Lesion Sterilization Tissue Repair: A Review.

As part of lesion sterilization and tissue restoration (LSTR), treatment for primary molars affected by extensive periapical pathosis and extreme resorption entails the use of a triple antibiotic mixture in an appropriate medium. In-depth explanation of all components of LSTR is the main focus of this review of the literature.

Platelet-Rich Fibrin (PRF) and its Application in Dentistry: A Literature Review.

Platelet-rich fibrin (PRF) is a biocompatible fibrin matrix that acts as a resorbable membrane, collecting platelet cytokines, growth factors, and cells and releasing them. It is easily extracted from blood. Many dentists use PRF, a concentrated growth factor solution, to treat various lesions and regenerate tooth and oral tissues. This research examines the pros, cons, and suggestions of using PRF in dentistry.

Reducing pain using vibrating device during local anesthesia among Indian pediatric dental patients.

The administration of local anesthesia constitutes one of the most anxiety-inducing and painful stimuli in pediatric dentistry. Therefore, it is of interest to evaluate the effectiveness of vibrating device in comparison to the conventional method for mitigating discomfort while administration of local anesthesia. A total of 30 children aged between 6 and 10 years, requiring local anesthesia for routine dental treatment, were allocated into two groups: a control group and an experimental group, with 15 children in each cohort. In the experimental group, a vibrating device was concurrently placed over the cheek during the administration of the local anesthesia. Pain and discomfort were assessed using both the Wong-Baker FACES Pain Rating Scale (WBFPRS) and the FLACC (Face, Legs, Activity, Cry, CONSOL ability) scale. It was observed that use of the vibrating device was found to be effective in reducing pain and discomfort during the administration of intraoral local anesthesia.

Pain Perception During Local Anesthesia Administration in Pediatric Dental Patients and The Impact of Pre-Cooling The Injection Site: An in-vivo Study.

Aim: Examining how pre-cooling affects children's experience of pain during local anesthetic administration is the primary goal of this study. Material and Methods: This study was conducted in vivo and involved 60 child patients who required local anesthetic in order to undergo dental procedures. Patients were divided into two groups based on a random chance: Group I was the control group, which did not receive any pre-cooling. Group II was the pre-cooling group, which allowed the injection site to be chilled with an ice pack for one minute prior to the administration of anesthesia. The Wong-Baker FACES Pain Rating Scale was used to evaluate the participants' level of pain perception immediately following the administration of the anesthetic injection. Results: The group that received pre-cooling showed a reduction in pain levels that was statistically significant when compared to the group that received control (P < 0.05). Conclusion: Pediatric dental patients may decrease local anesthesia pain by pre-cooling the injection site. This technique can be simply used in dental practices to improve patient experience, especially for children with dental anxiety or needle phobia.

Median Rhomboid Glossitis: A Case Study.

A smooth, red, oval, or rhomboid patch on the dorsal midline is the classic presentation of median rhomboid glossitis (MRG), a rare and benign lesion of the tongue. MRG is still not fully understood, which presents diagnostic hurdles and calls for additional clinical investigation. It is frequently associated with candidal infections. We describe a case of a 42-year-old man who initially appeared to have either mechanical irritation or thermal injury related to a painless patch on the dorsum surface of the tongue. We document a case of MRG that was consulted for a standard dental examination in this case report. This article also highlights a dentist's need to identify the lesion and provide appropriate education for the patient.

Bio-ceramics application in Dentistry.

Bioceramics have gained significant attention in dentistry due to their unique properties, including biocompatibility, osseointegration, and tissue regeneration. Therefore, it is of interest to report the various applications of bioceramics in dentistry, their advantages, limitations, and future considerations. Bio-ceramics such as zirconia and hydroxyapatite offer high biocompatibility and durability for dental application. They support bone integration for implants, resist wear, and mimic natural tooth aesthetics. Used in crowns, bridges, and fillings, bio-ceramics enhance healing and are pivotal in restorative and reconstructive dental procedures.

