Reattachment of Fractured Tooth: A Comprehensive Review.

Dental trauma is one of the most prevalent problems encountered in clinical practice. Traumatic injuries involving fractures of the anterior tooth are one of the most common problems among children and adolescents. There is a physical and social impact on patients' quality of life due to traumatic dental injuries (TDIs). Children and adolescents frequently present with a crown fracture that necessitates immediate intervention. Clinicians need to be aware of various treatment modalities for TDIs and have to address these injuries immediately. Due to advances in adhesive technologies, fragment reattachment is the treatment of choice when the fragment is available and well stored. The purpose of this article is to cover various techniques for reattaching fractured fragments and the most current developments in adhesive systems for this purpose.

Enhancing Aesthetics and Functionality of the Teeth Using Injectable Composite Resin Technique.

In order to prepare composite restorations without the requirement for tooth preparation, the injectable composite resin technique uses a clear silicone index in a minimally invasive direct approach to imitate a diagnostic wax-up. This case report features a 34-year-old female patient having aesthetic and functional concerns, notably spacing between the teeth, insufficient tooth visibility, and diastema in the upper anterior region. Upon clinical examination, spacing and midline diastema were observed. The maxillary incisors and canines were to have composite veneers made as part of the treatment plan. A wax-up and transparent silicone index was prepared following the assessment of a try-in of the prepared mock-up. Subsequenty, for restoring the teeth, a clear silicone index was used to inject and polymerize the flowable composite. The desired outcomes included elongated teeth to enhance visibility, closure of diastemas, and reshaping of the canines. Over a 12-month follow-up period, the patient exhibited no signs of soft tissue inflammation or significant wear. The described technique is characterized by its minimal invasiveness, cost-effectiveness, and suitability for definitive and provisional restorations. Desirable results can be achieved by appropriate planning and adhering to a meticulous planning while minimizing tooth structure loss.

Comparative Evaluation of the Efficacy of TheraCal LC, Mineral Trioxide Aggregate, and Biodentine As Direct Pulp Capping Materials in Patients With Pulpal Exposure in Posterior Teeth: A Triple-Blinded Randomized Parallel Group Clinical Trial.

Background The aim was to evaluate and compare the efficacy of TheraCal LC, mineral trioxide aggregate (MTA), and Biodentine as direct pulp capping (DPC) materials in patients with pulpal exposure in the posterior teeth. Methodology A total of 54 samples were assessed for eligibility. Out of this, 12 teeth samples failed to meet the inclusion criteria. Finally, 42 teeth samples were selected which were randomly distributed into three groups (n = 14). Groups A, B, and C received the intervention of MTA, Biodentine, and TheraCal LC, respectively. The assessment was performed clinically to check for postoperative pain, tenderness, and neural sensibility, and the radiographs were used to check the presence of periodontal ligament (PDL) space widening, calcified barrier, and periapical radiolucency at the follow-up of 21 days, three months, and 12 months. The outcomes depended on the clinical and radiographic success rates recorded at 12 months of recall. Results Overall successful outcome of DPC clinically at different periods was 97.61% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. The overall radiographic success rate of DPC at different time periods was 83.33% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. Conclusion Resin-based calcium-silicate agent (TheraCal LC) showed good efficacy and can be used in practice with the predictability of a good success rate both clinically and radiographically. Thus, TheraCal LC can be utilized as an alternative to MTA or Biodentine in clinical practice, with the predictability of similar successful outcomes in patients with pulpal exposure in the posterior teeth.

Hemisection: A Paradigm Shift in Prolonging Tooth Viability.

Splitting a molar means removing or separating the root and the accompanying crown portion. Hemisection of a damaged tooth aids in preserving the tooth structure and the existing alveolar bone surrounding the preserved root while also enabling the installation of a fixed prosthesis. This case report defines hemisection as an effective modality for preserving carious mandibular first molars with periodontal and periapical pathology.

Comparative evaluation of apical debris extrusion during root canal preparation using three different rotary file systems.

