RESUMEN
Context: Endodontic retreatment is the first line of treatment in cases of failed primary endodontic treatment. Although associated with challenges such as incomplete removal of obturating material, increased clinical time, and extrusion of apical debris, endodontic retreatment still has considerable success rate in the general population. Aims: The aim of this study was to evaluate and compare the efficacy of TruNatomy, ProTaper retreatment, and RaCe file systems to remove the obturating material, time taken to remove the obturating material, and apical extrusion of debris using cone-beam computed tomography (CBCT). Settings and Design: In vitro study. Subjects and Methods: Forty-five moderately curved mesiobuccal roots of the mandibular molars were instrumented up to #25, 4% taper and obturated with bioceramic sealer and lateral compaction technique. Teeth were divided randomly into three groups (n = 15). Teeth were retreated with TruNatomy, ProTaper retreatment, and RaCe file systems, respectively. Preretreatment and postretreatment CBCT scans were recorded and percentage of obturating material removed was calculated. Time taken to remove the obturating material and apical extrusion of debris was noted. Statistical Analysis Used: Descriptive statistics including percentage, mean, standard deviation, Tukey's post hoc test, Kruskal-Wallis test, and Mann-Whitney Post hoc test were used. Results: The total time needed for the removal of obturating material was comparatively shorter in the RaCe group, followed by the ProTaper retreatment group and TruNatomy group (P < 0.001). TruNatomy files were significantly better in removing the obturating material than the ProTaper retreatment files (P = 0.04). Statically, no difference between RaCe and TruNatomy files was noted. Apically extruded debris was more in the TruNatomy group than in the RaCe and ProTaper retreatment groups (P = 0.01). Conclusions: All tested endodontic files were effective in removal of obturating material, although none could completely remove the filling material and no system could completely eliminate apical extrusion.
RESUMEN
Aim: The aim of this study was to evaluate apical microleakage in root canals containing broken rotary instruments obturated with cold lateral condensation and thermoplasticized injectable gutta-percha, with different sealers, using glucose penetration leakage study. Materials and Methods: In this in vitro study, 96 extracted human mandibular premolars were decoronated, and the roots were randomly divided into eight groups (n = 12). Root canals were instrumented with #30 4% taper rotary files. The files were scratched 3 mm from the tip by a high-speed handpiece, and they were intentionally broken in the apical third of the canals. The middle and coronal sections of the canals were obturated by cold lateral condensation and thermoplasticized technique, using ZOE, resin, CaOH, and bioceramic sealers. Apical microleakage was measured using the glucose penetration method. Statistical Analysis: Independent Student's t-test and one-way ANOVA followed by Tukey's post hoc analysis were used for statistical analysis. Results: Bioceramic sealer group showed the least apical microleakage and this was then followed by the resin and CaOH groups demonstrating lesser apical microleakage and the highest microleakage was with the ZOE group. Mean apical microleakage scores between lateral and thermoplastic condensation techniques in each group were statistically significant (P < 0.001). Conclusion: Bioceramic sealer demonstrated the least apical leakage, whereas ZOE seal displayed the highest apical leakage.
RESUMEN
INTRODUCTION: Outcome data in pediatric plasma exchange, especially in nonrenal indications are scarce. We aimed to evaluate its role and outcome in our patients. SUBJECTS AND METHODS: A retrospective study of children admitted in the year 2016 to the Pediatric Intensive Care Unit requiring plasma exchange for nonrenal indications was undertaken. Plasma exchange was given as adjunctive therapy along with primary treatment for the disease concerned. Demographic and clinical data were studied, and descriptive statistical analysis was carried out. RESULTS: Ten children underwent plasma exchange during this 1-year period with a male: female ratio of 3:2 and a mean age of 10 years (range 3-16 years). The indications were acute disseminated encephalomyelitis (n = 2), acute neuromyelitis optica (n = 1), catastrophic antiphospholipid antibody syndrome secondary to systemic lupus erythematosus (SLE) (n = 1), severe SLE with cerebritis/hemophagocytic lymphohistiocytosis (HLH) (n = 2), severe dengue sepsis with HLH/multi-organ dysfunction syndrome (n = 2), and thrombotic microangiopathy secondary to snake bite envenomation (n = 2). All received either 1.5 or 2 times plasma volume exchange (mean sessions - 4, range = 1-6). The mean duration of stay in hospital was 17.2 days (range = 3-40 days), and follow-up was 78 days (range = 3-180 days), with the majority of children (8/10, 80%) survived from the catastrophic illness at the time of discharge. Two children (2/10, 20%) succumbed due to the disease per se in severe dengue sepsis in one and enterobacteriaceae sepsis (hospital-acquired pneumonia) in another. CONCLUSION: Plasma exchange was found to be beneficial as complementary therapy in a critical care setting, especially for nonrenal indications.
RESUMEN
OBJECTIVE: This study investigated whether the canal curvature has an influence on the accuracy of Electronic Apex Locator. MATERIALS AND METHODS: Sixty mandibular posterior teeth were decoronated. A number (No.) 10 file was inserted into the mesiobuccal canal and radiographs were taken to determine the degree of curvature by Schneider's method. Samples were divided into three groups of mild (<20°), moderate (20-36°) and severe curvature (>36°). After enlarging the orifice, the actual canal length was determined by introducing a file until the tip emerged through the major foramen when observed under 20X magnification. The teeth were embedded in an alginate model and the Root ZX was used to determine the electronic length. The data was analyzed by Kruskal-Wallis test followed by Mann-Whitney test. RESULTS: The difference in measurement of Actual and Electronic working length was statistically significant between group 1 and 2 (P < 0.05) as well as between group 1 and group 3 (P < 0.05) with group 1 showing the lowest difference. CONCLUSION: Considering ± 0.5 mm as tolerance limit for accuracy, the device was 95% accurate for the mild curvature group and 80% accurate for moderate and severe groups.
