Ethical Aspects concerning Instrument Separation and Perforations during Endodontic Treatment: A Cross-Sectional Study.

AIM: During endodontic treatment, dentists may face various unwanted procedural accidents, at any stage of the treatment that might compromise endodontic treatment outcome and bring obstacles to dentists as well. This study aimed to address and analyze several ethical concerns relating to the behavioural conduct of dentists towards endodontic instrument separation as well as perforation of the crown and/or root during root canal treatment in Riyadh, Saudi Arabia. METHOD: Hundred and eleven questionnaires were distributed among dentists working in Riyadh in university clinics and government and private sectors. Data were collected, reviewed, and statistically analyzed by Fisher's exact and chi-square tests at a 5% significance level, using SPSS software. RESULTS: 54.5% of the respondents have encountered instrument separation. 53.2% stated that they would inform the patient about the instrument separation. 43.6% of the respondents had experienced perforation during root canal treatment, and 54.9% reported that they would inform the patient of the accident. CONCLUSION: Within the limitation of this survey, we concluded that most of the dental professionals did not hesitate to adhere to the correct ethical conduct, and they would inform the patient if an incident occurred.

Case Report: Ectopic third molar in the maxillary sinus with infected dentigerous cyst assessed by cone beam CT.

Ectopic development of teeth in nondental areas is uncommon, especially in the maxillary sinus. A panoramic radiograph is the routine diagnostic radiographic examination performed for this type of eruption, although cone beam computed tomography (CBCT) is highly recommended for further localization of the ectopic tooth and assessment of the characteristics of any associated lesion before a surgical procedure. We report a case of a 13-year-old female student who presented with purulent discharge posterior to the upper right second molar with a bad taste and foul odour. Radiographic examination revealed a maxillary third molar tooth located at the posterosuperior aspect of the right maxillary sinus with a hyperdense lesion surrounding the crown, obliterating the sinus cavity. Both the tooth and dentigerous cyst were surgically removed under general anaesthesia through Caldwell-Luc antrostomy. After a three-month follow-up, the patient was symptom free and had an uneventful recovery. The rare and critical location of the reported third molar along with the infected dentigerous cyst indicates its complete enucleation to avoid complications as recurrence or malignant transformation.

Case Report: An association of the gubernacular canal, supernumerary tooth and odontoma with an impacted canine on cone-beam computed tomography.

This report describes a clinical case of asymptomatic compound odontoma in the anterior left side of the maxilla associated with an impacted canine and supernumerary tooth with a gubernacular canal of a 47- year-old female with no relevant medical history. Cone-beam computed tomography (CBCT) was performed for precise three-dimensional localization of each structure and assessment of their spatial relationship with the associated structures before surgery. The treatment protocol involved surgical enucleation of the odontoma and open extraction of both impacted and supernumerary teeth. The patient had uneventful healing and proceeded with the prosthodontic treatment plan. The dentist should be aware of the probability of a close relationship between the development of odontoma and presence of the gubernacular tract, which could be used as a future radiographic diagnostic criterion of an odontoma. Also, we recommend that more studies be performed in this field to deeply analyze the imaging characteristics of GT and its spatial association with various pathological lesions in the future.