Factors associated with the technical quality of root canal fillings performed by undergraduate dental students in a Malaysian dental school

Aim: A retrospective clinical audit was carried out on records of endodontic treatment performed bydental undergraduates. The audit was performed to evaluate the technical quality of root canal fillingsperformed by dental undergraduates and determine the associated factors. Methods: 140 records ofpatients who had received root canal treatment by dental undergraduates were evaluated throughperiapical radiographs by two examiners (ê=0.74). The root canal fillings had their quality evaluatedaccording to extent, condensation and presence of procedural mishap. Possible factors associatedwith technical quality such as tooth type, canal curvature, student level and quality of record keepingwere evaluated. Data were statistically analyzed using chi-square test (p<0.05). Results: Amongthe 140 root-filled teeth, acceptable extent, condensation and no-mishap were observed in 72.1%,66.4% and 77.9% cases respectively. Overall, the technical quality of 68 (48.6%) root-filled teethwas considered acceptable. Overall, non-acceptable root canal fillings were significantly morelikely to be observed in molars (69.2%), moderately and severely curved canals (71.4%) and juniorstudents (61.5%). There was no association between acceptable root canal fillings and quality ofrecord keeping. Conclusions: The technical quality of root canal fillings was acceptable in 48.6%cases and it was associated with tooth type, degree of canal curvature and student seniority.

Endodontic management of dilacerated and bayonet shaped roots / Tratamento endodôntico de raízes dilaceradas e em forma de baioneta

Successful root canal therapy requires a thorough knowledge of root anatomy and root canal morphology which may be quiet variable. The significance of internal root canal morphology has been emphasized by studies demonstrating that variations in canal morphology may affect the endodontic outcome. Consequently, in treating each tooth the clinician must assume that complex anatomy occurs often enough to be considered normal. Root dilaceration is one of the variations that may complicate the endodontic therapy. It is important for a clinician to have complete knowledge of internal anatomy relationships, careful interpretation of radiographs; proper access preparationand a detailed exploration of the interior of the tooth to achieve a successful treatment outcome. This paper reports successful endodontictherapy of severe dilaceration of the root of mandibular first molar and bayonet shaped root of maxillary first premolar and highlights theclinical considerations to be followed during the endodontic procedures to get the successful outcome.

Um tratamento de canal bem sucedido requer conhecimento profundo da anatomia da raiz dentária e morfologia do canal radicular, que pode ser variável. A importância da morfologia interna do canal radicular tem sido enfatizada por estudos que demonstram que as variações na morfologia do canal podem afetar o resultado do tratamento endodôntico. Consequentemente, no tratamento de cada dente, o clínico deve assumir que uma anatomia complexa ocorre com frequência suficiente para ser considerada normal. A dilaceração da raiz dentária é uma das variações que podem complicar o tratamento endodôntico. É importante para o clínico ter conhecimento completo das relações da anatomia interna, fazer uma interpretação cuidadosa de radiografias; preparar adequadamente o acesso e realizar uma exploração detalhada do interior do dente para conseguir um resultado de tratamento bem sucedido. Este artigo relata casos de terapia endodôntica bem sucedida de dilaceração severa da raiz do primeiro molar inferior e de raiz em forma de baioneta de um primeiro pré-molar superior e destaca as considerações clínicas a serem seguidas durante os procedimentos endodônticos para se obter êxito no tratamento.

Pharmacological Agents in Dentistry: A Review.

All clinicians should be fully aware of the recent trends in their speciality to enable them to provide effective and successful treatment to their patients. One vital aspect of the treatment is that the clinician should constantly update his knowledge on the drugs being administered during the course of treatment and their interactions. The purpose of this article is to review the current pharmacological agents being used in Prosthodontics along with their interactions and indications. The paper mainly focuses on Therapeutic drugs and drugs that aid in prosthodontics treatment. Therapeutic drugs include local anesthetics, antiseptics, steroids, analgesics, antimicrobials, antifungals, antianxity drugs, centrally acting muscle relaxants. Drugs that aid in prosthodontics treatment include astringents, vasoconstrictors, hemostatic agents, sialogogues, anti-sialogogues, denture cleansers, gum paints, denture cleansers, denture adhesives, ORAL protective agents and demulcents. An odontologist should have sound knowledge of the benefits and drawbacks of all these agents. This will enable the clinician to provide a safe and predictable treatment to the patients.

Microleakage of bonded amalgam restorations using different adhesive agents with dye under vacuum: An in vitro study.

Aim: In an effort to minimize tooth preparation, yet provide additional retention to compromised tooth structure, bonded amalgam restorations were introduced. Various resin-based adhesives have been tried earlier under bonded amalgam restorations. Still there are controversies regarding the outcome of bonded amalgam restorations regarding their adaptability to the tooth structure and microleakage. Therefore, this study was undertaken to compare the microleakage of bonded amalgam restorations using different adhesive materials. Materials and Methods: Standard Class I cavities were prepared on occlusal surfaces of 60 human molars. Teeth (n=60) were divided into three groups according to the material employed, as follows: group I: amalgam with glass ionomer cement (GIC) (type I); group II: amalgam with resin cement (Panavia F 2.0) and group III: amalgam with Copalex varnish as a control. Following restoration, the teeth were submitted to thermal cycling. The teeth were subsequently immersed in 2% rhodamine B dye under vacuum for 48 hours and sectioned to allow the assessment of microleakage under stereomicroscope. Results: The values were tabulated and the results were statistically analyzed using analysis of variance (ANOVA), Tukey's post hoc test and Kruskal-Wallis test. Amalgam with type I GIC showed the least leakage with no statistically significant difference (P value 0.226) when compared to amalgam with Panavia F 2.0 and amalgam with varnish (P value 0.107). Conclusion: It can be concluded that bonded amalgam with type I GIC is a good alternative to amalgam with resin cement (Panavia F 2.0) and amalgam with varnish for large restorations, with the added advantages of GICs. Clinical Significance: Bonded amalgam restorations prevent over-preparation and reduce the tooth flexure. GIC type I under amalgam provides chemical bonding in between amalgam and tooth structure and thus reduces the microleakage.

Comparative evaluation of the curve of Spee in two age groups and its relation to posterior teeth disclusion.

Objectives: This study aims to compare the curve of Spee in human permanent healthy dentitions in two age groups to the disclusion in the premolar and molar region during protrusion. Materials and Methods: Sixty subjects were chosen and equally divided into two age groups of 18-25 years and 35-44 years. The left side of the mandibular dental casts was photographed using a digital camera to measure the curve of Spee. The canine cusp, mesiobuccal cusp of the first molar and the distal cusp of the second molar were marked and joined to form an arc. Using AUTOCAD software, the radius for this arc was obtained. A protrusive interocclusal record was made using rigid bite registration material to measure the amount of posterior disclusion during edge to edge protrusion. A dial gauge with an accuracy of 1/100 of a millimeter was used to measure the distance between the cusp tip indentations at the region of the buccal cusp of the mandibular 2nd premolar and distobuccal cusp of mandibular 1st molar. The results obtained were statistically analyzed. Results: The radius of curve of Spee increased nonsignificantly with age. The mean disclusion values measured in premolar and molar region showed a nonsignificant decrease with age. Conclusion: As age advances, there is a flattening of the curve of Spee and a concurrent reduction in the disclusion values during protrusion.