Ganesh Bhat

A three-dimensional study of variations in root canal morphology using cone-beam computed tomography of mandibular premolars in a South Indian population.

BACKGROUND Conventional radiographic techniques being two dimensional, has its restrictions and is confined to limited diagnostic value. However, the incorporation of Cone Beam Computed Tomography (CBCT) gives a three dimensional insight to the tooth morphology and leads to better evaluation and treatment management. AIM The aim of this study was to evaluate and assess the root canal morphology of mandibular pre-molars in South Indian Population using CBCT radiographic technique. MATERIALS AND METHODS One thousand and eighty six and 814 fully erupted mandibular first and second premolars respectively were scanned using CBCT to evaluate the canal morphology according to Vertucci and Gulabiwalas classification. RESULTS The most common configuration in mandibular first and second premolars was Vertuccis Type I(83.81% and 93.48% respectively) followed by Type V (11.97% and 3.5% respectively). CONCLUSION South Indian population presented Type IV ertuccis canal morphology as the most common in mandibular first and second pre-molars followed by Type V. CBCT scanning poses a greater advantage in assessing the complexity of root canal morphology and planning an appropriate endodontic treatment for the same.

ANESTHETIC EFFICACY OF COMBINATION OF TWO PERCENT LIDOCAINE WITH 1:80,0 00 EPINEPHRINE AND 0.5 MOL/L MANNITOL FOR INFERIOR ALVEOLAR NERVE BLOCKS IN PATIENTS WITH SYMPTOMATIC IRREVERS IBLE PULPITIS: AN IN VIVO STUDY

The purpose of this prospective randomized single blind study was to determine the ane sthetic efficacy of combination of 2 % Lidocaine with 1 : 80,000 Epinephrine and 0.5 mol / L Mannitol in Inferior Alveolar Nerve (IAN) Blocks in patients with symptomatic irreversible pulpitis. 60 subjects randomly received IAN Blocks using the following t w o anesthetic formulations: one formulation comprised of 2.5 ml of 2 % Lidocaine with 1 : 80,000 Epinephrine and the other formulation comprised of 1.6 ml of 2 % Lidocaine with 1 : 80,000 Epinephrine and 0.9 ml of 0.5 mol / L Mannitol. The pain response of the patient was recorded on endodontic access and initial instrumentation using the He ft - Parker Visual Analogue Scale. From the statistical analysis obtained foll owing this study t he addition of 0.5 mol / L Mannitol to lidocaine with epinephrine formulati ons significantly improved effectiveness in achieving a g reater percentage of total pulpa l anesthesias compared with a lidocaine formulation without M annitol for IAN blocks. There is a significant improvement in the efficacy of IAN blocks when 2 % Lidocain e with 1 : 80,000 Epinephrine is administered in combination with 0.5 mol / L Mannitol. Based on the results of this study we can conclude that this combination of local anesthetic should be used on a regular basis to obtain successful anesth esia. However there is a need for more research as there are very few studies done on this aspect.

COMPARISON OF DEMINERALIZING EFFECT OF COMMERCIAL EDTA PREPARATIONS AT DIFFERENT TIME INTERVALS BASED ON MEASUREMENT OF THE AMOUNT OF PHOSPHORUS RELEASED FROM HYDROXYAPATITE

The objective of this in-vitro study is to compare the de mineralizing effect of commercial EDTA in different concentrations and different time intervals with respect to the amount of phosphorus released from hydroxyapatite. 96 freshly extracted maxillary central incisor roots were randomly grouped 4 groups of 24 specimens each. The first group, the control group was treated with saline. The second group was treated with a commercial preparation of EDTARC PREP. The third group was treated with a commercial preparation of EDTAGlyde and the fourth group was treated with a solution of 17 % EDTA. All the groups were treated with the respective formulations for time intervals one, three, ten and fifteen minutes each. The solutions obtained from each of the four groups were analyzed for phosphorus content using colorimetric analysis. Group II i.e. R C Prep showed the highest de mineralizing effect for 1, 3 and 10 minutes respectively. Group III i.e. Glyde showed the highest de mineralizing effect for 15minutes. Among the solutions containing EDTA, Group IV i.e. 17 % EDTA solution showed the least de mineralizing effect, despite the higher concentration. This is because of the additives present in commercially available chelating pastes.

