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ORIGINAL ARTICLES
Advanced methods for identification of middle mesial canal in mandibular molars: An
in vitro
study
Seema Mehrish Chavda, Sunita Anandswaroop Garg
July-December 2016, 28(2):92-96
DOI
:10.4103/0970-7212.195425
Introduction:
Failures of root canal treatment are mainly due to missed canals and ignorance about the anatomy of the root canal system. The middle mesial (MM) canal is one such type of canal in mandibular molars which is often missed. The aim of this study was to identify MM canals first with unaided eyes, then after troughing, followed by magnification and to compare it with cone beam computed tomography (CBCT).
Materials and Methods:
Fifty extracted mandibular first and second molars were taken. Preoperative CBCT scans were done for these intact teeth, which were not studied at this stage. Access cavities were made and detection and negotiation of the MM canals was done first with unaided eyes, followed by other added aids like troughing and magnification. Then, CBCT scans were evaluated to compare the incidence obtained and to study the configuration of the found canals.
Results:
The number of MM canal found with unaided eyes was 29% and 46% in the first and second molars which increased to 41.6% and 50% after troughing the groove between mesiobuccal and mesiolingual canal. It further increased to 45.85% and 53.8% after magnification. CBCT analysis showed same number of canals, but studying the canal configuration, clinically helped in negotiation of five otherwise nonnegotiable canals. Ninety percent of MM canals in the first molars and 100% in the second molars were confluent type, whereas 10% in the first molars were independent type.
Conclusion:
Troughing, magnification, and CBCT can help us in better identification and negotiation of otherwise difficult to find MM canals.
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9,874
1,346
Evaluation of efficacy of 2% lidocaine gel and 20% benzocaine gel for topical anesthesia
Amit Garg, Nisha Garg, Damanpreet Kaur, Sunila Sharma, Ibrahim Abu Tahun, Rajneesh Kumar
January-June 2016, 28(1):38-41
DOI
:10.4103/0970-7212.184338
Aim:
The objective of this study was to determine the pain produced from needle insertion at bilateral labial site prepared with topical application of 2% lidocaine gel, 20% benzocaine gel, and placebo paste at subsequent visits in a same patient.
Materials
and
Methods:
Forty healthy individuals aged 18-30 years old were subjected to three sessions in which they were treated with 2% lidocaine gel, 20% benzocaine gel, and placebo paste. in all sessions, a 26-gauge needle was inserted in maxillary labial mucosa before and 1 min after the drug application. Immediately, after needle insertion, participants indicated pain intensity on visual analog scale (VAS).
Results
and
Conclusions:
Pain responses were compared based on subjects' self-report using VAS. Results showed that lidocaine and benzocaine were equally effective, and both were better than placebo in reducing the pain of needle insertion.
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40,192
858
Root and canal morphology of mandibular incisors and canines in South Asian Indian population by canal staining and tooth clearing technique
Shishir Singh, Mansing Pawar
July-December 2016, 28(2):148-153
DOI
:10.4103/0970-7212.195435
Introduction:
To study the root canal morphology of mandibular incisors and canines in South Asian Indians using a staining and tooth clearing technique.
Materials and Methods:
One hundred each of mandibular central incisors, lateral incisors, and canine specimens were collected from various dental schools and clinics across India. Pulp tissue was removed and the root canals were stained with Indian ink. The specimens were subjected to decalcification in 10% nitric acid followed by dehydration in ascending concentrations of alcohol. Subsequently, specimens were cleared in methyl salicylate.
Results:
All hundred mandibular central incisors were single rooted with a single canal. Ninety-six percent had a single and 4% had two apical foramina. While 84% had Type I, 8% had Type II, 4% had Type III, and 4% had Type IV Vertucci's root canal anatomy. No lateral canals were seen. All hundred mandibular lateral incisors were single rooted with a single canal. While 92% had a single foramen, 8% had two apical foramina. While 80% had Type I, 8% had Type II, 4% had Type III, and 8% had Type IV Vertucci root canal anatomy. Four percent of the lateral incisors showed the presence of lateral canals. All hundred mandibular canines studied were single rooted with a single canal, one apical foramen. Ninety-two percent had a Type I and 8% had a Vertucci Type II root canal anatomy with 12% of the specimen showing the presence of lateral canals.
Conclusion:
Not much variation was seen in the root canal anatomies with Vertucci Type I anatomy predominating. Lateral canals were present in the mandibular lateral incisors and canines.
