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   2016| July-December  | Volume 28 | Issue 2  
    Online since December 9, 2016

 
 
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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.
  4,652 454 -
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.
  4,193 847 3
EDITORIALS
Revolutionary development of endodontic instruments and its implications
Hyeon-Cheol Kim
July-December 2016, 28(2):90-91
DOI:10.4103/0970-7212.195419  
  2,525 2,203 -
Editorial
Sanjay Miglani
July-December 2016, 28(2):89-89
DOI:10.4103/0970-7212.195420  
  1,164 3,373 -
ORIGINAL ARTICLES
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 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.
  3,465 559 -
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.
  3,213 469 -
ORIGINAL ARTICLES
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)2cement. Materials and Methods: Five different brands of Ca(OH)2cements 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)2cements released high amount of Ca ions compared to self-cured Ca(OH)2cements. Group V (Hydrocal) and Group III (TheraCal) were found to be the highest light-cured Ca ion releasing materials.
  2,871 468 2
CASE REPORTS
Healing of recurrent sinus tract after retrograde endodontic treatment of an associated lateral canal
Ritu Sharma, Ruhanijot Kaur Cheema
July-December 2016, 28(2):179-182
DOI:10.4103/0970-7212.195436  
A case report of the management of recurrent sinus tract associated with lateral canal is presented. In this report, a patient reported with a recurrent sinus tract after primary endodontic therapy. The sinus tract was traced with a gutta-percha point, which suggested the point of origin at the middle third of the root. An exploratory surgery revealed a lateral canal with extruded sealer. The canal was retroprepared and sealed with mineral trioxide aggregate. The sinus tract healed uneventfully. Postoperative healing of 18 months is presented. This case report demarcates the importance of lateral canals in endodontic pathosis.
  2,975 180 -
ORIGINAL ARTICLES
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.
  2,808 282 1
Identification of presence of Candida albicans in primary root canal infections: An in vitro study
Nidhi Shah, KS Madhu, BV Sreenivasa Murthy, Beena Hemanth, Sylvia Mathew, Shruthi Nagaraj
July-December 2016, 28(2):109-113
DOI:10.4103/0970-7212.195440  
Introduction: Microorganisms are recognized as the etiological agents for the majority of pulpal and periradicular diseases. Although bacteria are most researched, the contribution of fungi in endodontic infections is neglected. However, Candida albicans is the most commonly isolated fungi from the endodontic infections. Their identification is crucial for effective diagnosis and treatment planning. Hence, this study aimed to evaluate the presence of C. albicans in primary root canal infections using culture technique. Materials and Methods: Fifty root canal samples from primary endodontic infections were collected using file and paper point following disinfection protocol. Samples were inoculated in Sabouraud dextrose agar and incubated for 2–3 days. Taxonomy was evaluated using Gram-staining and germ tube test by macroscopic examination and optical microscopy. Results: Four out of 50 samples showed positive for C. albicans. Conclusion: This study confirmed the prevalence of 8% of C. albicans in primary endodontic infection.
  2,562 445 -
CASE REPORTS
Accidental ingestion and successful retrieval of an endodontic file from the left hypochondriac region using endoscopy
Pravek Khetani, Nidhi Sinha, Usha Dabas, Vipin K Dabas
July-December 2016, 28(2):183-187
DOI:10.4103/0970-7212.195430  
Ingestion of the endodontic instrument during root canal treatment is an undesirable yet not uncommon mishap in the practice of endodontics. Such incidents are on a rise owing to the increase in number of endodontic cases being performed by the endodontists and the dental practitioners in the modern times. Serious complications may be encountered if such endodontic mishaps are not handled timely and efficiently. The present case report discusses the management of a typical case of ingestion of an endodontic file which was successfully retrieved by an endoscopy procedure.