ROOT AND ROOT CANAL MORPHOLOGY AND ITS VARIATION OF THE HUMAN MANDIBULAR CANINE: A LITERATURE REVIEW

The objective was to review the literature of the root and root canal morphology of the human Mandibular canine. Published studies cite the anatomy and morphology of the mandibular canine tooth. Individual case reports of anomalies were included to demonstrate the extreme range of variation. Almost all of the teeth in the anatomic studies were single rooted (94.8 %). The incidence of two roots (5.2 %) was extremely rare. Anatomic studies of the internal canal morphology found that a single canal was present in 89.4 % of the teeth, while 10.6 % of the teeth had two or more canals. However, the root and root canal morphology of the mandibular canine can be extremely complex and requires careful assessment. As an Endodontist, one should be aware of all the probable nooks and crannies of the complex root canal, its protean permutations, and combinations, to render the finest possible treatment. As is the case with any other treatment, endodontic therapy; if performed in the properly delineated and precise manner spells more than 99 % success rate. This review article attempts to bring out the possible nuances of the complex root canal system and various methods of reckoning with these significantly essential details.

ASSESSMENT OF MERCURY RELEASE FROM DENTAL AMALGAM: AN IN VITRO STUDY

Exposure to mercury from dental amalgam restoration, with possible negative health effects, has generally been considered to occur via either erosion or evaporation directly from the surface of fillings, followed by ingestion. This study aims to assess the mercury release from dental amalgam and provide a basis for comparison between mercury release in oral cavities with single and multiple amalgam restorations at different time intervals. This study was conducted in A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, and included three groups I , II and III containing one, four and eight teeth respectively. The level of mercury vapors released from dental amalgam restorations was calculated from artificial saliva and measured using an atomic absorption spectrophotometer. The obtained results concluded that the continuous release of Hg vapor from dental amalgam tooth restorations decreases as the restoration ages, after 30 days there was no significant difference between the amount of mercury released from multiple and single tooth restorations.

Mandibular second molar with 3 mesial canals and a radix paramolaris

Mandibular first molar commonly has two roots, the mesial and the distal root. Surprisingly in some mandibular first molar has an unusual extra third root in between mesial and distal root. This extra root is the most commonly seen in lingual side and is called as radix entomolaris. If this extra root is seen on the buccal side, it is termed as radix paramolaris (RP), which is a very rare phenomenon. Recently, various case report studies has shown the presence of third canal in the mesial and distal roots of mandibular molars. They are named as middle mesial and middle distal canal, respectively. Here, we present a case report of mandibular second molar showing three canals in the mesial root and a RP.

Management of taurodont right mandibular second molar tooth: A case report

Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and requires special handling because of the proximity and apical displacement of the roots. In this case report, a 60-year-old male patient was referred for root canal treatment of his right mandibular second molar and on clinical examination, there was deep caries in the right mandibular second molar. Intraoral peri-apical radiographic examination of this tooth revealed a long crown containing large pulp chamber and two short roots with an apically located furcation, indicating hypertaurodontism. Endodontic treatment was completed with a combination of thermoplasticized gutta-percha technique and lateral condensation technique to achieve a successful obturation.

Endodontic management of maxillary 2 nd Molar with additional MB2 canal - 2 case reports.

The success of endodontic treatment depends on the dentists knowledge about root canal morphology and its possible anatomic variations. According to Ingle, occurrence of accessory canals in the mesiobuccal root of maxillary first molar is (61.1%), more than that of maxillary second molars(47.1%).17 Failure to locate these extra canals may result in endodontic failure. This article presents two case reports of maxillary second molar, in which an extra canal in the mesiobuccal root was located using visual, tactile and magnifying devices, followed by endodontic treatment of the same using single cone technique.