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The systematic review aimed to compare and evaluate the effect of resin-based sealers and bioceramic sealers on postoperative pain after endodontic treatment. Two reviewers independently conducted electronic search in PubMed, the Web of Science, ScienceDirect, the Wiley Online Library, SpringerLink, Google Scholar, and the Cochrane Library, employing a complete dual-review process to ensure the inclusion of all relevant studies in the review. The search was carried out until November 2021. After selecting eligible studies, the risk of bias assessment was carried out using the revised Cochrane risk-ofbias tool for randomized trials (RoB 2). A total of 1,931 studies were identified from the electronic search, and finally 10 studies were included after full-text assessment. In all our included studies, the visual analog scale (VAS) was used for recording pain scores. Most of the studies recorded pain intensity starting from 6 h to 7 days. The results showed that there was no significant difference between resin-based sealers and bioceramic sealers in terms of incidence or intensity of postoperative pain at any point in time.
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Dolor Postoperatorio , Materiales de Obturación del Conducto Radicular , Humanos , Cerámica , Dimensión del Dolor , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Materiales de Obturación del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/efectos adversosRESUMEN
Odontoma is a benign odontogenic tumour, which is rather considered hamartoma. Hamartoma is not a true neoplasm, rather a growth of abnormal mixture of cells found in the body area they normally grows. Fully developed odontomas generally consist of enamel, dentin and pulpal tissues, in an unorganised manner. Some of them may contain cementum too. These are further grouped into compound and complex, depending on their clinical, radiographic and histologic features. Odontomas are generally asymptomatic and slow growing, but may cause bone expansion and hinderance in tooth eruption. These lesions are generally diagnosed by coincidence in radiograph. We are presenting a case and surgical management of complex odontoma and post-operative dehiscence in the anterior right maxillary region of a 38-year-old male.
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Introduction: To assess the effects of different irrigation activation systems on postoperative pain using a Visual Analog Scale (VAS), using new laser irrigation activation system shock wave-enhanced emission photoacoustic streaming (SWEEPS), photon-induced photoacoustic streaming (PIPS), passive ultrasonic irrigation activation techniques, compared with the conventional irrigation (CI) method. Materials and Methods: Sixty patients suffering from symptomatic irreversible pulpitis in maxillary or mandibular molars were enrolled and randomly assigned to four different irrigation activation groups (n = 15) after chemomechanical root canal preparation. Preoperative and postoperative pain scores were recorded using VAS. The data were collected and subjected to statistical analysis using IBM SPSS 20.0 software at a level of significance being 0.05. Results: We observed that mean pain scores decreased with time in all patients in all groups. The decrease in pain score was found to be statistically significant (P < 0.05) among both the genders in Group 3 (PIPS) and Group 4 (SWEEPS). Postoperatively, pain scores decreased significantly using Group 4 (SWEEPS), followed by Group 3 (PIPS), Group 2 (ultrasonic activation), and Group 1 (conventional needle irrigation). No significant relation was observed statistically between pain scores and age groups among all groups, except for preoperative score in Group 3 and age groups. Conclusion: Postoperative scores were lower in laser-activated irrigation systems as compared to the other activation systems. The highest pain scores were observed in case of CI method, at pre- and post-operative periods.
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AIM: To evaluate and compare the formation of dentinal defects using hand Hedstrom files, XP-Shaper, TruNatomy, and Reciproc Blue file systems when used for oval shaped root canals. MATERIALS AND METHODS: One hundred and five extracted human mandibular premolars with single root and oval canals were selected for the study. Twenty-one teeth were unprepared (control), and the remaining teeth were divided into the prepared groups (n = 21), that is, Group H-Files, Group XP-Shaper, Group TruNatomy, and Group Reciproc Blue. All selected teeth were de-coronated perpendicular to the long axis of the tooth by using a diamond-coated disk with water cooling, leaving root segments approximately 16 mm in length. Each group was prepared according to the above file system. Then all roots were sectioned perpendicular to their long axes at 3, 6, and 9 mm from the apex using a diamond-coated disk under a continuous water stream. Each specimen was then checked for the presence of dentinal defects/microcracks. RESULT: The XP-Endo shaper group had the lowest number of defects (01/21 roots) 4.7%; TN (04/21) 19%, H-Files (04/21) 19%, and RC Blue (05/21) 23.8% had the highest incidence of defects. However, no significant difference was detected among these groups (P > 0.05). CONCLUSION: The motor-driven root canal instrumentation with rotary and reciprocating files and hand files may create microcracks in the radicular dentine, whereas the XP-Shaper file system produces minimal or less cracks compared to other tested rotary file systems and H-file instrumentation.