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5,424
500
Antimicrobial activity of different biological extracts as intracanal medicament against
Enterococcus faecalis
: An
in vitro
study
Muktishree Mahendra, Nikita Agrawal, Swapna Munaga, Sanjeev Tyagi
July-December 2016, 28(2):166-170
DOI
:10.4103/0970-7212.195433
Introduction:
A successful endodontic treatment depends upon complete debridement of microflora from the root canal system. However, due to complex root canal configuration, complete debridement through mechanical instrumentation alone cannot remove entire bacterial load. So the aim is
in vitro
evaluation of antimicrobial efficacy of biological extracts against
Enterococcus faecalis
MTCC-439 strain when used as intracanal medicaments. The medicaments used were Nissin, an antibiotic peptide; neem known for its antiseptic properties; platelet rich plasma (PRP) known for its regenerative properties and propolis, a resin extract derived from bees.
Materials and Methods:
Sixty single rooted lower premolar teeth which were extracted for orthodontic purpose were collected. Tooth specimens were sectioned at cement-enamel junction with a diamond saw to obtain a standard root length. The root canals of the specimen were instrumented with K3 rotary files followed by inoculation of
E. faecalis
strains and sealed with dental wax. The specimens were then kept in incubator for 21 days at 37°C and after that randomly divided into six treatment groups: Group I, 5 μL Normal saline; Group II, 5 μL Nisin (Vasta Biotech, Chennai); Group III, 5 μL propolis; Group IV, 5 μL neem; Group V, 5 μL PRP; Group VI, 5 μL Calcium hydroxide. Roots were then incubated for 7 days at 37°C. On 8
th
day, to evaluate the degree of infection, dentin chips from root canal of specimens were extracted with a sterile 6% K3 rotary file. Kruskal–Wallis test and Mann–Whitney U-test were applied for difference in colony forming units (CFUs) count for different medicaments.
Results:
In present
in vitro
study, Nisin showed no CFU while neem and propolis showed significantly less growth as compared to PRP and calcium hydroxide against
E. faecalis
.
Conclusions:
Nisin outreach propolis and neem in eliminating the
E. faecalis
when used as intracanal medicaments.
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6,468
794
Clinical evaluation of maintenance of apical patency in postendodontic pain: An
in vivo
study
Nisha Garg, Shruti Sharma, Ajay Chhabra, Aarushi Dogra, Ruhani Bhatia, Savita Thakur
July-December 2017, 29(2):115-119
DOI
:10.4103/endo.endo_28_17
Aim:
The purpose of this study was to compare the incidence of postoperative pain in 80 endodontically treated teeth, with and without apical patency, in relation to some diagnostic factors (vitality, presence of preoperative pain, group of treated teeth).
Materials and Methodology:
Apical patency was maintained during shaping procedures with a #10 K-file in one group (
n
= 40) and not in the other (
n
= 40). Root canal treatment was done in single visit. Pain was recorded 1st day, 2nd day and 7th day using VAS scale.
Results:
There were no statistically significant differences between patency and non patency groups regarding incidence and degree of postoperative pain. Only preoperative pain has significant effect on postoperative pain.
Conclusion:
Our study concluded that maintenance of apical patency did not increase the incidence of postoperative pain when considering all variables together.
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5,552
654
CASE REPORTS
Diagnostic and therapeutic approach in dens in dente
Walid Lejri, Ines Kallel, Omar Marwen, Nabiha Douki
July-December 2016, 28(2):192-198
DOI
:10.4103/0970-7212.195432
The dental invagination is an abnormal dental development merely agreed to be a gene-related disorder. There are three types of invaginations, of which Type I is the most common. The diagnosis is based on clinical and above all radiological examinations. An early prophylactic approach is often the most effective mean of treatment. This paper describes the clinical and radiographic features related to the different types of dens invaginatus and the therapeutic approach through several cases.
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11,674
916
Biradicular mandibular canine: A review and report of two cases
Akanksha Malik, Parul Bansal, Vineeta Nikhil, Digvijay Singh
July-December 2018, 30(2):159-162
DOI
:10.4103/endo.endo_92_17
Mandibular canine is generally considered to have one root and one canal, but it may possess two canals and even less frequently two roots and two or three canals. This article highlights the identification and endodontic management of two cases of a rare anatomical variation in mandibular canine with two roots and two canals.
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3,537
365
ORIGINAL ARTICLES
Anatomical relationship between roots of maxillary posterior teeth and maxillary sinus using cone-beam computed tomography
Mamta Kaushik, Pratyasha Kaushik, Neha Mehra, Roshni Sharma, Elkanti Soujanya, Uday Kumar
July-September 2020, 32(3):124-129
DOI
:10.4103/endo.endo_25_20
Aim:
Maxillary sinusitis of odontogenic origin accounts for approximately 10%–12% of maxillary sinusitis cases. The primary objective of the present study was to analyze the vertical relationship between the maxillary posterior roots and the adjacent maxillary sinus floor (MSF) in the Indian population using cone-beam computed tomography. The secondary objective was to correlate the data with age and gender.
