-
Journal of Oral Biosciences Dec 2021This systematic review was designed to measure the pooled prevalence of morphological variations in the root canal of permanent incisors and canines among Asian adults. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review was designed to measure the pooled prevalence of morphological variations in the root canal of permanent incisors and canines among Asian adults.
METHODS
An electronic search was conducted in the PubMed, Scopus, and EBSCO databases, and relevant studies were included. Studies reporting on the Vertucci canal configuration (types I to VIII) were included. A weighted proportion (pooled prevalence) with 95% confidence interval was calculated for each canal type, and the outcome was stratified based on country, technique of assessment, gender, and age.
RESULTS
Sixty articles were included in the final review. In all types of maxillary anterior teeth, the pooled prevalence of type I canal configuration was greater than 97%, whereas mandibular central incisor, lateral incisor, and canines had a prevalence of 78.4%, 69.2%, and 91.1%, respectively. Studies considering mandibular anterior teeth as a single entity had a lower prevalence of type I configuration (70.1%). Variations in root canal configurations were also observed between countries. Among gender, males had a significantly lower prevalence of type I and a higher prevalence of type II and III canal configurations in the mandibular anterior teeth. A variation in canal types was also noted with advancing age, with younger age groups showing more variations.
CONCLUSION
The majority of maxillary and mandibular anterior teeth have type I Vertucci canal configuration, but variations in mandibular anterior teeth, especially lateral incisors, are also common. Variations were also observed among population, gender, age, and prevalence based on the diagnostic techniques used.
Topics: Animals; Cone-Beam Computed Tomography; Dental Pulp Cavity; Incisor; Male; Mandible; Tooth Root
PubMed: 34547454
DOI: 10.1016/j.job.2021.09.004 -
Journal of Oral Biology and... 2020Luxation injuries are one of the most prevalent type traumatic dental injuries in primary dentition. The impact of these injuries may not only be limited to the primary... (Review)
Review
OBJECTIVE
Luxation injuries are one of the most prevalent type traumatic dental injuries in primary dentition. The impact of these injuries may not only be limited to the primary teeth but may also have adverse effects on the developing succedaneous tooth bud resulting in various unfavorable consequences. This systematic review aims at compiling the evidence of available literature regarding luxation injuries to primary teeth, etiology, treatment modalities, outcomes and sequelae on permanent teeth.
METHODOLOGY
Search of PubMed, Google Scholar, Cochrane Database of Systematic Reviews, SCOPUS and LILACS virtual health library was conducted for the literature published from January 1, 2007 to December 31, 2017. Two authors separately reviewed the literature and extracted the data from the included studies.
RESULTS
After screening 224 articles, 13 articles fulfilled the inclusion criteria. Most common etiological factor for injury (up to 44.8%) is fall while walking or running. The unfavorable outcomes which are mostly associated with luxation injuries are pulp canal obliteration ranging from 8.6% to 43.3% and pulp necrosis 8.6% -78.9%. Sequelae on succedaneous teeth vary with a high incidence of white or yellow brown discoloration of enamel (78%) and enamel hypoplasia (7.8%-28.3%).
CONCLUSION
Fall is the most common cause and regular monitoring is recommended for most of the luxated teeth. Pulp canal obliteration, pulp necrosis and tooth loss due to trauma are prevalent complications observed following luxation. White or yellow brown discoloration of enamel and enamel hypoplasia are the most common undesirable sequelae to permanent teeth.
PubMed: 32489826
DOI: 10.1016/j.jobcr.2019.12.001 -
Evidence-based Dentistry Jun 20243Mixtatin (a combination of Metronidazole, Minocycline, and Ciprofloxacin along with statins) is a novel biomaterial in pulp therapy, while Mineral Trioxide Aggregate... (Meta-Analysis)
Meta-Analysis
AIM
3Mixtatin (a combination of Metronidazole, Minocycline, and Ciprofloxacin along with statins) is a novel biomaterial in pulp therapy, while Mineral Trioxide Aggregate (MTA) is considered the gold standard in endodontics. This study aimed to compare the clinical and radiographic success rates of MTA and 3Mixtatin in pulp therapy of primary teeth.
