Publications

Scholarly Journals--Published

• Evid Based Dent (2024). https://doi.org/10.1038/s41432-024-00996-7 Effectiveness of mineral trioxide aggregate on postoperative pain in non-surgical endodontic treatment: a systematic review of randomized controlled trials Maryam Altuhafy, Vikranth Ravipati, Ravleen Nagi, Luay Jabr, Zegar Zegar & Junad Khan  Introduction Postoperative endodontic pain can negatively influence the quality of life of the patients. Mineral Trioxide Aggregate (MTA) has gained attention as a potential medicament in various endodontic procedures. MTA has been shown to have desirable properties such as biocompatibility, marginal adaptation, and sealing ability compared to other materials. Limited evidence is available about the effectiveness of MTA on the reduction of postoperative pain following endodontic treatment. This article aimed to compare the non-surgical post-endodontic pain-relieving effect of MTA compared with other materials. Methods Indexed databases (PubMed/Medline, EMBASE, OVID, Scopus, and Cochrane) were independently searched for relevant manuscripts published up to and until June 2023. Randomized controlled trials (RCTs) with a focus on teeth with pulp pathologies, with or without radiolucency, requiring primary endodontic treatment were included. Risk of bias across individual studies was performed using the Cochrane risk of bias tool for interventions. Results Out of the initial 169 articles searched, 9 RCTs met the selection criteria. The protocols were like all the studies, but the pain rating scales, filling material, and restoration materials varied. Out of the 9 included studies, in 4 studies MTA significantly reduced postoperative pain levels, 5 studies showed no difference between MTA and other materials, whereas 1 study reported an adverse effect of grey discoloration after MTA. Conclusion The findings of the present review indicate that MTA may reduce postoperative pain following non-surgical endodontic treatment. However, future standardized studies should be conducted to validate the results. (03/2024) (link)
• International Journal of Dental Materials 2024;6(1) Self-perceived pain levels following irrigation with various concentrations of sodium hypochlorite solution and gels: A systematic review of randomized clinical studies Junad Khan1,*, Maryam Altuhafy2, Ghida Askar3, Luay Jabr4, Zegar Zegar5 Background: Sodium hypochlorite, a prevalent root canal irrigation solution, valued for its antibacterial properties and tissue-dissolving abilities, varies in concentration (0.5% to 8.25%). However, its efficacy across formulations awaits systematic evaluation. Aim: To evaluate self-perceived post-operative pain levels in a 5.25% concentration of NaOCl in gel or solution form. Materials and Methods: An unrestricted search of indexed databases (PubMed, Embase, Scopus, Web of Science, and Cochrane) and a manual search were performed up to April 2023. Three randomized controlled trials (RCTs) compared a solution form of 5.25% NaOCl to other solution concentrations, whereas 2 RCTs compared a gel form of 5.25% NaOCl concentration to 5.25 % NaOCl solution form. The risk of Bias (RoB) assessment was conducted using the Cochrane tool. Results: A total of 5 RCTs met the inclusion criteria and were included in the review. Four RCTs used the visual analog scale (VAS), whereas 1 RCT used the numeric rating scale (NRS) to assess post-operative pain. Three RCTs had a moderate Risk of Bias (RoB), whereas 1 had a low and 1 had a high RoB. Conclusion: Based on the current evidence the concentration of NaOCl used during irrigation did not have any effect on the post-operative pain developed regardless of the use of a gel or solution forms. Future randomized studies with standardized protocols are needed to further investigate the efficacy of NaOCl concentration on postoperative pain in endodontic treatment. Keywords: Root canal, irrigation, Sodium hypochlorite, postoperative pain, endodontic. (03/2024)
• J Endod. 2019 Apr;45(4):453-458. doi: 10.1016/j.joen.2018.12.010. Epub 2019 Feb 13. Radiographic Indications of Vertucci Type V Configuration in the Distal Root of Mandibular Molars: A Case Series. Jeong JW1, Zegar Z2, Liu RY2, Makins SR2. Abstract Knowledge of the prevalent root canal anatomy and potential variations is necessary before the initiation of endodontic treatment. The purpose of this study was to aid in the detection and treatment of the Vertucci type V canal configuration when present in the distal root of the mandibular molars. This case series presents 3 radiographic indications of a type V configuration in the distal roots of the mandibular molars as revealed on conventional periapical radiographs: a "ghost" apex, a fast break canal, and eccentric canal tracing. Nonsurgical endodontic treatment was performed for 5 mandibular molars with the type V distal root canal. Four cases showed posttreatment resolution of symptoms and return of normal function. One case was classified as "failed" because of persistent symptoms and clinical signs. The tooth was surgically treated and subsequently healed. These case reports show the importance of visualizing and managing the anatomic variations of the canal system in distal roots of mandibular molars and incorporating these capabilities into clinical practice to enhance the occurrence of a successful outcome. Additionally, clinical guidelines are provided that can help clinicians overcome the challenges in diagnosing and treating such complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved. (04/2019) (link)