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   Table of Contents - Current issue
January-June 2018
Volume 30 | Issue 1
Page Nos. 1-96

Online since Monday, June 4, 2018

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Social media and networking: Its growing importance in endodontics p. 1
Sanjay Miglani
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Comparative evaluation of oxytetracycline versus QMix, MTAD, and ethylenediaminetetraacetic acid as smear layer removal agents: An in vitro study p. 2
Meenu Garg Singla, Nikhil Relhan, Himanshu Aggarwal
Aim: The aim is to evaluate the smear layer removal efficacy of Oxytetracycline and compare it with different endodontic irrigating solutions (QMix, mixture of tetracycline, citric acid, and detergent [MTAD] and ethylenediaminetetraacetic acid [EDTA]) under scanning electron microscope (SEM). Materials and Methods: Fifty single-rooted teeth were decoronated. All the root canals were shaped with K3XF rotary Ni-Ti instruments (#30.,06) and irrigation was done with 2 ml of 5.25% sodium hypochlorite (NaOCl) solution between each file change. The samples were divided randomly into the 5 groups (n = 10) depending on the final irrigant used as follows: 5.25% NaOCl as control (Group 1), 17% EDTA (Group 2), QMix (Group 3), BioPure MTAD (Group 4), and Oxytetracycline (Group 5). The final irrigation was done using 5 ml of the respective irrigating solutions, each for 60 s. Specimens were fractured longitudinally. For each root, the half containing most visible part of apex was selected for the SEM analysis. The presence/absence of smear layer was evaluated at the coronal, middle, and apical third of the root canal using three score criteria. Data were analyzed using Mann–Whitney U-test and Kruskal–Wallis test. Results: QMix showed the least smear layer scores followed by MTAD, EDTA, NaOCl, and Oxytetracycline. Conclusion: Within the limitation of this study, it can be concluded that the test irrigant Oxytetracycline failed to remove the smear layer throughout the entire length of the root canal.
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Comparative evaluation of different gutta-percha disinfecting agents: A microbiological study p. 9
Singh Shailja, Chandra Ramesh, Saxena Anubha, Siddiqui Shazia
Aim: The purpose of this study was to evaluate the effectiveness of chemical agents and herbal alternatives such as Aleo vera, Neem, and Amla for rapid decontamination of GP cones. Materials and Methods: The reference strains of E. Faecalis were obtained, to know the efficacy of different agents aginst this microbe. Two experimental groups used in this study comprises of Herbal agents and chemical agents. The extracts of the Herbal agents which included amla, aloe vera, neem were prepared whereas the chemical agents were commercially available. Chemical agents • Group 1% – 5% Sodium hypochlorite • Group 2% – 2% Glutaraldehyde • Group 3% – 2% CHX. Herbal agents • Group 4 – Amla • Group 5 – Aloe vera • Group 6 – Neem. The zone of inhibition of the different herbal and chemical agents were checked in two different media. Results: The result of the study showed that CHX was effective in disinfection of GP cones for 1 min followed by glutaraldehyde and sodium hypochlorite. Whereas, Amla was the most effective herbal extract in disinfecting GP followed by Aloe vera and Neem. Conclusion: t CHX and glutaraldehyde are efficient chemical disinfectants. Herbal agents also hold a promising future as a medium for disinfection, in which Amla gave the best results within a short duration of time.
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Root canal morphology of premolar teeth in the population of Maharashtra (Pune) compared to the other Indian population p. 15
Kulwinder Singh Banga, Ajinkya Mansing Pawar, Deepak Nagpal, Jayant Landge, Bhagyashree Thakur, Sweta Rastogi
Aim: The current study aimed to investigate the root canal anatomy and their variations associated with premolar teeth in a defined population using tooth-clearing technique. Materials and Methods: Three hundred extracted premolar teeth (maxillary and mandibular) were collected from western Maharashtra (Pune). Access cavities were prepared and samples were placed in 2.5% sodium hypochlorite for 48 h. They were then decalcified with 5% nitric acid, dehydrated, and rendered clear by immersion in methyl salicylate, and methylene blue dye was injected. After staining, cleared teeth were evaluated for (i) number of roots and root canals, (ii) number of apical foramina, (iii) shape of root, (iv) type of root canal based on Vertucci's classification, (v) presence of lateral canals and their locations, and (vi) presence of root curvatures. Results: Vertucci Type I canal configuration represented the highest percentage (72.66%) followed by Type II (11.66%), Type III (6.33%), Type IV (4.66%), Type VI (2.66%), Type V (1.66%), Type VIII (0.66%), and C shaped (2.33%). Accessory canals were detected in 22.8% and intercanal connections were observed in 24.8% while 54% showed apical delta. Conclusion: Such knowledge is clinically useful for localization, negotiation, and subsequent management of premolar teeth in the studied population.