Background: Endodontic success depends on the complete cleaning and shaping of the root canal. In order to achieve this goal, debris removal is essential. Even with improvements in instrument design, apical debris extrusion continues to be a cause of periradicular inflammation. The current study aimed to compare the amount of apically extruded debris throughout the canal instrumentation with TruNatomy, ProTaper Next, 2Shape rotary systems. Methods: A total of 60 freshly extracted single­rooted mandibular premolars were used. An access opening was made, and a working length was estimated. The samples were arbitrarily allocated into three groups i.e. Group I: TruNatomy (n = 20), Group II: ProTaper Next (n = 20), Group III: 2Shape (n = 20). During the canal instrumentation, the extruded debris were collected in preweighed Eppendorf tubes. Post-instrumentation, the tubes were placed in a hot air oven at 140°C for five hours. For calculating the dry debris weight, the tube's pre-instrumentation weight was deducted from the post-instrumentation weight. The data was analysed using one­way analysis of variance and post hoc Tukey's test. Results: Extrusion of debris was noted in all the specimens. TruNatomy rotary system showed least debris extrusion in comparison to ProTaper Next and 2Shape (P < 0.05). However, the results were statistically non-significant between ProTaper Next and 2Shape (P > 0.05). Conclusions: It was noted that all instruments apically extruded debris, with TruNatomy system being related to minimum extrusion.

Beyond Tradition: Non-surgical Endodontics and Vital Pulp Therapy as a Dynamic Combination.

Symptomatic irreversible pulpitis and apical periodontitis in mature permanent teeth present challenges in their management. Traditional treatment approaches, such as root canal therapy or tooth extraction, may compromise tooth structure and oral function. This review article explores the combination of non-surgical endodontic treatment and vital pulp therapy as an alternative approach for these conditions. The purpose is to examine this combined approach's effectiveness, benefits, challenges, and limitations. The objectives include reviewing the literature, evaluating clinical outcomes, discussing potential benefits, and providing recommendations for clinical practice. The combination approach aims to preserve tooth structure, promote healing, and reduce postoperative complications. The article discusses the rationale for combining the two techniques, presents evidence supporting their efficacy, and outlines the techniques and protocols involved. Clinical outcomes, case studies, potential challenges, and comparative analysis with traditional approaches are also explored. Future directions and research recommendations highlight areas for further investigation, innovations, and the development of clinical guidelines. In conclusion, the combination of non-surgical endodontic treatment and vital pulp therapy offers a valuable strategy for managing mature permanent mandibular molars with symptomatic irreversible pulpitis and apical periodontitis. Further research and advancements are needed to refine the treatment protocol and expand the evidence base, and clinicians should stay updated to provide optimal care and improve patient outcomes.

Application of Low-Level Laser Therapy in Endodontics: A Narrative Review.

Low-level laser therapy (LLLT) stands out in the realm of dentistry for its unique attributes that set it apart from traditional therapeutic approaches. This non-invasive and painless modality harnesses the power of low-intensity lasers, offering a distinct advantage in terms of safety and patient comfort. Unlike many conventional methods, LLLT does not rely on pharmaceutical interventions or invasive procedures, making it a gentle yet effective option for various dental applications. Its non-thermal, photobiomodulatory effects on cellular and tissue functions mark a notable departure from the more aggressive treatment modalities commonly associated with dentistry. This article provides an extensive exploration of LLLT's applications in dentistry, focusing on its mechanisms of action and biological effects, and emphasizes the uniqueness of LLLT as a transformative tool in modern dental care.

Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors.

This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.

Role of Fluoride in Dentistry: A Narrative Review.

Fluoride has performed a central role in the growth over the last fifty years. This report examines the present state of knowledge about fluoride's involvement in preventing dental caries. In recent years, our knowledge of the development of dental caries and the manner of operation of fluoride has been shifted. Dental caries is a constant procedure for enamel demineralization and remineralization, and fluoride plays an important part in this action by acting at the plaque-enamel contact. Fluoride's major method of action is now recognized as posteruptive. Fluoride's post-eruptive activity has led to the development of novel fluoride delivery systems. The importance of various fluoride delivery techniques on a population and societal level is discussed, along with suggestions.

Navigating Separated Instrument Retrieval: A Case Report.

Instrument separation during endodontic therapy is a complication occurring in 2% to 6% of cases. Focusing on the Masserann technique, the study presents a success rate of 55% in retrieving separated instruments. The technique's effectiveness is demonstrated through a case involving retrieving an instrument from the mandibular first premolar. The technique utilizes various tools, including trephine burs and an extractor, providing a reliable means to dislodge tightly wedged fragments. Despite limitations in specific tooth types and the necessity for frequent radiographic monitoring, the Masserann kit proves effective and underscores the importance of attempting retrieval before considering surgical interventions. The presented case exemplifies the technique's clinical applicability and positive outcomes in intricate scenarios, emphasizing its significance in endodontic practice.