scholarly journals Root Anatomy and Root Canal Configuration of Human Permanent Mandibular Premolars: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Jojo Kottoor ◽  
Denzil Albuquerque ◽  
Natanasabapathy Velmurugan ◽  
Jacob Kuruvilla

Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24%) while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.

2021 ◽  
Vol 12 (1) ◽  
pp. 9-18
Author(s):  
Brankica Davidović ◽  
Ljiljana Bjelović ◽  
Igor Radović ◽  
Bojana Davidović ◽  
Svjetlana Janković ◽  
...  

Introduction. Successful endodontic treatment depends upon the clinician's knowledge and ability to recognize and diagnose the presence of anatomical and morphological variations of the root and canal system. The aim of this study was to establish the number of roots and root canal configurations of the maxillary second premolar in the population of Bosnia and Herzegovina. Methods. The study sample was comprised of 150 maxillary second premolar teeth extracted for orthodontic or prosthetic reasons. Endodontic drills were used for trepanation of cavum dentis, and the number and patency of each root canal were determined by Kexpander # 15. Then, the samples were decalcified, made transparent and colored, to enable 3D viewing of the canal system. Decalcified teeth were observed from two projections (clinical and approximal) and analyzed in detail with a magnifying glass under 3 × and 5 × magnification in order to determine the number of roots, number of canals, root canal configuration using Vertucci's classification and number of anastomoses between canals. Statistical significance was obtained using Chi-square test. Results. The results obtained by decalcification of the teeth showed that, by radiographic analysis from the clinical projection, all the teeth had a single root. While, by the analysis from the approximal projection, 94.0% had one, 6.0% two roots. From the approximal projection, 70.7% with a single root canal and 29.3% with two root canals are visualized. The most common type of root canal configuration in the maxillary second premolars was Type I in both clinical (87.9%) and approximal projection (40.7%). Conclusion. These results emphasize the importance of knowing the variations in root canal morphology, because excluding the possibility of morphological variations can lead to failure of endodontic therapy


Scanning ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sung Eun Yang ◽  
Tae Yeon Lee ◽  
Kyung Jae Kim

This retrospective study of roots with C-shaped canals investigated their prevalence, configuration type, and lingual wall thickness, as well as the panoramic radiographic features of roots in permanent mandibular second molars confirmed to have C-shaped canals on cone-beam computed tomography (CBCT) in a Korean population. In total, 1884 CBCT images of mandibular second molars were examined by two endodontists to analyze the presence of C-shaped canals according to age and sex. The bilateral occurrence of C-shaped roots and their morphology on panoramic radiography were assessed and statistically analyzed using the chi-square test. The classification of Fan et al. was applied to categorize the configurations of C-shaped canals. The lingual wall thickness was calculated in the mesial, middle, and distal areas at the orifice and at 5 mm from the apex. The Mann–Whitney U test was used to analyze the mean difference of lingual wall thickness between the apex and orifice level. A P value of 0.05 was considered to indicate statistical significance in the statistical analyses. Of 2508 mandibular second molars, 924 (36.8%) had C-shaped root canals. The prevalence was significantly lower in the over 61 age group (24.08%) than in the 21–30-year age group (40.02%) and was higher in women (42.32%). Most cases were bilateral (85.9%). The C1 type was the most common (35.3%). The prevalence of C1 type canals decreased, while that of C3b type canals increased with age. In 75.2% of teeth having C-shaped root canals on CBCT, fused roots were observed on panoramic views. The difference in the lingual wall thickness at the orifice and 5 mm from the apex was significant in the middle area in all configurations of C-shaped root canals. When performing nonsurgical or surgical endodontic procedures of the mandibular second molars, clinicians should consider age, sex, ethnicity, and anatomical variations.


Author(s):  
Anna K. Dietl ◽  
Matthias W. Beckmann ◽  
Konrad Aumann

Abstract Purpose Villoglandular adenocarcinoma (VGA) of the uterine cervix has been classified as a rare subtype of cervical adenocarcinoma with good prognosis. A conservative surgical approach is considered feasible. The main risk factor is the presence of other histologic types of cancer. In this largest systematic review to date, we assess oncological outcomes associated with conservative therapy compared to those associated with invasive management in the treatment of stage Ia and Ib1 VGA. Methods Case series and case reports identified by searching the PubMed database were eligible for inclusion in this review (stage Ia–Ib1). Results A total of 271 patients were included in our literature review. 54 (20%) patients were treated by “conservative management” (conization, simple hysterectomy, and trachelectomy) and 217 (80%) by “invasive management” (radical hysterectomy ± radiation, hysterectomy, and radiation). Recurrences of disease (RODs) were found in the conservative group in two (4%) cases and in the invasive group in nine (4%) cases. There was no significant difference in disease-free survival (DFS) according to conservative or invasive treatment (p = 0.75). The histology of VGA may be complex with underlying usual adenocarcinoma (UAC) combined with VGA. Conclusion The excellent prognosis of pure VGA and the young age of the patients may justify the management of this tumor using a less radical procedure. The histological diagnosis of VGA is a challenge, and pretreatment should not be based solely on a simple punch biopsy but rather a conization with wide tumor-free margins.


