Browsing by Author "Al-Salehi, Samira"

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Assessment of the quality of endodontic re-treatment and changes in periapical status on a postgraduate endodontic clinic
(2020) Al-Salehi, Samira
Objective: The aim of this study was to assess endodontic retreatment outcomes based on quality of obturation and healing. Materials and Methods: A total number of 223 radiographs of patients who had received endodontic retreatment during the period (2008–2015) at a postgraduate teaching clinic were selected. Unreadable radiographs were all excluded. From the original sample of 223 in total 24 radiographs were discarded. The final sample thus consisted of 199 root canal fillings. All radiographs were individually evaluated for the density of the root filling as well as the distance between the end of the root canal filling and radiographic apex based on a six-point scoring system. Subsequently, patients were reviewed and follow up periapical radiographs were exposed. The outcome of healing was assessed using the Periapical Index (PAI) scoring system. The data were analysed using Chi Square test (p < 0.05). Results: The study revealed that 78.9 % of the endodontic retreatments were both homogeneity and length acceptable. The corresponding figure was only 13.1 % before endodontic retreatment. Conversely, homogeneity and length unacceptable before endodontic retreatment was 47.2 % reducing to a mere 2.5 % after retreatment. The results were statistically significant (P < 0.001). There was over 80 % improvement in periapical healing following endodontic retreatment and this was also statistically significant (P < 0.001). Conclusion: There was a significant improvement in outcome after endodontic retreatment on the postgraduate endodontic clinic. The success rate of endodontic retreatment was over 70 % which is in line with the endodontic literature. Radiographic follow up confirmed some 81 % improvement in healing rate following endodontic retreatment.
Guidelines on radiographic imaging as part of root canal treatment: a systematic review with a focus on review imaging after treatment
(2017) Al-Salehi, Samira
Aim: To identify guidelines on endodontics which make recommendations relating to post-root canal treatment radiological review imaging, to make an objective assessment of their quality using the AGREE tool and to examine the evidence cited in support of their recommendations. Methodology: The primary sources to identify published guidelines were MEDLINE (Ovidâ) and EMBASE. The search aim was to identify guidelines pertaining to the post-root canal treatment follow-up recommendations published from 1946 with the final search date being 26 June 2016. The primary search was supplemented by searching Internet search engines and several websites that might have guidelines. The guidelines obtained from the search end-result were assessed for quality and scientific evidence using the AGREE II instrument. Similarities and differences in the recommendations were identified. Results: Thirty guidelines were identified, seven of which met the inclusion criteria. Two guidelines used and clearly described the methods for obtaining scientific evidence from which the recommendations were set. The recommendations varied, particularly as regards the timing of the first review radiograph. Some guidelines lacked supporting evidence. Conclusions: The recommendations for post-root canal treatment radiographic follow-up varied amongst the identified guidelines. However, the methodology for obtaining the scientific evidence was poorly described in most of the guidelines. Guideline development groups should use the AGREE II instrument as a guide to produce higher quality guidelines.
Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before-after study
(2016) Al-Salehi, Samira
Objectives: The aim of this study was to evaluate the impact of limited volume CBCT upon diagnosis as part of endodontic management of posterior teeth. The null hypothesis that CBCT does not make any difference in endodontic diagnosis was tested. Methods: A single-centre “before-after” study was conducted in a secondary healthcare establishment. Eligible patients were all adults aged 18 years or over who were referred to a specialist endodontic unit. Further inclusion criteria were that the cases were either re-treatment or de novo root canal treatment where the anatomy was judged to be complex. Exclusion criteria included vulnerable groups and de novo endodontic treatment with uncomplicated root canal anatomy. As well as a full history and clinical examination, a high quality colour photographic intraoral image, two paralleling technique periapical radiographs and limited volume CBCT examination were carried out for each patient. All components, except the CBCT dataset, were combined into a Powerpoint presentation and assessed by 4 observers. A questionnaire was designed for the observers as part of the study. Results: CBCT information only changed the radiological findings and the final diagnosis in a minority of cases. There was no clear evidence that CBCT increases the confidence of observers or that CBCT was helpful in making a diagnosis. Conclusions: Routine use of CBCT cannot not be justified on the basis of a change in diagnosis and carefully selected use is appropriate. Clinical significance: CBCT is being increasingly used in the field of endodontics. The benefits gained from the use of CBCT must be carefully balanced against the increased radiation dosage. Determination of selection criteria for the use of CBCT in endodontics is, therefore, essential.
The relationship between endodontic case complexity and treatment outcomes
(2019) Al-Salehi, Samira
Objective: The aim of this work is to correlate between endodontic case complexities and treatment quality outcomes. Methods: Three hundred and forty nine radiographs of patients who had received endodontic treatment at a postgraduate dental institute in Dubai were retrieved from the Institute's data base. The majority of the cases were referred by in house general dental practitioners (GDPs). Unreadable radiographs were all excluded. From the original sample of 349,in total 51 radiographs were discarded. The final sample thus consisted of 298 root canal fillings of 211 patients treated by the endodontic postgraduate students. All radiographs were individually evaluated following the American Association of Endodontic Case Difficulty Assessment Form. Based on this, the technical quality of the root filling was evaluated for each individual case. Results: The sample consisted of 53% high,35% moderate and 12% minimal difficulty cases. Adequate homogeneity of root canal fillings were found in 93% of the cases. This compared with 90% of cases with adequate length of root fillings. There were statistically significant differences between the length of root canal filling and level of difficulty (p=0.016) but, no statistically significant difference between homogeneity of root canal filling and case difficulty (p=0.794). Conclusion: Eighty four percent (0.93×0.90=0.84) of the cases treated proved to be adequate in terms of length and homogeneity which is in line with published work of Endodontic treatment carried out by specialists. Clinical Significance: GDPs require robust guidelines to help with appropriate referral of patients to Endodontic specialists.
Use of Adhesive Techniques in the Management of Hypodontia
(2015) Al-Salehi, Samira
Abstract: The treatment and management of hypodontia are complex. Traditional treatments include the provision of conventional bridgework. Such treatment modalities are destructive of remaining tooth tissue particularly as the majority of patients presenting for treatment are young adults. This case report describes a 22 year old female Caucasian patient who was treated for missing permanent teeth using conservative adhesive non destructive techniques resulting in a pleasing aesthetic outcome.