Sangeeta Talwar

Comparison of physical and mechanical properties of mineral trioxide aggregate and Biodentine

BACKGROUND Mineral trioxide aggregate (MTA) fulfills many of the ideal properties of the root-end filling material. However, its low cohesive property often makes it difficult to handle. Biodentine, new calcium-silicate-based cement has been developed to improve some MTA drawbacks such as its difficult handling property and long-setting time. AIM The objective of this study was to compare at different times the microleakage of roots filled with Biodentine and white MTA (WMTA)-Angelus and to investigate their setting time, handling properties and compressive strength. MATERIALS AND METHODS Root canals of single-rooted teeth were instrumented, filled with either Biodentine or WMTA-Angelus (n=15 each) with two positive and two negative control roots and stored at 37°C. Sealing was assessed at 4, 24 h, 1, 2, 4, 8, and 12 weeks by a fluid filtration method. The initial setting time, handling properties, and compressive strength of the test groups were investigated by a vicat needle, questionnaire of operational hand feel, and universal instron machine, respectively. RESULTS Significant differences in microleakage were found between two groups at 4-h and 24 h (P<0.05) and no difference at 1, 2, 4, 8, and 12 weeks. No significant difference was seen in the setting time of MTA-Angelus and Biodentine, though latter was found to have better handling consistency. Compressive strength of Biodentine was significantly higher than MTA-Angelus. CONCLUSIONS The results suggest that the new calcium-silicate-based endodontic cement provides improvement in sealing ability as well as clinical manageability of dental filling materials.

Successful management of pulpo-periodontal lesion in maxillary lateral incisor with palatogingival groove using CBCT scan

Palatogingival groove is a rare developmental anomaly involving the lingual surface of the maxillary incisor and resulting in severe endodontic and periodontal lesions. This case report describes a multidisciplinary approach for the combined management of the endodontic and periodontal problems for successful rehabilitation of the involved tooth. Cone-beam computed tomography (CBCT) helped in correct diagnosis of the lesion and hence enabled effective treatment.

Nonsurgical Endodontic Retreatment of Advanced Inflammatory External Root Resorption Using Mineral Trioxide Aggregate Obturation

Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent.

Evaluation of Antimicrobial and Antifungal efficacy of Chitosan as endodontic irrigant against Enterococcus Faecalis and Candida Albicans Biofilm formed on tooth substrate

Background Bacterial biofilms formed on the root canal wall are often difficult to remove. This study aimed to evaluate the cytotoxic effect and antibacterial efficacy of chitosan when used as root canal irrigant against E. Faecalis and Candida albicans biofilm formed on tooth substrate. Material and Methods The present study evaluated antibacterial effect of 0.25% Chitosan, 0.5% Chitosan, 2% chlorhexidine and 3% sodium hypochlorite against Enterococcus faecalis and Candida Albicans. Agar-well diffusion methods, minimal inhibitory concentration tests and biofilm susceptibility assays were used to determine antibacterial activity. Teeth specimens were sectioned to obtain a standardized tooth length of 12mm. Specimens were inoculated with 10 mL of the freshly prepared E. Faecalis suspension and Candida albicans for 4 weeks. The specimens were then instrumented with ProTaper rotary files F3 size. After irrigation with test solution, three sterile paper points were placed into one canal, left for 60 s and transferred to a test tube containing 1 mL of reduced transport fluid. The number of CFU in 1 mL was determined. Results 3-week biofilm qualitative assay showed complete inhibition of bacterial growth with 3% Sodium hypochlorite, 2% Chlorhexidine and Chitosan except saline, which showed presence of bacterial growth. Significant reduction of colony forming units (CFU)/mL was observed for the chitosan groups and the antibacterial activity of the chitosan groups was at par with 3% NaOCl and 2% Chlorhexidine. It was observed that the chitosan showed no cytotoxicity at 3mg/ml and 10% cytotoxicity at 6mg/ml. Conclusions The use of chitosan as a root canal irrigant might be an alternative considering the various undesirable properties of NaOCl and chlorhexidine. Key words:Biofilm, Candida albicans, Chitosan, Cytotoxicity, Enterococcus faecalis.

CBCT Imaging Modality Used to Diagnose Dental Anomalies: Case Reports

The advent of CBCT has made it possible to visualize the dentition, the maxillofacial skeleton, and the relationship of anatomic structures in three-dimensions. adiographic imaging is essential in diagnosis, treatment planning and follow-up in endodontics. The interpretation of an image can be confounded by a number of factors including the regional anatomy as well as superimposition of both the teeth and surrounding dentoalveolar structures. As a result of superimposition, periapical radiographs reveal only limited aspects, a two-dimensional view, of the true three-dimensional anatomy. Additionally, there is often geometric distortion of the anatomical structures being imaged with conventional radiographic methods. These problems can be overcome by utilizing smallor limited-volume cone beam-computed tomography imaging techniques, which produce accurate 3-D images of the teeth and surrounding dentoalveolar structures. CBCT Imaging Modality Used to Diagnose Dental Anomalies: Case Reports

Complicated crown-root fracture treated using reattachment procedure: a single visit technique.

Complicated crown-root fracture of maxillary central and lateral incisors is common in case of severe trauma or sports-related injury. It happens because of their anterior positioning in oral cavity and protrusive eruptive pattern. On their first dental visit, these patients are in pain and need emergency care. Because of impaired function, esthetics, and phonetics, such patients are quite apprehensive during their emergency visit. Successful pain management with immediate restoration of function, esthetics and phonetics should be the prime objective while handling such cases. This paper describes immediate treatment of oblique crown root fracture of maxillary right lateral incisor with reattachment procedure using light transmitting fiber post. After two and half years, the reattached fragment still has satisfying esthetics and excellent function.

Endodontic management of horizontally placed molars after gunshot injury to mandible: a case report.

A 37-year-old man reported to our department with the history of gunshot injury to the mandible 15 years before. His anterior mandible had been resected earlier and bone graft was seen. Intraoral examination of lower jaw revealed 4 remaining mandibular molars. These teeth were severely rotated such that they lay horizontal with respect to the mandibular base. Preoperative Dentascan spiral computerized tomography (CT) of the patient revealed obliteration of the mesial canals of the mandibular right first molar and pear-shaped internal resorption defect in the distal canal of the same tooth. This paper reports the challenging endodontic management of a rare case of severely angulated teeth also exhibiting traumatic sequelae in both roots of the impact tooth. It also highlights the usefulness of spiral CT scan in diagnosis of traumatic sequelae such as pulp canal obliteration and internal resorption.