  2,793 190 -
Pressure-induced mesial root resorption of mandibular second molar consequential to an impacted third molar
Priya Mittal, Ajay Logani
July-December 2016, 28(2):176-178
DOI:10.4103/0970-7212.195438  
Resorption is a physiologic or pathologic process which results in mineralized tissue loss. Permanent teeth are resistant to physiologic resorption. Root resorption in such teeth is usually pathological. The aetiology is multi-factorial and encompasses pressure generated from an impacted tooth. Mandibular third molars are the most commonly impacted teeth. Owing to its proximity, distal root resorption of mandibular second molar may occur due to mechanical forces generated during the eruptive phase of impacted tooth. This article documents a case of pressure induced mesial root resorption of mandibular second molar consequential to an impacted third molar. To conclude with, it is prudent to consider all remotely related possibilities for any pathological process. This aids in establishing a correct diagnosis and prevent unnecessary iatrogenic complications
  2,289 162 -
ORIGINAL ARTICLES
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.
  2,067 302 -
The comparison of physicochemical properties of new and established root canal sealers
Richa Agarwal, Vineeta Nikhil
July-December 2016, 28(2):97-101
DOI:10.4103/0970-7212.195431  
Introduction: To evaluate and compare various physicochemical properties of different root canal sealers. Materials and Methods: Three root canal sealers, AH Plus, Endosequence BC sealer, and mineral trioxide aggregate (MTA) Plus were evaluated for their flow, radiopacity, dissolution, and coronal discoloration. The flow test was based on the section 7.2 of the International Organization for Standardization 6876. For radiopacity, test specimens were radiographed next to aluminum step wedge. Dissolution of all the sealers was evaluated in chloroform and Endosolv E for 2, 5, and 10 min. Finally, coronal discoloration was assessed using the CIE Laboratory color system at 1 day, 1 week, 1, 2, and 4 months period of time. Results: AH Plus showed the maximum mean flow (29.00 ± 0.75) mm followed by MTA Plus: (21.75 ± 0.75) mm and Endosequence BC sealer: (21.00 ± 3.19) mm. AH Plus showed maximum radiopacity, i.e. 221.25 ± 10.64 gray value followed by Endosequence BC sealer, i.e. 187.83 ± 8.24 gray value and MTA Plus with 180.34 ± 16.85 gray value. In dissolution, the best solvent at 10 min was chloroform. Among the sealers, MTA Plus was least dissolved followed by AH Plus and Endosequence BC sealer was the most. Endosolv E was the better solvent for Endosequence BC sealer. In coronal discoloration experiment, MTA Plus caused the most coronal discoloration at 4 months, i.e. ΔE 4.80 ± 1.01, while AH Plus caused the least amount of discoloration, i.e. ΔE 3.84 ± 0.92. Endosequence and MTA Plus caused clinically perceptible discoloration. Conclusion: Within the limitations of the present study, it can be stated that the tested sealers can be used clinically with a successful outcome as they have favorable physicochemical properties.
  2,074 288 -
Comparison of Fracture resistance of teeth obturated with different obturation materials and sealers: An in vitro study
Harshank Lakhera, Vijay R Mantri, Aparna Palekar, Ambar W Raut
July-December 2016, 28(2):159-165
DOI:10.4103/0970-7212.195428  
Introduction: The objective of the study is to evaluate and compare the vertical root fracture resistance of maxillary central incisors filled with different root filling materials and sealers. Materials and Methods: Sixty freshly extracted maxillary central incisor were decoronated 2 mm above the cementoenamel junction and were instrumented using K-flex files. Teeth were divided into four experimental groups and two control groups of ten each and root filled as Group A - Gutta-percha master cone and AH Plus sealer, Group B - Gutta-percha master cone and RealSeal sealer, Group C - RealSeal master cone and RealSeal sealer, Group D - RealSeal master cone and AH Plus sealer, Group E - roots were instrumented but not filled (negative control group), and Group F - roots were neither instrumented nor filled (positive control group). Restored teeth were subjected to compressive loading in a universal testing machine. Results: Group C showed highest fracture resistance among other groups, followed by Group F, Group D, Group B, and Group A. Group E showed the lowest fracture resistance value. According to an independent sample t-test, significant difference was found between Group A and Group C (P = 0.038), Group A and Group F (P = 0.048), Group B and Group C (P = 0.039), Group C and Group E (P = 0.024), Group D and Group E (P = 0.038), and Group E and Group F (P = 0.034), and the results were nonsignificant among other groups. Conclusion: The higher fracture resistance was seen in roots obturated with RealSeal system compared with Gutta-percha-AH 26 groups on vertical loading.
