Displaying publications 1 - 20 of 108 in total

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  1. Ahmed HMA, Dummer PMH
    Eur Endod J, 2018;3(1):9-17.
    PMID: 32161850 DOI: 10.5152/eej.2017.17064
    Objective: A new coding system for classifying the roots, main and accessory canals as well as developmental anomalies has been introduced recently. This paper discusses the advantages and potential application of the new system in research and clinical practice.

    Methods: A comprehensive analysis was undertaken on the most common, existing classification for root canal morphology. The advantages and potential applications of a new system for classifying roots and canal systems in research and clinical practice are discussed.

    Results: The analysis demonstrates deficiencies of the existing classification including lack of information on the number of roots, pulp chamber outline, lack of clarity in multi-rooted teeth, inability to define complex root canal configurations. The new coding system addresses the root and canal morphology in an accurate and systematic manner to provide detailed information of the tooth, root and canal anatomical features.

    Conclusion: With current advances in endodontic research and practice and the increasing body of knowledge on root and canal morphology, the deficiencies of the existing system used for classifying root canal morphology have become more apparent. The new system for classifying root, main and accessory canal morphology as well as teeth with anomalies has the potential to be used in research, clinical practice and education to accurately reflect the real anatomy of a tooth.

    Matched MeSH terms: Dental Pulp Cavity
  2. Salas H, Torres J, Pauro J, Ahmed HMA
    Int Endod J, 2021 Jan;54(1):147-149.
    PMID: 33351981 DOI: 10.1111/iej.13439
    Matched MeSH terms: Dental Pulp Cavity*
  3. Neelakantan P, Ahmed HMA, Chang JWW, Nabhan MS, Wei X, Cheung GSP, et al.
    Aust Endod J, 2019 Dec;45(3):407-413.
    PMID: 30520194 DOI: 10.1111/aej.12333
    This systematic review assessed the effect of different root canal instrumentation systems on endotoxin reduction from the root canal system. The literature search was conducted in two electronic databases (PubMed and Scopus) using specific key words. The search strategy followed the PRISMA guidelines. Qualitative synthesis and quantitative synthesis of the data were performed and data interpretation was done based on the guidelines in the Cochrane Handbook. The risk of bias was assessed using Cochrane criteria. The initial search yielded 600 citations, of which three papers met the criteria for inclusion in this review. Studies showed a significant reduction in endotoxin following rotary and reciprocating instrumentation, with no significant differences between them. The meta-analysis showed no statistical significant difference between reciprocation and rotary files (P > 0.05). In conclusion, the instrumentation techniques compared in this review decrease endotoxin content from root canals, with no significant difference between them.
    Matched MeSH terms: Dental Pulp Cavity*
  4. Karobari MI, Noorani TY, Halim MS, Dummer PMH, Ahmed HMA
    Int Endod J, 2019 Jun;52(6):917-919.
    PMID: 31074504 DOI: 10.1111/iej.13106
    Matched MeSH terms: Dental Pulp Cavity*
  5. Ahmed HMA, Keleş A, Wolf TG, Rossi-Fedele G, Dummer PMH
    Eur Endod J, 2024 Jan 01;9(1):1-7.
    PMID: 37990574 DOI: 10.14744/eej.2023.82713
    Matched MeSH terms: Dental Pulp Cavity*
  6. 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.
    Matched MeSH terms: Dental Pulp Cavity/anatomy & histology*
  7. Soh JA, Sheriff SO, Ramar NA, Pulikkotil SJ, Nagendrababu V, Neelakantan P, et al.
    Aust Endod J, 2019 Aug;45(2):171-176.
    PMID: 30230109 DOI: 10.1111/aej.12303
    In endodontic infections, inflammatory mediators such as cytokines are released, recruited and retained until the infection is eradicated. Root canal therapy is performed to prevent the spread of infection. The aim of this study was to investigate the effects of root canal debridement (cleaning and shaping) on periapical inflammation by measuring the levels of inflammatory cytokines, Interleukin-8 (IL-8) and Interleukin-10 (IL-10). The study includes twenty patients with pulp necrosis and asymptomatic apical periodontitis. Periradicular sample was collected using paper points before and after root canal debridement. Cytokine levels were determined by Sandwich Enzyme-Linked Immunosorbent Assay (ELISA). Data were analysed using paired t-test (PASW Statistics 18) (P = 0.05). All samples showed the presence of IL-8 and IL-10 prior to root canal debridement. Significantly reduced levels (P < 0.05) of IL-8 and IL-10 were detected after root canal debridement. In conclusion, root canal debridement significantly decreased the levels of the tested pro- and anti-inflammatory cytokine in the periradicular interstitial fluid.
    Matched MeSH terms: Dental Pulp Cavity*
  8. Mohd Ariffin S, Dalzell O, Hardiman R, Manton DJ, Parashos P, Rajan S
    Eur Arch Paediatr Dent, 2020 Aug;21(4):519-525.
    PMID: 32100200 DOI: 10.1007/s40368-020-00515-z
    AIM: Successful endodontic treatment of primary teeth requires comprehensive knowledge and understanding of root canal morphology. The purpose of this study was to investigate the root canal configurations of primary maxillary second molars using micro-computed tomography.

