Radiographical Measurements of Overeruption in Unopposed Posterior Teeth Among Selected Population of Saudi Arabia

The suspended replacement of extracted teeth may disrupt the structural integrity of the whole dental arch, particularly in posterior maxillary or mandibular tooth/teeth. This phenomenon often has consequences of masticatory deficiency and temporomandibular joint disorders. This work aims to assess and measure the overeruption of posterior teeth from panoramic radiographs (OPGs) and its relation to gender, age, tooth type, arch, sides, and cause of tooth loss. A total of 100 OPGs were included in this in vitro study. The level of posterior overeruption was measured in mm using the panoramic digital radiograph machine and its software systems. Other variables such as gender, tooth/teeth involved, arches, and side were considered. All parameter values were inputted to a software program and assessed. P value < 0.05 was considered as statistically significant. Males accounted for 63% of the OPGs. Age groups 18–30 and 31–45 years had the highest frequency and percentage (34%). Approximately 74% of the patients got their tooth/teeth extracted 4–6 years ago. The 0.7–1.2 mm overeruption subgroup had the highest proportion of 41%. The rate of overeruption in mandibular molars was 36%, which was the highest among the subgroups. Males had higher percentage than females in ≥60 and 31–45 age groups (84.65% and 76.5%, respectively), 4–6 years post-extraction time (85.7%), with significant differences, also, mandibular molars (85.0%) and mandibular arches (74.3%) were the higher among males. The highest level of overeruption was 0.7–1.2 mm, and mandibular molars were the most affected type. Significant differences between genders were detected in age groups, years after tooth loss, and arch side but not in cause of tooth loss, supra-erupted tooth type, and arch type parameters.

The Effect of Premedication with Curcumin on Post-Operative Pain in Single Visit Endodontic Treatment of Acute Pulpitis in Mandibular Molars: A Randomized Controlled Trial

Objective: The purpose of this randomized double-blind clinical trial was to compare the effect of a single pretreatment dose of Curcumin and placebo on post-operative pain for patients diagnosed with symptomatic irreversible pulpitis in mandibular molars treated in single visit. Methods: Forty-four patients with severe to moderate pain randomly received either Curcumin (400mg +20 mg pepper) or placebo (420 mg Starch) one hour before starting root canal treatment (n = 22 per group). Participants rated their pain using visual analogue pain scale (VAS): preoperatively and at 5 time points: immediately post-operative, 8, 12, 24 and 48 hours postoperative. Patients also stated emergency analgesic intake. The need for supplemental anesthesia during treatment was recorded. Mann-Whitney U-test compared the two groups at each time point, while Repeated-Measure ANOVA and Wilcoxon Signed Rank test compared time points within each group. A p-value <0.05 was considered statistically significant. Results: Baseline characteristics of both groups showed non-significant differences (P > 05). Curcumin group at 8, 12 and 24 hours revealed statistically significantly less VAS values (44.2, 26.7, 19.1) than the placebo (58.5, 43.3, 30.3), respectively, (P > 05). All patients in Curcumin group did not need emergency analgesics. Curcumin group revealed statistically significantly lower percentages for the need of supplemental anesthesia (27.3%) compared to placebo (68.2%), (P < 05). Conclusion: Single preoperative oral dose of Curcumin proved to be an effective premedication that reduced post-operative pain as well as the need of supplemental anesthesia for patients diagnosed with symptomatic irreversible pulpitis of mandibular molars.

A Successful Individual Endodontic Treatment of Severely Curved Root Canals in Mandibular Second Molars: A Case Report

Background and Overview The incidence rate of severely curved root canals in mandibular molars is low, and the root canal treatment of mandibular molars with this aberrant canal anatomy may be visibly and technically challenging. Case Description A 26-year-old Chinese female patient presented with intermittent and occlusal pain in the left mandibular second molar. The patient had undergone caries for filling restoration before endodontic consultation. With the aid of cone beam computed tomography (CBCT), a large periapical radiolucency was observed, and curved root canals in a mandibular second molar were confirmed, depicting a severe and curved distolingual root. Nonsurgical treatments, including novel individual preparation skills and techniques and the use of bioceramic materials as an apical barrier, were performed, and complete healing of the periapical lesion and a satisfactory effect were achieved. Conclusions and Practical implications A case of a severely curved root canal in a mandibular second molar was successfully treated and reported herein. The complex anatomy of the tooth and the postoperative effect were also evaluated via the three-dimensional (3D) reconstruction of CBCT images, which accurately identified the aberrant canal morphology. Furthermore, new devices and biomaterial applications combined with novel synthesis techniques can increase the success rate of intractable endodontic treatment.