Materials and Methods:
The shortest distance between 452 maxillary posterior teeth and the adjacent border of MSF was measured. The data were divided into three groups. Group IS included maxillary posterior teeth roots protruding into the sinus, Group CO included root apices contacting the MSF, and Group OS included root apices not contacting the MSF. The data obtained were correlated with age and gender.
Results:
The vertical distance of the root apices of second premolars from the MSF was significantly lesser compared to the root apices of first premolars (
P
< 0.05). The difference between the vertical distance of buccal roots and palatal roots (PRs) of first molar from the MSF was significantly more (
P
< 0.05). Majority of the roots of posterior teeth were located below the MSF border (Type OS). Type IS was most frequently seen for PRs of maxillary first molars (29.12%). The frequency of Type IS decreased with increasing age. The distance between the posterior root apices and the adjacent border of the MSF was found to be more in males compared to females.
Conclusion:
The PRs of maxillary first molars were found to be closest to the MSF. Variation in the vertical relationship was found by age and gender.
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2,916
276
Calcium ion release from four different light-cured calcium hydroxide cements
Wasifoddin A Chaudhari, Robin J Jain, Sameer K Jadhav, Vivek S Hegde, Manisha V Dixit
July-December 2016, 28(2):114-118
DOI
:10.4103/0970-7212.195426
Introduction:
The aim of this study was to compare calcium (Ca) ion-releasing capacity of four different light-cured calcium hydroxide [Ca(OH)
2
] cements with self-cured Ca(OH)
2
cement.
Materials and Methods:
Five different brands of Ca(OH)
2
cements were taken and they were grouped into five groups which are as follows: Group I - Dycal (control group), Group II - Septocal, Group III – TheraCal, Group IV - Cal LC, and Group V - Hydrocal. All specimens (
n
= 50) were prepared by mixing and curing the cements as per manufacturer's instructions. Each sample was placed on the bottom of a 4 cm high test tube in 10 ml deionized water at 37°C. This stored water was collected for Ca analysis and replaced after 7, 14, and 21 days. In this manner, ion release was measured after 7, 14, and 21 days by inductively coupled plasma-optical emission spectroscopy test.
Results:
Ca ion release from all groups at various time durations was measured and mean was calculated along with the standard deviation. These values were compared using two-way ANOVA and Tukey's
post hoc
test which showed highly significant result with
P
< 0.001.
Conclusions:
Within the limitations of this study, light-cured Ca(OH)
2
cements released high amount of Ca ions compared to self-cured Ca(OH)
2
cements. Group V (Hydrocal) and Group III (TheraCal) were found to be the highest light-cured Ca ion releasing materials.
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6,523
748
A comparative clinical study to evaluate the healing of large periapical lesions using platelet-rich fibrin and hydroxyapatite
Prashant Monga, Ruma Grover, Pardeep Mahajan, Vanita Keshav, Navkesh Singh, Gurbant Singh
January-June 2016, 28(1):27-31
DOI
:10.4103/0970-7212.184336
Aims:
To evaluate and compare the effectiveness of periapical surgery using mineral trioxide aggregate (MTA) as a retrograde filling material with/without using hydroxyapatite or platelet-rich fibrin (PRF) in curetted periapical defect and to evaluate the patients clinically and radiographically at each recall visit.
Subjects and Methods:
The study was conducted on thirty patients having periapical radiolucency in maxillary anterior teeth. The selected teeth were divided into three groups: Group A, Group B, and Group C having 10 teeth each. All the teeth were treated with single visit root canal treatment. The periapical curettage along with apicoectomy was followed thereafter. In all the groups, root end cavity was prepared. In Group A, root end cavity was filled with MTA. In Group B, root end cavity was filled with MTA followed by placement of hydroxyapatite in the curetted periapical defect. In Group C, root end cavity was filled with MTA followed by placement of PRF in the curetted periapical defect. In all the three groups, patient recall visits were scheduled after 1, 3, 6, and 9 months time interval for clinical and radiological examination.
Results:
A significantly higher rate of healing was observed after 9 months in Group C (82.36%) followed by Group B (65.16%) and Group A (60.12%).
Conclusions:
Placement of root end filling material contributes greatly to the success of surgical treatment. To enhance the healing of periapical defect, use of host modulating agents such as PRF is preferred over grafts as these are autologous and contain growth factors that promote faster healing of periapical defects.
