Stresses in Teeth with External Cervical Resorption Defects Restored with Different Biomimetic Cements: A Finite Element Analysis.

INTRODUCTION: This study compared the stress distributions in teeth with simulated external cervical resorption defects restored with different restorative materials and identified areas of high stress concentration. METHODS: A maxillary central incisor created in a scanned model using HyperWorks software (Altair Engineering Inc, Troy, MI) served as the control. External cervical resorption defects based on Shanon Patel's classification were created (1Bd/2Bd/3Bd) in the scanned model. The defects were restored using mineral trioxide aggregate, Biodentine, glass ionomer cement, and Bioaggregate. On all the models, a force of 100 N was applied on the palatal aspect 2 mm incisal to the cingulum directed at 45° along the long axis of the tooth. RESULTS: The stresses generated in dentin and cementum are less, with a restorative material having a high Young's modulus. For the 1Bd defect, MTA and Bioaggregate showed least stresses in dentin and cementum, respectively, whereas Biodentine had consistently lower stresses in dentin and cementum. Larger defects like 2Bd and 3Bd restored with Bioaggregate exhibited minimum stresses in dentin and cementum. CONCLUSIONS: Bioaggregate and Biodentine replace dentin with maximum stress and maximum strain. Elastic moduli similar to or higher than dentin are preferred for restoring cervical third resorptive lesions of the tooth.

Efficacy of 2% Paradichlorobenzene, 10% Citric Acid, 17% Ethylenediaminetetraacetic Acid, and 0.2% Chitosan at Removing Calcium Hydroxide From the Root Canals.

INTRODUCTION: Chronic infections often require the use of an intracanal medicament. Calcium hydroxide is the most commonly used intracanal medicament. However, retrieval of calcium hydroxide (CH) medicaments is a challenge. AIM: This study evaluated the efficacy of 2% paradichlorobenzene, 10% citric acid, 17% ethylenediaminetetraacetic acid (EDTA), and 0.2% chitosan in removing calcium hydroxide from the root canals. METHODS AND MATERIALS: Forty single-rooted mandibular premolars extracted for orthodontic reasons were selected for the study. After access opening, cleaning and shaping were performed following a standardized irrigation protocol, and the samples were pre-weighed for baseline weight. CH was placed in canals until the apex, and the specimen was incubated at 37 °C and 100% relative humidity for seven days. These samples were weighed again for quantitative analysis and subjected to cone beam computed tomography (CBCT) for volumetric analysis using ITK SNAP software (Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA). The samples were randomly divided into four groups based on the irrigant used for the removal of medicament. Group 1: 2% paradichlorobenzene; group 2: 10% citric acid; group 3: 17% EDTA; and group 4: 0.2% chitosan, all in combination with sonic agitation. After the removal of CH, weight and volumetric analyses were repeated, and the percentage difference was calculated. STATISTICAL ANALYSIS: Statistical analysis was done using the one-way ANOVA test for both weight and volumetric assessment, and the inter-group comparison was made using the post hoc Tukey test. RESULTS: The maximum retrieval was observed with 2% paradichlorobenzene by both weight (96.75%) and volumetric (91.42%) assessment, with p=0.00 and p=0.01, respectively. This was followed by 0.2% chitosan, 10% citric acid, and the least, 17% EDTA. CONCLUSION: Two percent paradichlorobenzene combined with sonic agitation was most efficient in removing CH, followed by 0.2% chitosan, 10% citric acid, and 17% EDTA chitosan.

Endodontic management of maxillary first molar with unusual anatomy.

This article reports nonsurgical endodontic management of bilateral maxillary first molars with an unusual morphology of a single root and a Sert and Bayirli type-IX canal configuration. A 41-year-old female reported with dull continuous pain in the maxillary left and right quadrants. On clinical examination, the maxillary first molars on both sides were carious with pulpal exposure and radiographic evaluation revealed an unusual anatomy of single root and single canal for both of them. Based on clinical and radiographic examination, tooth numbers 16 and 26 were diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Root canal treatment was initiated and cone-beam computed tomography (CBCT) imaging was advised on encountering unusual internal anatomy. The CBCT images revealed the presence single root and a Sert and Bayirli type-IX canal configuration bilaterally. Root canal treatment was performed under magnification using the dental operating microscope.

