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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
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.
  13,361 333 1
Negotiating the bends: An endodontic management of curved canals – A case series
Mithra Nidarsh Hegde, Anish Kumar Lagisetti, Manjiri N Honap
July-December 2017, 29(2):160-163
Negotiating the dilacerated and S-shaped roots often present a challenging situation in their Endodontic treatment. An insight of canal anatomy, coronal preflaring, precurving of all the hand instruments and use of smaller number files facilitates easy negotiation of canal curvature and maintenance of the shape without any procedural mishaps. All hand files are used in present cases with balanced force technique which has advantages of less extrusion of debris, less iatrogenic errors, and maintenance of instrument centrally. A thorough assessment of preoperative radiographs coupled with careful approach yielded into a safe and a successful endodontic treatment of such teeth. This case series presents two such interesting cases of endodontic management of curved canals.
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Retrieval of fractured Ni-Ti rotary instrument using ultrasonics and file braiding technique under surgical operating microscope
Velmurugan Natanasabapathy, Sathish Sundar, Vishnupriya Koteeswaran
January-June 2017, 29(1):65-68
During routine endodontic therapy, a clinician may encounter many procedural errors and obstacles which may alter the course of treatment; one such error is instrument separation. A separated instrument prevents complete cleaning and shaping of the root canal and this might potentially influence the course of the treatment. Hence, every attempt must be made to retrieve the broken instrument. There are various instrument retrieval kits and chairside techniques available for this purpose. The present case report is about the successful retrieval of separated nickel-titanium rotary instrument with the help of ultrasonics and file braiding technique under surgical operating microscope.
  2,972 338 -
Revolutionary development of endodontic instruments and its implications
Hyeon-Cheol Kim
July-December 2016, 28(2):90-91
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Sanjay Miglani
July-December 2016, 28(2):89-89
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Diagnostic and therapeutic approach in dens in dente
Walid Lejri, Ines Kallel, Omar Marwen, Nabiha Douki
July-December 2016, 28(2):192-198
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.
  2,738 278 -
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
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.
  2,451 536 1
Management of anterior tooth trauma: Two case reports
Suman Kaushik, Ritu Sharma, Vikram Sharma, Gaurav Setya, Garima Assudani, Anshul Arora
January-June 2016, 28(1):64-67
Various treatment options may be employed for coronal fracture of anterior teeth and root, depending on the level of fracture. The following case reports highlight the anterior tooth trauma managed with reattachment of fractured segments using post and cores. In the first case, an easy and ultraconservative technique without any tooth preparation is used which involves intraradicular support, i.e., fiber post and core. In the second case, an interdisciplinary approach is used to treat the root fracture where biological width was encroached. The flap was raised to expose the fractured root with a small amount of osteoplasty so that the segments could be checked for exact fit and bonding can be done with proper isolation of the operating field. Successful esthetics and function were restored by conservative and economical means, and 6 months follow-up showed no failure of bonding or postoperative pain, indicating crown, and horizontal root fracture after trauma should not go for extraction.
  2,609 302 -
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
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.
  2,593 263 1
Endodontic treatment of the maxillary central incisor with sequelae of dental trauma
Luiz Fernando Machado Silveira, Josue Martos, Melissa Feres Damian, Karoline Von Ahn Pinto
January-June 2016, 28(1):46-49
Dental trauma in immature teeth with necrotic pulp and apical foramen with large thin and fragile walls becomes a challenge to treat conventional endodontic treatment. The objective of this report is to demonstrate a clinical case in which the apexification through calcium hydroxide-based dressing, succeeded in forming a calcified apical barrier. It concluded that a barrier with mineral trioxide aggregate superimposed with the endodontic obturation of gutta-percha advocated in the central incisor led to a successful endodontic procedure.
  2,553 163 -
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
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 8th 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.
  2,208 410 -
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
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.
  2,233 346 1
Comparative evaluation of efficacy of three different irrigation activation systems in debridement of root canal isthmus: An in vitro study
Sunanda Gadaalay, Shruti Ishwar Hariramani, Praveen Dhore, Anita Kale, Madhuri Agrawal, Saurabh Doshi
January-June 2017, 29(1):39-42
Objective: The purpose of this study was to evaluate the effectiveness of different irrigation activation devices in removing debris from the isthmus area of mandibular molars. Materials and Methods: A total of 50 extracted human mandibular molars were selected, and access cavity was prepared. After determining the working length, instrumentation was done till ProTaper F2 with simultaneous irrigation with 5.25% NaOCl and 17% ethylenediaminetetraacetic acid. Later, the samples were divided into five groups containing ten samples each, that is, Endo-Irrigator Plus, EndoActivator, passive ultrasonic irrigation (PUI), manual dynamic activation (MDA), and control group. About 5.25% NaOCl was used for irrigation activation. Mesial roots were sectioned 4 mm from the apex and observed under a stereomicroscope at ×× 10 magnification for the presence of debris. Results: The Endo-Irrigator Plus demonstrated the least amount of debris followed by EndoActivator, PUI, MDA, and then control. There was statistically significant difference between the first three groups and MDI and control. However, there was no statistically significant difference between the first three groups. Conclusion: In this study, none of the devices were able to remove the debris completely. Nevertheless, Endo-Irrigator Plus, EndoActivator, and PUI could be used as effective irrigation activation devices.