  1,935 307 -
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.
  1,815 209 -
Effectiveness of hand and rotary instruments in retreatment of teeth filled with resin-based filling material: An in vitro study
Vanita Keshav, Sachin Passi, Prashant Monga, Pardeep Mahajan
July-December 2016, 28(2):132-136
DOI:10.4103/0970-7212.195424  
Introduction: Determination of the canal wall cleanliness and to detect the residual filling material after removal of old obturating material. Materials and Methods: Thirty single-rooted premolar teeth were instrumented with rotary universal Protaper to size F2 and filled with resilon. The removal of root canal fillings was done with manual Hedstrom files and rotary Protaper retreatment files (RPRs) with orange oil as a solvent. Two-dimensional images of the obturated and retreated roots were evaluated with AutoCAD for percentage of remaining filling material. This area was confirmed under the scanning electron microscope. The data were statistically analyzed by t-test to identify differences. Results: Statistically significant differences were obtained for remaining filling material between hand and rotary both the groups. It was found that the canals instrumented with RPRs had lesser percentage of remaining filling material as compared to the hand files. Residual filling material and debris was found mostly in the apical portion of the root canal, however middle and cervical portions were relatively clean. Conclusion: RPRs were efficient in removing resilon from root canals as compared to the hand files.
  1,763 185 -
Evaluating the quality of seal of root canals in the presence of separated rotary instrument when obturated with different obturation techniques using liquid photospectrometry
Manoj Ghanshyam Chandak, Fresca Bhagwandas Adwani, Nikhil Purushottam Mankar, Sneha Murlidhar Kela, Manjeet Nirmal Singh Dawani, Rakhi Manoj Chandak
July-December 2016, 28(2):102-108
DOI:10.4103/0970-7212.195423  
Introduction: Complete sealing of the root canal system is essential for the successful outcome of the endodontic treatment. unfortunately instrument may separate during biomechanical preparation and achieving a fluid tight seal may be difficult. Three dimensional obturation thus plays an important role in achievement of fluid tight in presence of separated rotary instruments. To evaluate the quality of seal of root canals in the presence of separated rotary instrument when obturated with different obturation techniques using liquid photospectrometry. Materials and Methods: One hundred and twenty freshly extracted mandibular human premolars with straight and single root canal were selected. The preparations of canal were completed by single file system with primary file size 25/08 (WaveOne system, Dentsply Maillefer, Switzerland). The roots were randomly assigned into two groups: Group I (n = 60) and Group II (n = 60). Group I (n = 60) was subdivided into three subgroups A, B, and C. Group A (n = 20): Roots were obturated with lateral condensation technique without sealer placement and without instrument being separated at apical third. Group B (n = 20): Roots were obturated with lateral compaction technique using epoxy resin based sealer (AH Plus) placed in canals without instrument being separated at apical third. Group C (n = 20): Roots were obturated with lateral compaction technique using epoxy resin-based sealer (AH Plus) placed along the root canals with instrument being separated at apical third. Group II (n = 60) was also subdivided into three subgroups A, B, and C with twenty roots in each subgroup. In subgroups A, B, and C of Group II, the same methodology was used, except obturation was done using thermoplasticized Gutta-percha (Calamus, Dentsply Maillefer, Switzerland). The modified glucose penetration setup was used and samples were then analyzed with a spectrophotometer (ELICO SL 244-double beam ultraviolet-visible) at 340 nm wavelength. Statistical analysis was done using descriptive and inferential statistics using Student's paired and unpaired t-test and softwares used in the analysis were SPSS 17.0 version and GraphPad Prism 5.0 version and P< 0.05 is considered as level of significance (P < 0.05). Results: Significant variation was found in mean glucose leakage in groups obturated with lateral condensation and thermoplasticized Gutta-percha (t = 2.10, P = 0.042). Conclusions: Leakage observed with thermoplasticized obturation was less when compared to lateral condensation. Three-dimensional obturation plays a crucial role than the separated instrument during endodontic therapy.
