Oral and Dental Medicine

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Accuracy of artificial intelligence technology in detecting number of root canal of human maxillary first molar : Diagnostic Accuracy Experimental Study /
Nofal, Sara Ragab,; Supervisor : Nihal Ezzat Sabet, Ahmed Hussein Abu El-Ezz. Includes Arabic Summary.
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Accuracy of artificial intelligence technology in detecting number of root canals in human mandibular first molars obturated and Indicated for retreatment : (Diagnostic accuracy experimental study) /
Alkady, Albaraa Samir,; Supervisor : Ahmed Abdelrahman Hashem, Ahmed Ghobashy, Ahmed Hussein. Includes Arabic Summary.
Statement of problem: Failure to disinfect and to locate all canals is a major reason for root canal primary and secondary failures, which may lead to periapical periodontitis. Cone beam computed tomography (CBCT) is considered the gold standard in canal detection although its use must be justified beforehand due to its high radiation dose. Using artificial intelligence (AI) software may enhance canal detection and avoid human error in interpreting CBCT images. Aim of the study: To evaluate the accuracy of new AI technology for detecting root canals in mandibular first molars retreatment cases in comparison to dentist clinical access cavity and CBCT imaging. Materials and methods: Thirty-five patients with obturated lower first molar(s) referred for retreatment was participated in this study. After a pre-treatment periapical x-ray to aid practitioner in access cavity formation a CBCT was performed for all cases. Stage 1: CBCT scans performed to all participants were randomly distributed and observed by the principle investigator and supervisors and the number of canals found was recorded. Stage 2: patients were randomly distributed on 6 post graduate students* students enrolled in the endodontic master’s program at MIU* students were then performed access cavity, the number of canals found will be recorded. Stage 3: CBCT images were uploaded to AI software, and the number of canals detected was be recorded. Data collected will be compared using 3 groups: Group 1: CBCT with co supervisor interpretation the control group Group 2: clinically after performing access cavity. Group 3: CBCT with the AI technology. All cases that failed to be detected by the AI software were then evaluated for more morphological features that may influence the accuracy of AI software.
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Accuracy of artificial intelligence technology in detecting number of root canals of obturated human maxillary second molars indicated for retreatment : diagnostic accuracy experimental study /
Hegab, Ayman Alaa Hussein,; Supervisor : Nihal Sabet, Ahmed Khalaf. Includes Arabic Summary.
Statement of the Problem: Endodontic treatment has always been a challenging procedure and failure to detect all canals and completely disinfecting the root canal system could lead to an endodontic failure. In retreatment cases, the endodontic procedure becomes more challenging and tricky requiring high knowledge and skills. Artificial intelligence software makes it easier in analysis of CBCT scans reducing dentist errors and improving treatment success rates. Aim of the study: The aim of the study is to evaluate the accuracy and reliability of an artificially intelligent software that would analyze, aid, support, and help the endodontist to detect the correct number of root canals of 35 obturated maxillary second molars indicated for retreatment in comparison to both Cone Beam Computed Tomography and Clinical observation. Materials and methods: This study included 35 Patients with Maxillary Second obturated molars indicated for re-treatment who underwent a pre-treatment CBCT, while only a pre-treatment periapical radiograph was taken to aid in access cavity preparation in the clinical stage. The study was levelled into three stages. CBCT Stage: Pre-operative CBCT scans of the patients were taken and randomly assigned to 2 co-supervisors who segmented, interpreted, and recorded the number of canals on a pre-formed information guide. Clinical Stage: A clinical stage where the enrolled patients were randomly distributed upon 6 researchers. Researchers then performed access cavities under DOM. The number of orifices found was recorded in a preformed information guide. AI stage: CBCT scans was uploaded to AI software by researcher and Number of canals found by the software were recorded. The results of the first two stages were then compared to the findings of the third stage to determine software accuracy. Cases with missed canals by the AI software underwent further evaluation of tooth morphological features, to determine the reason for the software’s detection failure. Results: There was a statistically significant difference between detected number of canals by the three methods (P-value = 0.018). AI showed higher percentage of two, three canals and lower percentage of four canals detection. The CBCT stage and the clinical stage showed complete agreement in their findings, however the CNN program inaccurately identified the proper number of canals in three cases. To evaluate the relationship between these cases and the potential impact of morphological variation on the AI software, the canal type was determined using Vertucci's classification. It was found that all three unsuccessful cases had a type II canal. There was an insignificant link between the canal morphology and the AI software's incapacity to detect canals. When the AI program was unable to accurately identify the proper number of canals, the average ratio of canal unity was around 60%. This means that around two-thirds of the canal length was considered as one canal, while only one-third of the length was considered as two separate canals.