Malocclusion among patients at Agartala, Tripura, India.

Malocclusion is the mal-relationship of dental arches with or without an irregularity of the teeth. Therefore, it is of interest to estimate the rate of occurrence of malocclusion within the population of Agartala city, Tripura, India. The study included 850 individuals ranging from 16 to 24 years of age, which were categorized into five distinct classifications, namely normal occlusion, Angle's Class I malocclusion, Class II Division 1, Class II Division 2, and Class III malocclusion. Data shows that normal occlusal alignment was observed in 29.41% of the participants, whereas a majority of 70.59% exhibited various forms of malocclusion among this population.

Smart Material for Smarter Dentistry.

Smart materials encompass a variety of substances, including smart antimicrobial peptides, pit and fissure sealants, impression materials, cement, and sutures. These materials can change properties under specific stimuli such as temperature, stress, moisture, pH, or electric and magnetic fields. These constituents signify the commencement of a novel era or epoch in the field of smart dentistry and exhibit the potential for enhanced efficacy in the future.

Comparative Evaluation of Two Different Topical Anesthetic Agents against Pain Associated with Intraoral Injections in Pediatric Dental Patients.

Aim: This study aimed to examine the effectiveness of two topical anesthetics in minimizing the discomfort related to intraoral injections. Material and Method: For the study, 40 healthy kids between the ages of 6 and 10 were chosen. To the injection site, two topical anesthetic products were applied: lignocaine hydrochloride gel and benzocaine 20% gel. The effectiveness of the topical agents was evaluated using a four-point scale, which was previously used by Topçuoglu and colleagues to evaluate pain. Result: A significant difference between the lignocaine group (2.1 ± 0.5) and the benzocaine group (1.2 ± 0.6) was found on a four-point scale (P < 0.05). Conclusion: Benzocaine demonstrates a higher degree of efficacy in comparison with lignocaine. However, additional research is necessary to ascertain the result of this study.

An In Vivo Evaluation of Postoperative Pain after Root Canal Instrumentation Using Manual K-files and Kedo-S Rotary files in Primary Molars.

Aim: To determine postoperative pain after root canal instrumentation using manual K-file and rotary Kedo-S files in primary molars. Material and Method: Thirty-six primary mandibular molars from 4- to 8-year-old children requiring pulpectomy were randomly split into two groups of 18 teeth each, that is, manual file K-file (Group I) and Kedo-S rotary file (Group II). Children's pre- and postoperative pain was assessed using a four-point scale at different time intervals. Results: From the result of the present study, it was observed that the Kedo-S group showed significantly less pain after 24, 48, and 72 h. Conclusion: It was concluded from the present research that patients enrolled in the Kedo-s group experienced less pain.

Incidence of Postoperative Pain after Single Visit Root Canal Treatment using XP-endo Shaper, 2Shape and ProTaper Gold Rotary Systems: A Prospective Randomized Clinical Trial.

OBJECTIVE: To evaluate the incidence of postoperative pain, treatment time and analgesic intake after single visit endodontic treatment of mandibular molars using XP-endo Shaper, 2Shape and ProTaper Gold rotary systems. METHODS: 150 patients with irreversible pulpitis were scheduled for single visit root canal treatment. Teeth were randomly assigned to one of the three groups: ProTaper Gold (PTG; Dentsply Tulsa Dental Specialties, Johnson City, TN), 2Shape (2S; Micro-Mega, Besancon, Cedex, France) and XP-endo Shaper (XPES; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Preoperative and postoperative pain was rated by the patients at the beginning of treatment and after 24, 48, 72 hours and 7 days on Heft Parker's visual analog scale (HP-VAS). RESULTS: Highest mean postoperative pain score was recorded in PTG (P<0.05), followed by 2S and XPES respectively at all time intervals. XPES exhibited maximum reduction from preoperative pain at 24 (48.67%) and 48 hours (96.90 %) with no pain at 72 hours. Treatment time was significantly least in XPES (P<0.05) followed by 2S and PTG; but no significant difference in analgesic intake was noted. CONCLUSION: XPES exhibited least postoperative pain at all time intervals and treatment time, followed by 2S and PTG rotary systems respectively. (EEJ-2022-04-053).

