Displaying publications 1 - 20 of 25 in total

  1. Kannan S, Kannepady SK, Muthu K, Jeevan MB, Thapasum A
    J Endod, 2015 Mar;41(3):333-7.
    PMID: 25476972 DOI: 10.1016/j.joen.2014.10.015
    The aim of this study was to determine the prevalence of pulp stones in the Malaysian population using radiographs, and to assess the association of pulp stones with gender, age, tooth type, dental arch and tooth status. Occurrence of pulp stones among the three races in Malaysia (Malay, Chinese and Indians) was also studied.
  2. Ahmed HM, Luddin N, Kannan TP, Mokhtar KI, Ahmad A
    J Endod, 2014 Oct;40(10):1517-23.
    PMID: 25127931 DOI: 10.1016/j.joen.2014.06.013
    The attachment and spreading of mammalian cells on endodontic biomaterials are an area of active research. The purpose of this review is to discuss the cell attachment properties of Portland cement (PC)-based materials by using scanning electron microscope (SEM). In addition, methodological aspects and technical challenges are discussed.
  3. Govindasamy V, Abdullah AN, Ronald VS, Musa S, Ab Aziz ZA, Zain RB, et al.
    J Endod, 2010 Sep;36(9):1504-15.
    PMID: 20728718 DOI: 10.1016/j.joen.2010.05.006
    Lately, several new stem cell sources and their effective isolation have been reported that claim to have potential for therapeutic applications. However, it is not yet clear which type of stem cell sources are most potent and best for targeted therapy. Lack of understanding of nature of these cells and their lineage-specific propensity might hinder their full potential. Therefore, understanding the gene expression profile that indicates their lineage-specific proclivity is fundamental to the development of successful cell-based therapies.
  4. Grande NM, Ahmed HM, Cohen S, Bukiet F, Plotino G
    J Endod, 2015 Nov;41(11):1778-83.
    PMID: 26514866 DOI: 10.1016/j.joen.2015.06.014
    During the evolution of mechanical instrumentation in endodontics, an important role has been played by reciprocating stainless steel files using horizontal rotational, vertical translational, or combined movements. These kinds of systems are still in use mainly as an accessory to help in the first phases of the treatment.
  5. Plotino G, Ahmed HM, Grande NM, Cohen S, Bukiet F
    J Endod, 2015 Dec;41(12):1939-50.
    PMID: 26480824 DOI: 10.1016/j.joen.2015.08.018
    Many reciprocating file systems (RFs) have recently been introduced. This article reviews the properties, effectiveness, and clinical outcomes of the RFs.
  6. Colaco AS, Pai VA
    J Endod, 2015 Nov;41(11):1871-4.
    PMID: 26364003 DOI: 10.1016/j.joen.2015.07.012
    This study aimed to evaluate the efficiency of 2 manual and 2 rotary gutta-percha (GP) removal techniques in terms of both the total operating time and GP remnants left in the canal.
  7. Sidhu P, Shankargouda S, Dicksit DD, Mahdey HM, Muzaffar D, Arora S
    J Endod, 2016 Apr;42(4):622-5.
    PMID: 26850688 DOI: 10.1016/j.joen.2015.12.027
    INTRODUCTION: Use of mobile phone has been prohibited in many hospitals to prevent interference with medical devices. Electromagnetic radiation emitted from cellular phones might interfere with electronic working length determination. The purpose of this in vitro study was to evaluate the effect of a smart phone (Samsung Galaxy Note Edge) on working length determination of electronic apex locators (EALs) Propex II and Rootor.