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5,150
564
An in vitro comparison of push-out bond strength of biodentine and mineral trioxide aggregate in the presence of sodium hypochlorite and chlorhexidine gluconate
Shishir Singh, Rajesh Podar, Shifali Dadu, Gaurav Kulkarni, Snehal Vivrekar, Shashank Babel
January-June 2016, 28(1):42-45
DOI
:10.4103/0970-7212.184339
Aim:
The aim of this
in vitro
study was to compare the push-out bond strength of Biodentine (Septodont, Saint Maur des Fosses, France) and mineral trioxide aggregate (MTA) (Angelus, Londrina, PR, Brazil) when treated with 3% sodium hypochlorite (NaOCl) and 2% chlorhexidine gluconate (CHX).
Materials and Methods:
Forty-six single canal premolars were selected for this study, and the canal spaces were prepared with #5 Gates glidden drill (1.3 mm diameter). The dentin of these teeth was horizontally sectioned into 1-mm-thick slices at the mid-root level. The samples were divided into two groups (
n
= 20). Biodentine and MTA were placed into the canal space of dentin slices. The samples were wrapped in wet gauze for 10 min and divided into two subgroups (
n
= 10) to be immersed into 3% NaOCl and 2% CHX for 30 min. No irrigation was performed in the controls (
n
= 3). After incubation for 48 h, the dislodgement resistance of the samples was measured using a universal testing machine. The samples were examined under a stereomicroscope to determine the nature of the bond failures.
Results:
Biodentine showed significantly higher push-out bond strength than MTA (
P
< 0.05) in the presence of both NaOCl and CHX. Within the MTA group, CHX further reduced the push-out bond strength when compared with NaOCl.
Conclusion:
Push-out bond strength is the force needed for the displacement of the dental material tested. The various irrigants used during the root canal therapy may increase or decrease the push-out bond strength of a material.
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845
CASE REPORTS
Single-visit apexification with Biodentine and platelet-rich fibrin
Nitin Khanduri, Deepak Kurup
July-December 2018, 30(2):181-183
DOI
:10.4103/endo.endo_122_17
Apexification is the process of induction of calcific barrier across the open apex or the continued apical development in an immature tooth with infected necrotic pulp. The presented case was of a 19-year-old male patient with discolored and fractured upper front left tooth and open apex. Immature permanent teeth pose difficulties during endodontic treatment because of the wide-open root apex and thin dentin walls. This article describes single-visit apexification using Biodentine, a new calcium silicate-based material as an apical barrier along with platelet-rich fibrin as internal matrix.
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613
ORIGINAL ARTICLES
Phytomedicine: Herbal venture in green endodontics
Kuljit Kaur, Tarun Kumar, Sunandan Mittal, Renu Bansal
July-December 2018, 30(2):98-102
DOI
:10.4103/endo.endo_115_17
Introduction:
Nature has bestowed a very rich botanical wealth. Antimicrobial agents of plant origin have enormous therapeutic potential.
Azadirachta Indica (AI) & Aloe Barbadensis (AB)
are the natural product that has gained interest in endodontics as irrigant due to their antibacterial effectiveness against several endodontic pathogens. Hence the purpose of this
in vivo
study was to compare the antimicrobial efficacy of
herbal (Azadirachta Indica & Aloe Barbadensis)
with conventional (Sodium Hypochlorite and Chlorhexidine Gluconate) irrigants in infected root canals.
Methodology:
One hundred and twenty five patients satisfying the inclusion criteria were selected. Before and after the root canal preparation, two canal samples were obtained by a harvesting method using a sterile paper point and then transferred for microbiological study.
Results:
The results of present study indicated that use of Sodium Hypochlorite showed greatest percentage reduction in Aerobic Microbial Load (87.58%) followed by Azadirachta Indica (82.24%), Chlorhexidine Gluconate (78.32%), Aloe Barbadensis (27.22%) and Distilled Water (15.73%). In anaerobic microbial load Azadirachta Indica showed greatest percentage reduction (78.43%) followed by Chlorhexidine Gluconate (78.12%), Sodium Hypochlorite (75.16%), Distilled Water (12.38%) and Aloe Barbadensis (-9.74%).
Conclusion:
The results of present study indicate that the number of post-irrigant positive cultures (CFU/ml) was significantly lower than the pre-irrigant cultures in all the groups.
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3,701
655
An
in vivo
double-blind randomized controlled study comparing the postoperative pain in single sitting root canal treatment under bupivacaine versus lignocaine used as a local anesthetic agent
Sumita A Bhagwat, Anacleta Heredia, Leena V Padhye
January-June 2019, 31(1):2-8
DOI
:10.4103/endo.endo_1_18
Aim:
This
in vivo
double-blind randomized control trial was carried out to evaluate the efficacy of a long-acting local anesthetic bupivacaine in preventing postoperative pain associated with single sitting endodontic treatment and to compare it with lignocaine when used as a local anesthetic agent.
