Cryotherapy in the Management of Vital Pulp: A Case Report.

Cryotherapy in vital pulp treatment is a procedure that involves the use of extreme cold temperatures to manage inflammation and promote healing in the dental pulp tissue. It has shown potential in preserving pulp vitality and reducing post-operative discomfort in procedures such as partial and full pulpotomy. Vital pulp therapy (VPT) aims to preserve the vitality and function of the dental pulp. With the proper diagnosis, technique, and materials, it can effectively treat moderately inflamed pulp and minimize the need for more invasive procedures. This article presents a case of vital pulp cryotherapy in a patient having moderately inflamed pulp.

Maxillary Mucinous Adenocarcinoma Mimicking a Lesion of Endodontic Origin: A Rare Case Report.

Periapical lesions of endodontic origin are fairly common in the oral cavity in association with tooth pulp infection. Most of these lesions will resolve with adequate root canal treatment and rarely cause suspicion of more insidious disease. Most clinicians tend to skip histopathological examination in cases where the lesion is excised or curetted. We present a rare case of mucinous adenocarcinoma in association an endodontically treated maxillary discoloured central incisor in a 38 year old patient with a history of root canal treatment about 15 years ago. Root canal re-treatment and wide excision was performed. Histology showed epithelial islands suggestive of a neoplasm. Immunohistochemistry was positive for CK7 and S100. Metastasis was ruled out and no evidence of recurrence has been noted in the 12-month follow up period. It is emphasized that any tissue removed from the surgical site should be analysed microscopically. (EEJ-2022-01-013).

Incidence of postoperative pain after single-visit and multiple-visit root canal therapy: A randomized controlled trial.

Background: Short-term complications after root canal therapy (RCT) include mild pain or flare-up. Patients regard these complications as a benchmark for the assessment of clinician's abilities. In this context, the evidence for recommending either one- or two-visit RCT is not consistent. Aims: This study aims to compare the prevalence of postoperative pain and tenderness to percussion after single-visit (SV) versus two-visit RCT on the mandibular first molar. Materials and Methods: The study was registered with www.ctri.nic.in (CTRI/2019/05/019067). Seventy individuals requiring RCT on a mandibular first molar were selected and randomly ascribed to either single- (Group 1, n = 35) or two-visit RCT (Group 2, n = 35). Postoperative pain levels were assessed using heft parker visual analog scale. The treated teeth were appraised for tenderness to percussion after 1 week of obturation. Statistical Analysis: Thirty-four patients were evaluated in each group: One patient, each, dropped out from both the groups. The data analysis was done using Student's t-test and Chi-square test. Results and Conclusion: Pain score in multiple-visit (MV) was significantly higher than SV after 12- (P = 0.039) and 48 h (P = 0.043). Short-term postoperative pain was higher in MV than SV RCT of mandibular first molar teeth.

Pulpal-anesthesia of a mandibular first molar with irreversible pulpitis by inferior alveolar nerve block plus buccal infiltration using articaine or lignocaine.

INTRODUCTION: This study aims to compare the efficacy of a combination of an inferior alveolar nerve block (IANB) plus buccal infiltration using 4% articaine versus 2% lignocaine in achieving anesthesia of lower first molar teeth with irreversible pulpitis. MATERIALS AND METHODS: Seventy adult patients were selected. A random sequence list was employed to administer IANB plus buccal infiltration. After the onset of lip numbness, cold test and electric pulp testing were performed. Five patients, four missed blocks and one no bleeding, were excluded. Heft Parker Visual Analog Scale scores during pulp extirpation were recorded. The data of sixty-five patients were statistically analyzed using Chi-square and Mann-Whitney U-test. RESULTS: The success rate after lip-numbness for articaine is 91.42% and for lignocaine is 94.28%. The difference is statistically, not significant (P = 0.6425). During access, the success rate for lignocaine is 96.87%, whereas 96.96% for articaine. This difference is also not significant (P = 0.982366). CONCLUSION: IANB plus buccal infiltration using articaine or lignocaine is equally effective in anesthetizing mandibular first molar with irreversible pulpitis.

Comparative evaluation of the effectiveness and fracture rate of three pathfinding nickel-titanium rotary instruments, Mtwo, OneG, and ProGlider, in mechanically negotiating moderately curved molar canals to the full working length.