    METHODS: Fifteen intact, non-carious single-rooted teeth were decoronated at the cementoenamel junction. Visually, working length was determined by using a #15 K-file under stereomicroscope (×20). The effect of cellular phones on electronic working length (EWL) was determined under 2 experimental settings: (1) in a closed room with poor signal strength and (2) in a polyclinic set up with good signal strength and 5 conditions: (1) electronically, without cellular phone in room; (2) electronically, with cellular phone in physical contact with EAL; (3) electronically, with mobile phone in physical contact with EAL and in calling mode for a period of 25 seconds; (4) electronically, mobile phone placed at a distance of 40 cm from the EAL; and (5) electronically, mobile phone placed at a distance of 40 cm and in calling mode for a period of 25 seconds. The EWL was measured 3 times per tooth under each condition. Stability of the readings was scored from 1 to 3: (1) good stability, (2) stable reading after 1 attempt, and (3) stable reading after 2 attempts. The data were compared by using analysis of variance.

    RESULTS: The EWL measurements were not influenced by the presence of cellular phone and could be determined under all experimental conditions.

    CONCLUSIONS: Within the limitations of this study, it can be concluded that mobile phones do not interfere with the EWL determination.

  8. Chai WL, Thong YL
    J Endod, 2004 Jul;30(7):509-12.
    PMID: 15220648
    The cross-sectional canal morphology and minimum widths of buccal and lingual canal walls were studied in 20 mandibular molars with C-shaped roots and canal orifices. The roots were mounted in clear resin blocks and sectioned transversely at 1-mm intervals. A total of 154 cross-sections were evaluated with an image analyzer. Twelve different longitudinal canal configurations were identified. The most prevalent were types 1-2 and 1-2-1 with each type occurring in four roots. Evaluation of the cross-sectional morphology showed that the configurations were complete "C" (27%), incomplete C (64%), and non-C (9%). The mean value for the minimum width of the lingual canal wall was 0.58 +/- 0.21 mm and the buccal wall was 0.96 +/- 0.26 mm. This suggests that there is a higher risk of root perforation at the thinner lingual walls of C-shaped canals during shaping and post canal preparation procedures. Both buccal and lingual canal walls were frequently narrower at mesial locations.
  9. Hussein FE, Liew AK, Ramlee RA, Abdullah D, Chong BS
    J Endod, 2016 Oct;42(10):1441-5.
    PMID: 27552839 DOI: 10.1016/j.joen.2016.07.009
    INTRODUCTION: Ignoring the cluster effect is a common statistical oversight that is also observed in endodontic research. The aim of this study was to explore the use of multilevel modeling in investigating the effect of tooth-level and patient-level factors on apical periodontitis (AP).

    METHODS: A random sample of digital panoramic radiographs from the database of a dental hospital was evaluated. Two calibrated examiners (κ ≥ 0.89) assessed the technical quality of the root fillings and the radiographic periapical health status by using the periapical index. Descriptive statistical analysis was carried out, followed by multilevel modeling by using tooth-level and patient-level predictors. Model fit information was obtained, and the findings of the best-fit model were reported.

    RESULTS: A total of 6409 teeth were included in the analysis. The predicted probability of a tooth having AP was 0.42%. There was a statistically significant variability between patients (P 

  10. Rossi-Fedele G, Ahmed HM
    J Endod, 2017 Apr;43(4):520-526.
    PMID: 28214018 DOI: 10.1016/j.joen.2016.12.008
    INTRODUCTION: The removal of obturation materials from the root canal system is a primary objective in root canal retreatment procedures. This systematic review aims to discuss the effectiveness of different instrumentation procedures in removing root-canal filling materials assessed by micro-computed tomography.

    METHODS: An electronic search in PubMed and major endodontic journals was conducted using appropriate key words to identify investigations that examined the effectiveness of obturation material removal assessed by micro-computed tomography.

    RESULTS: Among 345 studies, 22 satisfied the inclusion criteria. Seven studies compared hand instrumentation with Nickel-Titanium rotary or reciprocating systems. Three studies investigated rotary systems, and another three studies explored reciprocation. Eight studies compared rotary systems and reciprocation in removing filling materials from the root canal system. Other factors, such as the role of solvents and irrigant agitation, were discussed.