A comparative evaluation of fracture toughness, flexural strength, and acid buffer capability of a bulk-fill alkasite with high-strength glass-ionomer cement: An in vitro study.

Background: Although glass-ionomer cement (GIC) has many unique properties and advantages, it still lacks favorable mechanical properties. Cention N is a recent alkasite material with excellent mechanical properties. The purpose of this study was to compare the mechanical properties (fracture toughness [FT] and flexural strength [FS]) and acid buffer capability of an alkasite material to GIC. Materials and Methods: In this in vitro study, a total of 60 samples were prepared using Cention N or GIC. Twenty specimens (n = 10) were prepared using beam-shaped Teflon molds for FS, and twenty specimens (n = 10) were prepared with a similar mold with a notch for FT. These were evaluated on a universal testing machine using a three-point bend test. Twenty (n = 10) disk-shaped specimens were prepared for acid buffer capability. The samples were stored in distilled water for a week. This was followed by immersion in lactic acid with a pH of 4 for calculation of the materials acid buffering capacity at 30 and 60 min from exposure using a pH meter. The data obtained were tabulated and subjected to Kolmogorov-Smirnov test and Shapiro-Wilk test to assess the normal distribution and further analyzed using the Student's t-test to assess the level of significance, P < 0.05 was considered statistically significant. Results: The mean FT, FS, and acid buffer capability of Cention N were significantly higher than GIC at P < 0.05. Conclusion: The present study surmised that Cention N exhibited higher FT, FS, and acid buffer capability than GIC.

Knowledge and perception of dental practitioners regarding the use of devitalizing agents.

BACKGROUND: Pulpal pain is amongst the most severe pains experienced by humans. Various chemical agents are used routinely to devitalize the severely inflamed pulpal tissue. Most of these agents are harmful and have detrimental effects. This questionnaire-based study evaluated the awareness and perception of dental practitioners regarding the use of devitalizing agents during endodontic procedures, and various alternatives to minimize the use of these agents. METHODS: An open questionnaire was distributed to a total of 250 dental practitioners. It carried detailed information about the most common devitalizing agent used, the purpose of use, method, and duration of application, recommendations, complications encountered, awareness of complications, and various alternatives. The collected data were subjected to statistical analysis using SPSS (Statistical Package for Social Sciences) version 17.0 (IBM Statistics, Chicago, Illinois, USA). Descriptive statistics were drawn with respective percentages to have a comparative overview. RESULTS: 209 responses to 250 questionnaires circulated gave a response rate of 83.6%. Amongst them, 63.15% of dentists were using devitalizing agents. The most widely and frequently used devitalizing agent was Devitec (PD Swiss, Vevey, Switzerland) (36.3%), followed by Caustinerf forte (Septodont, Saint-Maur-des-Fosses, France) (29.5%). A total of 32.9% dentists were aware of the recommendations, and 66.02% were aware of the complications of devitalizing agents; 16.26% of dental practitioners encountered complications due to the use of devitalizing agents. The dentists listed the alternate methods regarding the use of pulp devitalizing agents. CONCLUSION: Although most of the dentists were aware of the harmful effects and few encountered complications with the use of devitalizers, they continued to use these agents because of the lack of an effective alternative.

Association of Hormonal Fingerprints and Dental Caries: A Pilot Study.

CONTEXT: Dental caries remains the most widespread oral disease among all age groups. Hormonal fingerprints (second digit: fourth digit ratio or 2D:4D ratio) are biomarkers displaying sexual dimorphism and diverse human phenotypic traits. A person's genetic makeup may influence the occurrence of dental caries. AIM: The present study aimed to evaluate the influence of digit ratio on the incidence of dental caries. SETTINGS AND DESIGN: Two hundred patients between 18 and 55 years, reporting for restorations or endodontic therapy, participated in the study. SUBJECTS AND METHODS: Hormonal fingerprints (2D:4D ratio) were measured with the help of a digital vernier caliper. Caries incidence was recorded using the DMFT index. STATISTICAL ANALYSIS USED: Data obtained were tabulated and statistically analyzed using Independent t-test and Chi-square test. RESULTS: Males had a less mean 2D:4D ratio than females, which was statistically significant (p-value = 0.003). Chi-square test was applied, and there was a statistically significant correlation between high digit ratio and caries experience (p-value = 0.002). Females with a high digit ratio and males with a low digit ratio were in the moderate and low caries risk groups with a p-value of 0.029 and 0.001 in the respective risk groups. CONCLUSION: The present study displayed a correlation between hormonal fingerprints (2D:4D ratio) and dental caries. An indicator of caries risk will help prevent caries by implementing oral hygiene measures, which will reduce its incidence as the most occurring oral disease.

