Comparison of compressive strength among three different intracanal post materials in primary anterior teeth: An in vitro study.

OBJECTIVE: The objective of our study was to compare the fracture resistance and the mode of failure among three different post materials in primary anterior teeth. MATERIALS AND METHODS: A total of sixty extracted primary anterior teeth were selected for the study. The samples were divided into three groups of twenty teeth each: Group I (Ribbond), Group II (Omega loop), and Group III (Glass fiber post). Pulp therapy was followed by intracanal post and crown buildup. The samples were mounted in self-cure acrylic and subjected to compressive strength test using universal testing machine (Instron). The maximum force at which the tooth fractured was recorded. RESULTS: The values were subjected to one-way analysis of variance. The mean compressive strength values of Ribbond, omega loop, and glass fiber post were found to be 83.25 N, 61.60 N, and 75.55 N, respectively. The P value was found to be 0.220. CONCLUSION: Group I (Ribbond) showed the highest fracture resistance values followed by Group III (Glass fiber post) and Group II (Omega loop). Although there is difference in mean values, they were nonsignificant.

Molecular detection of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque of healthy young children.

OBJECTIVE: The aim of the present study was to evaluate the presence of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) and Porphyromonas gingivalis (P. gingivalis) in subgingival plaque of healthy young children aged between 3 and 15 years using Polymerase Chain Reaction (PCR) and to compare their presence in children in their primary, mixed and permanent dentitions. METHOD: Subgingival plaque samples were collected from 120 healthy children and were grouped as Group I-Deciduous dentition, Group II- Mixed dentition and Group III- Permanent dentition, and were subjected to PCR assay. RESULTS: Binomial test and Proportions test were used for statistical analysis. A. actinomycetemcomitans and P. gingivalis were detected in 5% and 35%, 12.5% and 20%, and 0% and 27.5% samples in group I, II and III respectively. CONCLUSION: Both the microorganisms were present in group I and II. In group III only P. gingivalis was present. The results from this study do not necessarily pertain to differences in dentition but possibly to inter-individual differences.

Fracture reattachment in an immature permanent incisor with talon's cusp. A rare case report.

AIM: To report the successful and conservative management of a fractured immature permanent maxillary incisor tooth with talon cusp by fracture reattachment. SUMMARY: Coronal fractures of the maxillary anterior teeth are common dental injuries. Among these, the complicated fractures especially in immature teeth require an unambiguous treatment without any delay. When the tooth fragment is available and there is no (or minimal) violation of the biological width, reattachment is the preferable choice. It is a conservative procedure in which the original anatomic form, color, tooth contour, surface texture and aesthetics are preserved. The prognosis of this procedure depends on the patient's cooperation, good understanding about the treatment limitations and periodic follow up. This report emphasises the management of coronal fracture in immature teeth by reattachment.

Case report: management of crown-root fracture in lower first primary molar caused by injury to the chin: report of an unusual case.

BACKGROUND: Dental traumas are highly prevalent lesions in primary teeth, but crown-root fractures are seldom observed in primary molars. When trauma is sustained to the chin, the posterior primary teeth are at increased risk of trauma. The treatment of fractured teeth can be complicated, sometimes because of difficulties with the final restoration. CASE REPORT: A 4-year-old girl was referred to a Specialty Dental clinic by a general dental practitioner with complaints of pain in her left mandibular posterior teeth region while biting. History revealed that she had fallen ten days before while playing. Chin laceration was sutured in the trauma centre, but no dental treatment was carried out. She was subsequently discharged. Later, she had pain while biting for which she was referred to the clinic by her general dental practitioner. Extra-oral examination demonstrated a healing laceration on the chin. Radiographic examination showed the presence of an unusual complicated crown-root fracture of the left mandibular first primary molar. Pulpectomy was carried out and the fracture was stabilised with glass ionomer cement and a preformed metal crown was placed. FOLLOW-UP: Patient was reviewed after 3, 6 and 12 months both radiographically and clinically. Though radiographically it was found that the obturating material was resorbed completely at the 12 month visit, clinically the patient was asymptomatic until now (after 15 months). The patient is still under review. CONCLUSION: This case highlights the need for a systematic history and examination in all cases of dental trauma. It also demonstrates that conservative management is possible and not all primary teeth with crown-root fractures need to be extracted.

Esthetic splint--a novel concept for the management of bilateral condylar fracture.

Mandibular condyle is one of the most common sites of injury in the facial skeleton. But many condylar injuries remain undiagnosed. In rare situations, these injuries may result in serious adverse sequel in the patient's growth and development that are more difficult to treat at a later stage. In growing individuals, conservative management results in better functional outcome and good remodelling of the condyle. The aim of this article is to present a case report of a bilateral sub-condylar injury in a young child with a novel concept--an esthetic splint.