    METHODS: Extracted human primary maxillary second molars (n = 57) were scanned using micro-computed tomography and reconstructed to produce three-dimensional models. Each root canal system was analysed qualitatively according to Vertucci's classification.

    RESULTS: 22.8% (n = 13) of the sample presented with the fusion of the disto-buccal and palatal roots; of these, Type V was the most prevalent classification. For teeth with three separate roots (n = 44), the most common root canal type was Type 1 for the palatal canal (100%) and disto-buccal canal (77.3%) and Type V for the mesio-buccal canal (36.4%). Overall, 7% (n = 4) of mesio-buccal canals were 'unclassifiable'.

    CONCLUSION: The root canal systems of primary maxillary second molars were not only complex but had a range of configurations that may contribute to unfavourable clinical outcomes after endodontic treatment.

    Matched MeSH terms: Dental Pulp Cavity*
  9. Plotino G, Nagendrababu V, Bukiet F, Grande NM, Veettil SK, De-Deus G, et al.
    J Endod, 2020 Jun;46(6):707-729.
    PMID: 32334856 DOI: 10.1016/j.joen.2020.01.023
    INTRODUCTION: Negotiation, glide path, and preflaring are essential steps in root canal shaping procedures. This report aimed to discuss the terminology, basic concepts, and clinical considerations of negotiation, glide path, and preflaring procedures and the influence of these steps on root canal shaping.

    METHODS: This systematic review was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol has been registered with the International Prospective Register of Systematic Reviews (number CRD42019127021). A comprehensive literature search was performed by 2 independent reviewers using a selected search strategy in 2 electronic databases (PubMed and Scopus) until January 28, 2019. A further search was performed manually in endodontic journals. Studies investigating or comparing at least 1 shaping property resulting from root canal instrumentation with a glide path or preflaring in human extracted teeth or clinical studies were included.

    RESULTS: The literature shows that the definition of glide path and preflaring procedures remains controversial, which requires an elaboration in the American Association of Endodontists' Glossary of Endodontic Terms. After the removal of irrelevant and duplicated articles, 98 articles were included. The impact of glide path preparation and preflaring on working length determination, apical file size determination, canal transportation, separation of endodontic files, shaping time, dentinal microcrack formation, and extrusion of debris was discussed. Because of heterogeneity among the included studies, quantitative synthesis was not performed for most of the parameters.

    CONCLUSIONS: An evidence-based guideline is needed to define and correlate the basic concepts and current applications of each step of contemporary advancements in root canal instruments. Glide path preparation reduces the risk of debris extrusion, has no influence on the incidence of dentinal crack formation, and improves the preservation of the original canal anatomy. The creation of a glide path may have no impact on Reciproc files (VDW, Munich, Germany) in reaching the full working length. Preflaring increases the accuracy of working length determination. Further randomized clinical trials are required to evaluate the effect of a glide path and preflaring on root canal treatment outcomes.

    Matched MeSH terms: Dental Pulp Cavity*
  10. Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA
    BMC Oral Health, 2023 May 29;23(1):339.
    PMID: 37248469 DOI: 10.1186/s12903-023-03036-5
    BACKGROUND: A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars.

    METHOD: An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types.

    RESULTS: Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively.

    CONCLUSION: Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.

    Matched MeSH terms: Dental Pulp Cavity/anatomy & histology
  11. Pai ARV
    Br Dent J, 2023 Apr;234(7):488.
    PMID: 37059753 DOI: 10.1038/s41415-023-5755-3
    Matched MeSH terms: Dental Pulp Cavity*
  12. Karobari MI, Ahmed HMA, Khamis MFB, Ibrahim N, Noorani TY
    J Dent Educ, 2023 Aug;87(8):1089-1098.
    PMID: 37164913 DOI: 10.1002/jdd.13236
    PURPOSE: To assess the application and accuracy of two systems (Vertucci et al. 1974 and Ahmed et al. 2017) in classifying the root and canal morphology of human dentition among final-year undergraduates, interns, and postgraduate dental students in India.

    METHODS: The survey was conducted using physical and online presentation modes in two phases. Phase 1; PowerPoint presentation (PPT), describing the most used classification system (Vertucci et al. 1974) and its supplementary types and Ahmed et al. (2017) classification. A single presenter delivered the PPT to participants, using either a projector in an auditorium/seminar hall (face-to-face) or an online platform (zoom meeting software). Phase 2 involved determining the students' responses. A questionnaire was distributed amongst the participants after the lecture and collected for analysis. Fisher's exact test was used to analyze the data statistically, and the significance level was set at 0.05 (p dental students, and interns in India agreed that Ahmed et al. classification system is more practical and accurate for classifying the root and canal morphology.