Position Statement of IACDE for managing dental patients during COVID-19.

Coronavirus disease 2019 (COVID-19) has been a major health concern globally ever since it was declared as Pandemic by the World Health Organization in March 2020. Due to the evolving and contagious nature of coronavirus, it continues to remain a threat for dental health-care personnel. As the virus travels from person-to-person via direct contact through droplet inhalation, cough, and sneeze or through contact transmission, it remains infectious even through inanimate surfaces. A seemingly healthy asymptomatic person may have the potential to trigger the spread of this disease. Coronavirus has the capability of spreading through community transmission. There is no specific treatment or vaccine as of now for stopping the spread of COVID-19, hence universal precautions and awareness with mass involvement is required to ward off this pandemic. Dental health-care personnel are at immense risk due to the near proximity with patients and continual exposure to saliva, blood, and other body fluids. Management protocol regarding awareness and preventive measures should be laid down for dental clinic/hospital to contain the outspread of this infectious disease.

Comparing the Efficacy of Twin Mix and Lidocaine for Inferior Alveolar Nerve Blocks in Patients With Symptomatic Irreversible Pulpitis.

This randomized, active-controlled, double-blind, prospective clinical trial evaluated the anesthetic efficacy of 2% lidocaine with 1:200,000 epinephrine versus an admixture of 2% lidocaine with 1:200,000 epinephrine and 1 mL of 4 mg dexamethasone (Twin mix) for inferior alveolar nerve blocks (IANBs) in patients with symptomatic irreversible pulpitis (SIP) of the mandibular molars. Seventy-eight patients with SIP of mandibular molars were randomly allocated to the 2 groups of 39 subjects. All patients were required to have profound lip numbness within 10 minutes of local anesthetic deposition. The efficacy of pulpal anesthesia was confirmed by absence of pain or mild pain (Heft-Parker visual analogue scale ≤54 mm) during access cavity preparation and placement of glide path files. The collected data were subjected to independent t test, chi-square test, and Fisher exact test using SPSS software version 20.0 at a significance level of 0.05. IANB success rates for the lidocaine group and the Twin mix group was 66% and 68% respectively, which was not a statistically significant difference (p > .05). This study demonstrated that the anesthetic efficacy of Twin mix was equivalent to 2% lidocaine for IANBs in teeth with SIP.

Comparative evaluation of effects of natural antioxidants on the shear bond strength of composite resin to bleached enamel.

CONTEXT: The use of antioxidants immediately after bleaching showed increased bond strength. AIMS: This study aimed to compare the effects of natural antioxidants on the shear bond strength of composite resin to bleached enamel. MATERIALS AND METHODS: Fifty extracted single-rooted upper incisors were decoronated by sectioning the roots 2 mm below the cementoenamel junction, and then, crowns were embedded in autopolymerizing acrylic resin block (3.0 cm × 3.0 cm × 3.0 cm) with the labial surface exposed. They were randomly divided into five groups, depending on the type of antioxidant used (n = 10): (i) Group 1: control (no bleaching), (ii) Group 2: bleaching only, (iii) Group 3: bleaching + 10% sodium ascorbate (antioxidant), (iv) Group 4: bleaching + green tea, and (v) Group 5: bleaching + white tea. Labial surfaces of 40 teeth were bleached with 38% hydrogen peroxide for 20 min following manufacturer's instructions. After that, the experimental groups (Groups 3, 4, and 5) were treated with respective antioxidant solutions before composite restorations were done using a cylindrical plastic mold (3 mm × 5 mm). Shear bond strength of the specimens was tested under universal testing machine. STATISTICAL ANALYSIS: Data were analyzed with ANOVA and Tukey's post hoc test. RESULTS: There were statistically significant differences between shear bond strength of control groups (Groups 1 and 2) and experimental groups (P < 0.05), but no significant difference in bond strength was observed among the antioxidants used. CONCLUSION: Application of antioxidants immediately after bleaching showed increased bond strength. Green tea and white tea extract can be used as alternative antioxidants in improving the bond strength of enamel.