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Accuracy of artificial intelligence technology in detecting root canal number and morphology in maxillary second molars : A diagnostic accuracy experimental study /
Sami, Hebah Mohamed Eltaher Monir Mohamed,; Supervisor : Hossam Tewfik, Alaa Diab, Ahmed Hassan Ibrahim. Includes Arabic Summary.
A comprehensive understanding of root canal space anatomy is essential for clinicians to be able to treat and prevent apical periodontitis, the main reason for endodontic therapy. Approximately 40% of failed endodontic therapy is due to missed canals, indicating lack of clinical thoroughness in treatment. Maxillary second molars present with varying internal morphologies in different individuals, which is affected by age, genetics, and gender. Inadequacy in detecting these variations during treatment is reflected by the upper molars showing the top rates of endodontic treatment failures. Although many techniques have previously been employed to facilitate canal detection, CBCT is currently considered the gold standard in clinical canal structure exploration, as it has the potential to change initial diagnoses and treatment plans in almost 50% of cases. However, due to problems such as interobserver differences in interpreting scans and the need for training clinicians to read CBCT scans, a special interest has emerged in artificial intelligence (AI) technology to help overcome these problems. In this study, the accuracy of AI software in detection of canal number was compared to the radiographic detection using CBCT and the clinical detection using a DOM in maxillary second molars. Thirty-five patients with maxillary second molars requiring primary RCT with signs and symptoms of irreversible pulpitis or necrotic teeth that are restorable were selected. The number of canals were first detected radiographically from the CBCT by experienced endodontists and recorded, then 6 postgraduate students performed an EAC under the DOM and ultrasonic troughing and recorded canal number detected. Finally, the CBCT was uploaded to the AI software to detect the canal number. AI software accuracy was determined by comparing its results to the results of the 2 other groups. Further analysis of the AI generated report was done to assess the cases that canal number was incorrectly detected to evaluate the possible morphological features that might have been the reason for the incorrect detection. Another six cases in which AI software successfully detected the number of canals were randomly selected as a comparative group. Four main features were additionally assessed thoroughly, namely, the inter orifice distance, length of the mesiobuccal root, level of canal division from the root apex, and canal anatomy based on Vertucci classification. The method of analysis of the CBCT for data extraction for this assessment was standardized for all cases and done at the level of the CEJ. Results showed that the CBCT showed the highest percentage accuracy (100%) in the interpretation of canal morphology and number, while the clinical detection followed closely (94.2%), and the AI software was the lowest percentage accuracy (82.8%) amongst the 3 modalities. Its level of confidence was generally high with 79% of the correct cases and 50% of the incorrect cases being in the highest confidence level respectively. The four additional features assessed showed that the average inter-orifice distance is lower in the incorrect group and the average percentage canal unity was much higher. This indicated that the software is less likely to detect the MB2 canal if it is unified with the MB1 for more than 50% of the entire canal length, and that the smaller the inter-orifice distance the less likely is the software in detecting the MB2 canal. The canals’ Vertucci type did not seem to influence the software’s ability to detect the canal number. In general, the results of the AI software were promising, even if it is currently less than the other 2 modalities used, since the nature of the AI software with deep learning strategies spontaneously improves with the greater amount of data input to it with time. Although many studies agreed with the results of this study regarding the percentage accuracy of AI software, however some studies showed differing results that demonstrated higher accuracy of the AI software. This could be attributed to the differences in the study design, the type of AI software used, and the sample size. However, all studies agree that the future of AI software use in endodontic canal detection is highly encouraging.
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Accuracy of artificial intelligence technology in detecting the number of canals in human maxillary first molars indicated for retreatment : Diagnostic accuracy experimental study /
Sholkamy, Mostafa Sherif,; Supervisor : Abeer Hashem Mahran, Ahmed Hussein Abu El-Ezz. Includes Arabic Summary.