Methods:
A total of fifty patients with symptomatic irreversible pulpitis were selected to be included in the study. The patients were randomly divided into two groups: Group A patients were given lignocaine as local anesthetic and Group B were given bupivacaine. The root canal procedures for the patients were carried out in single sittings under rubber dam using hand ProTaper
™
system, 2.5% sodium hypochlorite as irrigant alternating with normal saline and obturation by lateral condensation technique. A questionnaire employing visual analog scale for pain assessment was given to the patient and instructions on how to fill the form were given. The patients were recalled after 2 days, and the pain was analyzed. The result was tabulated and statistically analyzed for incidence and degree of pain.
Results:
The mean overall postoperative pain for bupivacaine was lesser than that for lignocaine, and the difference was statistically significant.
Conclusion:
Based on our findings and in comparison with those of other studies, we reached the conclusion that it may be recommended that bupivacaine may replace lignocaine as the anesthetic of choice in the single visit endodontic protocol in order to reduce the incidence of postoperative pain often seen after single visit endodontic procedures.
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3,496
489
Comparative evaluation of shear bond strength of Biodentine, Endocem mineral trioxide aggregate, and TheraCal LC to resin composite using a universal adhesive: An in vitro study
Meenu Garg Singla, Palak Wahi
January-March 2020, 32(1):14-19
DOI
:10.4103/endo.endo_7_19
Introduction:
The efficacy of the bond between the restorative materials and the pulp capping materials has an important role in the success of vital pulp therapy.
Aims and Objective:
This study was conducted to investigate and compare the shear bond strength (SBS) of Biodentine, Endocem mineral trioxide aggregate (MTA), and TheraCal LC to resin composite using a universal adhesive at their respective initial setting time and to identify the specific modes of failure using a stereomicroscope at × 25 magnification.
Materials and Methods:
A total of 60 acrylic blocks were prepared. Each of the blocks were prepared 20 mm high and 12 mm diameter and had a central hole of 2 mm depth and 5 mm diameter. These acrylic blocks were divided into three groups of 20 samples each based on the liner that is condensed into prepared central hole as Group A – Biodentine, Group B – Endocem MTA, and Group C – TheraCal LC. Composite was then bonded to each sample using universal adhesive. SBS analysis was performed at a cross-head speed of 1 mm/min.
Observation and Results:
Mean SBS of Group B (Endocem MTA) with composite was found to be significantly lower than that of Group A (Biodentine) with composite which was further significantly lower than that of Group C (TheraCal LC) with composite.
Conclusion:
This present study concludes that the bond strength of resin-based light-curable TheraCal LC showed clinically acceptable and highest SBS values when used with a universal silane containing adhesive.
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4,770
687
Influence of access cavity design on the fracture resistance and root canal filling efficacy in simulated young permanent molars using cone-beam computed tomography: An
in vitro
study
N Greeshma Reddy, Sreebala G Naga, MG Manoj Kumar, NC H Srinivas, Shanthan Mettu, Dwitha Animireddy
July-September 2020, 32(3):130-136
DOI
:10.4103/endo.endo_34_20
Aims:
The aim of this study is to evaluate the influence of access cavity designs on the fracture resistance and root canal filling efficacy of simulated young permanent molars.
Methodology:
A total of seventy human unerupted impacted mandibular third molar teeth were collected. Ten were allocated as control; the remaining were designated as experimental, which were divided into three groups (20 each) based on access cavity design. All the samples were exposed to cone-beam computed tomography (CBCT) scanner before the access cavity preparation. Group I-The control group. Group IIa-traditional endodontic cavity (TEC), Group IIb-conservative endodontic cavity (CEC), Group IIc-ninja endodontic cavity (NEC). Endodontic access cavities were prepared and exposed to CBCT. Pre- and post-treatment percentage volumes of lost pericervical dentin were evaluated. Then the root canals were filled with calcium hydroxide and subjected to CBCT imaging for the evaluation of root canal filling efficacy. Evaluation of fracture resistance was carried out using a universal testing machine.
Results:
On observation, the volume of lost pericervical dentin was (14.8%) in TEC, (8.3%) in CEC and (6.8%) in NEC. There was no statistically significant difference (
P
> 0.05) between all the groups on root canal filling efficacy and the number of voids. Fracture resistance of the NEC and control group (
P
> 0.05) was greater compared to CEC and TEC.
Conclusion:
NEC is the accepted method that had better fracture resistance, with a minimum number of voids in the coronal and middle third of the root and had adequate apical seal compared to conservative and TECs.