  1,673 229 -
Comparative evaluation of desensitizing agent Vivasens and Laser for obliteration of dentinal tubules
Hemant M Asrani, Deepti N Jain, Anshul Asrani, Pooja Deshmukh, Abhishek Sankhla
July-December 2016, 28(2):154-158
DOI:10.4103/0970-7212.195437  
Introduction: The purpose of this study was to evaluate the ability of desensitizing agents VivaSens and Laser (Diode) on dentinal tubule occlusion and its effectiveness over time using scanning electron microscopy (SEM). Materials and Methods: Twenty-two extracted human maxillary premolars were selected and grouped as follows: Group I: VivaSens (Ivoclar), Group II: Diode laser, and Group III: Control group. Teeth were embedded in plaster of Paris molds, and cavities of 2 mm depth and 3 mm width were prepared on a buccal surface at the cervical region. Ten specimens were coated with VivaSens (Ivoclar) and ten specimens were lased with Diode laser (i lase-Biolase) whereas two specimens remained as control. These specimens were examined under SEM to find the occluding ability of agents and also their efficacy with time. The statistical analysis was done using ANOVA, post hoc test, and Student's t-test. Results: Both VivaSens and Diode laser were equally effective in the obliteration of dentinal tubules just after application as well as after 15 days of treatment. No statistically significant difference was found between VivaSens and Laser groups. Conclusions: From the limitations of this study, it can be concluded that occlusion and narrowing of open dentinal tubules have been successfully achieved with both treatment approaches throughout the specific period.
  1,689 201 -
A scanning electron microscope evaluation of smear layer removal from root canals prepared by manual or rotary instrumentation using three different irrigating systems: An in vitro study
Simran Pal Singh Bindra, Ajay Chhabra, Damanpreet , Nisha Garg, Varun Jindal, Sџnila Sharma
July-December 2016, 28(2):171-175
DOI:10.4103/0970-7212.195434  
Introduction: Smear layer removal after root canal instrumentation requires the use of irrigating solutions, either alone or in combination. The mechanical debridement efficacy of an irrigation delivery/agitation system is dependent on its ability to deliver the irrigant to the apical and noninstrumented regions of the canal space and to create a strong enough current to carry the debris away from the canal walls. Materials and Methods: Ninety extracted single-rooted anterior teeth were included in the study and divided into two groups of 45 each. Biomechanical preparation was done with hand files in Group A and with rotary files in Group B. Three subgroups were further made from each group, wherein Max-I-Probe, Endosonic files, and EndoActivator irrigation systems were used in subgroups I, II, and III, respectively. After irrigation with 10% citric acid, specimens were split and the root surfaces were evaluated under scanning electron microscope at cervical, middle, and apical levels. Results: The removal of smear layer was more complete in coronal and middle thirds than in the apical third. No significant difference was found on the removal of smear layer in manually or rotary instrumented groups. When mean scores for all the groups were obtained, Max-I-Probe hand file (Group IA) was found to be most effective in cleaning smear layer in cervical third of root canals, whereas Endosonic rotary showed the best result in both middle and apical third. Conclusion: EndoActivator system did not enhance the removal of smear layer as compared with Endosonic system and the conventional Max-I-Probe irrigation with NaOCl and 10% citric acid. removal of smear layer was more complete in coronal and middle thirds than in the apical third.
  1,667 210 -
Computed tomography evaluation of canal shaping and cleaning ability of three different instrumentation techniques; an in vitro study
L Krishna Prasada, Jayanth Nambiar, Mohit Kumar Khandelwal
July-December 2016, 28(2):119-126
DOI:10.4103/0970-7212.195421  
Introduction: The purpose of the study was to assess the root canal shaping and cleaning ability of three different instrumentation techniques namely step back, crown down and hybrid, using spiral CT. Materials and Methods: 90 extracted human mandibular first molar teeth was collected from the department of Oral and maxillofacial surgery, K.V.G Dental college and Hospital, Sullia, were selected for the study. Standard access cavities were made, and the teeth were sectioned into mesial and distal halves. The mesial half of the mandibular first molars were selected for the study. All the teeth were divided into groups of 15 each and instrumented using crown down, hybrid and step down techniques. They were divided into two sub groups and evaluated using spiral CT. Canal transportation and centering ability of the root canal using spiral CT was checked when instrumented using three canal preparation techniques. Kruskal Wallis and Friedman test were used to analyse the result. Result: Significant canal transportation occurred with hand instruments in the apical third. Hybrid technique was found to be superior in maintaining the original root canal anatomy and less amount of debris was seen in the apical third of the group instrumented using hand instruments. Conclusion: HYFLEX instruments produced cleaner and smoother and more even surface than the hand instruments. Iatrogenic errors are comparatively less in the group instrumented using hyflex rotary files. CT imaging techniques have been evaluated as noninvasive methods for the analysis of canal geometry and efficiency of shaping techniques that Nickel Titanium instruments remove less total dentine and result in less transportation especially in root canals with severe curvatures.