2021 ◽  
Vol 8 ◽  
pp. 204993612110337
Author(s):  
Diego-Abelardo Álvarez-Hernández ◽  
Rodolfo García-Rodríguez-Arana ◽  
Alejandro Ortiz-Hernández ◽  
Mariana Álvarez-Sánchez ◽  
Meng Wu ◽  
...  

Introduction: Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide. Materials and methods: We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms ‘American trypanosomiasis’ or ‘Chagas disease’. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures. Results: From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%. Discussion: CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD’s diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.


2017 ◽  
Vol 33 (4) ◽  
pp. 282-287 ◽  
Author(s):  
Fabricio R Santiago ◽  
Mario Piscoya ◽  
Yung-Wei Chi

Objective To evaluate patients’ self-perception of cosmetic improvement before and after they were presented with pre- and postprocedure photographs after sclerotherapy with 75% dextrose. Methods Treatments included sclerotherapy of reticular and varicose veins using 75% dextrose. All treated limbs were photographed and classified according to Clinical, Etiology, Anatomy, and Pathology classification and Venous Clinical Severity Score pre- and posttreatment. The patients were queried before and after viewing the photos during these visits and indicated if they were very unsatisfied, dissatisfied, satisfied, or very satisfied. Nonparametric kappa correlation coefficient and a Chi square test were used to measure associations among agreement (p < 0.05 indicated statistical significance). The paired Wilcoxon test was used to compare statistical differences in mean Venous Clinical Severity Scores measured at different times (p < 0.05 indicated statistical significance). Data were analyzed using STATA software (version 12). Results Individuals were more satisfied with the results of sclerotherapy after exposure to images portraying their limbs two months after the procedure (p = 0.0028). This effect was maintained six months after sclerotherapy (p = 0.0027). Conclusion Patient exposure to pre- and postsurgical photographs is a simple intervention with the potential of improving patient satisfaction up to six months after treatment with sclerotherapy.


2021 ◽  
Vol 30 (02) ◽  
pp. 103-106
Author(s):  
Ajeet Kumar ◽  
◽  
Naveed Iqbal ◽  
Javaria Farooq ◽  
Saad Uddin Siddiqui

OBJECTIVE: This study was performed to compare incidence of perforations in Latex and Nitrile examination gloves during Minor Oral surgical procedures performed under local anesthesia. METHODOLOGY: 100 pairs of latex and 100 pairs of Nitrile examination gloves where used to perform 200 minor oral surgical procedures under local anesthesia. After completion of every minor oral surgical procedure each gloves was examined by Water Inflation method to observe presence or absence of Perforations. A data sheet was used to collect data including type of Gloves used (Latex or Nitrile) presence of perforations, sites of perforations and nature of minor oral surgical procedures. Data was entered and analyzed using SPSS version 20. Descriptive analysis was conducted to calculate frequency and percentages of Number and sites of perforations for both Nitrile and latex examination gloves. Chi Square test was used to find out statistical significance of difference of perforations rate between Nitrile and Latex gloves. P value of < 0.05 was considered significant. RESULTS: Out of 200 latex gloves 23 (11.5) had 29 perforations whereas out of total 200 Nitrile gloves 28 (14%) had 22 perforations. Nitrile gloves had a statistically significant higher rate of perforations as compared to Latex gloves. (P value 0.043). For both Nitrile and Latex gloves left non dominant hand had highest frequency of perforations Latex 18 (81.81%) perforations and Nitrile 18(62.06%). Index finger and thumb were most frequent sites of perforations in both Latex and Nitrile gloves. CONCLUSION: Gloves perforations were more common in Nitrile examination gloves however total number of perforations was more in Latex examination gloves.


2021 ◽  
Author(s):  
Abdulhakim Abamecha ◽  
Daniel Yilma ◽  
Wondimagegn Adissu ◽  
Delenasaw Yewhalaw ◽  
Alemseged Abdissa