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3
2,885
274
A comparative clinical study on the correlation of working length determined using three different electronic apex locators with radiographic working length: An in vivo study
Devi S Lekshmy, PR Deepthi, C Ganesh, George Chacko, A Abhilash, SL Satheesh, Lakshmi Aravind, Siddharth V Nair, Sreeja Sreedhar
January-June 2016, 28(1):18-22
DOI
:10.4103/0970-7212.184325
Aim:
This
in vivo
study was done to correlate the values of three different electronic apex locators: Root ZX, iPex, and Apex ID, with the radiographic working length (WL).
Materials and Methods:
Nineteen maxillary incisors with completely formed root apices indicated for endodontic treatment were chosen. After access preparation, coronal flaring and pulp extirpation, electronic measurement of WL was done with a No: 15 K file using the three devices on each tooth. A WL radiograph was then taken with the file placed within the canal and the length determined by following Ingle's method. The data were then analyzed using the correlation coefficient and
Z
-test.
Results:
Root ZX showed the maximum correlation (
r
= 0.9881) with radiographic WL followed by Apex ID (
R
= 0.9731) and iPex (
R
= 0.9508). Root ZX had a statistically significant higher correlation with radiographic WL in comparison with iPex (
P
< 0.05).
Conclusion:
Maximum correlation of readings with the radiographic length was shown by Root ZX followed by Apex ID and then by iPex.
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3
6,058
577
Comparative evaluation of 2% chlorhexidine gel and triple antibiotic paste with calcium hydroxide paste on incidence of interappointment flare-up in diabetic patients: A randomized double-blinded clinical study
Tapati Manohar Sinhal, Ruchi Rani Purvesh Shah, Nimisha Chinmay Shah, Pratik Subhas Jais, Krupali Dhirubhai Hadwani
July-December 2017, 29(2):136-141
DOI
:10.4103/endo.endo_20_17
Aim:
Clinical evaluation and comparison of the effect of 2% chlorhexidine gel and triple antibiotic paste with calcium hydroxide on incidence of interappointment flare-up in diabetic patients.
Materials and Methods:
Thirty-six diabetes mellitus patients seeking endodontic treatment were assigned to three groups: Group I - calcium hydroxide paste, Group II - triple antibiotic paste, and Group III - 2% chlorhexidine gel. Access opening and chemomechanical preparation was done followed by the placement of intracanal medicaments. Samples were then assessed for the incidence of intra-appointment flare-up at 1, 2, 3, 7, and 14 days using verbal rating scale. Obtained scores were statistically analyzed using one-way ANOVA test and Tukey's
post hoc
test.
Results:
Total incidence of interappointment flare-up was found to be 13%. For all the groups, statistically significant difference (
P
< 0.05) was seen at days 1, 2, 3, and 7, with insignificant difference at day 14. Intragroup comparison showed statistically significant difference present between Group I and II and Group I and III with (
P
< 0.05) at days 1, 2, 3, and 7. No statistically significant difference was seen between Group II and III in all 14 days.
Conclusion:
Both triple antibiotic paste and 2% chlorhexidine gel were significantly effective for minimizing the interappointment flare-up and postoperative symptoms in diabetic patients. 2% chlorhexidine gel found to be more effective clinically, as compared to other experimental groups.
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4,351
496
Comparison of efficiency of manual(H-Files) and two rotary niti retreatment systems(Mtwo R files and HyFlex NT files) in removing Gutta-percha from root canals obturated with two different sealers by using stereomicroscope - An
in vitro
study
Pravin Kumar, Himanshu Sood, Surekha Puri Bhat, Jitendra Lohar, Sandhya Kapoor Punia, Rahul Bhargava
July-December 2017, 29(2):95-100
DOI
:10.4103/endo.endo_16_17
Objectives:
The aim of this study was to compare manual and two nickel titanium (NiTi) rotary retreatment systems in removing gutta-percha obturated with two different sealers.
Materials and Methods:
Sixty extracted, human, single-rooted mandibular premolars were selected. Endodontic treatment was performed using ProTaper Universal NiTi rotary instruments. Half of the samples were obturated with Tubliseal and remaining half were obtutared with AH Plus sealer with cold lateral compaction method. Subsequently, twenty teeth were retreated with manual retreatment system, and each twenty teeth was retreated with two different rotary retreatment systems. The roots were then grooved longitudinally, and both root halves were subjected to assessment under stereomicroscope, and images were taken with a digital camera. These images were evaluated for residual obturating material using AutoCAD software. Analysis of variance test and Bonferroni multiple comparison test were used for statistical analysis.
