Radiographic imaging is a common resource for endodontic diagnosis, treatment, and prognosis. Two-dimensional (2D) periapical and digital panoramic radiographs often showed image distortion; this issue was resolved with the emergence of three-dimensional (3D) conebeam computed tomography (CBCT). This review examines the accuracy of various radiographic techniques in the assessment of periapical lesion after endodontic treatment. Our goal was to determine whether a 2D radiograph (periapical and panoramic) is as accurate as a 3D radiograph (i.e., CBCT) in the assessment of periapical lesion after endodontic treatment. We searched the electronic databases Medline and Cochrane and trial registries for ongoing trials. We included both retrospective and prospective studies comparing the efficacy of periapical healing with various radiographic techniques after endodontic treatment. The outcome of interest was the percentage detection of periapical lesions and periapical healing assessment after endodontic treatment. All data were collected using a specially designed extraction form. We assessed the risk of bias in the studies using the Cochrane tool for diagnostic tests (QUADAS). We judged two studies to be at low risk and two to be at moderate risk of bias. Although there was a difference in the percentage detection of periapical healing efficacy by various radiographic techniques, all studies reported that CBCT had higher accuracy in the detection of periapical lesions compared to periapical and panoramic radiography. The next best choice is periapical radiographs, followed by panoramic radiographs as they provide better visualization and accuracy.
Objective The objective of this study was to evaluate the irrigant penetration using iohexol dye with four irrigation techniques. Methodology Single-rooted premolars were recently extracted and preserved in physiological saline solution. All the samples were standardized to 16 mm. Standard endodontic access was prepared using endoaccess bur (Dentsply Maillefer, Switzerland). The initial patency was established using #10 k file (Mani, Utsunomiya, Tochigi, Japan) to the working length. The cleaning and shaping were performed using the file system ProFit S3 in the following sequence: P0 (orifice enlarger), PF1 (yellow), PF2 (red) #25, and PF3 (blue) #30. The samples were randomly allocated in concealed opaque envelopes into four groups. This was performed by a trained dentist. Fifteen samples were allocated to one group. The groups were divided as follows: Group A—conventional needle (CN), Group B—side-vented needle (SVN), Group C—manual dynamic agitation (MDA), and Group D—EndoActivator (EA). The radiopaque dye irrigant agitation/activation was performed by one operator to prevent operator bias. Following irrigation using the different techniques, digital radiographs were taken, and the measurement was taken from the apical foramen to the point where the dye had penetrated apically for each tooth and the data were entered into an Excel sheet for all the four groups. Results Comparing the four groups, there was a statistically significant difference among the four groups (p < 0.05), thus, favoring the alternate hypothesis. EA had resulted in better penetration of the irrigant compared with the other three groups (p < 0.05). Conclusion It was evident that irrigant penetration was best achieved with the use of an EA followed by MDA, SVNs, and then the CN when the preparation was done till size 30 (PF3 #30) using ProFit S3 rotary file system.
Aim: The aim of the study was to compare the canal transportation, centering ability, and dentin removal of Profit S3 (PS3), One Curve (OC), and ProTaper Gold (PTG) systems using cone-beam computed tomography (CBCT). Materials and Methods: Thirty extracted human single-rooted premolars were used in the present study. Preinstrumentation scanning of all the teeth in arch form was taken using CBCT. To increase standardization, crowns were removed and only teeth measuring 16 mm were included in the study. The samples were randomly divided into three groups, with ten samples in each group; Group I was instrumented with PS3, Group II was instrumented with OC, and Group III – PTG. Postinstrumentation scans were performed, and the two scans were compared to determine canal transportation, centering ability, and dentin removal at 3, 6, and 9 mm, from the apex. Statistical Analysis: One-way-ANOVA and the independent t -test were done for the pairwise comparison. The significance level was set at P = 0.05; statistical analysis was performed with SPSS statistics version 20.0 (SPSS Inc., Chicago, IL, USA). Results: The mean canal centering ratio and canal apical transportation for PS3, OC and PTG show no statistical difference ( P > 0.05). The mean value of dentin removal showed a statistically significant difference between the three groups ( P < 0.05). PS3 and OC rotary file showed less removal of dentin compared to PTG ( P < 0.00). Conclusion: It was evident that PS3, OC, and PTG had no statistically significant difference when analyzed based on canal transportation and canal centering ratio. However, there was a significant difference among the three groups comparing the removal of dentin. PS3 and OC rotary file showed less removal of dentin compared to PTG.