Stress distribution of endodontically treated mandibular molars with varying amounts of tooth structure restored with direct composite resin with or without cuspal coverage: A 3D finite element analysis.

Background: Decision-making regarding whether cuspal coverage is required or not for the restoration of root canal-treated posterior teeth is still a matter of challenge for the dentist. Methodology: Four models of endodontically treated mandibular molars with mesio-occlusal (MO) cavity were designed and simulated with direct composite resin restorations. Group 1A - cavity width <½ the intercuspal distance restored without cuspal coverage, Group 1B - same as Group 1A but with cuspal coverage, Group 2A - MO cavity width >½ but <2/3rd the intercuspal distance restored without cuspal coverage, and Group 2B - same as Group 2A but with cuspal coverage. The models received occlusal load to simulate a mastication load. Static finite element analysis (FEA) was adopted for predicting the stress distribution generated in the restored tooth by the loading condition. Results: FEA of the models have shown that the variations in stress values were significant in bulk-fill material compared to enamel and other structures. Comparing the maximum and minimum principal stress values in the overall region demonstrated that 2A was safer, whereas 2B was found to be the worst case. Conclusions: The results indicate that restoration of endodontically treated mandibular molar with loss of one marginal ridge with composite resin without cuspal coverage revealed minimal internal stress values and showed the best performance overall.

Comparative Evaluation of Extrusion of Apical Debris and Irrigant using Three Different Rotary Systems with Conventional Irrigation Methods - An In vitro Study.

Aim: The present study aimed to compare and evaluate debris and irrigant extrusion from curved root canals using different rotary systems. Materials and Methods: 30 single-rooted mandibular canines were used in this study. The crown was decoronated, working length and initial apical diameter were established. A 1.5% agar gel model was used in this study. Samples were assigned randomly into 3 groups (n = 10 teeth per group). Protaper Next, OneShape, and Hanudent files were used according to the manufacturers' instructions for canal instrumentation. Apically extruded debris and irrigant was were computed by deducting the initial weight of the test apparatus without a tooth from its weight after the biomechanical preparation. Comparative analysis of the amount of apically extruded debris and irrigant for each of the instruments and the experimental models was performed. Results: The statistically significant difference was found between the three experimental groups. (P < .05). Among all the groups least extrusion was observed in the Protaper Next group when used in combination with conventional irrigation. Conclusion: All the instruments produced apically extruded debris and irrigant, but the maximum was seen with OneShape among the experimental groups.

A Study to Assess Anti-Inflammatory Effect of Vitamin D on Gingivitis: A Dose Dependent Randomised Controlled Trial.

Introduction: Vitamin D deficiency increases gingivitis risk. Studies show that higher vitamin D levels reduce inflammation. Materials and Methods: College conducted a double-blind, randomized, controlled trial on 451 people's vitamin D and gingival health at baseline. For three months, participants were given a placebo (group A), 1000 international units (IU) of vitamin D3 per day (group B), 500 IU per day (group C), or 2000 IU per day (group A). Gingival scores were recorded for three months to assess the anti-inflammatory effect (the first, second, and third). Vitamin D levels also affected gingivitis. Results: Vitamin D dose-dependently reduces gingivitis inflammation. Vitamin D administration negatively correlated with gingival index score. Anti-inflammatory vitamin D levels are 32-37 ng/ml. Conclusion: Vitamin D supplementation can reduce gingivitis severity. The optimal blood vitamin D level is 30-35 ng/ml.

Comparison of fracture resistance of endodontically treated maxillary first premolar with mesio-occlusal-distal access restored with composite resin, fiber post, and prefabricated metal posts restored with/without full-coverage metal crowns.

