The accuracy of two electronic apex locators on effect of preflaring and file size: An in vitro study.

AIM: This study was conducted to evaluate the effect of preflaring and file size on the accuracy of the Root ZX and E-PEX Pro electronic apex locators (EALs). MATERIALS AND METHODS: The actual working length was set 1 mm short of the apical foramen in the forty extracted mandibular premolars. The teeth were embedded in an alginate mold, and two examiners performed the electronic measurements using #10, #15, and #20 K-files. The files were inserted into the root canals until the "0.0" or "APEX" signals were observed on the light-emitting diode or display screens for the E-PEX Pro and Root ZX, respectively, retracting to the 1.0 mark. The measurements were repeated after the preflaring using the S1 and SX Pro-Taper instruments. The mean differences between the actual length and electronic length values were analyzed by the Wilcoxon signed-ranked test with a significance level of P < 0.05. The factors evaluated were "Accuracy of EALs," "size of file," and "presence of preflaring. RESULTS: No significant differences were observed in the accuracy of both EALs when compared with the actual lengths. On the size of the file, significant difference noticed with #20 K-file. The preflaring procedure significantly (P < 0.05) increased the accuracy of the measurements for the Root ZX and Epex Pro. CONCLUSIONS: The tested EALs showed acceptable accuracy, whereas the preflaring procedure revealed a more significant effect than the used file size.

Assessment of effect of 1% phytic acid and 17% ethylenediaminetetraacetic acid on calcium ion loss of radicular dentin: An ex vivo study.

AIM: The purpose of this study was to evaluate and compare the effectiveness of phytic acid and ethylendiamine tetraacetic acid (EDTA) in the removal of calcium ion from radicular dentin during endodontic procedure. MATERIALS AND METHODS: Twenty-five single-rooted mandibular premolar teeth were decoronated, and the roots were split longitudinally into two halves. Among obtained specimens, 45 specimens were randomly selected and divided into three groups (n = 15): Group 1 - distilled water, Group 2 - 17% EDTA, and Group 3 - 1% phytic acid. Samples in each group were immersed in the test solutions for specific time intervals, after which the same solution samples were subjected for the evaluation of amount of calcium ion release into the solution by Atomic Absorption Spectrophotometer. Data were analyzed using the one-way analysis of variance test. RESULTS: The use of 17% EDTA resulted in more calcium ion loss as compared to 1% phytic acid and distilled water. CONCLUSION: One percent phytic acid seems to be an appropriate irrigating solution because of its less demineralizing effect as compared to 17% EDTA on radicular dentin.

A comparative clinical evaluation of accuracy of six apex locators with intraoral periapical radiograph in multirooted teeth: An in vivo study.

AIM: The purpose of this clinical study was to compare and clinically, to evaluate the accuracy of six apex locators with intra oral periapical (IOPA) radiograph in multirooted teeth. MATERIALS AND METHODS: A total of 90 multirooted teeth (maxillary and mandibular molars) with irreversible, infected or necrotic pulp tissue and completely formed roots were included in this study and were divided randomly into six groups (Root ZX II, Raypex 6, I-Root, Romiapex A-15, Sybron Endo Mini and Root ZX mini). The working length was determined using six different apex locators, and the accuracy of the apex locators was compared with IOPA radiographs, to be categorized as accurate, short, and long or beyond. RESULTS: A total of 270 canals were evaluated, of which 233 (86.3%) canals exhibited acceptable working length, 28 (10.4%) canals exhibited short working length, and only 9 (3.3%) canals exhibited working length beyond the apex. There were a statistically significant results in all the groups (P < 0.05) and the comparison between the groups was statistically insignificant. CONCLUSION: The repeatability with that of apex locators is of great advantage, but the information gained from the radiographs cannot be obtained by any other means. Therefore, it is recommended that radiograph and apex locators are the best combinations in accurately determining the working length and the successful endodontics.

A Survey on Nickel Titanium Rotary Instruments and their Usage Techniques by Endodontists in India.

INTRODUCTION: The preference and usage of nickel titanium rotary instruments varies from individual to individual based on their technique, experience with the rotary systems and the clinical situation. Very limited information is available to explain the adoption of changing concepts with respect to nickel titanium rotary instruments pertaining to the endodontists in India. AIM: The aim of this study was to conduct a questionnaire survey to acquire the knowledge concerning different NiTi rotary instruments and their usage techniques by endodontists in India. MATERIALS AND METHODS: A Survey questionnaire was designed which consisted of 32 questions regarding designation, demographics, experience with rotary instruments, usage of different file systems, usage techniques, frequency of reuse, occurrence of file fracture, reasons and their management was distributed by hand in the national postgraduate convention and also disseminated via electronic medium to 400 and 600 endodontists respectively. Information was collected from each individual to gain insight into the experiences and beliefs of endodontists concerning the new endodontic technology of rotary NiTi instrumentation based on their clinical experience with the rotary systems. The questions were designed to ascertain the problems, patterns of use and to identify areas of perceived or potential concern regarding the rotary instruments and the data acquired was statistically evaluated using Fisher's-exact test and the Chi-Square test. RESULTS: Overall 63.8% (638) endodontists responded. ProTaper was one of the most commonly used file system followed by M two and ProTaper Next. There was a significant co relation between the years of experience and the file re use frequency, preparation technique, file separation, management of file separation. CONCLUSION: A large number of Endodontists prefer to reuse the rotary NiTi instruments. As there was an increase in the experience, the incidence of file separation reduced with increasing number of re use frequency and with experience, the management of separated file was better.

Comparative evaluation of immunohistochemistry, histopathology and conventional radiography in differentiating periapical lesions.

BACKGROUND AND AIM: Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. AIM: Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. MATERIALS AND METHOD: Thirty patients having large periapical radiolucency that do not heal successfully with routine endodontic therapy in relation to either maxillary or mandibular anterior teeth were selected for the study. Intraoral periapical radiographs were obtained and provisional diagnosis of the apical areas were made. Endodontic surgery was performed to enable histopathogical investigation. The histopathological interpretation was done to arrive at a final diagnosis and selected questionable granulomas were subjected for cytokeratin (CK-14) stain. RESULTS: The histopathological profile of lesions consisted of 66.66% periapical granulomas, 10% cysts, 6.67% abscess and 16.67% granulomas with cystic potential. The radiographic and histopathologic correlation was found in only 30% of these cases. Strong CK-14 expression was observed in all five cases of periapical granuloma with cystic potential. CONCLUSION: The radiographic diagnosis of periapical lesions remains inconclusive. Although histopathologic examination of periapical lesions gives true nature, the precise nature of subsets of periapical granulomas may be achieved with adjunct use of immunohistochemical markers.