    Matched MeSH terms: Dental Pulp Cavity/anatomy & histology
  13. Roy D, Chowdhury F, Shaik MM, Alam MK
    Dent Res J (Isfahan), 2014 Mar;11(2):222-7.
    PMID: 24932193
    Endodontic leakage research focus mainly on the quality of the apical seal of the root canal system and the newly introduced resilon/epiphany system claim to be superior to Gutta-percha in respect to obturation procedure. The aim of this study is to evaluate the root canal obturation completed by resilon/epiphany system.
    Matched MeSH terms: Dental Pulp Cavity
  14. Arora S, Gill GS, Abdulla AM, Saluja P, Baba SM, Khateeb SU, et al.
    J Pharm Bioallied Sci, 2020 Aug;12(Suppl 1):S635-S639.
    PMID: 33149534 DOI: 10.4103/jpbs.JPBS_82_20
    It is very rare (2%-6% cases) for a mandibular canine to have two root canals and the incidence of finding two roots with two root canals in a mandibular canine that too bilaterally is almost negligible. This case report discusses the presence and multidisciplinary management of such rarest configuration in both mandibular canines of a female patient. This case shows the importance of recognition of anatomical variations in successful accomplishment of root canal treatment.
    Matched MeSH terms: Dental Pulp Cavity
  15. Rusmah, M.
    Ann Dent, 1995;2(1):-.
    MyJurnal
    The root canal walls of twenty -five deciduous molar teeth with exposed and necrotic pulps were examined using thescanning electronmicroscope. Immediately after extraction, all teeth were fixed in Kamosky's solution. The coronal portion of the tooth was sectioned at about 2mm above the enamel cemental junction.The mesial and distal roots were separat~d and either split in the mesio-distal or bucco-lingual direction. All specimens were prepared for SEM. Obsevations showed that all roots were infected with organisms consisting of cocciand short rods. Some of the coccihad penetrated the dentine layer. However, the distribution of organisms is. not uniform throughout thecanals. Bacterialinvasion ismostinthecoronal region and reduces towards the apical region: Accompanying bacterial invasion is root canal walls deterioration. The odontoblastic processes are the first to deteriorate followed by the predentine layer.
    Matched MeSH terms: Dental Pulp Cavity
  16. 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.
    Matched MeSH terms: Dental Pulp Cavity/abnormalities*
  17. 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.
    Matched MeSH terms: Dental Pulp Cavity/anatomy & histology*
  18. Nagendrababu V, Segura-Egea JJ, Fouad AF, Pulikkotil SJ, Dummer PMH
    Int Endod J, 2020 Apr;53(4):455-466.
    PMID: 31721243 DOI: 10.1111/iej.13253
    BACKGROUND: Diabetes mellitus is the most common metabolic disorder amongst dental patients. The association between the diabetes and the outcome of root canal treatment is unclear.

    AIM: To conduct an umbrella review to determine whether there is an association between diabetes and the outcome of root canal treatment.

    DATA SOURCE: The protocol of the review was developed and registered in the PROSPERO database (CRD42019141684). Four electronic databases (PubMed, EBSCHOhost, Cochrane and Scopus databases) were used to perform a literature search until July 2019.

    STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: Systematic reviews with or without meta-analyses published in English assessing any outcomes of root canal treatment comparing diabetic and nondiabetic patients were included. Two reviewers were involved independently in study selection, data extraction and appraising the reviews that were included. Disagreements were resolved with the help of a third reviewer.

    STUDY APPRAISAL AND SYNTHESIS METHODS: The quality of the reviews was assessed using the AMSTAR tool (A measurement tool to assess systematic reviews), with 11 items. Each AMSTAR item was given a score of 1 if the criterion was met, or 0 if the criterion was not met or the information was unclear.

    RESULTS: Four systematic reviews were included. The AMSTAR score for the reviews ranged from 5 to 7, out of a maximum score of 11, and all the systematic reviews were classified as 'medium' quality.

    LIMITATIONS: Only two systematic reviews included a meta-analysis. Only systematic reviews published in English were included.

    CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Diabetes mellitus is associated with the outcome of root canal treatment and can be considered as a preoperative prognostic factor.

    Matched MeSH terms: Dental Pulp Cavity*
  19. Ahmed HM, Khamis MF, Gutmann JL
    Scanning, 2016 Nov;38(6):554-557.
    PMID: 26751249 DOI: 10.1002/sca.21299
    The root and root canal morphology of deciduous molars shows considerable variations. Consequently, a comprehensive understanding of the normal and unusual root and root canal configuration types in deciduous teeth is of prime importance. The purpose of this report is to describe a rare anatomical variation in a double-rooted maxillary deciduous molar examined by the dental operating microscope and micro-computed tomography. SCANNING 38:554-557, 2016. © 2016 Wiley Periodicals, Inc.
    Matched MeSH terms: Dental Pulp Cavity/anatomy & histology*
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