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Cavidad Pulpar , Dentina , Diseño de Equipo , Preparación del Conducto Radicular , Humanos , Preparación del Conducto Radicular/instrumentación , Instrumentos Dentales , Diente Premolar , Aleaciones Dentales/química , Níquel , Titanio , Ensayo de Materiales , RotaciónRESUMEN
Aim: The aim of this study was to evaluate and compare the regenerative endodontic potential of dexamethasone-coated bioglass nanofiber (Dex-BGnf), bioglass nanofiber (BGnf), and platelet-rich fibrin (PRF) for inducing regeneration in necrotic immature permanent teeth. Materials and Methods: A total of 36 (n = 12) immature necrotic teeth with or without evidence of periapical lesion were included in the study. Patients were randomly allocated into three groups, based on the scaffolds used: Group I (PRF), II (BGnf), and III (Dex-BGnf). The clinical (electric pulp test) and radiographic evaluations (percentage increase in apical diameter, root length, root dentin thickness, and periapical healing) were compared at 6 and 12 months after the procedure with baseline records. Statistical Analysis: One-way ANOVA, post hoc Tukey analysis, and Kruskal-Wallis test were used for evaluating the data. A 6- and 12-month improvement analysis was done using paired t-test and Friedman test. Results: Clinically, all the 36 teeth were asymptomatic, but none gave a positive response to Electric Pulp Test (EPT) in time interval of 12 months. Dex-BGnf showed a statistically significant improvement in terms of increase in root length (P = 0.020) and root dentinal thickness (P = 0.001) when compared to PRF after 12 months. Conclusion: The study has shown that Dex-BGnf yielded significantly better results than PRF for inducing apexogenesis in necrotic immature teeth.
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Background: Reactive oxygen species released on stimulation by periodontal pathogens cause oxidation of biomolecules and play significant role in periodontal disease pathogenesis. Aim: This study aimed to evaluate the levels of oxidative by-products malondialdehyde (MDA) and 8-hydroxy deoxyguanosine (8-OHdG) as biomarkers in chronic periodontitis patients compared to healthy as well as before and after nonsurgical periodontal therapy. The correlation between biomarkers and clinical attachment level was also evaluated. Settings and Design: A total of 112 subjects were included in this study. The subjects were divided into two groups (Group I included 56 healthy subjects and Group II constituted 56 chronic periodontitis patients) on the basis of clinical periodontal parameters. Materials and Methods: Group I subjects received no treatment and were evaluated once only for clinical and oxidative stress biomarker parameters. Nonsurgical periodontal therapy was carried out in Group II patients and they were evaluated at baseline and 3 months after therapy. Results: Both salivary and serum levels of MDA and 8-OHdG were found to be increased in chronic periodontitis patients as compared to healthy subjects. After nonsurgical periodontal therapy, the levels of MDA and 8-OHdG significantly reduced. Linear correlation between clinical attachment level and oxidative stress parameters was found to be positive and highly significant. Conclusion: It can be concluded that periodontal therapy is effective in improving the oxidative stress condition.
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Periodontitis Crónica , 8-Hidroxi-2'-Desoxicoguanosina , Biomarcadores/metabolismo , Periodontitis Crónica/terapia , Desoxiguanosina , Humanos , Malondialdehído , Estrés Oxidativo/fisiología , Índice Periodontal , Saliva/metabolismoRESUMEN
Aim: The aim of the study is to evaluate and compare the clinical and radiographic outcome of partial pulpotomy and full pulpotomy in mature permanent molars with symptomatic irreversible pulpitis using biodentine. Materials and Methods: A total of 66 vital mature permanent molars with irreversible pulpitis were randomly allocated to a partial pulpotomy (n = 33) and full pulpotomy group (n = 33). Biodentine was used as a pulp capping material which was covered with resin-modified glass ionomer cement (RMGIC) followed by composite restoration. Clinical and radiographic evaluation was done at 3, 6, and 12 months follow-up for tenderness, periapical radiolucency, dentine bridge formation, and root canal calcification. Data from the study were analyzed using a Friedman and Mann-Whitney test and the success rate was analyzed by Chi-square value. Result: No statistically significant difference was found between partial and full pulpotomy (P > 0.05) and the success rate was 80.7% and 92.8%, respectively, at 12 months follow-up period. Conclusion: Both partial and full pulpotomy can be used as a permanent treatment modality in symptomatic irreversible pulpitis of vital mature permanent molars.