Statement of Problem: Missed canals are one of the main causes of failure of primary root canal treatment. CBCT is considered the gold standard in morphology detection. Problems of using CBCT include high radiation dose and practitioner inability to interpret images. Artificial Intelligence (AI) technology may help overcome these problems. Aim: The aim of this study was to evaluate the accuracy of novel AI software in detecting the number of canals in 36 maxillary first molars indicated for retreatment, as well as, to compare it with accuracy of CBCT and clinical assessment. Materials and Methods: 36 Patients referred to MIU dental clinic for retreatment of upper first molars underwent pre-treatment CBCT, while only pretreatment periapical radiograph will be taken to aid in access cavity preparation in the clinical stage. The study included 3 stages: CBCT Stage: Pre-operative CBCT scans of the patients were taken and randomly assigned to 2 co-supervisors who upon scan segmentation recorded the number of canals on a pre-formed information guide. Clinical Stage: A clinical stage where the enrolled patients were randomly distributed upon 6 researchers. Practitioners then performed access cavities on the teeth under DOM. The number of orifices found was recorded on a preformed information guide. AI stage: CBCT images will be uploaded to AI software by primary investigator and Number of canals found by the software were recorded. Results of the first two stages were then compared to the findings of the third stage to determine software accuracy. Cases with missed canals by the AI software underwent further evaluation of tooth morphological features, to determine the reason for the software’s detection failure.
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Accuracy of artificial intelligence technology in detecting the number of root canals in human mandibular first molars : A diagnostic accuracy experimental study /
Abd-Elsamie, Salma Khaled Kamel,; Supervisor : Hossam Tewfik, Alaa Diab, Mohamed Alaa Fakhr. Includes Arabic Summary.
Artificial intelligence (AI) is revolutionizing various fields of medicine, including dentistry. In endodontics, AI has the potential to improve diagnostic accuracy, treatment planning, and overall patient care. There is minimal scientific evidence concerning the accuracy of the detection of the number of canals using Artificial Intelligence. The aim of this study is to define the accuracy of an Artificial Intelligence (AI) Software to detect the number of root canals in the mandibular first molars compared to the standard clinical method under magnification and to the gold standard using a Cone Beam Computed Tomography (CBCT). In addition, this study aims to determine the morphological variations in cases where the AI failed to detect all the canals. Thirty-Five patients presented to MIU dental clinics with mandibular first permanent molars requiring root canal treatment were selected according to the eligibility criteria. Teeth that met the criteria had pre-operative periapical x-rays taken. Adequate case and medical history were taken. Detection of the number of root canals was achieved by 3 methods: Radiographically using the CBCT as the gold standard, clinically using the DOM and using an AI software. After signing the informed consent, the patients underwent CBCT imaging using Endo mode to minimize the radiation exposure before treatment initiation. CBCT was coded based on the patients file numbers instead of names. The number of canals identified was recorded in a pre formed information guide. Using randomization software, the 35 patients were divided up amongst 6 post graduate students at random. A dental operating microscope was used to prepare the access cavity for each patient. In order to minimize the radiation dose to the patient, the CBCT was given to the postgraduate student after the number of canals was recorded. This helped to prevent inter-treatment periapical radiographs as working length X-rays. After that, the principal researcher, who was blind to the outcomes of the CBCT stage, carried out the AI stage individually. The Diagnocat AI Software was used to upload the CBCT images, and CBCT segmentation and deep learning techniques were employed. Next, the software's total number of canal identifications was recorded. The gathered data was divided into three groups based on the canal detection method into: CBCT Findings, Clinical Findings and AI Findings. Cases containing canals that were missed by the AI software had additional examination of the morphological features of each tooth from the CBCT. The six cases in which the AI software successfully detected the number of canals were randomly selected as a comparative group. For both groups the following features were included: the inter-orifice distance was measured in order to accomplish this, the length of the root, Vertucci classification type and the length of the Canal division measured from the apex and CEJ. In addition, from the axial cut of the CBCT, the inter-orifice distance was measured in the same manner between the canals that were not detected by the AI. Afterward, the mean inter-orifice distance was calculated for both the failed and successful cases. Those measurements were utilized to calculate the percentage of canal unity within the entire root length associated to the missed canals. The degree of accuracy was 100% for the DOM, 100% for the CBCT and 82.86% for the AI. It was clear that application of AI software didn’t detect the exact number of canals in all cases. The AI software detected the correct number of canals in only 29 cases. The use of DOM and CBCT detected all canals in all the 35 cases. Another analysis was done to relate the inaccuracies of the software to the morphology of the wrong cases detected. It was evident that the inter-orifice distance for the incorrectly detected cases was less than that of the cases correctly detected. Added to that, the percentage of canal unity was analyzed for the distal canals, which is the measure of the unity of both distal canals along the entire length of the root. The greater the union between both distal canals, the less likely the AI software will distinguish them as separate canals. The average percentage of canal unity of the incorrectly detected cases was greater than 50% and the percentage of canal unity for the correctly detected cases was a maximum of 20% which allowed the software to detect two distal canals.
