Displaying publications 1 - 20 of 64 in total

  1. Soo WK, Thong YL, Gutmann JL
    Int Endod J, 2015 Aug;48(8):736-46.
    PMID: 25130364 DOI: 10.1111/iej.12371
    To compare four gutta-percha filling techniques in simulated C-shaped canals based on filling quality at three cross-sectional levels, filling time and the apical extrusion of gutta-percha.
  2. Ahmed HM
    Int Endod J, 2013 Nov;46(11):1011-22.
    PMID: 23711096 DOI: 10.1111/iej.12134
    Paediatric endodontics is an integral part of dental practice that aims to preserve fully functional primary teeth in the dental arch. Pulpectomy of primary molars presents a unique challenge for dental practitioners. Negotiation and thorough instrumentation of bizarre and tortuous canals encased in roots programmed for physiological resorption are the main challenges for this treatment approach. Consequently, numerous in vitro and in vivo studies have been conducted to validate the application of some contemporary endodontic armamentarium for effective treatment in primary molars whilst maintaining favourable clinical outcomes. Electronic apex locators, rotary nickel-titanium files and irrigation techniques are at the forefront of endodontic armamentarium in paediatric dentistry. Hence, this review aims to map out the root and root canal morphology of primary molars, to discuss the application of electronic apex locators in primary molars and to provide an update on the preparation of their root canal systems.
  3. Ahmed HM, Abbott PV
    Int Endod J, 2012 Oct;45(10):883-97.
    PMID: 22621247 DOI: 10.1111/j.1365-2591.2012.02071.x
    Advances in endodontic materials and techniques are at the forefront of endodontic research. Despite continuous improvements, tooth discolouration, especially in anterior teeth, is considered an undesirable consequence following endodontic treatment as it creates a range of aesthetic problems. This article aims to discuss the intrinsic and internalized tooth discolouration caused by endodontic procedures, and to address the discolouration potential of materials used during root canal treatment, including root canal irrigants, intra-canal medicaments, endodontic and post-endodontic filling materials. In addition, the discolouration patterns caused by combined endodontic and nonendodontic aetiological factors are discussed. The recommended guidelines that should be followed by dental practitioners to prevent and manage tooth discolouration are also outlined.
  4. Gnanasegaran N, Govindasamy V, Abu Kasim NH
    Int Endod J, 2016 Oct;49(10):937-49.
    PMID: 26354006 DOI: 10.1111/iej.12545
    AIM: To investigate whether dental pulp stem cells from carious teeth (DPSCs-CT) can differentiate into functional dopaminergic-like (DAergic) cells and provide an alternative cell source in regenerative medicine.

    METHODOLOGY: Dental pulp stem cells from healthy (DPSCs) and carious teeth (DPSCs-CT) were isolated from young donors. Both cell lines were expanded in identical culture conditions and subsequently differentiated towards DAergic-like cells using pre-defined dopaminergic cocktails. The dopaminergic efficiencies were evaluated both at gene and protein as well as at secretome levels.

    RESULTS: The efficiency of DPSCs-CT to differentiate into DAergic-like cells was not equivalent to that of DPSCs. This was further reflected in both gene and protein generation whereby key neuronal markers such as nestin, NURR1 and beta-III-tubulin were expressed significantly lower as compared to differentiated DPSCs (P 

  5. Kanagasingam S, Hussaini HM, Soo I, Baharin S, Ashar A, Patel S
    Int Endod J, 2017 May;50(5):427-436.
    PMID: 27063356 DOI: 10.1111/iej.12651
    AIM: To compare the accuracy of film and digital periapical radiography (PR) in detecting apical periodontitis (AP) using histopathological findings as a reference standard.

    METHODOLOGY: Jaw sections containing 67 teeth (86 roots) were collected from nine fresh, unclaimed bodies that were due for cremation. Imaging was carried out to detect AP lesions using film and digital PR with a centred view (FP and DP groups); film and digital PR combining central with 10˚ mesially and distally angled (parallax) views (FPS and DPS groups). All specimens underwent histopathological examination to confirm the diagnosis of AP. Sensitivity, specificity and predictive values of PR were analysed using rater mean (n = 5). Receiver operating characteristics (ROC) analysis was carried out.