    CONCLUSIONS: The application of different instrumentation protocols can effectively, but not completely, remove the filling materials from the root canal system. Only hand instrumentation was not associated with iatrogenic errors. Reciprocating and rotary systems exhibited similar abilities in removing root filling material. Retreatment files performed similarly to conventional ones. Solvents enhanced penetration of files but hindered cleaning of the root canal. The role of irrigant agitation was determined as controversial.

  11. Nagendrababu V, Pulikkotil SJ, Veettil SK, Teerawattanapong N, Setzer FC
    J Endod, 2018 Jun;44(6):914-922.e2.
    PMID: 29709297 DOI: 10.1016/j.joen.2018.02.017
    INTRODUCTION: Successful anesthesia with an inferior alveolar nerve block (IANB) is imperative for treating patients with irreversible pulpitis in mandibular teeth. This systematic review assessed the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) as oral premedications on the success of IANBs in irreversible pulpitis.

    METHODS: Three databases were searched to identify randomized clinical trials (RCTs) published up until September 2017. Retrieved RCTs were evaluated using the revised Cochrane Risk of Bias Tool. The primary efficacy outcome of interest was the success rate of IANB anesthesia. Meta-analytic estimates (risk ratio [RR] with 95% confidence intervals [CIs]) performed using a random effects model and publication bias determined using funnel plot analysis were assessed. Random errors were evaluated with trial sequential analyses, and the quality of evidence was appraised using a Grading of Recommendations, Assessment, Development and Evaluation approach.

    RESULTS: Thirteen RCTs (N = 1034) were included. Eight studies had low risk of bias. Statistical analysis of good-quality RCTs showed a significant beneficial effect of any NSAID in increasing the anesthetic success of IANBs compared with placebo (RR = 1.92; 95% CI, 1.55-2.38). Subgroup analyses showed a similar beneficial effect for ibuprofen, diclofenac, and ketorolac (RR = 1.83 [95% CI, 1.43-2.35], RR = 2.56 [95% CI, 1.46-4.50], and RR = 2.07 [95% CI, 1.47-2.90], respectively). Dose-dependent ibuprofen >400 mg/d (RR = 1.85; 95% CI, 1.39-2.45) was shown to be effective; however, ibuprofen ≤400 mg/d showed no association (RR = 1.78; 95% CI, 0.90-3.55). TSA confirmed conclusive evidence for a beneficial effect of NSAIDs for IANB premedication. The Grading of Recommendations, Assessment, Development and Evaluation approach did not reveal any concerns regarding the quality of the results.

    CONCLUSIONS: Oral premedication with NSAIDs and ibuprofen (>400 mg/d) increased the anesthetic success of IANBs in patients with irreversible pulpitis.

  12. Nagendrababu V, Pulikkotil SJ, Sultan OS, Jayaraman J, Peters OA
    J Endod, 2018 Jun;44(6):903-913.
    PMID: 29602531 DOI: 10.1016/j.joen.2018.02.013
    INTRODUCTION: The aim of this systematic review (SR) was to evaluate the quality of SRs and meta-analyses (MAs) in endodontics.

    METHODS: A comprehensive literature search was conducted to identify relevant articles in the electronic databases from January 2000 to June 2017. Two reviewers independently assessed the articles for eligibility and data extraction. SRs and MAs on interventional studies with a minimum of 2 therapeutic strategies in endodontics were included in this SR. Methodologic and reporting quality were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), respectively. The interobserver reliability was calculated using the Cohen kappa statistic. Statistical analysis with the level of significance at P 

  13. Arslan H, Doğanay E, Karataş E, Ünlü MA, Ahmed HMA
    J Endod, 2017 Nov;43(11):1765-1769.
    PMID: 28967495 DOI: 10.1016/j.joen.2017.06.028
    INTRODUCTION: Low-level laser therapy (LLLT) is a practical, nonpharmacologic technique for reducing pain. This study evaluated the effect of LLLT on postoperative pain after root canal retreatment (RCR).