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Antibacterial Effect of a Diode Laser in the Eradication of Enterococcus feacalis, and Smear Layer Removal in Root Canal of Infected Teeth : (An in Vitro Study)
Hussein, Dina Nashaat Hassan,; Supervisor : Salma El Ashry, Ahmed Mostafa Ghobashy.
The definitive goal of root canal treatment is to obtain a root canal system free of irritants, as any remaining microorganisms can cause persistent inflammation in the periradicular tissues. Success of endodontic therapy depends on complete elimination of pathogenic micro flora from the root canal system. Enterococcus faecalis is the most common bacteria associated with persistent endodontic infections. It is a facultative gram-positive anaerobic coccus that has the ability to exist in root canals without the support of other microorganisms. It has the ability to infect the whole length of dentinal tubules within a few days, and is considered difficult to eradicate. It can also survive harsh environmental factors, and form biofilms that are difficult to detach. Biofilm disruption and root canal disinfection are the most important steps during root canal treatment. Sodium hypochlorite is one of the most commonly used irrigating solutions in endodontics. The antibacterial efficiency of sodium hypochlorite solution against E. faecalis is well known to be affected by its concentration and contact time. Adjunctive techniques of root canal disinfection have been proposed, and the introduction of lasers in endodontics is one. Lasers have dramatically improved the effectiveness and success rate of root canal treatment. According to several studies, the use of laser systems for endodontic disinfection provides an opportunity to reduce the problems concerning the difficult access of instruments and irrigants to certain areas of root canals, mainly at the apical ramifications. It has been recognized that near-infrared lasers (810 nm to 1340 nm) have greater depth of penetration when compared to the penetration power of chemical disinfectants, which allows for better bactericidal effect in deeper dentin layers. The use of photosensitizing agents has been proposed in endodontics used with methods such as ‘photodynamic therapy’ (PDT) or “photoactivated disinfection” (PAD). Photosensitizing solutions have better wetting capabilities as they have lower surface tension than sodium hypochlorite. Photosensitizer concentration, light intensity and time of application have to be precise in order to achieve optimal results. Laser thermal effect can generate damage to the dentin walls. Several studies investigated the laser-induced morphological effects on root canal walls. When they are used on dry tissue, near-infrared lasers produce characteristic thermal effects. Morphological alterations of the dentinal wall occur, and the smear layer is only partially removed. Dentinal tubules are primarily closed as a result of melting of the inorganic dentinal structures. Employing the correct parameters and treatment protocol for laser use in root canal disinfection and bacterial elimination can help replace the conventional syringe irrigation methods of disinfection, reduce the morphological alteration of root canal dentin, and improve the treatment outcome.
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Bond Strength and Adaptability of Bioceramics Root Canal Obturating System /
EL-Said, Nancy Magdy Mohamed,; Supervisor : Salma Hassan El-Ashry, Amira Galal Ismail.
Obturation of root canal complex is the most essential step in successful root canal therapy. It is described as "the three dimensional closure of the entire root canal system adapted to the cement-dentinal junction as close as possible". For an appropriate and acceptable root canal fluid tight seal; Small volume of sealers which are biologically compatible are used along with gutta percha core at apical, lateral and coronal sections of root canal system. New obturating material has been developed in Endodontics to enhance the sealing of the root canal system. Bio-ceramics were introduced; bioceramics are calcium silicate based material which exhibit excellent biocompatibility properties due to their similarity with biological hydroxyapatite, .bioceramics also have the ability to achieve excellent hermetic seal, form a chemical bond with the tooth structure and have good radio-opacity antibacterial properties as a result of precipitation in situ after setting. Total fill as one of the advances in bioceramics; it is bioceramic impregnated gutta percha with a premixed bioceramic sealer. It was claimed that the calcium phosphate-based system made for a more consistent and tighter adaptation to the dentinal walls as compared to gutta-percha. Total Fill BC sealer has higher qualities and handling abilities that prevents its shrinkage during setting and hardens in the presence of moisture. The wetting ability of the sealer is due to the small particle size, hydro-philicity and low contact angle; these properties enable the sealer to easily distribute in the dentinal tubules. It also shows a significant expansion of 0.20 percent. These characteristics create a gapless chemical bond between the sealer and dentinal walls. It is worth to study and evaluate the bond strength, the adaptation and effect of different volume of sealers on these properties.
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Bond strength and adaptation of Nano biodentine as a repair material for furcation perforations : (an in vitro study) /
Sedky, Khaled Mohamed,; Supervisor : Nihal E. Sabet, Mohamed A. Fakhr.
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Chemico-mechanical retrieval of two bioceramic based obturation techniques : (In vitro) /
Awad, Passant Gaber,; Supervisor : Kareem Mostafa Al batouty, Mohamed Mokhtar Nagy, Ahmed Hussein Abuelezz. Includes Arabic Summary.
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Comparative Analysis of the Cleaning Ability and Surface Topography of One Shape Single File versus Protaper Universal Files : An In Vitro Study /
Nabil, Shady,; Supervisor : Ehab Elsayed Hassanein, Amr Ahmed Bayoumi.
Biomechanical preparation, disinfection and obturation all together constitute equally important phases of the endodontic treatment. A successful outcome of root canal treatment depends on several factors such as, adequate cleaning of the root canal by removing infected and necrotic pulp remnants, elimination of microorganisms, complete removal of debris and smear layer to produce a perfect seal between the filling material and the root dentin, which is important on the outcome of the root canal treatment. Smear layer and debris may be one of the common causes of root canal treatment failure. Debris contains vital and/or necrotic pulp tissue and dentinal chips that loosely attach to the root canal walls, it is usually infected. The smear layer consists of dentine particles, remnants of vital or necrotic pulp tissues, bacterial components, and retained irrigants. The smear layer is reported to prevent the penetration of irrigating solutions, medications and filling materials into dentinal tubules, thus affecting the outcome of the root canal treatment. The basic design of root canal instruments has changed very little over the years, apart from the minor modifications such as new materials, improved cutting edges and greater flexibility. One of the many innovations in root canal instruments is the use of nickel titanium for file manufacture, which have two to three times more elastic flexibility than stainless steel files and appear to be more fracture resistant compound to stainless steel files. During last decade several new Ni-Ti instruments for manual root canal preparation, as well as for use in rotary endodontic hand pieces have been developed, in order to facilitate the difficult and time consuming 1 Introduction process of cleaning and shaping the root canal system and to improve the final quality of root canal preparation. From these new rotary files are ProTaper Universal files and One Shape file which may help in removal of smear layer during endodontic treatment and thus increasing the quality of root canal treatment outcome. After using these NiTi instruments a several defects may appear on the surface of these files. These defects may lead to the fracture of the endodontic file during the cleaning and shaping of the root canal, which may lead to the failure of the root canal treatment. So it is important to have the knowledge about these defects in order to prevent the fracture of the endodontic file while usage that may lead to the failure of the treatment. Introduction of scanning electron microscope (SEM) has proved to be valuable method for assessment of the ability of the endodontic procedures to remove debris from root canals thus enabling comparison of instruments and techniques, and also using SEM in the assessment of the defects appears in the files after usage.
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Computed Tomographic assessment of a noval NiTi system in Retreatment procedure : (an in Vitro study) /
Abd El Wahab, Maram Hossam El-Din,; Supervisor : Nihal Sabet, Mohamed Mokhtar Nagi.