METHODS AND MATERIALS
MEDLINE (PubMed), CENTRAL, Web of Science, Scopus, ProQuest databases, and Google Scholar were searched to identify randomized controlled trials (RCTs) on pulp therapy with 3Mixtatin and MTA in primary teeth, published up to February 2023. It should be noted that the protocol was previously registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021243626). RCTs were assessed independently by two researchers in terms of eligibility and quality. Data extracted and tabulated. The Cochrane Risk of Bias (RoB-2) tool was used to assess the risk of bias. The effect sizes were evaluated utilizing risk ratios (RRs). The heterogeneity investigation was conducted utilizing I² measurement at α = 0.10.
RESULTS
Out of 86 retrieval records, four articles met the inclusion criteria. Based on clinical and radiographic outcomes, the application of 3Mixtatin in the pulp therapy of primary teeth was as successful as MTA in 12 months (Clinical RR = 1.087 | Radiographic RR = 2.132). The RoB-2 tool showed a low risk of bias in all included RCTs.
CONCLUSION
The limited evidence showed the clinical and radiographic efficacy of 3Mixtatin as a potential alternative to MTA. Further empirical research with larger sample sizes and strict methodology will be essential to substantiate this assertion.
Topics: Humans; Aluminum Compounds; Calcium Compounds; Ciprofloxacin; Drug Combinations; Evidence-Based Dentistry; Metronidazole; Minocycline; Oxides; Randomized Controlled Trials as Topic; Root Canal Filling Materials; Silicates; Tooth, Deciduous
PubMed: 38448571
DOI: 10.1038/s41432-024-00987-8 -
Journal of Dentistry Mar 2024The present systematic review and meta-analysis aimed to evaluate the success rate of root canal retreatment filled with gutta-percha and the variables related to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The present systematic review and meta-analysis aimed to evaluate the success rate of root canal retreatment filled with gutta-percha and the variables related to retreatment success.
DATA
The PRISMA guidelines were followed for the present review. The study protocol was registered in the International Prospective Database of Systematic Reviews (PROSPERO CRD42021283134). Risk assessment was performed using the Newcastle-Ottawa scale. Funnel plots were used to detect publication bias and asymmetry was assessed using Egger's tests.
SOURCES
PubMed, Scopus, ScienceDirect, Cochrane, and additional sources were searched.
STUDY SELECTION
Studies published until 10 December 2022. Clinical studies evaluating the success of root canal retreatment filled with gutta-percha with at least a 1-year follow-up were selected.
RESULTS
Ten studies and one unpublished study fulfilled the inclusion criteria for quantitative analysis. The success rate of non-surgical root canal retreatment was 71% (95% CI: 66%-76%) with strict criteria and 87% (79% - 93%) with loose criteria for 1-3 years of follow-up, and 77% (66% - 86%) with strict criteria for a 4-5 years of follow-up. Endodontically retreated teeth with periapical lesions had a lower success rate under strict criteria. The tooth type, dental arch, initial periapical index (PAI) score, and the number of visits also affected the treatment success rate under strict criteria. For the loose criteria, teeth with larger periapical lesions and higher initial PAI scores had a lower success rate.
CONCLUSIONS
According to the present systematic review and meta-analysis, non-surgical root canal retreatment results in favourable outcomes. The presence of a periapical radiolucency, periapical lesions >5mm, a higher initial PAI score, multiple-visit retreatments, and mandibular and molar teeth resulted in a lower success rate.
CLINICAL SIGNIFICANCE
Non-surgical root canal retreatment filled with gutta-percha techniques is a relatively predictable procedure with a high success rate. Several variables can affect retreatment success, mainly the presence and size of a periapical lesion and the type of tooth.