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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
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.
  2,029 296 -
Smear layer removal efficacy of herbal extracts used as endodontic irrigants: An in vitro study
MA Sebatni, AA Kumar
January-June 2017, 29(1):35-38
Aim: This study aimed to evaluate the smear layer removal efficacy of various herbal extracts, namely, green tea extract, orange oil, and neem leaf extract using the scanning electron microscopic analysis. Materials and Methods: The samples were divided into four groups having ten teeth each (n = 10); the groups were divided accordingly, Group A: sodium hypochlorite (control), Group B: green tea extract, Group C: orange oil, and Group D: neem leaf extract. Each tooth was then split longitudinally and was prepared for examination by scanning electron microscope under ×1500 and ×3000. Statistical Analysis: The smear layer removal scores were compared statistically within the groups using analysis of variance and Tukey's honest significant difference test (P < 0.05). Results: The canals treated with neem leaf extract exhibited significant smear layer removal when compared to those treated with orange oil, sodium hypochlorite, and green tea extract. Conclusion: The highest amount of smear layer removal efficacy was seen in the canals treated by neem leaf extract.
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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
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.
  2,003 195 -
Endodontic management of variations in root canal configuration of maxillary first molar: Two case reports
Neelam Mittal, Reema Malik
January-June 2016, 28(1):68-71
Thorough knowledge of root morphology and its associated root canal anatomy forms the prime basis for the success of any endodontic therapy. Although rare, variations in canal number and configuration could affect the treatment outcome. Managing these additional canals with abnormal morphology is a challenging task for every clinician. This case report presents the successful management of two maxillary first molars with aberrant root canal morphology. The first case has two palatal root canals with a total of five canals and the second case has two distobuccal canals.
  1,966 213 -
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
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.
  1,902 248 -
Efficacy of the EndoActivator system used throughout the endodontic cleaning and shaping procedure to disinfect root canals infected with Candida albicans
Fahd Alsalleeh
January-June 2017, 29(1):7-10
Objective: The purpose of the present investigation was to analyze the effectiveness of using the EndoActivator™ (EA) system (DENTSPLY Tulsa Dental Specialties, Tulsa, OK) throughout the cleaning and shaping process to disinfect root canals contaminated with Candida albicans . Materials and Methods: Forty-six extracted human single-rooted teeth were selected. Except for those used as negative controls, the teeth were standardized and then infected with C. albicans . Infected teeth were randomly divided into four experimental irrigation protocol groups (n = 10); normal saline, normal saline with EA activation, 6% sodium hypochlorite (NaOCL), or 6% NaOCL with the EA activation. Three teeth were left untreated to serve as positive controls. Teeth not included in control groups were instrumented with ISO Profile rotary files (DENTSPLY-Tulsa Dental, York, PA). In groups that utilized the EA, the irrigant was activated throughout the procedure. Results: All samples of the positive control and saline groups showed C. albicans growth. The negative controls had no growth and NaOCL alone groups showed one sample growth. When the EA was used with NaOCL, three samples showed C. albicans growth. Conclusion: EA activation throughout the procedure did not add any benefit to disinfect root canal system against C. albicans .
  1,913 226 -
Root canal morphology and assessment of incidence, type, and position of isthmus in permanent mandibular central incisor in North Indian population: An in vitro study
Surekha Puri Bhat, Rahul Sheth, Pravin Kumar, Ankita Khilosiya
July-December 2017, 29(2):107-114
Background and Objectives: Mandibular incisor's anatomy presents a challenge when making endodontic access because of its small size and high prevalence of two canals and isthmus within them. The main objective of this study is to evaluate the root canal anatomy and its aberrant morphology in mandibular central incisors. Knowing the variations in canal anatomy such as two canals, presence of isthmus, type, its prevalence, and position in the mandibular central incisors, which help improve the procedure of successful root canal treatment. Materials and Methods: One hundred and twenty extracted human mandibular central incisor teeth were collected. Two different studies have been performed. Sixty teeth were studied through tooth clearing and dye penetration technique. Teeth were decalcified with 5% nitric acid, dehydrated with increasing concentrations of alcohol and rendered clear by immersion in methyl salicylate. Hematoxylin dye was inserted in access cavity and canals. The samples were observed under dental operating microscope. These samples were evaluated for root canal morphology to assess its root canal configuration. Sixty teeth were studied through sectioning of apical 3 mm (1, 2, and 3 mm from the apex) simulating a surgical resection method was followed. The sectioned samples were observed under stereomicroscope for evaluating isthmus and its type. Results and Conclusion: Sectioning study showed that canal shapes varied from round to oval, long oval, and ribbon shaped, while the prevalence of isthmus was more at 3 mm section. Tooth clearing study showed that 46.6% teeth had single canal, 49.8% teeth had two canals, and only 5% teeth had two separate apical foramina.