Abstract Background: Anti-malarial drug resistance, in particular resistance to Plasmodium falciparum, challenges the treatment and control of malaria. In Ethiopia, the first-line treatment of uncomplicated falciparum malaria has been changed from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) in 2004. To maximize efficacy of anti-malarial drugs and ensure adequate treatment outcomes; monitoring drug efficacy regularly is vital to establish rational malaria treatment guidelines. This systematic review and meta-analysis is performed to obtain an overall stronger evidence to guide management of uncomplicated falciparum malaria from the existing literature in Ethiopia after policy changes in 2004.Methods: A systematic literature search was performed using the preferred reporting items for systematic review and meta-analysis (PRISMA) from published therapeutic efficacy studies conducted in Ethiopia from 2004 to 2020. The search was performed from Pubmed, Google Scholar and Clinical trial registry databases to identify literature. Two reviewers independently assessed study eligibility and extracted data. While computing the efficacy of AL, polymerase chain reaction (PCR)-corrected cure rate (adequate clinical and parasitological response, ACPR) at 28th day was considered as the primary endpoint. Meta-analysis was computed using OpenMeta-Analysis software to calculate the pooled ACPR. Statistical heterogeneity was evaluated with the Cochran chi-square test (X2) test and inverse variance index (I2). Publication bias was analyzed using funnel plots and Egger’s test statistics. The review protocol is registered in PROSPERO, number CRD42020201859.Results: Out of studies screened, fifteen studies fulfilled the inclusion criteria, and were included in final analysis with a total number of 1523 participants. Treatment success of AL for uncomplicated falciparum malaria in all combined studies was 98.4% [(95% CI 97.6–99.1), P< 0.001]. Polymerase chain reaction (PCR)-corrected AL treatment success rate of 98.7% [(95% CI 97.7-99.6), P<0.001)]. The efficacy of AL with PCR-corrected cure rates ranging from 95.0 to 99.4% in per-protocol analysis, and 88.8 to 97.4% in intention-to-treat analysis. Based on the analysis, Cochrane chi-square test (X2) test and inverse variance index (I2) indicated that the included studies with heterogeneity (X2=20.48, (df=14), P=0.116 and I2=31.65%). The highest parasite positivity rate at day-3 was 5.7%. Adverse events ranged from mild to serious but were not directly attributed to the drug.Conclusion: The present review has shown that AL is efficacious and safe for treatment of uncomplicated malaria in Ethiopia. However, few therapeutic efficacy studies were conducted in Ethiopia after treatment guideline was revised in 2004. AL has been used more than a decade in the study population without other alternative artemisinin-based combination therapy in Ethiopia and considering that the potential evolution of drug resistance is of a great concern, regular and continuous monitoring of its efficacy is warranted.


Author(s):  
Briseida Mayel Perez-Avelino ◽  
Nicolás Padilla-Raygoza ◽  
Verónica Benitez-Guerrero ◽  
María Luisa Sánchez Padilla ◽  
Vicente Beltrán-Campos ◽  
...  

Objective: To determine the relationship of the perception of lifestyle with the level of physical activity in people with type 2 diabetes and without type 2 diabetes. Study Design: Analytical cross-sectional observational study in Celaya, Guanajuato, Mexico. Methodology: Sample composed of 100 people with type 2 diabetes and 100 people without type 2 diabetes, the lifestyle questionnaire and IPAQ questionnaire were used. Descriptive statistics were calculated for sociodemographic variables; it was calculated Chi-square test and Odds Ratio.  To demonstrate the statistical significance of results, the value of P was set at .05. Statistical analysis was performed in STATA 13.0 ®. Results: In patients with Type 2 Diabetes predominated females, married, who never went school and elementary and BMI ≥ 25 kg/m2; among patients without Type 2 Diabetes, predominant males, singles, went school or university, BMI ≥25 kg/m2; no relationship was found between lifestyle perception and level of physical activity in adults with type 2 diabetes (X² = 0.0022 gl 1 P = .96) neither it was found a significant relationship between lifestyle perception and level of physical activity in adults without type 2 diabetes (X² = 5.23 gl 1 P = .02 RM = 2.85 95% CI = 0.80 to 10.4). Conclusion: The results show that self-perception of lifestyle and physical activity is different in people with less age, more schooling, males.


2020 ◽  
pp. 9-11
Author(s):  
Madhu Kumari ◽  
Kumari Bibha ◽  
Abha Sinha ◽  
Debarshi Jana

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.


2019 ◽  
Vol 3 (9) ◽  
pp. 283-289
Author(s):  
Shuchi Sukul ◽  
Goldy Rathee ◽  
Parimal Anand ◽  
Sakshi Kataria ◽  
Pratibha Taneja

OBJECTIVES: The present research was conducted to assess incidences of root microcracks caused by hand and rotary file system at different lengths MATERIAL AND METHODS: This in-vitro study was undertaken to assess incidence of root microcracks caused by hand and rotary file system at different lengths In total, 100 the mandibular premolar with straight roots determined with intact, fully formed apices were taken. Samples were randomly distributed into 5 groups based on the file system used: a) Group A: Control, b) Group B: Reciproc, c) Group C: WaveOne, d) Group D: One Shape and e) Group E: ProTaper. Pearson Chi-square test was used to determine the differences between groups. The dentinal defects were expressed as percentage of samples with microcracks in each group. Level of statistical significance was set at p-value less than 0.05. RESULTS: The chi square test was used to compare the Distribution of the number of teeth in which cracks were observed on the horizontal sections. It was found to be significant with group ProTaper showing maximum cracks at 3,6,9 mm level as compared to other file systemCONCLUSION: Nickel-titanium instruments causes cracks on the apical root surface or in the root canal wall. ProTaper causes maximum dentinal cracks as compared to other file systems


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