    RESULTS: Sensitivity was 0.16, 0.37, 0.27 and 0.38 for FP, FPS, DP and DPS, respectively. Both FP and FPS had specificity and positive predictive values of 1.0, whilst DP and DPS had specificity and positive predictive values of 0.99. Negative predictive value was 0.36, 0.43, 0.39 and 0.44 for FP, FPS, DP and DPS, respectively. Area under the curve (AUC) for the various imaging methods was 0.562 (FP), 0.629 (DP), 0.685 (FPS), 0.6880 (DPS).

    CONCLUSIONS: The diagnostic accuracy of single digital periapical radiography was significantly better than single film periapical radiography. The inclusion of two additional horizontal (parallax) angulated periapical radiograph images (mesial and distal horizontal angulations) significantly improved detection of apical periodontitis.

  6. Kanagasingam S, Lim CX, Yong CP, Mannocci F, Patel S
    Int Endod J, 2017 May;50(5):417-426.
    PMID: 27063209 DOI: 10.1111/iej.12650
    AIM: To compare the diagnostic accuracy of periapical radiography (PR) and cone beam computed tomography (CBCT) in detecting apical periodontitis (AP) using histopathological findings as a reference standard.

    METHODOLOGY: Jaw sections containing 67 teeth (86 roots) were collected from unclaimed bodies due for cremation. Imaging was carried out to detect AP by digital PR with a central view (DP group), digital PR combining central with 10˚ mesially and distally angled (parallax) views (DPS group) and CBCT scans. All specimens underwent histopathological examination to confirm the diagnosis of AP. Sensitivity, specificity and predictive values of PR and CBCT were analysed using rater mean (n = 5). Receiver-operating characteristic (ROC) analysis was carried out.

    RESULTS: Sensitivity was 0.27, 0.38 and 0.89 for DP, DPS and CBCT scans, respectively. CBCT had specificity and positive predictive value of 1.0 whilst DP and DPS had specificity and positive predictive value of 0.99. The negative predictive value was 0.39, 0.44 and 0.81 for DP, DPS and CBCT scans, respectively. Area under the curve (AUC) for the various imaging methods was 0.629 (DP), 0.688 (DPS), and 0.943 (CBCT).

    CONCLUSIONS: All imaging techniques had similar specificity and positive predictive values. Additional parallax views increased the diagnostic accuracy of PR. CBCT had significantly higher diagnostic accuracy in detecting AP compared to PR, using human histopathological findings as a reference standard.