AIM: To evaluate the scouting ability of three pathfinding nickel-titanium rotary instruments in moderately curved molar canals. MATERIALS AND METHODS: Ninety maxillary and mandibular molars were collected and were divided randomly into three groups each having 15 maxillary and 15 mandibular molars. The teeth were mounted on a specific apparatus for simulation of dento-alveolar socket. After access cavity preparation, the canals were negotiated with 08 K-file. Glide path preparation was performed using Mtwo or ProGlider or OneG instruments. The number of teeth in which the file reached the full working length (RFWL), number of passes required, and number of fractured instruments were recorded and subjected to statistical analysis using Chi-square, Kruskal-Wallis, and Mann-Whitney tests. RESULTS: There was a significant difference between the groups (P < 0.05). The RFWL of ProGlider was significantly higher than that of Mtwo (P = 0.005) and OneG (P = 0.037). The percentage of fracture with ProGlider was 6.67% and both Mtwo and OneG had 26.67% frequency. The difference was not statistically significant (P > 0.05). There was significant difference in the number of insertion passes in maxillary distobuccal (P < 0.05), mandibular mesiobuccal (P < 0.01), and distal (P < 0.01) canals. ProGlider was the most effective pathfinding instrument due to its file's design and a progressive taper of 2%-8%. This achieves a greater preflaring of the coronal and middle portions of the root canal, rendering the advance of the instrument toward the apex easier. CONCLUSION: ProGlider performed more efficiently and with less instrument breakage in scouting moderately curved canals of molar teeth.

Electrolyzed saline an alternative to sodium hypochlorite for root canal irrigation.

OBJECTIVES: The aim of this study is to evaluate electrolyzed saline, produced from a custom-made chair side apparatus for its cleaning effect on root canal walls. METHODS: A chair side apparatus has been designed to produce and dispense electrolytically activated solutions (Electrolyzed saline) for the purpose of root canal irrigation. Two different solutions, one, which is oxidizing in nature, consisting primarily of Chlorine derivatives and another, reducing in nature, consisting primarily of sodium hydroxide, are obtained. A combination of these two solutions was used for root canal irrigation in extracted teeth. Root canals were split and the samples were subjected to Scanning electron microscopic evaluation. RESULTS: Under the conditions of this study, electrolyzed saline significantly cleaned the root canal surfaces well, opening the dentinal tubules and removing the smear layer. SIGNIFICANCE: There has been a constant search for the ideal root canal irrigant. Sodium hypochlorite has been vastly used but its toxicity and storage risks are of concern. Electrolyzed saline has been produced from saline and the apparatus prepares and dispenses the solution chair side, obviating storage needs.

Endodontic management of mandibular second premolar with three canals.

Mandibular premolar can present a complex pulp anatomy. Apart from the usual single root and single canal a many other variations may be seen. Hence not only a thorough knowledge of the root canal anatomy but also it's variations are indispensable pre requisites for the success of any endodontic treatment. Good magnification and CBCT scans will definitely be beneficial for successful endodontic treatment. The present case provides evidence that mandibular premolars may have more than one canal.

Preventive endodontics by direct pulp capping with restorative dentin substitute-biodentine: A series of fifteen cases.

INTRODUCTION: Treatment of mechanical exposure of the pulp during caries excavation presents a clinical challenge. In this case series of 15 patients, with a follow-up period of over a year, the outcome of direct pulp capping with Biodentine (septodont) after mechanical pulp exposure was assessed. AIM OF STUDY: The aim of this study is to evaluate the outcome of direct pulp capping with Biodentine in deeply carious teeth when pulp was mechanically exposed during caries excavation and cavity preparation. Vital pulps exposed during caries excavation in molar teeth were treated with 3% sodium hypochlorite for 2 min. If adequate hemostasis was achieved, the pulp tissue was capped with Biodentine, which covered the entire pulpal floor. This was followed by the placement of a layer of resin-modified glass ionomer cement and a final layer of composite resin (Filtek Z350-3M) to complete the restoration. The patients were recalled periodically and evaluated for any evidence of pulpal/periapical pathology. RESULTS: In the follow-up period that ranged from 12 to 24 months, all teeth were asymptomatic. CONCLUSION: Biodentine appears to be a suitable material for direct pulp capping under clinical conditions. However, long-term follow-up studies and controlled trials involving a large sample size are warranted.

Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography.

Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals.

Endodontic treatment of a mandibular second premolar with three roots and three canals.

Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals.