Radiographic assessment of endodontic accidents at a Nigerian tertiary health institution: a one-year retrospective study

Introduction: Dental treatment can produce iatrogenic injury to the tooth with endodontic procedural errors occurring during the various stages of endodontic treatment. This study determined the prevalence and pattern of endodontic accidents in clinical practice at a tertiary health center in Nigeria. Methodology: This was a retrospective study of teeth treated with conventional hand-held file systems. Digital peri-apical working length, pre-obturation and post obturation radiographic images of teeth which received root canal treatment, were assessed for the presence or absence of errors. All errors present were recorded and data analysis was done using IBM SPSS version 22.0. Results: The prevalence of procedural errors was 31.3% with ledges being the most prevalent error followed by transportation while gouging was the least encountered error. Majority (83.8%) of the errors occurred during root canal instrumentation. A higher proportion of molars had errors compared to the other types of teeth with the prevalence of errors increasing from incisors to premolars and then to molar teeth. The mandibular molars were found to be most frequently involved in procedural errors. Conclusion: The prevalence of procedural errors seems high. Practitioners should show greater care during the canal preparation stage and to maintain the accuracy of the working length throughout the procedure, as errors which occur during canal preparation accounted for the vast majority of errors seen in this study. Special care should be taken when working on molars, which had a significantly higher error rate when compared to anterior teeth or premolars

Aberrant anatomy in endodontically treated teeth in a Nigerian Teaching Hospital

Objective: The anatomical features of teeth show wide morphological variations. These variations include coronal and radicular aberrations. They are thought to be influenced by age, gender, race and evaluation methods. Therefore, an in-depth knowledge of both normal and unusual dental morphology is vital in the practice of endodontics. The objective of the study was to investigate the incidence of aberrant root anatomy in endodontically treated teeth among adult patients attending the Endodontic unit of a tertiary hospital in Southern Nigeria. Methods: A retrospective review of all clinical records of adult patients who attended the Endodontic unit of the Department of Restorative Dentistry, University of Benin Teaching Hospital (UBTH) Edo State, Nigeria from January 2013 to January 2018 for root canal treatment (RCT). The demographic and clinical data were retrieved from the patients' records and analyzed using IBM SPSS version 20. Results: A total of 927 patients, comprising445 (48.0%) males and 482 (52.0%) females (a ratio of 1:1.1) underwent endodontic treatment during the study period. The age range of patients was 18-80 years. The total number of teeth treated was 1016. Aberrant root anatomy was observed in 161 (15.8%) of the studied sample. It was more frequently seen in mandibular 118 (29.9%) than maxillary 43 (6.9%) teeth. Aberrant root anatomy occurred most frequently in mandibular second molars 42 (38.9%) followed by the maxillary first molars 32 (38.1%). These aberrations were observed in the roots and canal numbers of treated teeth while the occurrence of aberrant anatomy was higher in females (9.9%) than males (5.9%). Conclusion: In this study, aberrant root anatomies were mostly observed in mandibular teeth and among female patients. Clinicians should be aware of the existence of wide variations in root form and canal morphology during endodontic procedures. The alertness is helped by the use of Dental operating microscopes or other magnification devices, multiple periapical radiographs with angular cone shift or other contemporary imaging modalities in revealing tooth anatomy that would otherwise be missed

Andodontic treatment: an analysis of demand by adult patients in a tertiary hospital in southern nigeria

Objective: An increase in dental awareness and need to maintain good oral health, in a growing population will necessitate an increased demand for root canal treatment (endodontic treatment). In emerging economies like Nigeria, the trend appears similar to what obtains in more developed economies where patients are keen on retaining their teeth. The objective was to determine the reasons for endodontic treatment and pattern of demand for treatment among adult patients attending the Endodontic unit of a tertiary hospital in Southern Nigeria. Methods: A retrospective review of all clinical records of adult patients who attended the Endodontic unit of the Department of Restorative Dentistry, University of Benin Teaching Hospital (UBTH) Edo State, Nigeria from January 2012 to December 2014 for root canal treatment (RCT). The demographic and clinical data were retrieved from the patients' records and analysed using SPSS version 20. Results: A total of 485 patients, comprising 226(46.6%) males and 259(53.4%) females (a ratio of 1:1.4) underwent endodontic treatment during the study period. The age range of patients was 18-68 years. In the studied population, the highest demand for endodontic treatment 219(45.2%) was among the 20-29 years' age range. The commonest indication for RCT was irreversible pulpitis (48.4%). The total number of teeth treated was 522. More posterior teeth 338(64.8%) were treated than anterior 184(35.2%). The mandibular first molar 96(18.4%) was the most frequently treated tooth. More maxillary teeth 332(63.6%) underwent RCT than mandibular teeth 190(36. 4%).Endodontic treatment was mostly completed in multiple visits 439(84.1%). A total of 279 (57.5%) patients had their treatments covered by the National Health Insurance Scheme (NHIS). Out of pocket payments accounted for 40.2% of patients who had endodontic treatment. Conclusion: There was a greater demand for root canal treatment among female and young adult patients. Most of the procedures were performed on maxillary teeth while the mandibular first molar was the most frequently treated tooth

Diabete et therapeutiques endodontiques

"Le diabete est une pathologie systemique endocrine qui touche un grand nombre de personnes dans le monde et plus de 1;5 Millions d'individus au Maroc selon les dernieres statistiques annoncees en 2011 par le ministere de la sante publique. Les manifestations buccales du diabete sont nombreuses et comprennent en dehors des maladies parodontales ""sixieme complication chronique du diabete""; la xerostomie; les lesions de la muqueuse buccale; les complications infectieuses; le retard de cicatrisation; mais aussi les lesions irreversibles du parenchyme pulpaire et les pulpopathies. Cet article expose la specificite de la prise en charge du patient diabetique en endodontie; les risques encourus lors des therapeutiques endodontiques ainsi que les precautions a prendre en pre; per et post operatoire; en collaboration avec le diabetologue. "