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AIM: This study aimed to evaluate and compare the possibility of regaining pulp sensibility and objectives of regeneration procedure in mature necrotic teeth using regenerative endodontics. MATERIALS AND METHODS: A total of 36 mature necrotic teeth were selected and a regenerative endodontic procedure was performed. A total of four groups, each involving n = 9 teeth per group were randomly grouped as (1) periapical bleeding, (2) platelet-rich fibrin (PRF), (3) collagen, and (4) hydroxyapatite. Pulp testing and radiographic assessment of periapical healing (PH) were recorded at every 3-month interval for 1 year. Readings were compared as qualitative data using the Kruskal-Wallis test to see the inter-group significant difference. RESULTS: Readings of pulp sensibility revealed non-significant results in all intervals. At 3 and 6 months, 22.3% in the PRF group and 11.15% in collagen group; and at 9 months, 44.4% in PRF group, 33.3% in the collagen group and 22.2% in hydroxyapatite group; and at 12-months, 66.6% in PRF, 44.4% in the collagen group, 33.3% in the hydroxyapatite group and 11.1% in the periapical bleeding group showed a positive response to the cold test. But all groups did not show a positive response to heat and electric pulp testing and showed good PH in all groups at the end of 12 months. CONCLUSIONS: The presence of sensibility to cold test is indicative of the formation of vital pulp-like tissues, which was the highest in the PRF group, followed by the collagen, hydroxyapatite and periapical bleeding groups.
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Fibrina Rica en Plaquetas , Endodoncia Regenerativa , Pulpa Dental , Necrosis de la Pulpa Dental/terapia , Humanos , Tratamiento del Conducto RadicularRESUMEN
AIM: The aim of the study was to evaluate and compare the retreatability of BioRoot RCS and AH Plus sealer with two different retreatment file systems using cone-beam computed tomography (CBCT) for assessing the filling remnants. MATERIALS AND METHODS: A total of sixty mandibular premolars with single and oval root canals were prepared till size F3 and obturated with GP/AH Plus (Group 1) and GP/BioRoot RCS (Group 2). Canals were then retreated using two different retreatment file systems - ProTaper Universal Retreatment (PTUR) system and NeoEndo Retreatment system. The ability to re-establish working length (WL) and apical patency was recorded, and the percentage volume of residual filling material was evaluated using CBCT at the coronal, middle, and apical thirds. Data from the study were analyzed using one-way analysis of variance with Pearson's Chi-squared analysis and the Kruskal-Wallis test. RESULTS: No statistically significant difference was found in the amount of residual sealer (AH Plus and BioRoot RCS) after retreatment throughout the whole study (P > 0.05) at various root canal levels. Furthermore, the BioRoot RCS group retreated with the PTUR system showed a higher frequency of failure in re-establishing WL and regaining apical patency than the other groups. CONCLUSION: Complete removal of root canal sealers could not be achieved regardless of the type of sealer used and the retreatment technique employed. Furthermore, in clinical settings, the retreatability of novel BioRoot RCS may be deemed feasible.