Topics: Dental Pulp Cavity; Gutta-Percha; Retreatment; Root Canal Filling Materials; Root Canal Preparation; Root Canal Therapy; Treatment Outcome; Humans
PubMed: 38145805
DOI: 10.1016/j.jdent.2023.104809 -
BioMed Research International 2022This study is aimed at combining the sample sizes of all studies on permanent maxillary teeth conducted in different regions of the Kingdom of Saudi Arabia (KSA) to... (Review)
Review
AIM
This study is aimed at combining the sample sizes of all studies on permanent maxillary teeth conducted in different regions of the Kingdom of Saudi Arabia (KSA) to obtain a large sample size that represents the population of the KSA. The outcome of these combined studies is compared with international studies in terms of the number of roots, number of canals, and canal configurations on the basis of Vertucci's classification. . The studies were systematically reviewed using the Preferred Reporting Items for Systematic Review and Meta-analysis chart. Studies were included in the analysis if they were conducted in the KSA, involved permanent human maxillary teeth, and had a sample of more than 10 teeth (power). By contrast, studies were excluded if they involved deciduous teeth in the sample size, investigated nonhuman teeth, were not conducted in the KSA, and were case reports, case series, review studies, and anomalies. Relevant literature was searched from PubMed, Scopus, Web of Science, Embase, Cochrane, and Direct Science by two calibrated teams, starting in August 2020, without time limits or language restrictions.
RESULTS
The database searches and cross-referencing identified a total of 19 relevant studies. All maxillary canines ( = 1,018) had one root, whereas 98.4% had one canal and 98.3% had Vertucci type I. Moreover, 63.2% of the maxillary first premolars had two roots, and 91.4% had two canals. The most common Vertucci root canal configuration was type IV (64.6%). The maxillary second premolars mostly had one root (84.4%) and one canal (50.4%). The most common canal configuration was Vertucci type I (47.1%). The majority of maxillary first molars had three roots (98.9%), 48.7% of which had three canals, and 46.4% had four canals. The most prevalent feature of the canal morphology of mesiobuccal roots was Vertucci type II (35.3%). The investigated maxillary second molars had three roots, 88.0% of which had three canals.
CONCLUSION
This systematic review represents the Saudi population since samples were combined from different studies from different regions of the country. Variations in findings were observed in the same group of teeth from different regions and the same region, while the overall combined samples results fell within the range of other international studies.
Topics: Cone-Beam Computed Tomography; Dental Pulp Cavity; Dentition; Saudi Arabia; Tooth Root
PubMed: 35075425
DOI: 10.1155/2022/3428229 -
Journal of Dentistry Apr 2022This study aims to review systematically the dental pulp response to silver diamine fluoride (SDF) treatment, including the inflammatory response, pulp cells activity,... (Review)
Review
OBJECTIVE
This study aims to review systematically the dental pulp response to silver diamine fluoride (SDF) treatment, including the inflammatory response, pulp cells activity, dentinogenesis, silver penetration, and the presence of the bacteria in the dental pulp.
DATA
In vitro studies, animal studies, clinical studies, and case reports on the use of SDF on vital dental pulp were included. Quality assessment of the included studies was conducted. A narrative synthesis of the collected data was performed.
SOURCES
A systematic search was performed in ProQuest, PubMed, SCOPUS, and Web of Science databases for articles published from inception to Nov 1, 2021.
STUDY SELECTION
The initial search identified 1,433 publications, of which five publications met the inclusion criteria. These five publications reported the effect of direct/ indirect SDF application on the vital pulp of a total of 30 teeth. Direct SDF application on vital pulp caused pulp necrosis. Indirect SDF application caused none or mild inflammatory response of dental pulp. The odontoblasts in the dental pulp showed increased cellular activity. Tertiary dentine was formed in the pulpal side of the cavity with indirect SDF application. Accentuated incremental lines of tertiary dentine reflected disturbances in mineralisation. Silver ions were found to penetrate along the dentinal tubules but were not detected inside the pulp.
