Rajamani Indira

Depth of Penetration of Four Resin Sealers into Radicular Dentinal Tubules: A Confocal Microscopic Study

BACKGROUND The aim of this in vitro study was to evaluate the depth of penetration of 4 different endodontic resin sealers into the radicular dentinal tubules with the aid of confocal microscopy. METHODS Eighty single-rooted teeth were instrumented and divided into 4 groups composed of 20 teeth each. The samples were obturated with AH Plus, RealSeal, EndoRez, and RoekoSeal resin sealers, respectively. The core material in all the groups was Resilon. The teeth were sectioned at the coronal, middle, and apical thirds and viewed under confocal microscope to determine the depth of penetration of the sealer into the dentinal tubules. RESULTS The results showed that the maximum penetration was exhibited by RealSeal resin sealer, followed by AH Plus, RoekoSeal, and EndoRez. The coronal third showed the maximum penetration, followed by middle third and least at the apical third. CONCLUSION Under the parameter of this study, RealSeal resin sealer exhibited the maximum penetration.

Anesthetic Efficacy of Four Percent Articaine for Pulpal Anesthesia by Using Inferior Alveolar Nerve Block and Buccal Infiltration Techniques in Patients with Irreversible Pulpitis: A Prospective Randomized Double-blind Clinical Trial

INTRODUCTION The study was designed as a randomized double-blind trial to evaluate the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine in inferior alveolar nerve block (IANB) and infiltration anesthetic techniques to anesthetize mandibular molars with irreversible pulpitis. METHODS The study was composed of 2 test arms and 1 control arm. Subjects in the test arms received either a standard IANB or a buccal infiltration (B Infil) of 4% articaine with 1:100,000 epinephrine, whereas the subjects in the control arm received a standard IANB of 2% lidocaine with 1:100,000 epinephrine. Subjects self-reported pain response was recorded on Heft Parker Visual Analogue Scale after local anesthetic administration during access preparation and pulp extirpation. RESULTS For statistical analysis Pearson χ(2), Students paired t test, 1-way analysis of variance, and Friedman tests showed no significant difference in success rates among the 3 arms of the trial. CONCLUSIONS Although B Infil and IANB of 4% articaine were equally effective, B Infil can be considered a viable alterative in IANB for pulpal anesthesia in mandibular molars with irreversible pulpitis.

Anatomical variations of mandibular premolars in Chennai population.

AIM To analyse the prevalence of anatomical variations of mandibular premolars in Chennai population. METHODOLOGY It was observed, during the routine treatment of mandibular premolars that aberrations were becoming common. This necessitated an encompassing study on 500 patients, evaluating the occurrence of these aberrations. The parameters of this study included sex predilection, unilateral/ bilateral occurrences, and comparison of the incidence of anatomical variations in mandibular first and second premolar canal configuration. The study pattern was designed to observe these premolars using Radiovisiography (RVG) in different angulations to highlight the anatomical aberrations. The results were subjected to statistical analysis, which were performed using SPSS (Statistical Package for Social Science) statistical program version 10.0.5. Descriptive statistics were computed for all the variables. RESULT The present study revealed high incidence of anatomical aberrations in mandibular premolars among Chennai population. Out of the 500 patients studied, 123 patients [24.6%] showed anatomical variance in the canal configuration. There was high incidence of Vertuccis Type IV canal configuration as compared to Type V, Type II and Type VIII in the descending order of occurrence. CONCLUSION Within the limitations of this in-vivo study, it was inferred that the incidence of aberrations in the canal configuration of mandibular premolars is common and due considerations are to be given during endodontic intervention.

Role of casein phosphopeptide amorphous calcium phosphate in remineralization of white spot lesions and inhibition of Streptococcus mutans

Introduction: To promote the remineralization by ionic exchange mechanism instead of invasive techniques many remineralizing agents can be used. Objective: To evaluate the remineralization effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs) and its inhibitory effect on Streptococcus mutans colonization. Materials and Methods: The study group consisted of 60 subjects exhibiting at least 1-WSL. Subjects were randomly divided into 2 groups: A test group using CPP-ACP cream (GC-Tooth Mousse, Leuven, Belgium) and a control group using only fluoride containing toothpaste for a period of 3-month. Baseline WSLs were scored using DIAGNOdent device (KaVo Germany) and the saliva samples were collected to measure S. mutans counts. After the 3-month period the WSLs were again recorded and the saliva collection was repeated. Result: DIAGNOdent measurements were increased by time (P = 0.002) in the control group and no statistically significant difference (P = 0.217) was found in the test group by the 3-month period. In both groups, the mutans counts were decreased in the 3-month experimental period. Conclusion: These clinical and laboratory results suggested that CPP-ACP containing cream had a slight remineralization effect on the WSL in the 3-month evaluation period however, longer observation is recommended to confirm whether the greater change in WSLs is maintained.

Endodontic management of a mandibular first molar with three distal canals confirmed with the aid of spiral computerized tomography: A case report

Identification and treatment of extra canals is the cornerstone to successful endodontic practice. Over the years, many diagnostic aids have evolved to facilitate the clinician in detection of hidden canals and to familiarize with the internal radicular anatomy. This case report highlights the rare incidence of 3 canals in the distal root of a permanent mandibular first molar. A spiral computerized tomography scan was used as a noninvasive diagnostic tool to confirm the diagnosis.

Prevalence of radix entomolaris in mandibular permanent first molars: a study in a South Indian population

OBJECTIVE Anatomical racial variations are an acknowledged characteristic in permanent molars. Generally, mandibular first molars have 2 roots; however, the presence of a third root, radix entomolaris (RE), is a major anatomic variant among many population groups. This study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in a South Indian population. STUDY DESIGN Five hundred patients of South Indian origin possessing bilateral mandibular first molars were selected. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened and the incidence of 3-rooted mandibular first molars and the correlation between left and right side occurrence and between either gender was recorded. RESULTS The prevalence of 3-rooted mandibular first molars was 18.6% of the patients examined and 13.3% of the teeth examined. There was no statistically significant difference between genders or side of occurrence (P > .05). The bilateral incidence of a symmetric distribution was 43.01%. CONCLUSIONS RE is considered an Asiatic trait. The occurrence of this macrostructure in the South Indian population was 13.3%, which was lower than that of other patients of Mongoloid origin. The clinician must thoroughly examine the radiograph before initiation of endodontic therapy.

Remineralization of early enamel lesions using casein phosphopeptide amorphous calcium Phosphate: An ex-vivo study

Objective: This study aimed at qualitatively evaluating the remineralization potential of casein phosphopeptide amorphous calcium phosphate on artificial early enamel lesions in an ex-vivo scenario by observing the treated tooth surface using a scanning electron microscope (SEM). Materials and Methods: This randomized study was conducted on 10 subjects undergoing orthodontic treatment with premolar extraction as part of their treatment. Artificial white lesions were created with the application of 37% phosphoric acid for 20 mins. Teeth were then divided into two groups: one experimental and the other control. Customised orthodontic band with a window was luted with intermediate restorative material in the experimental group whereas in the control group, band without a window was luted. The casein phosphopeptide amorphous calcium phosphate (GC TOOTH MOUSSE) paste was then applied on the window region of the experimental group for 3 mins thrice daily after meals for 14 days, whereas no paste was applied in the control group. After 14 days, teeth were extracted and viewed under an SEM. Results: The study groups showed remineralization of the lesions as compared with the control group in most of the samples. Conclusion: Casein phophopeptide could significantly remineralize the artificial enamel lesions in vivo.

Comparison of temperature rise in the pulp chamber with different light curing units: An in-vitro study

Aims/Objectives: This in vitro study was designed to measure and compare the temperature rise in the pulp chamber with different light curing units. Materials and Methods: The study was done in two settings-in-vitro and in-vivo simulation. In in-vitro setting, 3mm and 6mm acrylic spacers with 4mm tip diameter thermocouple was used and six groups were formed according to the light curing source- 3 Quartz-Tungsten-Halogen (QTH) units and 3 Light-Emitting-Diode (LED) units. For the LED units, three modes of curing like pulse-cure mode, fast mode and ramp mode were used. For in-vivo simulation, 12 caries free human third molar tooth with fused root were used. K-type thermocouple with 1 mm tip diameter was used. Occlusal cavity was prepared, etched, rinsed with water and blot dried; bonding agent was applied and incremental curing of composite was done. Thermal emission for each light curing agent was noted. Results: Temperature rise was very minimal in LED light cure units than in QTH light cure units in both the settings. Temperature rise was minimal at 6mm distance when compared to 3 mm distance. Among the various modes, fast mode produces the less temperature rise. Temperature rise in all the light curing units was well within the normal range of pulpal physiology. Conclusion: Temperature rise caused due to light curing units does not result in irreversible pulpal damage.

Antifungal Efficacy of 5.25% Sodium Hypochlorite, 2% Chlorhexidine Gluconate, and 17% EDTA With and Without an Antifungal Agent

INTRODUCTION The aim of this in vitro study was to evaluate the efficacy of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate (CHX), and 17% EDTA as a final irrigant with and without the inclusion of an antifungal agent (1% clotrimazole) on Candida albicans. METHODS Sixty-five single-rooted instrumented and inoculated with a suspension of C. albicans. The experimental specimens were divided into two groups. The irrigant group was divided into three subgroups and irrigated with 5.25% NaOCl, 2% CHX, and 17% EDTA, respectively. The irrigant with antifungal group was divided into three subgroups and irrigated with 5.25% NaOCl, 2% CHX, and 17% EDTA respectively followed by 1% clotrimazole. Aliquots from the experimental teeth were plated on 4% Sabouraud agar (Tital Biotech, Delhi, India), and the colony-forming units (CFUs) were evaluated under light microscopy (400x). RESULTS NaOCl, 5.25%, exhibited superior antifungal efficacy compared with 2% CHX and 17% EDTA (p < 0.001). On inclusion of 1% clotrimazole, there was a significant decrease in the CFU (p < 0.001); 5.25% NaOCl and 2% CHX with clotrimazole showed significantly greater antifungal properties than 17% EDTA with clotrimazole (p < 0.001). CONCLUSION One percent of clotrimazole proved to be effective against C. albicans when used along with root canal irrigants as a final rinse.

Mandibular first premolar with two roots and three canals

This case report presents a relatively uncommon clinical case of a mandibular premolar with two roots and three canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. Sound knowledge of root canal anatomy, appropriate assessment of the pulp chamber floor, critical interpretation of radiographs and high-magnification examinations are highly desirable to achieve the best possible outcome in complicated root canal therapy.