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INTRODUCTION: The relationship of tobacco use to dental caries is still unclear. The aim of this study is to assess the relationship between smoking and smokeless tobacco usage and prevalence of dental caries and its pattern in the Varanasi population. MATERIALS AND METHODS: In this study, 472 elderly dentate and consenting individuals were included. Individuals were examined with the aid of mouth mirror, No. 23 explorer, and cotton rolls. The age of the study group ranged from 16 years to 75 years. Individuals were categorized as smoking tobacco users, smokeless tobacco users, and the combination of these two. Frequency and dosage of tobacco usage was recorded. Dental caries was measured using decayed, missing, and filled teeth (DMFT) index. Oral hygiene practices such as mode, material, and frequency of brushing were also recorded. Data were assessed using SPSS 17.0 using Chi-square, t-test, ANOVA test, and binary regression. RESULTS: Caries rate was similar in both males and females (2.57 and 2.70), and the difference was not statistically significant. Caries was higher in individuals with habits when compared to those who were not having habits. There was no statistically significant association between individuals who were smokers, using smokeless tobacco, frequency, mode, and material of brushing with caries pattern. Among smokers, DMFT increased with frequency and duration of smoking, and it was statistically significant; however, in smokeless tobacco users, this was not the case. There was a positive correlation with DMFT and frequency of smoking. CONCLUSION: The study has shown that tobacco habit is a risk factor for increased caries activity, and it is higher in smokers as compared to smokeless tobacco chewers.
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Comprehensive understanding of variations in the root canal morphology of a maxillary molar is useful for performing successful endodontic treatment in such cases. This case report describes endodontic management of a case with such aberrant root canal morphology of a maxillary second molar having a single root and single canal.
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AIM: The aim of this study is to evaluate and compare the regenerative potential of natural scaffold [platelet-rich fibrin (PRF)] and artificial scaffolds (commercially available collagen, placentrex, and chitosan) in necrotic immature permanent teeth. MATERIALS AND METHODS: Necrotic immature permanent maxillary incisors with or without radiographic evidence of periapical lesion were included. Access opening was done under rubber dam isolation. Canal disinfection was done using minimal instrumentation, copious irrigation, and double antibiotic paste as interappointment medicament for 4 weeks. After 4 weeks, asymptomatic teeth were divided into four groups on the basis of scaffolds used for the revascularization procedure: group I (PRF); group II (collagen); group III (placentrex); group IV (chitosan). The clinical and radiographic evaluations of teeth were done at 3, 6, and 12 months after the procedure and compared with baseline records. RESULTS: Clinically, patients were completely asymptomatic throughout the study period. Radiographically, all cases showed an improvement in terms of periapical healing, apical closure, root lengthening, and dentinal wall thickening. PRF and collagen gave better results than placentrex and chitosan in terms of periapical healing, apical closure, and dentinal wall thickening. CONCLUSION: Revascularization procedure is more effective and conservative over apexification in the management of necrotic immature permanent teeth. This study has shown that PRF and collagen are better scaffolds than placentrex and chitosan for inducing apexogenesis in immature necrotic permanent teeth.
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Fibrina Rica en Plaquetas , Antibacterianos , Apexificación , Necrosis de la Pulpa Dental , Dentición Permanente , HumanosRESUMEN
BACKGROUND: A definite cause and effect relationship between tobacco use and caries are lacking in literature. AIM: The aim of this study is to determine the influence of tobacco dependence on caries development in young male adults. MATERIALS AND METHODS: Three hundred healthy adult males in the age group of 20-40 years were divided into three groups containing 100 participants each. Group A: participants using smokeless tobacco; Group B: participants who smoke tobacco; and Group C: participants who have never used tobacco. Their dependence on tobacco was assessed using the Fagerstrom test for nicotine dependence. Their dental caries status was assessed using decayed-missing-filled teeth/decayed-missing-filled surfaces (DMFT/DMFS) index adopted by the WHO (1987). Observations were statistically analyzed using Mann-Whitney test, and P < 0.05 was considered statistically significant. RESULTS: Mean DMFT/DMFS was significantly higher for Groups A and B as compared to Group C. Within Group A, mean DMFT/DMFS increased significantly with increased dependence on smokeless tobacco. Within Group B, highest DMFT/DMFS was found in participants with low dependence on smoked tobacco while least mean DMFT/DMFS was found in participants with high dependence. CONCLUSION: Both forms of tobacco proved to be a significant risk factor for increased caries development. Thus, tobacco use should be an important factor in caries risk assessment of patients.