    METHODS: This study enrolled patients (N = 36) who required root canal retreatment (RCR) on mandibular molar teeth, presented with periapical lesions with periapical index scores of 2 or 3, and had a pain visual analog scale (VAS) <50 and a percussion pain VAS <50. The participants were divided into 2 groups: (1) patients scheduled for RCR followed by LLLT (n = 18) and (2) patients scheduled for RCR followed by a mock LLLT (placebo) (n = 18). Postoperative pain was assessed using the VAS. Data were collected and statistically analyzed with the chi-square test, the independent sample t test, and the Mann-Whitney U test (P = .05).

    RESULTS: On the first 4 days, postoperative pain significantly reduced in the LLLT group compared with the placebo group (P  .05). The number of patients who needed analgesics was lower in the LLLT group than in the placebo group (P 

  14. Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F
    J Endod, 2017 Jan;43(1):16-24.
    PMID: 27986099 DOI: 10.1016/j.joen.2016.09.023
    INTRODUCTION: Sodium hypochlorite (NaOCl) extrusion beyond the apex, also known as "a hypochlorite accident," is a well-known complication that seldom occurs during root canal therapy. These "accidents" have been the subject of several case reports published over the years. Until now, no publication has addressed the global synthesis of the general and clinical data related to NaOCl extrusion. The main purpose of this article was to conduct a systematic review of previously published case reports to identify, synthesize, and present a critical analysis of the available data. A second purpose was to propose a standardized presentation of reporting data concerning NaOCl extrusions to refine and develop guidelines that should be used in further case report series.

    METHODS: A review of clinical cases reporting NaOCl accidents was conducted in June 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combined an electronic search of the PubMed database and an extensive manual search.

    RESULTS: Forty full-text articles corresponding to 52 case reports published between 1974 and 2015 were selected. Four main categories of data were highlighted: general and clinical information, clinical signs and symptoms of NaOCl extrusions, management of NaOCl extrusions, and healing and prognosis. Overall, up to now, clinical cases were reported in a very unsystematic manner, and some relevant information was missing.

    CONCLUSIONS: A better understanding of the potential causes, management, and prognosis of NaOCl accidents requires a standardization of reported data; this study proposes a template that can fulfill this objective.

  15. Heng BC, Gong T, Wang S, Lim LW, Wu W, Zhang C
    J Endod, 2017 Mar;43(3):409-416.
    PMID: 28231979 DOI: 10.1016/j.joen.2016.10.033
    INTRODUCTION: Dental follicle stem cells (DFSCs) possess neurogenic potential because they originate from the embryonic neural crest. This study investigated whether neural differentiation of DFSCs can be enhanced by culture on decellularized matrix substrata (NSC-DECM) derived from neurogenesis of human embryonic stem cells (hESCs).

    METHODS: The hESCs were differentiated into neural stem cells (NSCs), and NSC-DECM was extracted from confluent monolayers of NSCs through treatment with deionized water. DFSCs seeded on NSC-DECM, Geltrex, and tissue culture polystyrene (TCPS) were subjected to neural induction during a period of 21 days. Expression of early/intermediate (Musashi1, PAX6, NSE, and βIII-tubulin) and mature/late (NGN2, NeuN, NFM, and MASH1) neural markers by DFSCs was analyzed at the 7-, 14-, and 21-day time points with quantitative real-time polymerase chain reaction. Immunocytochemistry for detection of βIII-tubulin, PAX6, and NGN2 expression by DFSCs on day 7 of neural induction was also carried out.

    RESULTS: Quantitative RT-PCR showed that expression of PAX6, Musashi1, βIII-tubulin, NSE, NGN2, and NFM by DFSCs was enhanced on NSC-DECM versus either the Geltrex or TCPS groups. Immunocytochemistry showed that DFSCs in the NSC-DECM group displayed more intense staining for βIII-tubulin, PAX6, and NGN2 expression, together with more neurite outgrowths and elongated morphology, as compared with either Geltrex or TCPS.

    CONCLUSIONS: DECM derived from neurogenesis of hESCs can enhance the neurogenic potential of DFSCs.