  7. Ahmed HM, Hashem AA
    Int Endod J, 2016 Aug;49(8):724-36.
    PMID: 26174943 DOI: 10.1111/iej.12508
    Anterior teeth may have aberrant anatomical variations in the number of roots and root canals. A review of the literature was conducted using appropriate key words in major endodontic journals to identify the available reported cases as well as experimental and clinical investigations on accessory roots and root canals in anterior teeth. After retrieving the full text of related articles, cross-citations were identified, and the pooled data were then discussed. Results revealed a higher prevalence in accessory root/root canal variations in mandibular anterior teeth than in maxillary counterparts. However, maxillary incisor teeth revealed the highest tendency for accessory root/root canal aberrations caused by anomalies such as dens invaginatus and palato-gingival groove. Primary anterior teeth may also exhibit external and internal anatomical variations in the root, especially maxillary canines. Therefore, dental practitioners should thoroughly assess all teeth scheduled for root canal treatment to prevent the undesirable consequences caused by inadequate debridement of accessory configurations of the root canal system.
  8. Ahmad M, Roy RA, Kamarudin AG
    Int Endod J, 1994 Jan;27(1):26-31.
    PMID: 7806408
    The present study was undertaken to see if there was any variability in the power output of Piezon-Master 400 ultrasonic files when driven using different generators, tranducers and file holders. The displacement amplitude of the oscillating tip of the file in air was used as a measure of the power output. The results showed that there was considerable variability in the power output of Piezon-Master 400 ultrasonic files of similar size and length when driven using different generators, transducers and file holders. In consideration of this, it is recommended that a calibration device be incorporated in the ultrasonic unit so that the operator will have some knowledge of when the unit is working at its maximum efficiency.
  9. Ngeow WC, Thong YL
    Int Endod J, 1998 Sep;31(5):367-71.
    PMID: 9823142
    Dental pulp is prone to dystrophic mineralization; this mineralization can be so extensive that the entire root canal system is obliterated. As a result, root canal treatment can become a difficult if not impossible task. This article presents the endodontic management of a tooth with an obliterated pulp chamber and associated with a discharging sinus in a teenage patient. The role of a calcium hydroxide lining to induce mineralization and cause the obliteration of the pulpal space is also discussed.
  10. Ahmad M, Roy RA, Kamarudin AG, Safar M
    Int Endod J, 1993 Mar;26(2):120-4.
    PMID: 8330934
    The pattern of oscillation of a Piezon-Master 400 ultrasonic file driven by a piezoelectric transducer was studied in air and on water. In addition, the displacement amplitudes of the files were measured. The findings were compared with those observed with the Cavi-Endo unit reported in another study (Ahmad 1969). It was observed that the file vibrated such that a standing wave was formed on the file and it exhibited points of maximum deflection (antinode) and points of minimum deflection (node) with the largest deflection occurring at the apical end. This pattern of oscillation was similar to that exhibited by the Cavi-Endo file which employed a magnetostrictive transducer. However, the displacement amplitudes were very much higher than those exhibited by the Cavi-Endo. It is considered that the 120 degrees angle of the file holder inherent in the Piezon-Master 400 unit and the more effective power transmission with the piezoelectric transducer may have contributed to the large amplitudes.
  11. Ahmed HMA, Versiani MA, De-Deus G, Dummer PMH
    Int Endod J, 2017 Aug;50(8):761-770.
    PMID: 27578418 DOI: 10.1111/iej.12685
    Knowledge of root and root canal morphology is a prerequisite for effective nonsurgical and surgical endodontic treatments. The external and internal morphological features of roots are variable and complex, and several classifications have been proposed to define the various types of canal configurations that occur commonly. More recently, improvements in nondestructive digital image systems, such as cone-beam and micro-computed tomography, as well as the use of magnification in clinical practice, have increased the number of reports on complex root canal anatomy. Importantly, using these newer techniques, it has become apparent that it is not possible to classify many root canal configurations using the existing systems. The purpose of this article is to introduce a new classification system that can be adapted to categorize root and root canal configurations in an accurate, simple and reliable manner that can be used in research, clinical practice and training.
  12. Ahmed HMA, Neelakantan P, Dummer PMH
    Int Endod J, 2018 Feb;51(2):164-176.
    PMID: 28635100 DOI: 10.1111/iej.12800
    Thorough knowledge of anatomical complexities of the root canal system has a direct impact on the effectiveness of canal preparation and filling, and is an essential prerequisite for successful root canal treatment. A wide range of complex variations in root canal anatomy exists, including root canal configuration type, developmental anomalies and minor canal morphology such as accessory canals and apical deltas. Accessory canals and apical deltas have been associated with pulp disease, primary canal infection, canal reinfection and post-treatment disease. The current definitions of accessory canal anatomy are not standardized and potentially confusing. Given their role in endodontic disease and their impact on treatment outcomes, there is a need to have a simple classification of their anatomy to provide an accurate description of their position and path from the canal to the external surface of the root. The purpose of this article is to introduce a new system for classifying accessory canal morphology for use in research, clinical practice and training.
  13. Ahmed HMA, Versiani MA, De-Deus G, Dummer PMH
    Int Endod J, 2018 Oct;51(10):1182-1183.
    PMID: 30191599 DOI: 10.1111/iej.12928
  14. Saber SEDM, Ahmed MHM, Obeid M, Ahmed HMA
    Int Endod J, 2019 Mar;52(3):267-278.
    PMID: 30225932 DOI: 10.1111/iej.13016
    AIM: To investigate the number of roots and root canal configurations using two coding systems and the root canal diverging and merging levels in extracted maxillary premolars in an Egyptian subpopulation using cone beam computed tomography (CBCT).

    METHODOLOGY: A total of 700 maxillary premolars were examined using CBCT in an Egyptian subpopulation. The number of roots was identified, and root canal configurations were classified according to Vertucci's classification and a new system for classifying root and canal morphology. In addition, the position where roots bifurcated and the levels where canals merged or diverged were identified. Fisher's exact test and independent t-test were used for statistical analysis, and the level of significance was set at 0.05 (P = 0.05).

