Antimicrobial efficacy of endodontic irrigants from Azadirachta indica: An in vitro study.

OBJECTIVE: This study analyzed the antimicrobial effect of five irrigants formulated from different parts of the tree Azadirachta indica (Neem) and compared with 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate through an agar diffusion test. MATERIALS AND METHODS: A clinical isolate of Candida albicans was innoculated on Sabourad Dextrose Agar and Enterococcus faecalis (ATCC 29212) on Sheep Blood Agar. Wells with 6 mm diameter were created in agar and 100 µL aliquiots of each irrigant were introduced to five different wells. After incubation, the largest uniform diameter of the inhibition zone was recorded. RESULTS: The leaf extract of the tree and a mixture of the seed-bark powder dissolved in dimethyl sulfoxide were active against both organisms. The other neem-based irrigants, a leaf powder dissolved in dimethyl sulfoxide, aqueous bark decoction and neem oil, did not possess any antimicrobial efficacy. Sodium hypochlorite completely inhibited growth of C. albicans and the leaf extract had larger inhibition zones than chlorhexidine (p = 0.011) or the seed-bark irrigant (p = 0.008). Against E. faecalis, inhibition zones with chlorhexidine were the largest and differed significantly from sodium hypochlorite (p = 0.039), leaf extract (p = 0.008) and seed-bark irrigant (p = 0.011). CONCLUSIONS: Two neem irrigants displayed antimicrobial properties. The efficacy of the standard endodontic irrigants varied depending on the organisms tested. CLINICAL RELEVANCE: Neem-based endodontic irrigants may be formulated for clinical application.

Nonsurgical management of a nonvital tooth with orthodontically induced external root resorption and extensive periapical pathology.

The purpose of this article is to report a rare case of orthodontically induced external root resorption of a maxillary left central incisor with a large periapical radiolucency; it was treated successfully with a conservative approach that included the use of calcium hydroxide. The tooth was nonvital and had grade III mobility. It was treated endodontically for 2 years with an interim filling of calcium hydroxide mixed with propylene glycol. After 2 years, the postoperative intraoral periapical radiograph showed good periapical healing with complete resolution of periapical radiolucency. There was a significant reduction in the mobility of the tooth, from grade III to grade I.

Evaluation of tooth preparations for Class II cavities using magnification loupes among dental interns and final year BDS students in preclinical laboratory.

BACKGROUND: With the advances in optical technology, dentistry has been benefitted in varied ways over the ages. AIM: The aim of this study was to assess the effect of dental magnification loupes on psychomotor skill acquisition during preclinical operative exercise. METHODS: 40 Typhodont teeth tooth no. 36 and 46 (Frasaco - U.S.A.) were mounted on the acrylic lower jaw base of Phantom Head. Teeth are prepared for class II (MO) cavity with conservative design using micromotor, mouth mirror and probe. Tooth no.36 was prepared using magnifying loupes while tooth no.46 was prepared without the loupes. Data collected was statistically analyzed using Chi square test. RESULTS: The results revealed that tooth preparations were better under magnifying loupes as compared to those without it with statistically significant difference with Kappa value 0.64 for samples with loupes and 0.76 for without loupes. Moreover, the study samples expressed their difficulty for using the magnifying loupes during the tooth preparation since they were using it for the first time. CONCLUSIONS: Magnifying loupes help the dental students to have better vision, thus improved dexterity with hands while preparing the tooth for restoration. However, dental students have to get adapted to the loupes for the ease of using loupes. Using loupes frequently may help them to get adapted to the loupes.

Comparative anti-microbial efficacy of Azadirachta indica irrigant with standard endodontic irrigants: A preliminary study.

OBJECTIVE: The anti-microbial efficacy of 2.5% sodium hypochlorite (SHC) and 0.2% chlorhexidine gluconate were compared with an experimental irrigant formulated from the Neem tree, Azadirachta indica A. Juss. MATERIALS AND METHODS: A sample of 36 single rooted anterior teeth with periapical radiolucency and absence of response to vitality tests that required root canal treatment were selected for this study. The test irrigants and their combinations were assigned to five different groups and saline served as the control. Access cavities were prepared using an aseptic technique and samples collected for both anaerobic culture and Gram stained smears, followed by irrigation and sample collection again. The number of organisms were expressed in colony forming units/ml after 72 h of incubation; the smears were analyzed for their microbial loads and tissue clearance and assessed as per defined criteria. RESULTS: Our results found the maximum reduction in microbial loads, when analyzed by culture method, with a combination of SHC and the experimental neem irrigant. Maximum tissue clearance on the Gram Stained smears was also found with the same combination. CONCLUSION: Neem irrigant has anti-microbial efficacy and can be considered for endodontic use.

Endodontic management of hypo-, meso- and hypertaurodontism: case reports.

Taurodontism is a morpho-anatomical developmental anomaly rarely seen in teeth. It is characterised by lack of constriction at the level of cementoenamel junction with elongated pulp chambers and apical displacement of bifurcation or trifurcation of roots. This gives the tooth a rectangular or cylindrical appearance. This paper reports successful endodontic therapy of cases with hypo-, meso- and hypertaurodontism in healthy individuals with no associated syndrome or anomaly.

A comparative evaluation of postobturation apical seal following intracanal irrigation with maleic acid and EDTA: a dye leakage under vacuum study.

OBJECTIVE: The aim of the study was to evaluate the postobturation apical seal following irrigation with 7% maleic acid (MA) or 17% EDTA using dye leakage under vacuum method. STUDY DESIGN: Seventy single-rooted human anterior teeth were subjected to root canal instrumentation. Based on the final irrigating solution used, samples were divided into 3 groups: (1) 17% EDTA + 2.5% NaOCl, (2) 7% MA + 2.5% NaOCl, (3) 0.9% saline. Then samples were obturated and placed in 2% rhodamine B dye solution under vacuum pressure for 30 minutes and allowed to remain in the dye for 7 days. Samples were then longitudinally split and examined for dye leakage under stereomicroscope. Data were analyzed using the Kruskal-Wallis test. RESULTS: MA showed the least apical leakage compared with EDTA and saline. Saline showed maximum leakage. CONCLUSION: Final irrigation with 7% MA improved the postobturation apical seal compared with 17% EDTA.

In vitro sustained release of calcium ions and pH maintenance from different vehicles containing calcium hydroxide.

INTRODUCTION: Calcium hydroxide is widely used as an intracanal medicament in endodontics. Its therapeutic effects depend on the dissociation of calcium hydroxide into calcium and hydroxyl ions, which, in turn, depends on the vehicle used. The purpose of this in vitro study was to evaluate the sustained release of calcium ions and the pH change of calcium hydroxide over a period of 30 days when formulated with propylene glycol, polyethylene glycol 6000, chitosan, and guar gum. METHODS: Various formulations were prepared and placed inside the root canals of human teeth and were suspended in glass vials containing distilled water. At specific time intervals, the calcium ion concentration was analyzed using an ultraviolet spectrophotometer. pH changes of the medium were measured at various time intervals up to 30 days. RESULTS: Results revealed that chitosan formulation showed the maximum sustained release of calcium ions compared with the other three formulations. All the formulations exhibited high alkaline pH upto 30 days. CONCLUSION: From the results of this in vitro study, it can be concluded that chitosan can be used as a promising vehicle for for the sustained release of calcium ions from the calcium hydroxide in the root canal system.