The primary objective of root canal treatment is the ability to remove irritants, to clean, shape and fill the root canal system three-dimensionally and prevent recontamination from bacterial irritants. Various Obturation techniques used for filling the root canals include lateral condensation, vertical compression, and thermoplastic gutta-percha techniques. The retrospective study aimed to evaluate the various obturation techniques used in mandibular molars. For this retrospective study data collection was based on patient records of Saveetha Dental College, Chennai and consisted of a total of 1903 cases evaluated based on the obturation technique within the time frame of 10th June 2019 to 1st March 2020. In this study, the obturation technique was evaluated based on the patients age, gender, procedure and based on the tooth in which obturation was done. Inclusion criteria consisted of the tooth that underwent endodontic treatment in patients within the age group of 18 to 60 yrs, a tooth with irreversible pulpal disease or chronic apical periodontitis, permanent tooth and mandibular molars. Exclusion criteria consisted of patients above 60 years, primary tooth, teeth in which root canal treatment was not undertaken, teeth with the presence of huge periapical lesions, severely calcified canals etc., severe periodontal disease, teeth apart from mandibular molars. All the values were then statistically analysed. In this study, 1930 patients (848 are females, and 1055 were males with a mean age of 24 years) were included. It was observed in this retrospective study that there was a significant difference between the various types of obturation technique used in mandibular molars. Matched single cone obturation technique was the preferred technique of obturation in the majority of the cases (62.4%). Single cone obturation technique has advantages over other techniques of obturation due to the fewer stress forces implied apically, thereby preventing an excess of sealer extrusion.
Tooth loss is the terminal event in the life of a tooth and is a frequent episode in individuals who are uncared and have neglected oral hygiene. Tooth loss has various ill effects on an individual such as impairment of masticatory function, bad phonetics, unpleasant aesthetics, TMJ disorders, psychological issues, social withdrawal which results from decrease in confidence level. It is evident that caries and periodontitis are the most common causes for tooth loss with caries being the commonest between them. Neglected oral health may result in caries progression, which will lead to formation of root stumps. The aim of the study is to find the prevalence and incidence of root stumps of permanent teeth in pediatric patients. The study was performed under a university setting where the data of patients with root stumps of permanent teeth was collected by reviewing patients records and analysing the data of 86000 patients. The collected data was compiled, reviewed, tabulated and entered in SPSS software for statistical analysis. The study shows that only 2% were extractions of root stumps of permanent teeth. Extraction of root stumps of permanent teeth were more prevalent in patients of 9 and 11 years of age (34%) with a female predilection with most common teeth being the maxillary second premolar (22.2%). This study indicates the negligence of parents regarding the oral health of the children and provides insight on parents’ care towards the oral health of the child. Preventive measures such as topical fluoride application and usage of denial fissure sealants should be encouraged to prevent caries. Thus, the preservation of the natural dentition should be the ultimate goal of the dental professionals.
Introduction: Candida albicans and Enterococcus faecalis are the most predominant microorganisms found in the canals of failed root canal treated teeth. Thorough debridement of an infected root canal and complete elimination of microorganisms are objectives of effective endodontic therapy. For thousands of years, humans have used herbs as the primary means to sort out health issues and illnesses. Not all herbs have shown to provide scientific evidence as medicine to illness. Neem is a Botanical herb that is truly remarkable with its scientific value, a tropical evergreen native to India. Although different agents have been suggested as root canal irrigants, sodium hypochlorite and EDTA are the most popularly used. Aim: To compare the antimicrobial efficacy of commercially available irrigants, 17% EDTA and a herbal product, neem leaf extract compared with 3% sodium hypochlorite as a control against Enterococcus faecalis and Candida albicans. Materials and Methods: The antimicrobial activity was determined using the agar well diffusion method. Freshly prepared neem leaf extracts, 17% EDTA, 3% Sodium hypochloriteStandard strain of E. Faecalis and C. Albicans were used in this study. These isolates were subcultured on to Brain heart infusion agar (BHI agar) and HI-chrome candidal differential media respectively. The agar well diffusion test was performed in brain heart infusion media and broth. The plates were incubated at 37°C for 24 hours and the zone of inhibition was recorded and analyzed statistically. Results: Zones of inhibition were present with Neem leaf extract suggestive of antimicrobial properties. Zones of inhibition were greater with Neem extract than 17% EDTA. Hence, further research should be directed towards the use of this herbal extract as an irrigant clinically with endodontic therapy. Conclusion: Within the limitation of this study, it was found that neem leaf extract had a significant antimicrobial effect against E. Faecalis and C. Albicans compared to EDTA and Sodium Hypochlorite. Since the study is a qualitative analysis, further testing needs to be done to final quantitative analysis of the antimicrobial activity of neem leaf extract.
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