Patients typically need a root canal treatment when there is inflammation or infection in the root canals. Root canal treatment is an oftenstraightforward procedure to relieve pulpal pain and render the tooth function and asymptomatic. During root canal treatment, an endodontist carefully removes the pulp inside the tooth, cleans, disinfects and shapes the root canals, and obturate to seal the space. A three-dimensional obturation of the system of the root canal through the whole length of the canal is one important goal under which successful root canal therapy can be achieved. Many obturation techniques have been introduced to obtain a threedimensional filling of the root canal system and increase the quality of the apical seal, although root canal treatment has high success rate when conducted appropriately, failures could happen that are usually accompanied by badly treated canals. Unfortunately, failure of endodontic treatment is mainly caused by intraradicular infection. This endodontic infection should be treated by removal of the filling material and retreatment procedure There are many techniques that have been proved to be effective in the removal of the materials that fill the root canal from root canal system, such as the usage of endodontic hand files, Gates Glidden burs,Nickel Titanium rotary devices, laser, ultrasonic devices ,heated device, as well as the usage of assistant solvents. Traditionally, the usage of hand files in the elimination of gutta percha in the presence or absence of solvent can be a boring, time consuming procedure particularly if the root filling material is perfectly compressed Recently, a novel rotary nickel titanium system which were tailored for retreatment processes have been included to endodontics field. The 1 Introduction protaper universal retreatment (PTUR) system is one of these systems, Protaper Universal retreatment files which was designed to be used in sequence to remove filling material with Rotation motion. None of the retreatment instruments examined the reciprocation motion on retreatment procedure, hence in this study Wave one and wave one gold were used as a retreatment instrument. Recently, using of Cone-beam computed tomography (CBCT) in endodontics became a common technique .It showed a great competence in comparison with other traditional radiographic techniques in many cases such as the assessment of the root canal system and resorptive lesions. In addition it helps in the diagnosis of apical periodontitis, and in designing a plan for treatment of endodontic surgery. Although a great deal of useful information can be obtained from Cone Beam Computed Tomography, we must also consider that Cone Beam Computed Tomography is a radiographic technique with an exposure dose that is significantly greater than intraoral radiography. To avoid overuse or abuse of Cone Beam Computed Tomography, several guidelines have been published Therefore, this work was accomplished to examine the efficacy of Wave One and Wave One Gold in retreatment procedure
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Digitized Analysis of Thermal Changes on External Root Surface of Teeth Embodying Separated Endodontic Files Retrieved By Different Ultrasonic Tips /
Hassanein, Ahmed Mohammed Mohammed Abdulmoez,; Supervisor : Nihal Sabet, Mohamad Fakhr.
One of the most basic procedures in modern dental practices is endodontic treatment, which has helped in the preservation of teeth that would have been otherwise extracted. Motor driven, endodontic instruments are commonly used in su nickeltitanium (NiTi) ch procedures with a more predictable treatment outcome due to their good shaping ability of the root canal. Unfortunately, not all treatments result in optimum long term healing. Occasionally during root canal therapy, a file could separate within a root canal system blocking access to the apical canal terminus. Even with the introduction of NiTi files, which are more been an increase in file separation incidents. flexible , there has The general principle for removing a fractured instrument is based on th e fundamental principles and objectives of root canal treatment. A fractured instrument may be an obstacle to mechanical and chemical treatment of an infected root canal system. Bacteria and pulp tissue, which remain in the root canal because of insufficie nt cleaning, may have a negative impact on treatment outcome. Several methods have been proposed to remove obstructions from within the root canal, with varying degrees of success . Ultrasonics have been shown to be a highly successful technique in removing separated instruments in vitro and in vivo in association with the operating microscope . This has led to an increase in the popularity of this technique among endodontists. These ultrasonic systems are composed of special designe d tips to trephine the dentin around the fractured fragment. The ultraso nic vibration of the tip is transmitted to the separated file so it becomes loose and is eventually dislodged. However, such a procedure may give rise to complications such as excessiv e loss of dental structure, root perforation, secondary fracture of the fragment, and excessive rise in temperature on the other root surface. The periodontal tissues could suffer sever the temperature rise s above the 10°C threshol e irreversible damage if d. Irreversible bone and attachment damage as well as dehydration effects on dentin will occur if the temperature of the outer root surface exceed 10°C, often resulting in resorption and necrosis to the supporting periodontium. Dentine thickness, type of ultrasonic tips, power setting, and application time are some of t he factors that might influence this temperature rise. Coolant application while ultrasonic tips are activated is another important factor. Previous studies showed a significant decrease in temperature rise on the external root surface during ultrasonic re water or air coolant were used. Trieval of intracanal posts when The use of a coolant during such procedure is thus advisabl will greatly lower the accumulated temperature e; as it on the outer root surface, and by doing so, lower the risk of permanent periodontal t issue damage. However, many clinicians might not always accept the use of a coolant as it lowers their visibility of the operating field. This may increase the time needed for successful retrieval, which increases the chances for errors like root perforati on and excessive thinning of the remaining radicular dentin, resulting in a poorer prognosis for the case. (6,7) T hus t he aim of this study is to assess the thermal changes on the outer root surface and the remaining dentin thickness during the ret of a separated ultrasonic tip file within the apical third of the rieval root canal using different designs, and how will the use of water coolant affect the time needed for file retrieval.
