Journal of Dental Medicine

Background and Aim: A considerable percentage of failure in Endodontic treatments in maxillary molars is attributed to undiscovered second mesiobuccal canal (MB₂).There are different methods for discovering and accessing to this canal. The purpose of this ex vivo study was to compare the detection ability of three methods (direct look, fiberoptic loup and surgical microscope) to find MB₂ after troughing with ultrasonic.

Materials and Methods: In this experimental study, we selected 90 extracted maxillary molars (45 first and 45 second molars) in which after access cavity preparation MB₂ canal was not discovered by direct vision and endodontic explorer. They were divided into 3 groups (n=30). The dentinal shelf between mesiobuccal and palatal canals was eliminated by an endodontic ultrasonic tip (troughing). After that, first group was searched by direct vision, second group by a loup and fiberoptic light and third group by dental operating microscope. Data were analyzed, specificity and sensitivity were calculated.

Results: The results showed that 21%, 61%, and 92% of MB₂ canals after troughing was found by direct vision, fiberoptic loup, and surgical microscope, respectively.

Conclusion: Based on the results of this study, surgical microscope and loup with fiberoptic are preferred methods for discovering MB₂ canal. Troughing with ultrasonic can help find MB₂ canal in all methods.

  3- Dentist

  Background and Aims: An attractive, well-balanced smile is a paramount treatment objective of the modern orthodontic therapy. The purpose of this study was to determine the effects of the buccal corridor size and tooth-gingival display on the smile esthetics as perceived by two groups of the students.

  Materials and Methods: A colored image of a woman frontal posed smile was selected. The image was altered digitally to produce different buccal corridor sizes (6%, 12.5% and 20%) and different tooth-gingival displays (maxillary central incisors and 2 mm of gingival, maxillary central incisors and dental papilla and 80% of the maxillary central incisors). The different buccal corridor sizes and tooth-gingival displays were combined to produce 9 images. These altered images were rated by 120 medical and dental students using Visual Analogue Scale (VAS). Data were analyzed using Mann-Whitney test, Pairwise comparison LSD test, Repeated measure MANOVA and ICC (Intraclass Correlation Coefficient).

  Results: The smile which had the buccal corridor size of 12.5% and complete incisor display without gingival display received the highest rates among the nine smile images in the dental students group. But in the medical students group the smile with the buccal corridor size of 12.5% and 2 mm gingival display, received the highest rates among the nine smile images. There was no significant difference in judging between the male and female raters for the both groups (P>0.05). The dental students were more critical about the increasing of the gingival display.

  Conclusion: In the treatment procedure that may lead to the combination of wide buccal corridor and more tooth-gingival show, more caution should be considered.