Background: A myriad of materials and procedures have been recommended for restoring the root-filled teeth with significant loss of tooth structure and the most common method being the use of "posts." Material and Methods: A mesio-occluso-distal preparation was done on eighty intact maxillary first premolars, followed by access preparation and cleaning and shaping with rotary files. All samples were obturated and divided into four groups (n = 20). In Group 1, 3-mm gutta-percha was removed and restored using composite resin; Group 2 - Group 1 + crowns; Group 3 - prefabricated fiber post + crowns; and Group 4 - prefabricated metal post + crowns. All the groups were subdivided into eight groups (n = 10), fractured with 90° vertical and 45° oblique loading by a universal testing machine. Statistical Analysis: Fracture resistance was analyzed and compared by means of two-factorial two-way analysis of variance and Scheffe's post hoc test. Results: Under 90° loading, the fracture load of teeth restored with the Nayyar's composite resin core and crown was greatest. Under 45° loading, the fracture load of teeth restored with prefabricated metallic posts was significantly (P < 0.05) less than that in other groups. Under 45° load, group with fiber post exhibited significantly (P < 0.05) more number of favorable fractures than other groups. Conclusion: Under the conditions of vertical and oblique loadings, fiber post and composite resin core with a full-coverage crown is the most effective restorative modality for protecting the remaining tooth structure in pulpless teeth.

A Comparative Evaluation of Smear Layer Removal Using Erbium:YAG Laser-Activated Irrigation, Sonic Irrigation, and Manual Dynamic Irrigation: A Scanning Electron Microscope Study.

Introduction: The conventional chemomechanical procedures are ineffective in complete disinfection of the pulp space due to the complexities of the root canal architecture. The present study aims to compare the efficacy of erbium: YAG laser-activated irrigation, sonic irrigation, and manual dynamic irrigation in the removal of the smear layer through a scanning electron microscope study. Methods: Fifty extracted single rooted mandibular premolars with single canal were used and instrumented until F3 ProTaper rotary file reached the working length. Upon the completion of the canal preparation, each specimen was irrigated with 3 mL of 4% NaOCl for 3 minutes, 3 mL saline for 1 minute and 3 mL of 17% EDTA for 3 minutes. The teeth were assigned to three experimental groups (n=15 each): manual dynamic irrigation, sonic irrigation (EndoActivator), and Er:YAG laser using an X pulse tip. Root canals were sectioned longitudinally and the smear layer at the apical, middle and coronal third was examined under a scanning electron microscope. Smear layer scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests at P = 0.05. Results: The Er:YAG laser group showed significantly lower smear layer scores in the apical third as compared to all other groups. EndoActivator resulted in better cleaning efficacy at the apical area compared to manual dynamic agitation. Conclusion: This study showed results in favor of Er:YAG with an X-pulse tip followed by EndoActivator activation.

An In Vitro Study of Effect of Beveling of Enamel on Microleakage and Shear Bond Strength of Adhesive Systems in Primary and Permanent Teeth.

AIM AND OBJECTIVES: This in vitro study evaluated the effect of beveling of enamel on microleakage and shear bond strength of total-etch adhesive system: prime and bond NT and self-etch: adhesive system: XENO V in primary and permanent teeth. MATERIALS AND METHODS: A total of 120 extracted human molars (60 primary and 60 permanent) were selected for the study. For microleakage examination, a sample size of 40 was chosen. Two rectangular slots of equal dimensions were prepared on the buccal surface of each tooth and a bevel was given on either of the slots. Each slot was restored using a composite resin with prior application of the selected bonding agent following which all the samples were soaked in 1% methylene blue dye for 48 hours. Then each tooth was sectioned horizontally and evaluated. The remaining 80 samples were subjected to the shear bond strength test. Class II cavities of standard dimension were prepared and bevel was given on each sample following which selected bonding agent was applied and restored with a composite resin. The specimens were placed in a fixture and the shear bond strength was determined using the universal testing machine. RESULTS: With respect to microleakage, the least was exhibited by beveled preparations in permanent teeth using the self-etch adhesive system and the highest shear bond strength was exhibited by beveled preparations using the total-etch adhesive system in permanent teeth. CONCLUSION: Beveling of enamel improved the marginal integrity and shear bond strength of self-etch and total-etch adhesive systems in both primary and permanent teeth. HOW TO CITE THIS ARTICLE: Patanjali S, Arora A, et al. An In Vitro Study of Effect of Beveling of Enamel on Microleakage and Shear Bond Strength of Adhesive Systems in Primary and Permanent Teeth. Int J Clin Pediatr Dent 2019;12(3):205-210.