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Comparative evaluation of buckling resistance of Proglider and One-G file: An in vitro study p. 21
Priyanka Himmatrao Patil, Meenal Nitin Gulve, Swapnil Janardan Kolhe
Aim: Comparative evaluation of buckling resistance of Proglider and One-G file, An In vitro Study. Materials and Methods: The test instruments – Proglider and One-G files were subjected to a devised buckling resistance test, which consisted of the application of an increasing load in the axial direction of the instrument by using a universal testing machine. The maximum load required to generate a lateral elastic displacement of 1 mm was recorded for each instrument. Data were analyzed using the one-way ANOVA test. Results: The results indicated that the buckling resistance of One-G files is significantly better than Proglider files (P < 0.05). Conclusion: One-G rotary files manufactured with conventional nickel-titanium alloy showed higher buckling resistance compared to Proglider files manufactured with M-wire alloy.
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Evaluation of healing after periapical surgery using platelet-rich fibrin and nanocrystalline hydroxyapatite with collagen in combination with platelet-rich fibrin p. 25
Monika Thanikasalam, Shafie Ahamed, Sai Sathya Narayana, S Bhavani, G Rajaraman
Aims: This study aims to demonstrate the bone regeneration in the periapical region using platelet-rich fibrin (PRF) and nanocrystalline hydroxyapatite (NcHA) with collagen in combination with PRF and their effects on healing in periapical tissues. Subjects and Methods: Fourteen patients (15 surgical sites) were selected and distributed into three groups: Group I – Replacement with PRF, Group II – Replacement with PRF and NcHA with collagen bone graft (SYBO GRAF – C, Eucare pharmaceuticals ltd., Chennai, Tamil Nadu, India), and Group III – Control group. In all the three groups, patient recall visits were scheduled after 1-, 3-, and 6-month time interval for clinical and radiological examination. Radiovisiography image was analyzed using RADIANT Digital Imaging and Communications in Medicine VIEWER. Results: A significantly higher rate of healing was observed after 6 months in Group II (100%) followed by Group I (92%) and Group III (86%). Conclusion: It was concluded that combination of PRF and nanocrystalline hydroxyapatite with collagen produced a significantly faster bone regeneration. The conventional technique and PRF were less predictable with its healing response.
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Root canal cleanliness after preparation with ultrasonic handpiece and hand instruments: An in vitro comparative scanning electron microscope study p. 32
Sunil B Rao, R Nageswar Rao, VC Sunil Kumar, Roopa Babannavar, Manjunath Muniyappa, Shah Naman
Aim and objective: This study aims to compare the efficacy of root canal cleanliness using hand instrumentation and ultrasonic handpiece under the scanning electron microscope. Materials and Methods: Forty five central incisor were collected and access opening was done. cleaning and shaping of all the samples were done with three different groups 1- Ultrasonic file. group-2 with Hand files and Group-3 were prepared with Ultrasonic + hand files and debris and smear layer were evaluated with SEM . Results: Group 1 (ultrasonic) removed smear layer superiorly, followed by Group 3 (ultrasonic/hand instrumentation) and Group 2 (hand instrumentation), and Group 3 (ultrasonic/hand instrumentation) showed superior cleanliness of debris followed by Group 1 (ultrasonic) and Group 2 (hand instrumentation). Conclusion: (1) At the apical, middle, and coronal third level for removal of debris, Group 3 showed superior cleanliness followed by Group 1 and Group 2. (2) At the apical, middle, and coronal third level for removal of smear layer, Group 1 showed superior cleanliness followed by Group 3 and Group 2.