Evaluation of alpha-adrenomimetic agents for gingival retraction: A randomized crossover clinical trial.

CONTEXT: The displacement of the gingiva around the tooth allows proper access during preparation, precise impression taking, and cementation procedures that has a direct bearing on the health of the periodontium. Several methods and agents are used for this purpose. AIMS: The primary aim of the study was to clinically evaluate the efficacy of naphazoline as a gingival retraction agent. The secondary aim was to compare it with tetrahydrozoline and aluminum chloride. SETTINGS AND DESIGN: Fifteen patients participated in a randomized crossover clinical trial at the Army College of Dental Sciences, Secunderabad, Telangana, India. SUBJECTS AND METHODS: Preliminary maxillary impressions were made with irreversible hydrocolloid for all patients to fabricate custom trays. After that, baseline impressions and cast for control group measurements were prepared. Gingival displacement was carried out in the right maxillary central incisor for all, with retraction cord soaked in three agents, either, aluminum chloride, tetrahydrozoline, or naphazoline. These agents were used in all patients with a washout period of 14 days. Elastomeric monophase impressions and die stone casts were recorded for each group. The central incisors were sectioned, and gingival retraction was measured using a measuring stereomicroscope. STATISTICAL ANALYSIS USED: The gingival displacement was statistically analyzed using one-way ANOVA and post hoc Bonferroni. RESULTS: Naphazoline had the highest retraction (138.160 µm) followed by tetrahydrozoline (136.039 µm) and aluminum chloride (130.759 µm). CONCLUSIONS: Naphazoline, tetrahydrozoline, and aluminum chloride show a clinically and statistically significant amount of displacement when compared to control. Among the three agents, naphazoline showed maximum displacement and maybe a good alternative with fewer side effects.

Clinical Management of Root Resorption: A Report of Three Cases.

Root resorption is a pathological condition that may be an endodontic challenge if not diagnosed and treated correctly. The recent advances in the imaging technologies and material science have enabled the clinician to visualize the structural changes accurately and repair them with materials providing favourable seal ability. In this article, we report three cases of root resorption with different presentations which were diagnosed with the help of cone beam computed tomography (CBCT) and successfully managed. The series highlights the importance of diagnosis in unusual clinical situations and recommends early commencement of optimal management for longevity of tooth for health and function.

Effect of different periodontal ligament simulating materials on the incidence of dentinal cracks during root canal preparation.

Background. The present study was undertaken to evaluate the incidence of dentinal cracks during root canal preparation with different periodontal ligament simulating materials in vitro. Methods. Seventy freshly extracted human mandibular first premolars were selected and divided into 7 groups in terms of simulating material: group 1: polyether impression material; group 2: polyvinyl acetate adhesive; group 3: polyvinyl siloxane impression material; group 4: cyanoacrylate adhesive; group 5: epoxy resin adhesive; group 6: positive control, without any periodontal ligament simulation; and group 7: negative control, where neither a periodontal ligament simulating material was used nor canal preparation was carried out. Root canal preparation was carried out in all the groups followed by sectioning of roots at 3 mm, 6 mm and 9 mm. The sections were evaluated under a stereomicroscope at ×2.5 for the presence or absence of cracks. Chi-squared test was used to compare the appearance of defective roots between the different experimental groups. Results. The least number of cracks were found in the negative control group, followed by group 1 where polyether impression material was used for periodontal ligament simulation. The difference was significant with a P-value of 0.002 for coronal sections. Conclusion. Under the limitation of the present study, polyether and polyvinyl siloxane (light body) can both be used for simulation of periodontal ligament.

Stress distribution in endodontically treated abfracted mandibular premolar restored with different cements and crowns: A three-dimensional finite element analysis.

