3rd day (Mann–Whitney U test with Bonferroni correction; p <.007). A significant difference in the limitation of general functions was observed at the second day (p <.07) with the higher values in the PR group. The combined QoL score between the two groups was found to be non‐significant. However, none of the patients experienced intraoperative complications or neurovascular exposure. The mean surgical time was lesser in the CBCT group (p <.05). Radiographic healing revealed a success rate of 96.2% for the PR group and 95.8% for the CBCT group with no significant difference between the groups. Conclusion: Participants in the CBCT group experienced substantially less early postoperative swelling and limitation in general functions, in comparison with the PR group. However, preoperative CBCT had no effect on other QoL parameters and intraoperative complications in medium‐risk patients. Furthermore, CBCT did not exhibit any added advantage over periapical radiography in terms of assessing healing outcome following endodontic microsurgery. CBCT offered surgically relevant anatomic information for pre‐surgical planning and ensured the treatment rendition with a significantly reduced operative time. [ABSTRACT FROM AUTHOR]

Root canal system typically has a diverse canal configuration. One of the most difficult aspects of ensuring successful endodontic treatment is accurately identifying all canals found in a tooth. Diverse root canal configurations are not uncommon, even if the majority of maxillary incisors have a single root canal. One canal bifurcating into two at the apical third is exceptionally rare, with only two case reports previously reported. For the precise diagnosis of certain anatomical peculiarities, a thorough evaluation of preoperative diagnostic radiographs is highly required. As of periapical radiography, which is the most important diagnostic imaging for determining root canal anatomy, is limited by its two-dimensional nature, technological innovations such as cone beam computed tomography can be extremely beneficial. This paper emphasizes the significance of preoperative diagnostic imaging in the treatment planning of maxillary central incisors with unusual root canal morphology. [ABSTRACT FROM AUTHOR]

Discharging facial lesions of dental etiology are almost always difficult to diagnose. Due to the lack of dental signs in most patients, these lesions are often misunderstood and overlooked. Such patients often seek cosmetic therapy and end up undergoing unnecessary treatments, if an odontogenic source is not established. To make an accurate diagnosis, a comprehensive medical and dental history, as well as knowledge of the various presentations of facial lesions, is of pivotal importance. The cases identified here were misdiagnosed at first, and they were treated with antibiotics and surgical procedures as a result. Root canal operations were performed after referral to a dental unit, and the sinus tract eventually healed. This emphasizes the significance of taking odontogenic sources into account when treating head and neck lesions. [ABSTRACT FROM AUTHOR]

Background: Pulpotomy has been proposed as an alternative for the management of irreversible pulpitis in permanent molars with closed apices. Aim: To compare the performances of calcium hydroxide (CH), mineral trioxide aggregate (MTA), and platelet-rich fibrin (PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis. Materials and Methods: Fifty-four permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups, and full pulpotomy was performed using CH, MTA, or PRF as pulpotomy agents. Pain intensity was recorded using numeric rating scale score at baseline, 24 h, 7 days, 6 months, and 1 year. Clinical and radiographic assessments were done at 6 months and 1 year. Statistical Analysis: Kruskal-Wallis test and Friedman test were used for intergroup and intragroup comparison of pain scores, respectively. The radiographic outcomes between the three study arms were compared using Chi-square test. Results: Clinical success rate was 94.4% at 7 days, which dropped to 85.4% at 12 months. All three agents were equally effective in providing pain relief at all the intervals tested, with no significant difference between them (P > 0.05 at all intervals). However, at 6 months and 12 months, 26.2% and 52.4% teeth depicted slight widening of periodontal ligament space. No significant difference was observed between the radiographic success rates observed with the three groups (P = 0.135 at 6 months, 0.717 at 12 months). Conclusion: Pulpotomy exhibited a high clinical success rate in mature molars with irreversible pulpitis and selection of biomaterial did not affect its outcome. [ABSTRACT FROM AUTHOR]

Brief Background: Drug induced immune thrombocytopenia (DITP) is a relatively rare, potentially hazardous disorder characterized by drug- dependent antibodies which bind to platelets and cause their destruction in the presence of responsible drug. It's important to be aware of the clinical manifestations of DITP as it will aid in efficient management of the patient without untoward sequelae. In certain cases, a careful vigil for such manifestations may even lead to detection of the condition in previously undiagnosed cases. However, there are very few reports of DITP in dental literature making it difficult for a dentist to identify the disorder when such a patient reports for dental treatment. Thus, a case report of a patient with DITP is presented. Materials and Methods: Intraoral examination revealed spontaneous bleeding from gingiva which was not consistent with the degree of gingival inflammation observed. Based on history, clinical findings and laboratory evaluation, a provisional diagnosis of DITP was established and patient suitably managed. Discussion: Discussion highlights the oral manifestations of the condition and management of such patients in dental setup. Summary and Conclusions: Any case of acute onset thrombocytopenia must be investigated carefully to determine if any drug is responsible for the condition. Correct diagnosis of DITP will lead to timely intervention and efficient management of the patient. [ABSTRACT FROM AUTHOR]