Enamel thickness in primary teeth.

OBJECTIVE: The aim of this study was to determine the enamel thickness of all primary teeth in both maxilla and mandible. STUDY DESIGN: An in vitro study was performed with fifty primary teeth including five each of central and lateral incisor, canine, first and second primary molars in both maxillary and mandibular region. Samples were mounted on wax sheets and scanned using a 64-slice CT scanner which were then 3D reconstructed. Three serial slices were obtained from the middle of the coronal portion of each tooth. Volume rendering was done to differentiate three distinct zones of enamel, dentin and the pulp from each slice. A box was constructed touching the borders of the image on all the surfaces and the mid-point of each side was taken to measure the enamel thickness. RESULTS: Tests used were ANOVA, Post-hoc Tukey's test and student's paired t-test. Enamel thickness was not the same on all the sides. Intergroup comparisons between maxillary anterior and posterior teeth showed difference in enamel thickness. On comparing the mandibular anterior and posterior teeth, the posteriors showed a greater value of enamel thickness on all the sides (p < 0.05). CONCLUSION: Primary enamel does not follow the same thickness patterns on all sides. It is also different in each primary tooth. There was an increase in enamel thickness in posterior teeth on comparison to their anterior counterparts in both maxilla and mandible. Enamel thickness was more on the distal aspect compared to mesial in all samples.

Dental management of hemophiliac child under general anesthesia.

Hemophilia is the most common inherited bleeding disorder. Hemophilic patients should be cosidered as special patients. There is no contraindication to general dental treatment for hemophiliacs, as they generally do not involve bleeding. But caution must be used with any surgical procedures that involve the local and general anesthesia. Such patients should always be managed in the setting of specialized units with appropriate clinical expertise and laboratory support. Recent advances in the management of hemophilia have enabled many hemophiliac patients to receive surgical dental procedures in an outpatient dental care on a routine basis. The purpose of this case report is to provide a few management strategies when providing full mouth rehabilitation under anesthesia and replacement therapies that are available. In addition, overviews of possible complication that may be encountered when providing such treatment are discussed here.

Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: a scanning electron microscopy study.

AIM: The purpose of this in-vitro study is to determine the efficacy of various irrigants in removing the smear layer in primary teeth root canals after hand instrumentation. MATERIALS AND METHODS: The present study consisted of 30 human primary incisors which were sectioned at the cementoenamel junction horizontally. The specimens were divided randomly into four experimental and one control group having six teeth each and each group was treated with the specific irrigant. 5.25% NaOCl, 5.25% NaOCl + 10% EDTA, 6% citric acid, 2% chlorhexidine, saline (control) were the irrigants evaluated for efficacy in removal of smear layer. The specimens were split along the longitudinal axis using a chisel after placing superficial grooves in cementum not extending to the root canal. The exposed surface was subjected to scanning electron microscopic analysis to reveal the efficacy of irrigants in removal of smear layer. The representative areas were evaluated twice at 15 days interval by a single evaluator. The scale for the smear layer removal by Rome et al was modified and used in the present study. RESULTS: The pictures from the scanning electron microscopy showed that among the tested irrigants, citric acid has the best efficacy to remove the smear layer without altering the normal dentinal structures, which was supported by the lowest mean smear scores. The pictures from the 10%EDTA + 5.25% sodium hypochlorite group showed that even though it removed the smear layer, it adversely affected the dentine structure. SEM pictures of the other groups like sodium hypochlorite, chlorhexidine revealed that these irrigants does not have the capacity to remove the smear layer in primary teeth. CONCLUSIONS: The results of the present study clearly indicate the superior efficacy of 6% citric acid than the other tested irrigants on removing the smear layer in primary teeth root canals.

Management of recurrent fracture of central incisor with internal resorption using light transmitting (luminex) post.

The normal root canal anatomy may be altered in various pathological processes and making it very difficult and at times impossible to achieve ideal obturation by normal methods. Internal resorption is one among them. There are several treatment protocols advised for this pathological condition. A crown-root fracture is defined as a fracture involving enamel, dentin and cementum and accounts for 5% of all traumatic injuries to the permanent dentition. In anterior teeth, these fractures are usually caused by direct trauma and often complicated in fully erupted teeth. In cases where the fracture line extends down along the long axis of the root, extraction of the tooth is indicated. The purpose of this report is to present the use of light transmitting post system to reinforce the crown root fractured maxillary central incisor due to trauma and internal resorption.