Results and Conclusion:
Results of the present study showed that no system was able to completely remove all debris from the root canals. The minimum amount of debris was seen in the group obturated using Tubliseal sealer and retreated with Hyflex NT retreatment system followed by Mtwo retreatment system and finally the manual retreatment protocol. Regarding the time taken, Mtwo retreatment files took least time to remove the obturating material in all sealer groups.
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574
Comparison of Five different methods of Working length determination: An
ex vivo
study
Palani Selvi Kamaraj, Hemalatha Parandhaman, Vidhya Raguganesh
October-December 2020, 32(4):187-192
DOI
:10.4103/endo.endo_30_20
Aim:
The aim of the study was to determine the accuracy and reliability of working length determination using tactile sensation method, digital radiographic method, and electronic apex locator (EAL) in lower premolars
in vivo
and to compare the lengths so measured to the working length measured with cone-beam computed tomography (CBCT) and the actual working length (AWL) with magnifying loupe,
ex vivo
.
Materials and Methods:
Thirty mandibular premolars scheduled for orthodontic extraction were selected. Under local anesthesia, access cavities were prepared and the working lengths were determined by two operators after blinding, using the tactile sensation method, digital radiographic method (radiovisiography [RVG]), and EAL, and tabulated. The teeth were then extracted and subjected to CBCT to determine the working length (CBCTWL). The AWL of the teeth was measured with a K-file that was inserted into the root canal until the file tip is visible at the apical foramen which was confirmed using a magnifying loupe (×8). The values were then statistically analyzed.
Statistical Analysis:
The SPSS version 20 software (IBM Corp., Armonk, NY, USA) was used to perform statistical analyses, and the confidence interval was determined at
P
< 0.05. Kappa test was used for the determination of the intra-observer agreement for each method. The comparison of the means of the groups was assessed using repeated measures ANOVA with Greenhouse–Geisser correction and
post hoc
Bonferroni test.
Results:
There is a significant difference between the methods in determining the working length. Based on the correlation values on reliability, CBCT method has a more positive correlation with AWL measured using magnifying loupe, followed by EAL, RVG, and tactile sensation.
Conclusion:
Hence, we conclude that the use of EAL technique is clinically effective for measuring the working length which correlates more positively with the CBCTWL and AWL. Diagnostic CBCT scan can be used as a reliable method for determining the working length.
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4,489
410
REVIEW ARTICLE
Calcium sulfate applications in dentistry: A literature review
Yousof H Sinjab, Khaled H Sinjab, Claudia Navarrete-Bedoya, James L Gutmann
October-December 2020, 32(4):167-174
DOI
:10.4103/endo.endo_156_20
Calcium sulfate (CS) is a ubiquitous compound that has been incorporated in several medical and dental procedures. This can be attributed to its many advantageous characteristics, including being resorbable as well as its biocompatibility. Primarily, it was used to help treat a variety of osseous defects by acting as a bone substitute. Due to its unique properties, other therapeutic applications have been identified. Whilst the outcomes of these applications are varied, they have shown to be beneficial within the disciplines of endodontics, periodontics and oral & maxillofacial surgery. The aim of this review is to thoroughly discuss CS including its characteristics, chemical and physical properties, and known relative indications in dentistry. Clinical studies reporting the outcomes of CS for particular treatment modalities are further analyzed and discussed.
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3
4,633
437
CASE REPORTS
High strength and bonding achieved with new flexible EverStick posts: A case report
Asit Vats, Sanjeev Srivastava, Mitali Kukreja, HS Chhabra
July-December 2016, 28(2):188-191
DOI
:10.4103/0970-7212.195429
Tooth structure that remains after endodontic treatment has been undermined and weakened by all of the previous episodes of caries, fracture, tooth preparation, or restoration. A post and core becomes a necessity in most of the cases. The tooth is further weakened when the clinician decides to give a full coverage crown which leads to greater tooth structure loss. In these two case reports, a novel technique has been discussed involving a new material in which lost tooth structure is restored by means of direct composite resin. The teeth following the treatment are structurally strong and possess good esthetics.
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7,779
911
ORIGINAL ARTICLES
Comparative evaluation of push-out bond strength of resin-based sealer and mineral trioxide aggregate-based sealer after using normal saline and 2% chlorhexidine as a final irrigant:
In vitro
study
Pooja Ravindrakumar Gupta, Shalini D Aggarwal, Shirin P Kshirsagar, Karan Bhargava, Vinay Rai, Monika Chawla
January-June 2016, 28(1):32-37
DOI
:10.4103/0970-7212.184337
Aim:
The aim of this study was to compare the push-out bond strengths of a resin-based sealer and a mineral trioxide aggregate (MTA)-based sealer after using normal saline and 2% chlorhexidine (CHX) as the final irrigant.