    RESULTS: More than half of maxillary first premolars were double-rooted, and the majority of maxillary second premolars were single-rooted (P 

  15. Nagendrababu V, Pulikkotil SJ, Sultan OS, Jayaraman J, Soh JA, Dummer PMH
    Int Endod J, 2019 Feb;52(2):181-192.
    PMID: 30099740 DOI: 10.1111/iej.12995
    The aim of the present systematic review was to evaluate the effectiveness of technology-enhanced learning (TEL) in the field of Endodontics to improve educational outcomes compared to traditional learning methods. Randomized controlled studies published in English were identified from two electronic databases (PubMed and Scopus) up to May 2018. Two authors independently performed study selection, data extraction and assessed the risk of bias (ROB). Any teaching method using TEL was considered as the intervention, and this was compared to traditional methods. The outcome measuring the effectiveness of learning activities was evaluated by Kirkpatrick's four-level training evaluation model. The four levels of training outcomes are as follows: Reaction, Learning, Behaviour and Results. A meta-analysis was performed to estimate the standardized mean difference (SMD) by the random effects model. In total, 13 studies were included in the systematic review. Only three studies were assessed as 'low' ROB. A meta-analysis could not be performed in the domains of Reaction and Behaviour. No significant difference was observed in knowledge gain (Learning domain) between TEL and traditional methods (SMD, 0.14 (95% CI -0.10 to 0.39) I2  = 62.7%). Similarly, no difference was observed in performance (Behaviour domain). A variable response was found in attitude (Reaction domain). From the available evidence, it can be concluded that TEL is equally as effective as traditional learning methods.
  16. Ahmed HMA, Dummer PMH
    Int Endod J, 2018 Apr;51(4):389-404.
    PMID: 29023779 DOI: 10.1111/iej.12867
    Understanding the normal anatomical features as well as the more unusual developmental anomalies of teeth, roots and root canals is essential for successful root canal treatment. In addition to various types of root canal configuration and accessory canal morphology, a wide range of developmental tooth, root and canal anomalies exists, including C-shaped canals, dens invaginatus, taurodontism, root fusion, dilacerations and palato-gingival grooves. There is a direct association between developmental anomalies and pulp and periradicular diseases that usually require a multidisciplinary treatment approach to achieve a successful outcome. A number of classifications have categorized tooth, root and canal anomalies; however, several important details are often missed making the classifications less than ideal and potentially confusing. Recently, a new coding system for classifying root, root canal and accessory canal morphology has been introduced. The purpose of this article is to introduce a new system for classifying tooth, root and canal anomalies for use in research, clinical practice and training, which can serve as complementary codes to the recently described system for classifying root, as well as main and accessory canal morphology.
  17. Pulikkotil SJ, Nagendrababu V, Veettil SK, Jinatongthai P, Setzer FC
    Int Endod J, 2018 Sep;51(9):989-1004.
    PMID: 29480930 DOI: 10.1111/iej.12912
    This systematic review (SR; PROSPERO database: CRD42017075160) and network meta-analysis (NMA) identified the most effective oral premedication for anaesthetic success of inferior alveolar nerve blocks (IANB) in cases of irreversible pulpitis. Medline and Ebscohost databases were searched up until 10/2017. Randomized controlled trials (RCT) studying the effect of oral premedication, alone or in combination, on the success of IANB for cases of irreversible pulpitis, compared to placebo or other oral premedications, were included. Quality of the included studies was appraised by the revised Cochrane risk of bias tool for randomized trials. Pairwise analysis, NMA and quality of evidence assessment using GRADE criteria were performed. Nineteen studies (n = 1654 participants) were included. NMA demonstrated that compared to placebo, dexamethasone was most effective in increasing anaesthetic success (RR, 2.92 [95% CI 1.74,4.91]; SUCRA = 0.96), followed by NSAIDs (RR, 1.92 [95% CI 1.63,2.27], SUCRA = 0.738) and Tramadol (RR, 2.03 [95% CI 1.18,3.49], SUCRA = 0.737). Premedication with acetaminophen added to NSAIDs demonstrated similar efficacy as NSAIDs alone (RR, 1.06 [95% CI 0.79,1.43]). Sensitivity analyses proved the superiority of dexamethasone or NSAIDs over any other premedications. Subgroup analyses of specific dosages in comparison with placebo demonstrated that dexamethasone 0.5 mg was most effective, followed by ketorolac 10 mg, piroxicam 20 mg, ibuprofen 400 mg + acetaminophen 500 mg and Tramadol 50 mg. Ibuprofen 400 mg, 600 mg and 800 mg had a significantly improved IANB success, while Ibuprofen 300 mg had no effect. Oral premedication with dexamethasone, NSAIDs or Tramadol significantly increased anaesthetic success. More trials are needed to evaluate the premedication effects of dexamethasone or Tramadol for improved anaesthetic success of IANB when treating irreversible pulpitis.
