Recently, various diagnostic tools have emerged with a view to enhance endodontic treatment. Cone-beam computed tomography (CBCT) is presented as a new endodontic tool. The narrow field CBCT reduces the negative effects of anatomic noise, geometric distortion, and technique sensitivity observed on two-dimensional images. It can be used to identify canal morphology, numbers of canals, and relative positioning even in the presence of calcific metamorphosis (CM) and dystrophic calcifications. Calcific metamorphosis is characterized by the deposition of hard tissue within the pulp canal space. Most of the literature advices the treatment of CM through observation and periodic examination. Thus, it is imperative for the clinician to identify calcified canals preoperatively for conservative treatment approach. This case series illustrates about the versatility of CBCT over the conventional radiology for detecting calcified canals.
How to cite this article
Chougule AR, Kundabala M, Mohan RP, Shetty N. Cone-beam Computed Tomography: A Resolution to Paradoxical Judgments in Endodontic Diagnosis. World J Dent 2016;7(2):100-106.
Introduction: Bacteria plays a principal role in the pathogenesis and progression of pulpal and periapical diseases. The chronic resistant bacterial existence in the root canals has a greater influence on the endodontic treatment outcome by the persistence of periapical tissues. Higher proportions of enterococci, ranging from 29 to 77% are found in filled root canals with the persistent periapical disease. Placement of an intracanal medicament can reduce the bacterial load.
Materials and methods:Extracted and decoronated, 72 nos. single-rooted human teeth prepared to maintain the root length of 18 mm were selected for the study. After instrumentation, E. faecalis suspension was inoculated in each of the root canal and teeth were incubated at 37° C for 72 hours within the orbital incubator. Root canal samples were randomly divided into four groups. After placement of various medicaments (namely saline, triantibiotic paste, mixture of calcium hydroxide [Ca(OH) 2 ] and omeprazole and carnosic acid) inside the canal, teeth were divided into three subgroups of five samples and incubated at 37° C under humid conditions for the time period of 24 hours, 48 hours and 7 days within Orbital incubator. Viable cell count assay was used to see the effect of these antimicrobials on E. faecalis biofilm.
Results:Results were statistically evaluated using Kruskal-Wallis one-way analysis of variance tests. A p-value < 0.05 was considered significant Conclusion: Carnosic acid showed better antimicrobial properties compared to TAP, calcium hydroxide and omeprazole over the experimental period of time.Clinical significance: A preliminary study using carnosic acid which is a plant derivative as an intracanal medicament.
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