CONCLUSION
According to the limited available literature, direct SDF application causes pulp necrosis. Indirect SDF application is generally biocompatible to dental pulp tissue with a mild inflammatory response, increased odontoblastic activity, and increased tertiary dentine formation. Future studies with precise quantitative and qualitative tests, larger sample size and longer follow-up time are imperative to understand the biological activity of dental pulp to SDF treatment.
Topics: Animals; Dental Caries; Dental Pulp; Dental Pulp Necrosis; Dentin, Secondary; Fluorides, Topical; Quaternary Ammonium Compounds; Silver Compounds
PubMed: 35139409
DOI: 10.1016/j.jdent.2022.104066 -
BMC Oral Health Jun 2021The aim of this paper was to systematically review the root canal configuration (RCC) and morphology literature of the mandibular second premolar (Mn2P). (Meta-Analysis)
Meta-Analysis
BACKGROUND
The aim of this paper was to systematically review the root canal configuration (RCC) and morphology literature of the mandibular second premolar (Mn2P).
METHODS
Systematic research of five electronic databases was performed to identify published literature concerning the root canal configuration (RCC) of the Mn2P up through July 2020. Studies were selected according to predefined search terms and keywords inclusion criteria: "root canal configuration", "root canal system", "root canal morphology", "mandibular second premolar", "mandibular premolars", "morphology" and "anatomy". Further possible studies were identified by cross-referencing and screening the bibliographies of the selected articles.
RESULTS
From 1622 retrieved studies, 44 studies investigating the internal morphology of 17,839 Mn2Ps were included. Most examined Mn2Ps were single-rooted (89.5-100%); two-rooted (0.1-8%) and three-rooted (0.1-3.5%) Mn2Ps at lower frequency. Most frequent RCCs reported were 1-1-1/1 (55.3-99.6%) followed by 1-1-2/2 (0.5-57%) and 2-2-2/2 (0.6-18%). The meta-analysis of seven studies demonstrated that a significantly higher number of RCC type 1-2-1/1 (OR [95%CI] = 2.05 [1.27, 3.33]) and 2-2-2/2 (OR [95%CI] = 2.32 [0.65, 8.63]) were observed in male than in female patients.
CONCLUSIONS
Different RCC research methods have been reported. Whereas clearing and radiographs were commonly used in the past, CBCT has been prevalent in recent years. A globally high frequency of a 1-1-1/1 RCC in the Mn2P has been reported. Nevertheless, the probability that different, more complicated RCCs can appear in Mn2Ps should not be underestimated and, thus, should be taken into consideration when making decisions during an endodontic treatment.
Topics: Bicuspid; Dental Pulp Cavity; Female; Humans; Male; Mandible; Root Canal Therapy; Tooth Root
PubMed: 34134669
DOI: 10.1186/s12903-021-01668-z -
Australian Endodontic Journal : the... Apr 2023The aim of the present systematic review was to summarise and evaluate the studies comparing the role of contracted endodontic cavities (CECs) and traditional endodontic... (Review)
Review
The aim of the present systematic review was to summarise and evaluate the studies comparing the role of contracted endodontic cavities (CECs) and traditional endodontic cavities (TECs) in terms of instrumentation efficacy. The present systematic review comprised of a search of the online databases of Cochrane, PubMed, Google Scholar and grey literature. The articles which were pertaining to instrumentation efficacy in contracted and traditional endodontic cavities were selected based on the PRISMA checklist. Out of the 660 articles which were obtained, irrelevant articles were excluded and a total of 17 articles were selected for this systematic review which assessed the instrumentation efficacy. Eleven studies compared the volume of dentin removed and canal transportation ability. Four studies compared the pulp debridement, and two studies compared the anti-bacterial efficacy between the two groups. The extrusion of debris between the groups was compared by one study. Out of the 17 studies included, 11 studies proved that contracted endodontic cavities negatively impacted the instrumentation efficacy. Hence, the data suggest that the traditional endodontic access cavities have better results when comparing the instrumentation efficacy.