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BACKGROUND: This study aimed to formulate and characterize in-situ gel containing levofloxacin and metronidazole to release drugs in controlled manner for treatment of periodontitis. MATERIAL AND METHODS: Medicated in-situ gel with levofloxacin (10% w/v), metronidazole (25% w/v) and vehicle in-situ gel without drugs having poloxamer 407 (20% w/v) and chitosan (0.5%, 1%, 1.5%, 2.0% 2.5% w/v) were prepared and characterized for physicochemical, mechanical properties, stability and in-vitro drug release. Fourier transform infrared spectroscopy and differential scanning calorimetery studies were done. Optimized formulation was evaluated by scanning electron microscope (SEM) and in-vitro antimicrobial activity against 5 bacterial strains. RESULTS: The results revealed that drugs and polymers were compatible to formulate. All formulations were light yellow, clear and syringeable except formulation having 2.5% w/v chitosan. pH was in the range of 6.20 to 6.74. 1.0% w/v and 1.5% w/v chitosan formulations showed gelation temperature 37 ± 0.32 °C and 34 ± 0.21 °C. Further, mucoadhesive strength indicated mucoadhesivity of gel. In-vitro release study of 1.5% w/v chitosan formulation showed initial burst where about 55-60% MZ and 60-70% LVF got released within 6-7 hrs followed by sustained release upto 48 hrs. SEM images of 1.5% w/v chitosan optimized medicated in-situ and vehicle in-situ gel appeared similar indicating homogeneous mixing of polymers with drugs. In-vitro antimicrobial study showed that medicated in-situ gel was more effective than vehicle. CONCLUSIONS: In conclusion, optimized 1.5% w/v chitosan in-situ gel was thermoresponsive, mucoadhesive, syringeable, and released drugs in slow and controlled manner with effectiveness against broad range of microbes.
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BACKGROUND: In India, Ayurveda is considered to be more effective and cheaper than modern medicine. Ayurvedic literature shows its use in treating oral diseases also. However, their effectiveness, in comparison with the allopathic mode of management, has not been assessed previously. The aim of this randomized controlled clinical trial was to compare the efficacy of ayurvedic drugs over chlorhexidine in treating chronic periodontitis. MATERIALS AND METHODS: Four hundred and eight participants, in the age group 20-49 years, suffering from mild-to-moderate chronic periodontitis were included in this study. Community periodontal index for treatment needs (CPITN) score was recorded, and oral prophylaxis was done for each patient. They were then randomly divided into 6 groups: control group (I), chlorhexidine (II), Khadiradi vati (III), Dashansanskar churana (IV), Neem (V), and Apamarga (VI); based on the drugs used by patients for the maintenance of oral hygiene after oral prophylaxis. Patients were recalled at 1 week, 1 month, and 3 months after oral prophylaxis. CPITN score was re-recorded for each patient at each follow-up. Reduction in CPITN score indicated improvement in the periodontal health. Observations were statistically analyzed using univariate ANOVA and P value was set at <0.5. RESULTS: Improvement in CPITN scores in 6 groups was as follows: I - 42.0%, II - 76.37%, III - 82.03%, IV - 83.46%, V - 78.8%, and VI - 29.9%. Higher mean percentage improvement was seen when patients used these drugs for 3 months as compared to 1 month. CONCLUSION: Dashansanskar churana and Khadiradi vati showed better results than chlorhexidine and were found to be superior in managing mild-to-moderate cases of chronic periodontitis.
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BACKGROUND: The knowledge of the ABO blood group phenotype of the patients and their correlation with the periodontal disease maybe important in the development of early treatment strategies, and it would be helpful to target non-responding areas to periodontal therapy of the susceptible individuals. AIMS: The present study was conducted to determine whether there was any correlation between periodontal diseases and ABO blood groups and Rh factor. MATERIAL AND METHOD: This study was carried out on 537 subjects attending Faculty of Dental Sciences OPD in BHU. Subjects were divided into three groups: group I (healthy subjects), group II (subjects with gingivitis), and group III (subjects with periodontitis) based on periodontal examination (Gingival index, Bleeding Index, Probing pocket depth and clinical attachment level). ABO Blood grouping were done and correlated with the periodontal status of study subjects. Statistical Analysis: Data was analyzed using the statistical software namely Statistical Package for the Social Sciences (SPSS, Version 16, IBM Analytics) and Systat 8.0. RESULTS: In this study, there was a greater prevalence of gingivitis in blood group O and periodontitis in blood group B. The blood group AB showed the least prevalence of periodontal diseases. Similarly gingivitis and peridontitis were significantly higher among Rhesus positive groups when compared with Rhesus negative groups. CONCLUSION: Considering the results of this study, it can be concluded that ABO blood groups and Rh factor could be a risk factor for the development of periodontal disease.