  16. Nocca G, Ahmed HMA, Martorana GE, Callà C, Gambarini G, Rengo S, et al.
    J Endod, 2017 Sep;43(9):1545-1552.
    PMID: 28734651 DOI: 10.1016/j.joen.2017.04.025
    INTRODUCTION: The literature reveals controversies regarding the formation of para-chloroaniline (PCA) when chlorhexidine (CHX) is mixed with sodium hypochlorite (NaOCl). This study aimed to investigate the stability of PCA in the presence of NaOCl and to examine the in vitro cytotoxic effects of CHX/NaOCl reaction mixtures.

    METHODS: Different volumes of NaOCl were added to CHX (mix 1) or PCA (mix 2). Upon centrifugation, the supernatant and precipitate fractions collected from samples were analyzed using high-performance liquid chromatography. The cytotoxic effects of both fractions were examined on human periodontal ligament and 3T3 fibroblast cell lines.

    RESULTS: High-performance liquid chromatographic analysis showed no PCA signal when NaOCl was mixed with CHX (mix 1). In mix 2, the intensity of PCA was decreased when NaOCl was added to PCA, and chromatographic signals, similar to that of CHX/NaOCl, were also observed. The mortality of precipitates exerted on both cell lines was lower compared with that of supernatants.

    CONCLUSIONS: The discrepancy in the data from the literature could be caused by the instability of the PCA in the presence of NaOCl. The CHX/NaOCl reaction mixture exhibits a wide range of cytotoxic effects.

  17. Nagendrababu V, Aly Ahmed HM, Pulikkotil SJ, Veettil SK, Dharmarajan L, Setzer FC
    J Endod, 2019 Oct;45(10):1175-1183.e3.
    PMID: 31551112 DOI: 10.1016/j.joen.2019.06.008
    INTRODUCTION: This systematic review compared the anesthetic efficacy between Gow-Gates (GG), Vazirani-Akinosi (VA), and mental incisive (MI) nerve blocks (NBs) with inferior alveolar nerve blocks (IANBs) in mandibular teeth with irreversible pulpitis using meta-analysis and trial sequential analysis (TSA).

    METHODS: Studies were identified from 4 electronic databases up to June 2019. Randomized clinical trials (RCTs) comparing the anesthetic success rate of GG, VA, and MI NBs with IANBs in mandibular premolars and molars with irreversible pulpitis were included. The quality of selected RCTs was appraised using the revised Cochrane risk of bias tool. Random-effects meta-analyses of risk ratio (RR) and 95% confidence intervals (CIs) were calculated, and random errors were evaluated by TSA. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach.

    RESULTS: Five RCTs were included; 2 of them were classified as low risk of bias. No significant difference was observed in the anesthesia success rate compared between GG and IA NBs (RR = 1.10; 95% CI, 0.82-1.48; I2 = 0%). Similarly, no difference was evident between MINB and IANB (RR = 1.15; 95% CI, 0.97-1.36; I2 = 0%). Overall, the cumulative success rates for the 3 anesthetic techniques were low. TSA showed a lack of firm evidence for the results of the meta-analysis between GG NB and IANB. The Grading of Recommendations, Assessment, Development and Evaluation approach evaluation showed that the evidence was of moderate quality for GG NB and IANB compared with low quality for MI and IA NBs. Because only 1 study was available comparing VA NB and IANB, a meta-analysis was not performed. The adverse effect associated with MI NB was swelling, whereas it was prolonged numbness for IANB.

    CONCLUSIONS: GG NB and IANB showed similar anesthetic efficacy compared with IANB in mandibular teeth with irreversible pulpitis. However, the success rates for each technique indicate the need for supplemental anesthesia. Further well-designed RCTs evaluating different anesthetic techniques with and without supplemental injection are required to provide stronger evidence.