  18. Neelakantan P, Ahmed HMA, Wong MCM, Matinlinna JP, Cheung GSP
    Int Endod J, 2018 Aug;51(8):847-861.
    PMID: 29377170 DOI: 10.1111/iej.12898
    The aim of this systematic review was to address the question: Do different irrigating protocols have an impact on the dislocation resistance of mineral trioxide aggregate (MTA)-based materials? The review was performed using a well-defined search strategy in three databases (PubMed, Scopus, Web of Science) to include laboratory studies performed between January 1995 and May 2017, in accordance with PRISMA guidelines. Two reviewers analysed the papers, assessed the risk of bias and extracted data on teeth used, sample size, size of root canal preparation, type of MTA-based material, irrigants, canal filling method, storage method and duration, region of roots and the parameters of push-out testing (slice thickness, plunger dimensions and plunger loading direction), the main results and dislocation resistance values (in MPa). From 255 studies, 27 were included for full-text analysis. Eight papers that met the inclusion criteria were included in this review. There was a wide variation in dislocation resistance due to differences in irrigation sequence, time and concentration of irrigants, storage method and duration, and the parameters of push-out bond strength testing. A meta-analysis was not done but qualitative synthesis of the included studies was performed. No definitive conclusion could be drawn to evaluate the effect of irrigation protocols on dislocation resistance of MTA-based materials. Recommendations have been provided for standardized testing methods and reporting of future studies, so as to obtain clinically relevant information and to understand the effects of irrigating protocols on root canal sealers and their interactions with the dentine walls of root canals.
  19. Nagendrababu V, Dilokthornsakul P, Jinatongthai P, Veettil SK, Pulikkotil SJ, Duncan HF, et al.
    Int Endod J, 2020 Feb;53(2):232-249.
    PMID: 31520403 DOI: 10.1111/iej.13217
    A systematic review aims to answer a focussed research question through a structured review of the evidence, using a predefined methodology, which often includes a meta-analysis. A meta-analysis is a statistical method used to combine the effect estimates from the individual studies included in a systematic review. Systematic reviews and meta-analyses are positioned at the highest level in the hierarchy of clinical evidence. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was introduced in 2009 to help authors improve the quality and reliability of systematic reviews and meta-analyses. Recently, the volume of systematic reviews and meta-analyses in the field of Endodontology has increased; however, the quality of the published manuscripts has been reported to be sub-optimal, which does not take account of the systematic reviews that were rejected because of more obvious deficiencies. The aim of this paper is to present a comprehensive glossary of terminology commonly used in systematic reviews and meta-analyses in an attempt to provide easily understood definitions and explanations to assist authors when reporting systematic reviews and meta-analyses and to allow those wishing to read them to become better informed.
  20. Ahmed HMA, Musale PK, El Shahawy OI, Dummer PMH
    Int Endod J, 2020 Jan;53(1):27-35.
    PMID: 31390075 DOI: 10.1111/iej.13199
    Knowledge of root and canal morphology is essential for the effective practice of root canal treatment. Paediatric endodontics aims to preserve fully functional primary teeth in the dental arch; however, pulpectomy procedures in bizarre and tortuous canals encased in roots programmed for physiologic resorption are unique challenges. A new coding system for classifying the roots and main canals (https://doi.org/10.1111/iej.12685), accessory canals (https://doi.org/10.1111/iej.12800) and developmental anomalies (https://doi.org/10.1111/iej.12867) has been introduced recently. This paper discusses challenges for describing root and canal morphology in primary teeth and describes the potential application of the new classification system for root canals in the primary dentition.
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