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Quantitative assessment of surface roughness with chlorine dioxide irrigant on root canal dentin by three-dimensional confocal laser scanning microscopy p. 38
Rejitha R Kamalasanan, Swapna V Devarasanahalli, MA Ranjini, Mohd Sibghatullah Khatib, Suby Khan, Roopa R Nadig
Aim: (1) To evaluate the active chlorine concentrations of 3% sodium hypochlorite (NaOCl), 5% chlorine dioxide (ClO2) and 13.8% ClO2using iodometric titration. (2) To evaluate the effects of different concentrations of ClO2 (5% and 13.8%) with or without 17% ethylene diamine tetraacetic acid (EDTA), on the surface roughness of radicular dentin using three-dimensional-confocal laser scanning microscopy (CLSM). Materials and Methods: Fifty extracted human permanent single rooted mandibular premolars were decoronated, longitudinal split into halves and randomly divided into five groups based on the different irrigation regime: Group 1: 3% NaOCl + 17% EDTA, Group 2: 5% ClO2 +17% EDTA, Group 3: 5% ClO2,Group 4: 13.8% ClO2,and Group 5: Saline. The specimens were observed under CLSM to measure the surface roughness. Iodometric titration of the test irrigants were done to evaluate the concentration of active chlorine. Data were statistically analyzed using one-way analysis of variance and Bonferroni test. Results: Mean surface roughness values to root canal dentin were as follows: 13.8% ClO2 >3% NaOCl + 17% EDTA >5% ClO2 + 17% EDTA >5% ClO2> Saline. The active chlorine concentration was highest for 13.8% ClO2and chlorine loss % was highest for 5% ClO2. Conclusion: According to the present study, 5% ClO2produced root canal dentin roughness with minimal erosiveness, which is advantageous. Hence, it can be considered to be an alternate endodontic irrigant. Nearly 13.8% ClO2should be reevaluated as an irrigating solution, because of its significiant dentin roughness and thus it can promote microleakage.
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A comparative evaluation of the efficacy of different mandibular anesthetic techniques in patients with irreversible pulpitis p. 45
Rini Sharma, T Jayakumar, S Lekha, A Srirekha, Srinivas Panchajanya, RS Shwetha, Kamal Odedra
Aim: To determine the most efficacious anaesthetic technique in irreversible pulpitis by comparing the anaesthetic efficacies of Gow-Gates, Vazirani-Akinosi, Inferior alveolar nerve block with buccal infiltration and conventional Inferior alveolar nerve block (IANB) using 2% Lidocaine with 1:80,000 epinephrine as the anaesthetic agent in mandibular first molars. Methodology: 120 patients with inflamed vital pulp and lingering pain on removal of the stimulus were randomly divided into 4 groups in which the local anaesthetic was administered by the different techniques. Group I (n = 30) Gow-Gates technique. Group II (n = 30) Vazirani-Akinosi technique. Group III (n = 30) IANB with buccal infiltration. Group IV (n = 30) Conventional IANB. Anaesthesia was considered effective when ''no pain'' or “mild pain” felt by the patient during access preparation. Results: The Statistical software used were SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1. The results demonstrated that the Gow-Gates technique showed greater anaesthetic success (66.7%) followed by Vazirani Akinosi technique (60%) as compared to the conventional IANB. There was however no statistical significance observed between the groups. Conclusion: Gow Gates mandibular conduction block may increase the anaesthetic success rates in cases of irreversible pulpitis in mandibular molars as compared to other techniques.
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Comparison of effect of ethylenediaminetetraacetic acid solution and ethylenediaminetetraacetic acid paste on canal transportation using cone beam computed tomography: An in vitro study p. 50
Rohit Anil Tambake, Sadashiv Daokar, Kalpana Patil, Sejal Shinde Tambake, Prachi S Mapari, Pawan Raktade
Aims: The aim of the present study was to compare the effect of saline, ethylenediaminetetraacetic acid (EDTA) 17% solution and EDTA paste on root canal transportation. Subjects and Methods: Moderately curved mesiobuccal roots of 24 maxillary molars were standardized in length and randomized into one control and two experimental groups. All teeth were scanned by cone beam computed tomography (CBCT) to determine the root canal shape and measure the parameters required for comparison before instrumentation. The canals were instrumented with 0.06 taper rotary files to size #25. All groups were irrigated with saline. Group 1 was prepared with RC-Prep (Premier Dental, Philadelphia, PA, USA) and in Group 2, EDTA 17% solution (Pulpdent Corp., Watertown, MA, USA) was used. After preparation, postinstrumentation scan was performed. Pre- and post-instrumentation images were obtained at three levels, 3 mm from the apical end of the root (apical level) and 3 mm below the orifice from the coronal level (15 mm from the apex) and the mid-root level (8 mm from the apex) were compared using CBCT software. The amount of canal transportation was assessed. Statistical Analysis Used: The data were analyzed with one-way analysis of variance (α = 0.05) and the Tukey post hoc test. Results: Less canal transportation was observed in experimental groups than the control group. Group 1 showed significantly less canal transportation than Group 2 and control group. Conclusions: EDTA preparation had a significant effect on canal transportation.