  1,886 230 -
Esthetic and endodontic management of anterior teeth with impacted foreign objects in the root canals: A case series
Dipanshu Kumar, Aparna Singh, Nidhi Agarwal, Asib Ahmad Rizvi, Ashish Anand
January-June 2016, 28(1):50-52
Managing trauma to anterior teeth in children is a challenge for dentists. It can be further complicated by the presence of a foreign body in the root canal which acts as an additional nidus of infection. This foreign body is often diagnosed accidentally after radiographic evaluation. Thorough and careful clinical and radiographic assessments are required for complete retrieval of foreign body without much damage to the tooth structure. This paper presents a case series of two case reports where successful complete retrieval of foreign objects was performed from the root canals of permanent incisors followed by esthetic management of the involved teeth.
  1,935 140 -
Comparative evaluation of the efficacy of three different irrigation devices in removal of debris from isthmus: An in vitro study
Aparna Birajdar, Sucheta Sathe, Manisha Dixit, Srilatha Shanmugasundaram
January-June 2016, 28(1):2-6
Aim: To evaluate the cleaning efficacy of endoactivator, EndoVac (EV), and self-adjusting file (SAF) as irrigant adjunct in the removal of debris from isthmus. Materials and Methods: Forty extracted human mandibular molars were taken. Canals were prepared up to F4 protaper file. Irrigation after each file size was done by 1 ml normal saline. Final irrigation was done by 4 ml of 5% NaOCl and activated in each canal for 1 min with different activating systems. Teeth were divided randomly into 4 groups according to activation system as manual activation (control group, n = 10), Group 2 SAF system (n = 10), Group 3 endoactivator (n = 10), and Group 4 EV (n = 10). After activation final flush was done with 1 ml saline. The mesial root of each tooth was sectioned and checked for isthmus cleanliness by stereomicroscopic analysis. Images were analyzed by ImageJ software. Percentage of debris remaining in each group was calculated. Results: There is no statistically significant difference in cleaning efficacy of endoactivator, EV, and SAF systems. Conclusion: All three techniques remove debris from isthmus area more efficiently than manual dynamic activation.
  1,791 256 -
Determination of root canal configuration and the prevalence of “C-shaped” canals in mandibular second molar in central and South Gujarat population: An in vitro study
Tapati Manohar Sinhal, Ruchi Rani Purvesh Shah, Nimisha Chinmay Shah, Pratik Subhas Jais, Krupali Dhirubhai Hadwani
July-December 2017, 29(2):90-94
Aims: The aim of the present study was to determine the canal configuration and the prevalence of “C-shaped” canals in mandibular second molar in Central and South Gujarat population. Materials and Methods: A total of 122 mandibular second molar teeth were collected and stored in 10% formalin. Identification of these teeth as mandibular second molar was confirmed by two independent observers. An endodontic access cavity was then prepared in each tooth. Then, they were injected with India ink and demineralized, they were made clear and transparent with methyl salicylate. Then, anatomy of their canals was studied. Results: Out of 122 mandibular second molars, prevalence of “C-shaped” canals was 10.65% (13 teeth). These configurations were seen mostly in single-rooted mandibular second molars. Out of five categories of “C-shape,” predominantly found category was (C1) – 46.15%. Conclusion: Hard tissue of mandibular second molar contains dental pulp which can take a variety of configurations and shapes. The great differences reported among studies with regards to anatomy of the mandibular second molars and prevalence of “C-shaped” canals may be attributable to study methods and racial differences.
  1,360 634 -
Comparison of new irrigating solutions on smear layer removal and calcium ions chelation from the root canal: An in vitro study
Anika Mittal, Shifali Dadu, Bidya Yendrembam, Anju Abraham, Neetu Sharma Singh, Paridhi Garg
January-June 2018, 30(1):55-61
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.
  1,691 263 -
Comparative evaluation of the effect of proton pump inhibitors associated with calcium hydroxide on Enterococcus faecalis: An in vitro study
Chitharanjan Ganesh, Preethi Ann Koshy, Lekshmy S Devi, Sreeja Sreedhar, Lakshmi Aravind, Siddharth Nair, George Chacko, SL Satheesh
January-June 2016, 28(1):7-10
Introduction: The purpose of this in vitro study was to evaluate the concentration dependent effect of proton pump inhibitors on the action of calcium hydroxide against E. faecalis using a broth dilution study. Methods: Calcium hydroxide at a concentration of 16 mg/ml, pantoprazole and Lansoprazole at a concentration of 1 mg/ml made into dilutions of 6.25 and 25 μg/ml was incorporated into a broth containing E. faecalis and spectrophotometrically analysed at 630 nm at two time parameters of 12 hours and 24 hours. Results: At 12 hours there was statistically significant growth inhibition by group 5 (calcium hydroxide and lansoprazole 6.25 μg/ml). At 24 hours,the maximum Inhibition of E. faecalis was demonstrated by group 2 (calcium hydroxide and chlorhexidine 2%) and group 5 (calcium hydroxide and lansoprazole 6.25 μg/ml). Conclusion: Concentration dependent usage of proton pump inhibitors along with calcium hydroxide have potential in the eradication of persistent apical periodontitis.
  1,699 201 -