Objectives: To evaluate whether low concentration sodium hypochlorite (NaOCl) disinfectant protocol can achieve a sufficient amount of disinfection to provide a conducive environment for clinical and radiographic success of regenerative endodontic procedure. Materials and methods: This systematic review includes necrotic immature permanent anterior teeth below 20 years of age using triple antibiotic paste as an intra-canal medicament and autologous platelet concentrates as scaffold. The interventional group was low concentration (≤2%) NaOCl and comparator group included high concentration (>2%) NaOCl as disinfectant. Cochrane risk of bias assessment 2 (RoB 2) tool was used for assessment of risk of bias. Included studies were evaluated for the absence of clinical signs and symptoms, increase in root length and apical closure on radiograph, and positive response to vitality testing. Results: After evaluation, seven studies were included. Clinical success rate was seen in 98.33% cases in low concentration (≤2%) and 95% cases in high concentration (>2%) NaOCl. The radiographic success rate was 86.66% in low concentration (≤2%) and 80% in high concentration (>2%) NaOCl disinfection. Positive response for vitality testing was seen in 46.66% cases in low concentration (≤2%) and 38.70% in high concentration NaOCl (>2%). Conclusion: Low concentration (≤2%) NaOCl is as effective as high concentration (>2%) to achieve disinfection of the root canal. However, an increased success rate is associated with the use of low concentration (≤2%) NaOCl. Response to pulp vitality is observed to be superior with low concentration (≤ 2%) NaOCl although it might be attributed to a longer follow-up period.
Ectopic eruption is a disturbance in the eruptive path of a tooth in an abnormal position leading to many local problems, such as premature loss of the second primary molars, space loss, increased prevalence of dental caries, supra-eruption of the opposing molars, a mesial inclination of the permanent maxillary first molars, and class II molar relationship. The present case report describes the management of an ectopically erupting mandibular first molar in an 8-year-old child with a modified Halterman appliance. Halterman appliance was modified by incorporating cross-arch anchorage. Follow-up was carried out at 1 month, 3 months,6 months, and 9 months until distalization of the molar was achieved. Space analysis was carried out and a fixed functional space maintainer was cemented which was followed up at 12 months. According to the present case report, a modified Halterman appliance is an effective appliance in achieving distalization of an ectopically erupting permanent molar in a mixed dentition period. Keywords: Ectopic Eruption; Orthodontic Appliance; Tooth Uprighting
Photobiomodulation with diode lasers of 660 and 810 - 980 nm is used for the proliferation of fibroblasts and to enhance the healing of oral lesions or surgical wounds. It has the potential to stimulate the formation of reparative dentin and preserve pulp vitality. Photobiomodulation uses low-level laser therapy (LLLT) which works on the principle of supplying direct bio-stimulative light energy to the cells. Based on these characteristics, numerous studies are conducted on photobiomodulation with a diode laser for pulpotomy in primary molars. This review article aims to provide data to clinicians regarding varying parameters used for photobiomodulation in pulpotomy and their clinical outcomes in primary molars.
Early loss of deciduous teeth can cause the drifting of teeth reducing the space available for the eruption of permanent successors and thus maintenance of space is critical to prevent malocclusion. At times, multiple decayed teeth can occur simultaneously with a single-tooth anterior crossbite, which is a major functional concern to the dentist and esthetic concern to the parents during the developmental stage of a child. Hence, there is a need for an appliance that can cater to both conditions of space management and anterior crossbite correction concurrently. The following case series focuses on the time taken and the comfort of the patient and for the correction of crossbite using a Modified Nance palatal appliance. All three cases took an average of 1 week for crossbite correction and patients showed superior comfort and compliance.
Pediatric digital dentistry incorporates computer-aided designing and manufacturing of the crowns which enhances their marginal and internal adaptation. This allows the application of newer materials for the fabrication of crowns. Most importantly, digital workflow makes the procedure easy and comfortable for pediatric patients. The objective of this case series was to evaluate the clinical appearance and success of custom-made esthetic crowns for pediatric population. The case series presents two cases of PMMA crowns using subtractive manufacturing and two of photopolymer resin crowns using additive manufacturing. Both subtractive manufacturing and additive manufacturing have shown better marginal integrity and improved aesthetics in this case series. According to the current literature available and the present case series, these crowns have good biocompatibility, are esthetic, and more importantly relatively inexpensive.
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