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Effect of calcium hydroxide nanoparticles incorporation on the physical properties of root canal sealer : (in vitro study).
Shafei, Rana Alaa Eldin Ali,; Supervisor : Abeer Hashem Mahran, Mohamed Nabeel.
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Effect of contracted access cavity preparation on procedural errors in curved root canals in molars : An in-vitro study /
Zakhary, Marina Hesham Fawzy,; Supervisor : Salma Al-Ashry, Nihal Sabet, Ahmed Khalaf. Includes Arabic Summary.
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Effect of Different Instrumentation Motions on the Canal Cleanliness and File Surface Topography : In-Vitro Study /
Wahba, Marc Albert Louis,; Supervisor : Ihab ElSayed Hassanein, Mohamed Mokhtar Nagy.
Root canal treatment procedure aims to clean and shape the root canal system achieving a complete seal of the 3D space and its accessory canals. However, the thorough mechanical and chemo-mechanical treatments have shown to produce an environment of less bacterial count, but not bacterial free.(1) Cutting dentin with either hand or rotary instruments results in shattering of the mineralized tissues, producing a considerable amount of debris. These of collagen matrixes small size are spread all over the surface forming what is known as the smear layer.(2) This layer of amorphous structure is of 1-2 um and may contain bacteria and their by-products. It compromises the penetration of irrigants, intra canal medicaments, and the adaptation of the root filling materials into dentinal walls. Thus, compromising the seal with obturating material resulting in percolation of fluids from the inflamed periapical tissues, causing failure of the treatment.(3) This problem necessitates a thorough chemical debridement; but unfortunately, no irrigating solution has the power of acting simultaneously on both the organic and inorganic elements of the smear layer. Over the past few decades, changes in the understanding of the concepts of cleaning and shaping the root canal systems led to the evolution from the use of manual hand files to the use of rotary nickel titanium files, making them part of the new era in endodontics as it is generally believed that engine-driven or manually used nickel-titanium (NiTi) instruments produce better-prepared root canals than their stainless steel counterparts. These different Rotary methods of canal preparation rapidly transformed the shaping process in comparison with the traditional hand files. The concept of automated reciprocation was then re-introduced in 2008 after it has been discarded in 1964 as the resulted in a greater number of procedural errors. This time the reciprocation was commenced using single NITi file ProTaper (F2) to completely shape the root canal. This was shown to be effective at cleaning the canal as the full ProTaper system and extrude similar amount of apical debris.(5) However, no file or type of motion have been identified as the ideal, and that is due to the inherent properties of the NiTi alloy and the different changes they undergo following the mechanical preparation.
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The effect of Er, Cr : YSGG laser on the reduction of the root canal bacteria in cases with contracted endodontic access cavity design : An in-vitro study /
Darwish, Ahmed Mohamed Sayed Metwally,; Supervisor : Hossam Tewfik, Alaa Diab, Mohamed Nabeel. Includes Arabic Summary.