  1,595 214 -
CASE REPORTS
Management of maxillary central incisor with an extracanal and periapical cyst using cone-beam computed tomography as a diagnostic aid
Bhavana Chandradhara, A Arun, K Shashikala, N Vanamala
July-December 2016, 28(2):199-202
DOI:10.4103/0970-7212.195439  
The success of endodontic treatment depends on the knowledge of internal and external anatomy of the tooth, the normal supporting tissues of the tooth and any pathology related to it. The a im of the present study is to present the management of maxillary incisor with two canals and periapical lesion. The presence of two canals in maxillary central incisor was confirmed with cone-beam computed tomography. The tooth was cleaned and shaped with hand filing and obturated with lateral condensation technique. Periapical lesion was treated with surgical approach. 1-, 3 and 9-month follow-ups showed good healing of periapical tissue and suffi cient bone formation. The patient remained asymptomatic. Sufficient knowledge of the normal root canal anatomy and its variations, and proper treatment planning aids in successful endodontic treatment.
  1,585 125 -
ORIGINAL ARTICLES
Effect of maintaining apical patency and passive ultrasonic irrigation on irrigant penetration into the apical third of root canals: An in vivo study
Abhay Ishwarchandra Kamra, Jalpa Mansukh Tank, Kulwinder Singh Banga
July-December 2016, 28(2):127-131
DOI:10.4103/0970-7212.195422  
Introduction: The aim of this study was to determine whether the use of a patency file and passive ultrasonic irrigation (PUI) is related to the presence of a radiopaque irrigating solution in the apical third of human root canals in vivo. Materials and Methods: 20 human root canals were randomly divided into 4 groups. 1: Conventional needle irrigation without apical patency, 2: PUI without apical patency, 3: Conventional needle irrigation with apical patency, 4: PUI with apical patency. Apical patency was maintained with a no. 10 K-file 1mm beyond the working length. PUI was done using an endosonic file attached to the ultrasonic unit. The canals were shaped with the Pro Taper system. Irrigation was performed with solution prepared with a radiopaque contrast medium and sodium hypochlorite 5.25%. Digital images were taken and a calibrated reader determined the presence or absence of the irrigating solution in the apical third. Results: Significantly more canals with irrigant in the apical third were found after PUI and after maintain apical patency. Conclusion: PUI and maintaining apical patency improves irrigant penetration.
  1,472 203 1
CASE REPORTS
Spontaneous retropharyngeal emphysema postendodontic treatment
Praveen Shrishail Byakod, Preeti Praveen Byakod, Basawaraj Biradar, Sudha Biradar
July-December 2016, 28(2):203-205
DOI:10.4103/0970-7212.195441  
Facial and cervical emphysema occurs as a result of air entering through the facial planes, a condition rarely seen in dental practice. In dentistry, compressed air is used to run the high-speed airotor drills and three-way air syringes. These two equipment are to be used with great precaution, especially when minor surgical procedures are done. It is highly recommended not to use these in major surgical procedures. Here, we present a case of spontaneous retropharyngeal emphysema, iatrogenically induced in a 64-year-old healthy patient undergoing root canal therapy on mandibular canines 33 and 43. Diagnosis has to be precise as this condition mimics allergic reactions and hematoma.
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LETTER TO EDITOR
Indian Endodontic Society: Looking beyond horizons…
KS Banga
July-December 2016, 28(2):206-206
DOI:10.4103/0970-7212.195418  
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