CONTEXT: Noncarious cervical lesions may penetrate the pulp and require root canal treatment followed by crown placement. Such teeth may be susceptible to fracture, especially at the cervical area. AIMS: To estimate which combination of restorative material and crown resulted in homogenous stress-strain distribution of endodontically treated abfracted mandibular premolar using three-dimensional finite element model (FEM). SETTINGS AND DESIGN: A three-dimensional model of mandibular single-rooted premolar along with alveolar bone was created in finite element analysis (FEA) software preprocessor ANSYS rel 14.5 FEM software (ANSYS Inc., Houston, USA, 1994). Cervical lesion was created in the model with specific dimensions, 3 mm mesiodistally and 2 mm gingivoocclusally with enamel occlusal margin and dentin gingival margin. MATERIALS AND METHODS: Tooth was simulated to be root canal treated and restored with different types of cements and crowns followed by placing a static load of 300 N at an angle of 135°. Analysis was run and stress distribution pattern was studied. RESULTS: Cervical region of an endodontically treated tooth is subjected to stresses, irrespective of restorative material used. Porcelain fused to metal (PFM) crowns showed least strain values with different postendodontic, restorative materials. CONCLUSIONS: FEA is a predictable and reproducible model to predict stress-strain behavior. PFM crowns with different postendodontic restorative materials showed least strain values in the cervical area of abfracted, endodontically treated premolars.

Management of a permanent maxillary first molar with unusual crown and root anatomy: a case report.

The aim of this article was to showcase the endodontic management of a maxillary first molar with an unusual crown and root anatomy. Clinical diagnosis of the roots and root canal configuration was confirmed by a cone-beam computed tomography (CBCT) and the detection of the canals was made using a dental operating microscope. CBCT images revealed the presence of 5 roots with Vertucci type I canal configuration in all, except, in the middle root which had 2 canals with type IV configuration. The 6 canal orifices were clinically visualized under the dental operating microscope. Clinicians should familiarize themselves with the latest technologies to get additional information in endodontic practice in order to enhance the outcomes of endodontic therapy.

Effect of Green Coffee Bean Extract on Streptococcus mutans Count: A Randomised Control Trial.

INTRODUCTION: Mouth rinses have been popularly used as a supplementary oral hygiene aid. A lot of commercially available mouth rinses possess few adverse effects, which has necessitated the search for alternative and herbal mouth rinses. AIM: The aim of the study was to assess the effect of rinsing with green coffee bean extract in comparison with chlorhexidine mouthwash and sterile water on salivary Streptococcus mutans count. MATERIALS AND METHODS: A randomized parallel controlled clinical trial was planned and 45 subjects aged between 18-22 years were selected. The subjects were divided into three groups (n=15 in each group): Group A: Study group: 2% Green coffee bean extract, Group B: Positive control: 0.2% Chlorhexidine (CHX), Group C: Negative control: Sterile water. Group A subjects rinsed mouth with 5 ml of 2% Green coffee bean extract for one minute. Group B subjects rinsed mouth with 5 ml 0.2% CHX mouthwash for one minute. Group C subjects rinsed mouth with 5 ml of Sterile water for one minute twice daily for two weeks. Baseline samples (Pre rinse) were collected on day 1 and post rinsing saliva samples were collected after 14 days. The samples were cultured using Mitis Salivarius Agar enriched with Bacitracin and colonies were counted using a hand held digital colony counter. The statistical analysis was done using paired t-test, One-way variance ANOVA and Post-Hoc tests. RESULTS: The Green coffee bean extract group showed a statistical significant reduction in Streptococcus mutans colony count before and after intervention which was comparable with CHX group. CONCLUSION: Green coffee bean extract as a mouthwash can be explored as a safe and effective alternative to CHX mouthwash.

A comparative evaluation of remineralizing ability of bioactive glass and amorphous calcium phosphate casein phosphopeptide on early enamel lesion.

BACKGROUND: This study was done to evaluate remineralizing potential of bioactive glasses (BAGs) and amorphous calcium phosphate-casein phosphopeptide (ACP-CPP) on early enamel lesion. MATERIALS AND METHODS: Twenty freshly extracted mandibular premolars were sectioned sagittally. The buccal half was impregnated in acrylic resin blocks and treated with 37% phosphoric acid in liquid form, to demineralize enamel surface to simulate early enamel lesion. The samples were divided into two groups. The samples in Group I were treated with ACP-CPP (GC Tooth Mousse) and in Group II with BAG (Sensodyne Repair and Protect) and stored in saliva to prevent dehydration. The samples were tested for microhardness. The data obtained was analyzed using ANOVA post hoc multiple comparison and independent sample t- test and presented as a mean and standard deviation. RESULTS: All the samples showed a decrease in the microhardness after demineralization. After application of remineralizing agents, Group II showed a highly significant increase in the microhardness (P < 0.05) after 10 days, while Group I showed a significant increase in microhardness after 15 days (P < 0.05). CONCLUSION: Both the remineralizing agents tested in this study can be considered effective in repair and prevention of demineralization. BAG showed better results initially, but eventually both have similar remineralizing potential.