There is minimal scientific evidence concerning the effect of contracted endodontic access cavity design (CEC) combined with Erbium, Chromium: yttrium-scandium-gallium garnet (Er,Cr:YSGG) laser on intracanal bacterial biofilm reduction. So, the aim of the present in-vitro study was to compare the antimicrobial efficacy of sodium hypochlorite and Er,Cr YSGG laser on E.faecalis biofilm reduction when employing two different endodontic access cavity designs in maxillary first premolar teeth. Sixty intact maxillary first premolar human teeth were randomly allocated into two main equal groups (n=30) according to the access cavity design utilized. Group 1, traditional access cavity preparation and Group 2, contracted access cavity preparation. Following access cavity preparation initial root canal preparation was performed, teeth were then sterilized, and inoculated with E.faecalis for 21 days. Colony forming units (CFUs) per milliliter counts were determined after inoculation to ensure biofilm growth. Mechanical preparation was performed using ProTaper Gold rotary NiTi system up to size F2. The first bacteriological sample (S1) was obtained following mechanical preparation. The teeth of each main group were further divided into 3 equal subgroups (n=10) according to the final disinfection protocol. Group A, irrigation using Saline solution; Group B, irrigation with 5.25% NaOCl and 17% EDTA; Group C, (Er,Cr: YSGG) Laser irradiation. A second bacteriological sample (S2) was obtained following the final disinfection protocol. Microbiological quantification was performed for samples using paper points and CFU. The results showed that only NaOCl completely eradicated E.faecalis bacterial biofilm in both cavity designs. Er,Cr: YSGG laser subgroups (1C and 2C) showed significantly higher bacterial reduction in comparison to saline irrigated groups (1A and 2A). Access cavity design had a significant effect on bacterial biofilm reduction in both subgroups; saline irrigated samples (A) and laser irradiated groups (C) in which traditional access cavity design exhibited higher bacterial reduction than contracted access cavity design, however, the design had no influence on bacterial reduction when NaOCL irrigation was used
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Effect of Green Tea Extract Root Canals Irrigant on Enterococcus Faecalis Population and Dentin Bond Strength : (An in Vitro Study) /
Sawares, Sandy Samir Alphonse,; Supervisor : Hossam Mohamed Essam Eldin, Mohamed Mokhtar Nagy
Root canal Instrumentation is considered the most important and critical phase in endodontic treatment. Mechanical enlargement of the root canal can partially clean and remove contents of the canal. Conjugation between a chemical agent and the mechanical instrument is critical in achieving maximum results. Different root canal irrigants have been suggested and tested. Most of the chemical agents have the disadvantages of being toxic to the surrounding living tissue. However, the chemical action of the root canal irrigant is very essential for total elimination of microorganisms. Sodium Hypochlorite have been the most popular and widely used irrigant over several decades for its unique ability to dissolve root canal contents and its strong antimicrobial action. However, its ability to remove the smear layer and its allergic potential were regarded as major disadvantages. Three dimensional sealing of the root canals have always been the most important goal for successful treatment. Thus, the use of root canal sealers with adequate adhesive properties have been strongly recommended. However, bonding to root canal dentin is affected by multiple factors, among which, the change in chemical nature of dentin induced by root canal irrigants. Hence, a shift toward natural materials as root canal irrigants have been strongly advocated in the last decade. Green tea extract exhibit important biological and pharmacological properties that favored its use in the medical and dental fields. The strong antibacterial action of green tea extract together with being a herbal natural material encouraged its suggestion for usage as root canal irrigant. Reviewing the literature showed several studies testing and comparing the antimicrobial action of green tea, however, its effect on the bonding capacity of the root canal dentin does not appear to be adequately addressed.
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The effect of Nano MgO and Nano silver fluoride on canal cleanliness and smear layer removal : (An in vitro study) /
Sorour, Karim Khaled Abd-Elraheem,; Supervisor : Abeer Abdel Hakeem El Gendy, Mohamed Nabil. Includes Arabic Summary.
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The effect of silver nano-irrigant and erbium chromium: YSGG laser on the smear layer removal and microhardness of root canal dentine : in-vitro study /
Aboudoura, Moustafa Mohamed Samy Moustafa,; Supervisor : Reem Ahmed Lutfy Abdel Rahman, Ahmed Hussein Abu El-Ezz. Includes Arabic Summary.