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BACKGROUND: The periodontal diseases are the most prevalent oral diseases worldwide especially in developing countries like India. The objective of this cross-sectional survey was to determine the prevalence of periodontal diseases and treatment needs (TNs) in a hospital-based population. MATERIALS AND METHODS: Totally, 500 men and women (15-74 years) were recruited and periodontal status of each study subject and sextant was evaluated on the basis of community periodontal index of TNs, and thereafter TN for each subject and sextant was categorized on the basis of the highest code recorded during the examination. RESULTS: A total of 500 subjects (59% males and 41% females) was divided into seven age groups, that is, 15-19, 20-24, 25-34, 35-44, 45-54, 55-64, and 65-74 years and sextants were included from the 486 subjects. Healthy periodontium, bleeding on probing, calculus, shallow pockets, and deep pockets were found in 3.9%, 6.58%, 50.61%, 20.98%, and 17.90% subjects, respectively. Males were more affected with shallow and deep pockets as compared to females. Periodontal diseases in the early stages were more prevalent in the younger age groups, whereas advanced stages were more prevalent in older age groups. 17.90% subjects and 11.48% sextants need complex treatment. About 77.98% subjects and 73.15% sextants require either oral hygiene instructions or oral hygiene instructions and oral prophylaxis. Only 3.9% subjects and 15.36% sextants were healthy and needed no treatment. CONCLUSIONS: Periodontal diseases were found to be 96.30% in the study population and the results indicate that majority of the population need primary and secondary level of preventive program to reduce the chances of initiation or progression of periodontal diseases thereby improving their systemic health overall.
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INTRODUCTION: This study was designed as a clinical trial to evaluate and compare the regenerative potential of platelet-rich fibrin (PRF), platelet-rich plasma (PRP), and blood clot in immature necrotic permanent teeth with or without associated apical periodontitis. METHODS: Access preparation was done under rubber dam isolation. Copious irrigation was done with 2.5% NaOCl and triple antibiotic paste was placed as an intracanal medicament. After 4 weeks, the cases were divided into four groups with five patients in each group. The study design had three test arms and one control arm. Group I in which mineral trioxide aggregate apexification was carried out and it was kept as control group to evaluate the regenerative potential of blood clot and platelet concentrates, Group II in which blood clot was used as scaffold in the canal, Group III in PRF was used as scaffold, and Group IV in which PRP carried on collagen was used as a scaffold. RESULTS: The clinical and radiographic evaluation after 6 and 18 months was done by two independent observers who were blinded from the groups. The scoring was done as: None score was denoted by, Fair by 1, Good by 2, and Excellent by 3. The data were then analyzed statistically by Fisher's exact test using Statistics and Data 11.1(PRP Using harvest Smart PReP2) which showed statistically significant values in Group III as compared to other Groups. CONCLUSION: PRF has huge potential to accelerate the growth characteristics in immature necrotic permanent teeth as compared to PRP and blood clot.
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INTRODUCTION: The purpose of this study was to analyze the relation of tooth length and distal wall thickness of mesial roots in mandibular molars at different locations (ie, 2 mm below the furcation and at the junction between the middle and apical third). METHODS: Forty-five mandibular first molars were taken, and the length of each tooth was measured. Then, specimens were divided into three groups according to their length: group I-long (24.2 mm ± 1.8), group II-medium (21 mm ± 1.5) and group III-short (16.8 mm ± 1.8). mesial root of each marked at two levels - at 2 mm below the furcation as well as at junction of apical and middle third of roots. The minimum thickness of the distal root dentine associated with the buccal and lingual canals of the mesial roots was measured, The distance between the buccal and lingual canals and the depth of concavity in the distal surface of the mesial roots were also measured. RESULTS: Statistical analysis was performed by using analysis of variance and the Student-Newman-Keuls test. The minimum thickness of the distal wall of the mesiobuccal canal was significantly different (P < .001) between groups 1 (long) and 3 (short). CONCLUSIONS: Distal wall thickness of the mesiobuccal root and distal concavity of the mesial root of mandibular first molars were found to be thinner in longer teeth compared with shorter teeth.