Fracture of tooth after trauma is distressing to a person because of the discomfort and pain due to pulpal injury. Crown root fractures of anterior teeth cause concomitant periodontal injury and there will be concern about appearance, and aesthetics. Management of pulpal and periodontal tissue relieves pain and restoration of tooth form regains patients confidence. Restoration of fractured tooth will be accepted readily if it is minimally invasive, less expensive, and aesthetically acceptable. Reattachment is an option for restoration of anterior teeth compared to other artificial replacements because of its appearance as natural. This method is favourable when the fractured fragment is intact and available. Utilization of pulp space for retention of fragment is achieved by the insertion of a dentine bonding post. This case report describes a case of tooth reattachment after trauma in which the pulp space is utilized to bond a fiber-reinforced post for retention after periodontal tissue management.
Background:
The focus of caries management has shifted to the early detection of caries and noninvasive methods of management of incipient lesions with novel remineralizing agents.
Aim:
The aim of this study is to evaluate and compare the remineralization potential of a novel laboratory synthesized strontium-doped nanohydroxyapatite (SrnHAp) paste to a commercially available regular dentifrice.
Materials and Methods:
Sixty enamel specimens (4 mm × 4 mm × 1 mm) were divided into two groups based on the type of dentifrice applied: Group I – regular toothpaste and Group II – SrnHAp paste. Calcium/phosphorous ratio of all sound specimens was evaluated using Scanning Electron Microscopy-Energy Dispersive X-ray analysis. Samples in both groups were subjected to demineralization, and the calcium/phosphorous ratio was analyzed. The samples were then subjected to remineralization using the specific agents in each group, and the mean calcium–phosphorus ratio was assessed. Cytotoxic evaluation of both pastes was done by direct microscopic observation and MTT assay.
Statistical Analysis:
Comparison of mean calcium and phosphorous values of sound enamel, demineralized, and remineralized specimen in Groups I and II was done using the one-way ANOVA and Tukeys
post hoc
test. Intergroup comparison after remineralization was done using the Student's
t
-test.
Results and Conclusion:
Group II showed higher remineralization potential than Group I and was statistically significant. Cytotoxicity of novel paste was less compared to the regular toothpaste. SrnHAp showed better remineralization than regular toothpaste and can be considered for enamel repair in incipient carious lesions.
Objective:
Double antibiotic paste is a root canal medicament used in regenerative endodontics and its long-term exposure to dental hard tissues was shown to reduce its mechanical properties. The amoxicillin-clavulanate paste is a medicament effective against endodontic pathogens and is effective in endodontic regeneration. Its effect on radicular dentine is yet to be investigated. The purpose of this study is to investigate and compare the effects of double antibiotic paste and amoxicillin-clavulanate paste on the microhardness of radicular dentine.
Materials and Methods:
The root canal of 45 premolars was mechanically prepared and divided into three groups for the placement of intracanal medicament: Group 1 (
n
= 15) double antibiotic paste, Group 2 (
n
= 15) amoxicillin-clavulanate paste, and Group 3 control group (
n
= 15). All the specimens were subject to microhardness testing at 500 and 1000 microns depth for 1 week, 1 month, and 3 months and analyzed.
Results:
There is no significant reduction in microhardness of radicular dentin at 1 week on all the three groups. At 1 month and 3 month period, the amoxicillin-clavulanate paste is found to have no significant effect on dentin microhardness when compared to double antibiotic paste.
Conclusion:
The use of amoxicillin-clavulanate paste as an intracanal medicament does not cause significant weakening of dentin even after its long-term use.
There are several reasons for a root canal therapy to be unsuccessful. One of the causes for endodontic failure is instrument separation. As a consequence of fracture, access to the apical portion of the root canal is obstructed, leading to improper disinfection. The retrieval of separated instrument followed by obturation to the working length is the treatment option. Many factors can make retrieval difficult. In such cases, management can be done even by bypassing the separated instrument. Another factor for endodontic failure is underobturation. It may be due to block or ledge in the apical third of the canal. Proper instrumentation with frequent confirmation of apical patency during instrumentation can prevent formation of ledge. The inability to treat all the canals is the other cause leading to endodontic failure. Bacteria residing in these canals lead to the persistence of symptoms. Proper evaluation of the radiograph with proper deroofing can prevent chances for missed canals. Combination of all these factors can make retreatment difficult. This case report discusses two endodontic failure cases. In the first case, a premolar tooth with separated instrument and incomplete obturation was treated by retrieval of separated instrument and the obturation of both canals to working length was done. The second one was a molar tooth which had a missed canal, a separated instrument, and an incomplete obturation. Missed canal was negotiated and the fractured instrument was bypassed and root canal was obturated.
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