Strategic dentin preservation is the prime objective of this case report (i.e. leaving a truss of dentin between the 2 cavities thus prepared). Permanent teeth with an indication for endodontic treatment can be treated via the truss access cavity design rather than traditional access cavity protocol using copious irrigation. The teeth were then given post-endodontic restorations. Endodontically treated teeth did not show any post-operative symptoms or any presence of post-operative periapical radiolucency or flare-up. The main objective of Orifice oriented access/truss access approach mainly stresses on the preservation of the healthy tooth structure with the minimally invasive approach. This minimal invasive approach in truss access designs avoids the need for conventionally placed crowns. Thus, the aim of this case report was to strategically plan truss access cavity designs on premolars.
To evaluate and compare the antimicrobial efficacy of Chitosan, Ethylenediaminetetraacetic acid, Sodium Hypochlorite and Chlorhexidine against Enterococcus faecalis at room temperature of the irrigant, at warm temperature (60 o Celsius) of the irrigant and after intracanal heating (180 o Celsius) of the irrigant. Materials and method: A total of 120 extracted single-rooted teeth were infected for 21 days with E. faecalis after instrumentation with Pro Taper system. Before irrigation procedure, dentinal shavings were collected in 1 ml of sterile broth and incubated. The optical density of each broth was measured using digital colorimeter and initial readings were recorded. Samples were then divided into five groups of 24 teeth in each group-Group A: Sodium hypochlorite irrigation, Group B: EDTA irrigation, Group C: Chitosan irrigation, Group D: Chlorhexidine irrigation, Group E: Saline irrigation. Each group was further divided into three subgroups -(I) Room temperature of irrigant (II) Warm temperature of irrigant (III) Intracanal heating of irrigant. After irrigation, dentinal shavings were collected and optical density recorded. The values were analysed statistically with Student's t test and analysis of variance followed by Post-Hoc Bonferroni's correction test; p-value < 0.05 was considered to be statistically significant. Results: The post irrigation optical densities in all the groups were significantly lower than pre irrigation values. Sodium hypochlorite and Chlorhexidine demonstrated better antimicrobial efficacy followed by Chitosan and EDTA, whereas the least efficacy was shown by Saline which was the control group. Differences in optical density using different irrigants were found to be higher by intracanal heating of irrigants followed by warm irrigation and room temperature irrigation (p<0.0001). Conclusion:Chitosan exhibited effective antimicrobial effect similar to Chlorhexidine and Sodium Hypochlorite. Intracanal heating was most effective for elimination of E.faecalis followed by warm irrigation as compared to that of room temperature of the irrigant.
The aim is to compare the antimicrobial efficacy of calcium hydroxide, combination of sesame oil with chitosan paste combination and combination of sesame oil with polyethylene glycol paste intracanal medicaments on Enterococcus Faecalis at 72 hours, 8 days and 14 days respectively. Materials and Methodology: A total of 72 single-rooted anterior teeth were selected, root canal preparation was done, and teeth were divided into three groups and contaminated with E. faecalis, which were further divided into four test groups each according to intracanal medicaments used. After 21 days, the 72 samples were randomly divided into three groups (n=18) according to the medicaments used and are as -Group 1: Negative Control, No medicament used Group 2: Calcium Hydroxide intracanal medicament paste Group 3: Sesame oil with chitosan paste Group 4: Sesame oil with polyethylene glycol The specimens were then incubated at 37 0 C in an incubator until evaluation. After 72 hours, 6 samples per group were retrieved from the incubator and analyzed. Values on continuous variable (CFU) were shown as mean ± SD across four study groups. The intergroup statistical comparisons were done using one-way analysis of variance (ANOVA) with Bonferroni's correction for multiple group comparisons. Results 1) All the medicaments showed reduction in the bacterial load of Enterococcus Faecalis. However, Calcium hydroxide medicament with Sesame oil and chitosan medicament showed better reduction in the colonies than Sesame oil with polyethylene glycol. 2) Significant reduction of bacterial load was also observed at 14 days when compared after 72 hrs and 8 days in all the three medicaments. 3) Calcium hydroxide medicament and Sesame oil with Chitosan compared to sesame oil with chitosan. Conclusion:In this study, all the three groups showed reduction in the bacterial count of Enterococcus Faecalis, however complete eradication of this stubborn organism was not achieved which is still a drawback of intracanal medication of root canal therapy. However, Calcium hydroxide medicament with Sesame oil and chitosan medicament showed better reduction in the colonies than Sesame oil with polyethylene glycol.
The aim of this article is to review Morinda citrifolia in the field of endodontics. Herbal medicaments have been used as remedies for various illnesses and diseases for centuries. Furthermore, it has been a topic of interest in dentistry for many years. Morinda citrifolia juice (MCJ), also commonly known as "Noni," a tropical fruit, has a wide range of uses in endodontics and in the eradication of endodontic pathogens without any potential side effects. A literature review is conducted using electronic databases, such as "PubMed," "Google Scholar," and "Scopus," using keywords "Herbal Medicine" and "M. citrifolia." Furthermore, an advanced or refined search was carried out using the keywords "Endodontics," "Root canal Therapy," "Irrigation," "Herbal Endodontics," and "Endodontic Disinfection." The MCJ can be used as an endodontic irrigant along with ethylenediaminetetraacetic acid (EDTA) as an adjuvant to sodium hypochlorite and chlorhexidine (CHX) due to its better smear layer removal properties and antimicrobial activity. It also does not have any major side effects as compared with sodium hypochlorite and CHX. It also helps in caries prevention and control, which is the main crux for the requirement for endodontic treatment. Further studies on MCJ on the endodontic aspect of dentistry can alter the chemical aspect of endodontic therapy in the near future. The MCJ, due to its advantages compared with sodium hypochlorite and CHX, can be used in the field of endodontics.
Root canal treatment is said to be completely successful when the tooth is restored and comes back to normal function. A more complex restoration is required after endodontic treatment when compared to normal tooth restoration, because of factors such as extensive caries, post-treatment root canal dentin and even the economics condition of the patient. With the availability of newer high strength materials like lithium disilicate dentists are now able to offer better esthetics and high strength restoration which withstands heavy occlusal forces with even thin layers. Thus, the aim of this case series is to summarize the recent advances of post endodontic restorations, various new materials their indications depending on the remaining tooth structure and the teeth that needs to be restored.
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