Topics: Root Canal Preparation; Dental Pulp Cavity; Molar; Dental Pulp
PubMed: 36029227
DOI: 10.1111/aej.12679 -
European Journal of Oral Sciences Aug 2023This systematic review aimed to investigate whether root canal treatment caused greater stress than other dental treatments for patients and dentists. All peer-reviewed... (Meta-Analysis)
Meta-Analysis Review
This systematic review aimed to investigate whether root canal treatment caused greater stress than other dental treatments for patients and dentists. All peer-reviewed literature published in English between January 1990 and January 2023 was included. This included randomized/non-randomized control trials, cohort studies, case-control studies, and cross-sectional studies. An electronic search used PubMed, Scopus, Medline, Cochrane Collaboration, and Embase. Hand searching supplemented the screening pool. Studies examining physiological or psychological stress measures within patients or providers of dental treatment (dentists, dental specialists, and dental students) were eligible. The study must have reported on the stress outcome for root canal treatment and at least one other dental procedure. After screening 3639 eligible records, there were 23 studies included, varying from very-low to low certainty of evidence. This review found that root canal treatment was more psychologically stressful for patients than routine restorative or cleaning procedures. However, the stress of root canal treatment relative to other dental procedures, especially extractions, was inconclusive for both dental patients and providers. Since patients regard root canal treatment as more stress-evoking than other routine dental procedures, providers should endeavour to minimise their own bias toward root canal treatment when providing adequate information for an informed treatment choice.
Topics: Humans; Cross-Sectional Studies; Dental Pulp Cavity; Root Canal Therapy; Dentists; Case-Control Studies
PubMed: 37357152
DOI: 10.1111/eos.12941 -
International Endodontic Journal Oct 2023Pulpitis characterized by spontaneous pain can result in debilitating pain. Dogma has existed to offer only have two treatment options, namely root canal treatment (RCT)... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pulpitis characterized by spontaneous pain can result in debilitating pain. Dogma has existed to offer only have two treatment options, namely root canal treatment (RCT) or extraction, although pulpotomy has always remained a potential treatment modality.
OBJECTIVE
This review aimed to answer the following research question: 'Does pulpotomy (partial or full) (I) result in better patient and clinical reported outcomes (O), compared with RCT (C) in permanent teeth with pulpitis characterized by spontaneous pain (P) evaluated at various time intervals?' (T).
METHODS
Two authors independently performed study selection, data extraction and risk of bias assessment. The literature search was conducted in the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials. English language clinical trials comparing the patient and clinical reported outcomes between RCT and pulpotomy were included. The meta-analysis was performed on a fixed-effect model and the quality of evidence assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
RESULTS
Two randomized clinical trials were included. Amongst two trials, one has published four reports at different time points involving the same cohorts. The meta-analysis revealed no difference in postoperative pain (Day 7) between RCT and pulpotomy (OR = 0.99, 95% CI 0.63-1.55, I = 0%) and quality of evidence was graded as 'High'. Clinical success was high at year 1, 98% for both interventions, however, decreased over time to 78.1% (pulpotomy) and 75.3% (RCT) at 5 years.
DISCUSSION
Pulpotomy is a definitive treatment modality that is as effective as RCT. This could have a significant impact on treatment of such patients affording the advantages of retaining a vital pulp and preventing the need for RCT.
CONCLUSION
This review could only include two trials, hence there is insufficient evidence to draw robust conclusions. The clinical data accumulated so far suggests no difference in pain between RCT and pulpotomy at Day 7 postoperatively and a single randomized control trial suggests that the clinical success rate for both treatment modalities is similar long term. There is a need for more well-designed trials by different research groups to develop a stronger evidence base in this area.
REGISTRATION
PROSPERO database (CRD42021259744).
Topics: Humans; Pulpotomy; Pulpitis; Dental Pulp Cavity; Root Canal Therapy; Pain, Postoperative; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 36209498
DOI: 10.1111/iej.13844