The Effect of Coconut Oil pulling on Streptococcus mutans Count in Saliva in Comparison with Chlorhexidine Mouthwash.

OBJECTIVES: Oil pulling is an age-old practice that has gained modern popularity in promoting oral and systemic health. The scientific verification for this practice is insufficient. Thus, this study evaluated the effect of coconut oil pulling on the count of Streptococcus mutans in saliva and to compare its efficacy with that of Chlorhexidine mouthwash: in vivo. The null hypothesis was that coconut oil pulling has no effect on the bacterial count in saliva. MATERIALS AND METHODS: A randomized controlled study was planned and 60 subjects were selected. The subjects were divided into three groups, Group A: STUDY GROUP: Oil pulling, Group B: STUDY GROUP: Chlorhexidine, and Group C: CONTROL GROUP: Distilled water. Group A subjects rinsed mouth with 10 ml of coconut oil for 10 minutes. Group B subjects rinsed mouth with 5 ml Chlorhexidine mouthwash for 1 minute and Group C with 5 ml distilled water for 1 minute in the morning before brushing. Saliva samples were collected and cultured on 1st day and after 2 weeks from all subjects. Colonies were counted to compare the efficacy of coconut oil and Chlorhexidine with distilled water. RESULTS: Statistically significant reduction in S. mutans count was seen in both the coconut oil pulling and Chlorhexidine group. CONCLUSION: Oil pulling can be explored as a safe and effective alternative to Chlorhexidine. CLINICAL SIGNIFICANCE: Edible oil-pulling therapy is natural, safe and has no side effects. Hence, it can be considered as a preventive therapy at home to maintain oral hygiene.

Regenerative endodontics--Creating new horizons.

Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and exciting with the ability to shape the future of endodontics. This article highlights the fundamental concepts, protocol for treatment, and possible avenues for research in regenerative endodontics.

Comparative evaluation of voids present in conventional and capsulated glass ionomer cements using two different conditioners: an in vitro study.

This in vitro study evaluated the presence of voids in powder-liquid and capsulated glass ionomer cement. 40 cavities were prepared on root surfaces of maxillary incisors and divided into four groups. Cavities were conditioned with glass ionomer cement liquid (GC Corporation, Tokyo, Japan) in Groups 1 and 3 and with dentin conditioner (GC Corporation, Tokyo, Japan) in Groups 2 and 4. Conventional powder-liquid glass ionomer cement (GC Fuji II, GC Corporation, Tokyo, Japan) was used as a restorative material in Groups 1 and 2. Capsulated glass ionomer cement (GC Fuji II, GC Corporation, Tokyo, Japan) was used in Groups 3 and 4. Samples were sectioned and viewed under stereomicroscope to check for the presence of voids within the cement and at the cement-tooth junction. Data was analyzed using one-way ANOVA and Tukey's post hoc tests. Group 4 showed statistically significant results (P < 0.05) when compared to Groups 1 and 2 for voids within the cement. However, for voids at the margins, the results were statistically insignificant.

Antibiotic prescribing habits of dental surgeons in hyderabad city, India, for pulpal and periapical pathologies: a survey.

Aim. To determine the antibiotic prescribing habits for pulpal and periapical pathology among dentists in Hyderabad city, India. Methodology. A total of 246 questionnaires were distributed to all the dentists registered with the local dental branch. Demographic details and questions regarding type and dosage of antibiotics prescribed for allergic and nonallergic patients were recorded. Inferential statistics were performed, and P < 0.05 was considered statistically significant. Results. The response rate for the study was 87.8%. Around 148 (68.5%) of respondents regularly prescribed antibiotics for endodontic management. The first antibiotic of choice for patients with no history of medical allergies was a combination of amoxicillin and metronidazole, followed by amoxicillin alone (29.1%). The first antibiotic of choice in case of allergy to penicillin was erythromycin. Necrotic pulp with acute apical periodontitis with swelling and moderate/severe preoperative symptom was the condition most commonly identified for antibiotic therapy (92.1%). Conclusion. The present study reveals that the overall antibiotic prescribing practices among this group of dentists were quite high, and there is a need for more educational initiatives to rationalize the use of antibiotics in dentistry.