Comparison of the incidence of postoperative pain after using a continuous rotary system, a reciprocating system, and a Self-Adjusting File system in single-visit endodontics: A prospective randomized clinical trial.

AIM: The aim of this study is to compare the incidence of postoperative pain using the ProTaper Next (PTN), WaveOne Gold (WOG), and Self-Adjusting File (SAF) systems. MATERIALS AND METHODS: Two hundred and fourteen patients with irreversible pulpitis were selected for single-visit endodontics. The teeth were blindly assigned to three groups based on the instrumentation system used: Group A (PTN), Group B (WOG), and Group C (SAF). Participants were asked to note the incidence of the pre- and postoperative pain on a visual analog scale at different time intervals. Paired t-test and one-way ANOVA were used along with post hoc Tukey's test. RESULTS: The greatest mean pain in Group A (PTN) and Group B (WOG) was found to be maximum in the first 24 h with a significant reduction in pain at the subsequent observation time points of 48 h, 72 h, and 7 days. Group C (SAF) showed minimum pain followed by Group B followed by Group A which showed comparatively higher pain scores even at the end of 7 days. CONCLUSIONS: In single-visit endodontics, SAF system may prove to be a better system compared with PTN and WOG as it produces minimal postoperative pain, thus improving the overall acceptance of endodontic treatment.

Effect of Oral Premedication on the Efficacy of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Double-Blind, Randomized Controlled Clinical Trial.

INTRODUCTION: It is generally accepted that achieving complete anaesthesia with an Inferior Alveolar Nerve Block (IANB) in mandibular molars with symptomatic irreversible pulpitis is more challenging than for other teeth. Therefore, administration of Non-Steroidal Anti-Inflammatory Agents (NSAIDs) 1 hour prior to anaesthetic administration has been proposed as a means to increase the efficacy of the IANB in such patients. AIM: The purpose of this prospective, double-blind, randomized clinical trial was to determine the effect of administration of oral premedication with ketorolac (KETO) and diclofenac potassium (DP) on the efficacy of IANB in patients with irreversible pulpitis. MATERIALS AND METHODS: One hundred and fifty patients with irreversible pulpitis were evaluated preoperatively for pain using Heft Parker visual analogue scale, after which they were randomly divided into three groups. The subjects received identical tablets of ketorolac, diclofenac pottasium or cellulose powder (placebo), 1 hour prior to administration of IANB with 2% lidocaine containing 1:200 000 epinephrine. Lip numbness as well as positive and negative responses to cold test were ascertained. Additionally pain score of each patient was recorded during cavity preparation and root canal instrumentation. Success was defined as the absence of pain or mild pain based on the visual analog scale readings. The data was analysed using One-Way Anova, Post-Hoc Tukey pair wise, Paired T - Test and chi-square test. Trial Registery Number is 4722/2015 for this clinical trial study. RESULTS: There were no significant differences with respect to age (p =0.098), gender (p = 0.801) and pre-VAS score (DP-KETO p=0.645, PLAC-KETO p =0.964, PLAC-DP p = 0.801) between the three groups. All patients had subjective lip anaesthesia with the IAN blocks. Patients of all the three groups reported a significant decrease in active pain after local anaesthesia (p< 0.05). The post injection VAS Score was least in group 1 (KETO) followed by group II (DP) & maximum in group III (PLACEBO). CONCLUSION: Oral pre-medication with 10 mg KETO resulted in significantly higher percentage of successful inferior alveolar block in patients with irreversible pulpitis than pre-medication with 50 mg DP & PLAC.

A comparative antimicrobial analysis of various root canal irrigating solutions on endodontic pathogens: an in vitro study.

BACKGROUND AND OBJECTIVES: Evolution in understanding the poly-microbial environment of both endodontic infections and that of failed root canal treatments has been debatable over the years. The present study was designed to compare and analyze the effect of various root canal irrigation solutions on certain endodontic pathogens in vitro. MATERIALS AND METHODS: To analyze in vitro the zone of inhibition of the micro-organisms the following irrigating solutions were employed: a. Sodium hypochlorite (NaOCl) 5% b. Sodium hypochlorite (NaOCl) 3% c. Chlorhexidine 2% d. Chlorhexidine (CHX) 0.12% e. Doxycycline 0.01% f. Doxycycline 0.005% g. MTAD. An agar culture plate inoculated with four endodontic pathogens was used namely 1. Enterococcus faecalis (MTCC-439) 2. Candida albicans (MTCC-183) 3. Fusobacterium nucleatum (ATCC-25586) 4. Peptostreptococcus anaerobius (ATCC-27337) The inoculums were streaked out on the trypticase soy agar plate for discrete colonies with a wire loop using standard method. The inoculated plates carrying the antibiotic disks were incubated in an anaerobic jar in the following way-Anaerobic incubation-the following procedure was used to provide anaerobiosis with an increased concentration of carbon dioxide. By this method the zone of inhibition obtained by different irrigating solutions against different pathogens could be compared. RESULTS: MTAD showed maximum antibacterial activity. In case of C. albicans MTAD was less effective than 5% NaOCl, 3% NaOCl and 2% CHX, 0.12% CHX. However, it was more effective against E. faecalis, F. nuleatum and P. anaerobicus. In any case, antimicrobial activity is not the only prerequisite for an endodontic irrigant. E. faecalis strain used in this study showed resistance to doxycycline; also doxycycline was ineffective against C. albicans at 0.01% and 0.005% concentrations. CONCLUSION: It was found that MTAD was more antimicrobial than 5% NaOCl for some of the test micro-organisms; however the ability of MTAD to dissolve pulp tissue is not comparable to 5% NaOCl. In addition, 5 and 3% NaOCl showed signifcant antimicrobial activity against all test micro-organisms. The best option for a primary endodontic irrigant therefore is 5% NaOCl.

Partial Edentulism based on Kennedy's classifcation: an epidemiological study.

BACKGROUND: The aim of this study was to determine the incidence of different Kennedy's classes of partial edentulism during 18 months period. MATERIALS AND METHODS: Patients were clinically examined for various Kennedy's classes of partial edentulism in the outpatient department (OPD), prosthodontics, GPRDCH, Kurnool (Andhra Pradesh). RESULTS: Of the total 1,420 OPD patients, Kennedy's class III was the most frequent classification encountered (62%) and followed by Kennedy's class I (18%), class II (11%), and class IV (9%) in decreasing order. CONCLUSION: The patients with various Kennedy's classes of partial edentulism can be offered various treatment modalities like removable cast partial dentures, fixed partial dentures, over dentures and implant supported dentures. This study can be crucial for screening the population for incidence of tooth loss as a factor of gender and age. Clinical significance: Tooth loss appears to have an important role in the loss of esthetics and mastication. Study of incidence of various classes of partial edentulism provides clinically useful information for dental training and continuing education.

Nanotechnology in dentistry: Present and future.

Nanotechnology is the manipulation of matter on the molecular and atomic levels. It has the potential to bring enormous changes into the fields of medicine and dentistry. A day may soon come when nanodentistry will succeed in maintaining near-perfect oral health through the aid of nanorobotics, nanomaterials and biotechnology. However, as with all developments, it may also pose a risk for misuse. Time, economical and technical resources, and human needs will determine the direction this revolutionizing development may take. This article reviews the current status and the potential clinical applications of nanotechnology, nanaomedicine and nanodentistry. How to cite the article: Bhardwaj A, Bhardwaj A, Misuriya A, Maroli S, Manjula S, Singh AK. Nanotechnology in dentistry: Present and future. J Int Oral Health 2013;6(1):121-6.