Radix Entomolaris: Case Report with Clinical Implication.

Usually first mandibular molars have one mesial and distal root but in some cases there are anatomical variations wherein the number of roots and root canals vary. Presence of an additional lingual root distally in mandibular molars is called radix entomolaris (RE). Appropriate diagnosis is must before starting with root canal procedure in these teeth to ensure successful treatment outcome. The report describes the endodontic management of mandibular molar with RE. HOW TO CITE THIS ARTICLE: Arora A, Arya A, Chauhan L, Thapak G. Radix Entomolaris: Case Report with Clinical Implication. Int J Clin Pediatr Dent, 2018;11(6):536-538.

Prevalence of Osteosclerosis Among Patients Visiting Dental Institute in Rural Area of Western India.

BACKGROUND: Idiopathic osteosclerosis (IO) is a benign lesion of unknown aetiology and is not attributed to any dysplastic, inflammatory, neoplasia, or systemic disorder. AIMS AND OBJECTIVES: To assess the prevalence and distribution of IO according to its location and to patients' age and gender, among rural population of western India. MATERIALS AND METHODS: Seven hundred and fifty patients were examined for the presence of IO in the jaw bone. After a thorough clinical examination, radiographic examination was done using OPG. Age specified by WHO were used 5, 12, 15, 35-44 and 65-74. The data collected was than tabulated and subjected to descriptive statistics and chi square test. RESULTS: Among the total study population 89 (11.8%) were found to be suffering from IO out of which 27 (7.2%) were males and 62 (16.53%) were females. The maximum number of IO cases cases was seen among the age group of 35-44 y, 33 (22.0%) and minimum in 5 y 9 (6%). CONCLUSION: IO is higher among the females as compared to males and mostly seen among the 3(rd) and 4(th) decade individuals.

Efficacy of preprocedural mouth rinsing in reducing aerosol contamination produced by ultrasonic scaler: a pilot study.

BACKGROUND: The aerosol generated by an ultrasonic scaler contains microorganisms that can penetrate into the body through the respiratory system of dental surgeons and patients. The aim of this pilot study is to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorhexidine gluconate, an herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols. METHODS: This single-center, double-masked, placebo-controlled, randomized, three-group parallel design was conducted over a period of 45 days. Twenty-four patients with chronic periodontitis were divided randomly into three groups (A, B, and C) of eight patients each to receive 0.2% chlorhexidine gluconate, herbal mouthwash, and water, respectively, as a preprocedural rinse. The aerosol produced by the ultrasonic unit was collected at patient's chest area, doctor's chest area, and assistant's chest area on blood agar plates in all three groups. The blood agar plates were incubated at 37°C for 48 hours, and the total number of colony-forming units (CFUs) was counted and statistically analyzed. RESULTS: The results showed that CFUs in groups A and B were significantly reduced compared with group C, P <0.001 (analysis of variance). Also, CFUs in group A were significantly reduced compared with group B, P <0.05 (independent t-test). The numbers of CFUs were highest at the patient's chest area and lowest at the assistant's chest area. CONCLUSION: This study suggests that a routine preprocedural mouthrinse could eliminate the majority of bacterial aerosols generated by the use of an ultrasonic unit, and that 0.2% chlorhexidine gluconate is more effective than herbal mouthwash.