  18. Nagendrababu V, Pulikkotil SJ, Jinatongthai P, Veettil SK, Teerawattanapong N, Gutmann JL
    J Endod, 2019 Apr;45(4):364-371.
    PMID: 30737050 DOI: 10.1016/j.joen.2018.10.016
    INTRODUCTION: This review aimed to find the most effective oral premedication in reducing pain in adults after nonsurgical root canal therapy (NSRCT) using network meta-analysis.

    METHODS: The review protocol was registered in the PROSPERO database (CRD42017071899). A literature search was performed in the MEDLINE and EBSCOhost databases until June 2017 with no language restriction. Randomized controlled trials evaluating the efficacy of oral premedications, whether given alone or in combination, compared with other agents, placebo, or no treatment in adult patients before NSRCT for postoperative pain were included. Nonintervention studies, nonendodontic studies, animal studies, and reviews were excluded. The quality of the studies was assessed using the revised Cochrane risk of bias tool. Pair-wise meta-analysis, network meta-analysis, and quality of evidence assessment using the Grading of Recommendations Assessment, Development and Evaluation criteria was performed.

    RESULTS: Eleven studies comparing pharmacologic groups of medications were included in the primary analysis. Compared with placebo, corticosteroids (prednisolone 30-40 mg) was ranked best for reducing postoperative pain (median difference [MD] = -18.14 [95% confidence interval (CI), -32.90 to -3.37] for the pain score at 6 hours; MD = -22.17 [95% CI, -36.03 to -8.32] for the pain score at 12 hours; and MD = -21.50 [95% CI, -37.95 to -5.06] for the pain score at 24 hours). However, the evidence was very low (6 and 24 hours) to moderate quality (12 hours). Nonsteroidal anti-inflammatory drugs were ranked least among the medications, and the quality of this evidence was very low. Additional analysis based on the chemical name showed that sulindac, ketorolac, and ibuprofen significantly reduced pain at 6 hours, whereas piroxicam and prednisolone significantly reduced the pain at 12 and 24 hours. Etodolac was found to be least effective in reducing pain. Overall, the evidence was of moderate to very low quality.

    CONCLUSIONS: Based on the limited and low-quality evidence, oral premedication with piroxicam or prednisolone could be recommended for controlling postoperative pain after NSRCT. However, more trials are warranted to confirm the results with a higher quality of evidence.

  19. Decurcio DA, Rossi-Fedele G, Estrela C, Pulikkotil SJ, Nagendrababu V
    J Endod, 2019 Apr;45(4):387-393.e2.
    PMID: 30833095 DOI: 10.1016/j.joen.2019.01.013
    INTRODUCTION: This systematic review and meta-analysis aimed to assess whether machine-assisted agitation resulted in less postoperative pain (PP) compared with syringe irrigation with needle alone in adult patients undergoing root canal treatment.

    METHODS: A literature search was performed in 3 electronic databases for articles published before August 2018. Randomized clinical trials published in English that compared PP between machine-assisted agitation and syringe irrigation with needles as part of nonsurgical root canal treatment were included. Two authors were independently involved in the article selection process, data extraction, and assessment of the quality of included studies using the revised Cochrane risk of bias tool. The pooled effect estimates of the standardized mean difference (SMD) between machine-assisted agitation and syringe irrigation with needle was calculated by a random effects-modeled meta-analysis. A subgroup meta-analysis was performed. The quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development and Evaluations approach.

    RESULTS: Six studies were included for systematic review. Meta-analysis was performed using 3 studies and showed that machine-assisted agitation resulted in less PP compared with syringe irrigation with needle at 24 hours (SMD = -0.73; 95% confidence interval, -1.04 to -0.42; I2 = 30.6%) and 48 hours (SMD = -0.60; 95% CI, -0.85 to -0.35; I2 = 0%). The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the PP outcomes (24 hours and 48 hours) was graded as "moderate" quality.

    CONCLUSIONS: Machine-assisted agitation reduced PP compared with syringe irrigation with needles in nonsurgical root canal treatment. Future clinical trials are needed to support the result of this review.

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