Materials and Methods:
Fifty percent of the samples were irrigated with 2% CHX, and other 50% samples were irrigated with normal saline as the final irrigant. Each set of twenty samples was then further split into groups based on the sealer used. For Group 1 - AH Plus
®
(Dentsply, Maillefer, Ballaigues, Switzerland), a resin-based sealer was used after using normal saline as the final irrigant (
n
= 10). In Group 2 an MTA-based sealer was used after using normal saline as the final irrigant (
n
= 10). In Group 3, AH Plus
®
(Dentsply, Maillefer, Ballaigues, Switzerland) was used after using 2% CHX as the final irrigant (
n
= 10). In Group 4, an MTA-based sealer was used after using 2% CHX as the final irrigant (
n
= 10). After obturation, all the samples were cut perpendicular to their long axis to obtain slices of 3mm each from the coronal and middle third. The discs were then subjected to assess the push-out bond strength by using the Universal Testing Machine.
Results:
AH Plus
®
(Dentsply, Maillefer, Ballaigues, Switzerland) showed a significant higher push-out bond strength as compared to the MTA-based sealer after using both saline and 2% CHX. The highest Push-Out Bond Strength was seen with AH Plus
®
(Dentsply, Maillefer, Ballaigues, Switzerland) after using 2% CHX.
Conclusion:
AH Plus
®
(Dentsply, Maillefer, Ballaigues, Switzerland) after using CHX as the final irrigant has shown the best result among all the groups.
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4,529
448
Comparative evaluation of dissolution of a new resin-coated Gutta-percha, by three naturally available solvents
Gaurav Kulkarni, Rajesh Podar, Shishir Singh, Shifali Dadu, Rucheet Purba, Shashank Babel
July-December 2016, 28(2):143-147
DOI
:10.4103/0970-7212.195442
Introduction:
The aim of this study was to evaluate and compare the effectiveness of eucalyptus oil, orange oil, and clove oil in dissolving resin-coated Gutta-percha (RCGP) cones.
Materials and Methods:
RCGP cones (EndoREZ,) (
n
= 70) and conventional GP cones (
n
= 70) with ISO size 25 and 4% taper were used for the study. Cones of each type were divided into three groups of twenty each, for immersion in eucalyptus oil, clove oil, and orange oil for 5 and 15 min immersion times. Ten GP cones from each group served as control and were immersed in distilled water. Each sample was weighed initially before immersing in the respective solvents. Cones were removed after specified immersion period, washed in distilled water, and allowed to dry. The samples were then re-weighed and statistical analysis was done.
Results:
Orange oil was most effective in dissolving both RCGP and conventional GP when compared to eucalyptus and clove oil. RCGP dissolved more readily than conventional GP in orange oil.
Conclusion:
Orange oil was the most effective solvent of EndoREZ RCGP and conventional GP among all tested solvents.
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4,424
399
Efficacy of calcium hydroxide, mushroom, and
Aloe vera
as an intracanal medicament against
Enterococcus faecalis
: An
in vitro
study
Bijo Kurian, DV Swapna, Roopa R Nadig, MA Ranjini, K Rashmi, Subha Rani Bolar
July-December 2016, 28(2):137-142
DOI
:10.4103/0970-7212.195427
Introduction:
To evaluate and compare antimicrobial efficacy of calcium hydroxide, extracts of mushroom and
Aloe vera
leaves against
Enterococcus faecalis
, and to assess the minimal inhibitory concentration (MIC) of extracts of mushroom and
A. vera
against
E. faecalis.
Materials and Methods:
Ninety freshly extracted single-rooted teeth were decoronated and canals enlarged up to F3 (ProTaper). The samples were sterilized and infected with
E. faecalis
and incubated for 21 days. Teeth samples were then divided into three groups. Group 1: calcium hydroxide, Group 2: mushroom extract, and Group 3:
A. vera
extract. At the end of 1, 3, and 5 days, microbiological sampling and culturing were done from the root canal dentinal shavings obtained and colony forming units (CFUs) were counted. The MIC was determined for two plant extracts against
E. faecalis
strains using ELISA microdilution method. Statistical analysis was done using analysis of variance technique and multiple comparisons were done using (
post hoc
test) Bonferroni test.
Results:
The number of CFUs was statistically significant in all the groups. Percentage reduction of CFUs was highest in mushroom followed by
A. vera
and calcium hydroxide. MIC for calcium hydroxide was 40 mg/ml,
A. vera
extract 60 mg/ml, and for mushroom extract 40 mg/ml.
Conclusions:
Antibacterial activity of the mushroom extract was highest followed by
A. vera
extract and then calcium hydroxide, at all time periods tested in this study. Antibacterial activity of all the groups increased with time.
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April, 2016