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Comparison of new irrigating solutions on smear layer removal and calcium ions chelation from the root canal: An in vitro study Highly accessed article p. 55
Anika Mittal, Shifali Dadu, Bidya Yendrembam, Anju Abraham, Neetu Sharma Singh, Paridhi Garg
Background: The action of endodontic instruments leads to the formation of smear layer during biomechanical preparation. Smear layer removal not only enhances the three-dimensional sealing of the root canal system but also improves the dentinal tubule disinfection. Aim: With the help of scanning electron microscope (SEM), assessing the effectiveness of smear layer removal from the root canal wall using various final irrigating solutions, and to quantify, the concentration of calcium ions in these solutions after irrigation using atomic absorption spectrophotometry with flame. Materials and Methods: Forty human maxillary canines were selected and prepared and the final irrigation was performed to quantify the concentration of calcium ions released with 0.2% chitosan, apple cider vinegar, and 15% ethylenediaminetetraacetic acid (EDTA), which were then composed and analyzed using atomic absorption spectrometry. From the middle and apical thirds of the root canal, the smear layer removal was evaluated using SEM. Results: There was statistically significant difference between 0.2% chitosan and the other solutions with regard to smear layer removal. The highest concentrations of calcium ions were obtained with apple cider vinegar followed by 0.2% chitosan and 15% EDTA. Conclusion: Nearly 0.2% chitosan showed greater smear layer removal as compared to apple cider vinegar which enhanced the release of the highest concentrations of calcium ions than the other solutions verified.
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Evaluation of bacterial contamination of dental unit water lines before and after the use of 1% (Lysoformin 3000) disinfectant and awareness of the dental unit waterline disinfection among the practicing dental surgeons of Vadodara city p. 62
Dhaval Bhadra, Nimisha Shah, Parth Patel, Meetkumar Dedania
Purpose: The aim is to evaluate the bacterial contamination in dental unit waterlines (DUWLs) before and after the use of the disinfectant 1% (Lysoformin 3000) for its efficacy also assess the awareness about the same among the practicing dental surgeons of Vadodara city. Methodology: A volume of 20 ml water samples from the DUWLs from the clinics of the practicing dental surgeons of Vadodara city was collected. And were asked to answer a validated questionnaire in private. Disinfection of the waterlines was performed twice a week for 2 weeks with 1% disinfectant (Lysoformin 3000) and the samples were again collected. Qualitative and quantitative microbiological analysis was performed for both the predisinfected and postdisinfected samples. Results: Predisinfection samples showed a mean colony count of 670.35 colony forming unit (CFU)/ml which was reduced to 63.90 CFU/ml (P < 0.001) postdisinfection. Questionnaire assessment showed that 70% awareness of the participants about DUWL infections and the microorganisms associated. However, only 20% practiced any type of DUWL disinfection. Conclusion: Lysoformin 3000 can be promising to be used a DUWL disinfection solution as an easy to use and readily available solution with great antibacterial properties. However, still more long-term studies are required to check for its efficacy in anaerobic bacteria as well as resistant species of microorganisms.
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Comparative evaluation of the antibacterial activity of two Biocompatible materials i.e. Biodentine and MTA when used as a direct pulp capping agent against streptococcus mutans and Enterococcus faecalis- An in vitro study p. 66
Aditi Subodh Jain, Asmita Singh Gupta, Rupika Agarwal
Aim: This study aims to evaluate and compare the antibacterial potential of biodentine and mineral trioxide aggregate (MTA) cement against Streptococcus mutans and Enterococcus faecalis. Materials and Methods: Biodentine and MTA were used to assess the antibacterial efficacy against S. mutans and E. faecalis., using the agar well diffusion test. Agar plates were incubated at 37°C for 24 h in an incubator. The diameter of bacterial inhibition zones around each well was measured to the nearest size in mm with a digital caliper. Results: Inhibition zones formed by Biodentine against S. mutans and E. faecalis were significantly larger than the zones formed by MTA (P < 0.05). Conclusion: From the present study, it can be concluded that Biodentine and MTA have antimicrobial activity against S. mutans and E. faecalis, but higher mean zone of inhibition was recorded in biodentine.
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A randomized controlled study of the use of mineral trioxide aggregate angelus (white) and biodentine as pulp capping materials p. 69
Shanmugapriya Baskaran, Shafie Ahamed, Sai Sathya Narayana, S Bhavani, G Rajaraman
Introduction: The purpose of the present study was to evaluate the short-term clinical outcomes of pulp capping using mineral trioxide aggregate (MTA) Angelus (Angelus Londrina, PR, Brazil) or Biodentine (Septodont, Saint Maur des Fosses, France) as capping materials in a prospective randomized controlled study. Subjects and Methods: A total of 50 teeth were confirmed to eligible for pulp capping randomly assigned into either the MTA Angelus or the Biodentine Group (25 teeth per group). Direct\indirect pulp capping was performed using these two materials, and clinical and radiographical evaluations were performed at 0, 3, and 6 months after the treatments. Teeth with no response to pulp vitality test and those exhibiting clinical or radiographic signs and/or symptoms of irreversible pulpitis or pulp necrosis were considered to be failures. Results: Forty-five patients (47 teeth) were examined at the 6-month follow-up (patient recall rate = 92%); 23 of these teeth were in the MTA Angelus group, and 24 were in the Biodentine group. The overall success rate was 93%, and the success rates in the MTA Angelus and Biodentine groups were 95.5% (21/23 teeth) and 96% (23/24 teeth), respectively. Statistical analyses of these success rates did not reveal any significant difference between the groups. Conclusions: In this randomized controlled study, no significant difference in the short-term clinical outcomes of direct\indirect pulp capping using MTA Angelus or Biodentine as the capping material was found.
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Successful surgical retreatment of a midroot fracture in the mandibular incisor p. 76
IB Geeta, P Sindhu Padmanabha, Apoorva Saxena
Root fractures account 0.5-7% of all the dental traumatic injuries, with only 5% incidence in mandibular incisors. Management of horizontal root fracture presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fractured fragments. Achieving stable fracture reduction is inversely proportional to the severity of dislocation, mobility and pulpal injury. Extraction and replacement is the treatment for severely mobile teeth. Endodontic intervention is required for non- healing fractures. This case report presents a successful surgical retreatment of horizontal root fracture of a mandibular incisor using fiberpost. The fiberpost, as intra-radicular splint, represents conservative approach for treatment of horizontal root fracture rather than succumbing the tooth for extraction.
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Intentional reimplantation p. 81
Ashish K Jain, Ashima Jakhar, Nitesh Dahiya, Palavi Anish Naware
The aim of this case report is to highlight the importance of intentional reimplantation as an alternative to endodontic surgery, where due to the vicinity of critical anatomical structures, surgical approach was risky. Atraumatic extraction was performed followed by the removal of previously extruded gutta-percha, re-root canal treatment, and along with root-end filling with mineral trioxide aggregate, preceding reimplantation.
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Maxillary first molar with two roots and two root canals: A rare case report p. 84
Parul Bansal, Vineeta Nikhil, Pulkit Malhotra, Vishakha Singh
A thorough knowledge of root canal morphology and good anticipation of their possible morphological variations may help to prevent iatrogenic errors and ensure success. The morphology of permanent maxillary first molar has been studied extensively with more emphasis on extra number of roots and root canals; however, the presence of two canals in two-rooted maxillary first molar has rarely been documented in the literature describing tooth and root canal anatomies. This case report documents the successful endodontic management of a two-rooted maxillary first molars with two canals, which was present bilaterally.
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Tooth reattachment: Reincarnating the originals p. 88
Indra Gupta, Apoorva Khullar, Niharika Mishra, Surabhi Ghosh
The following article comprises three cases of coronal fracture of anterior teeth depicting various treatment modalities, including endodontic treatment of the tooth followed by post placement and reattachment of the fragment to reciprocate the original form and function. Furthermore, we have tried to reattach a fragment without interfering with the vitality of the tooth to let the injured pulp heal naturally and the results are encouraging.
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Event report p. 95
Shikha Kanodia
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Retraction: 'Barodontalgia- A review p. 96

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