Clinical effect of Augmentin as intracanal medicament compared with no any medication on endodontic flare-up in cases of symptomatic apical periodontitis- a pilot study

Objective: To assess the clinical effect of Augmentin as intracanal medicament on endodontic flare-up in comparison with no any intracanal medicament in cases of symptomatic apical periodontitis

Study Design: Comparative study

Place and Duration of Study: This study was conducted at the Operative Dentistry Department, Dental OPD Liaquat University of Medical and Health Sciences, Jamshoro from June to October 2015

Results: The mean age of the patients was 30.42 +/- 7.754. The males and females were 42% and 58% respectively. The types of teeth were anterior and posterior 58% and 42% respectively. Teeth with pulpal status with irreversible pulpitis and pulp necrosis were 46% and 54% respectively. The mean value of preoperative pain level was 8.24 +/- 0.797, pain after 24 hours was 4.54 +/- 1.606 and after 7 days was 1.10 +/- 0.931. The association of study group and effectiveness on pain [control of pain] showed that in group 1, 70% effective and 25% not effective, as compared to group II 30% effective and 75% not effective with P value 0.001

Conclusion: It is concluded that "The patients in which Augmentin was used as intracanal medicaments showed a greater decrease in pain levels over the observation period when compared to the control group"

Selection of single-visit and multiple-visit root canal treatment protocol: a survey of endodontic specialists and general dental practioner of Pakistan

Objective: The aim of this study is to determine the selection and preference of single- and multi-visit root canal therapy by specialist's endodontists and general dental practitioners of Pakistan and to inquire their motive for selecting the choice of treatment protocol in their practice

Study Design: Comparative study

Place and Duration of Study: This study was conducted at the Department of Operative Dentistry and Oral Biology, Institute of Dentistry, LUMHS, Jamshoro from May 2016 to August 2016

Material and Methods: A close ended questionnaire was send via emails, WhatsApp and Facebook accounts to 20 specialist endodontists and 150 selected GDPs in Pakistan to investigate their preference and motive for selecting the choice of treatment protocoleither single- or multi-visit for their patients. A literature search determined the commonest factors affect the choice of treatment either single- and multi-visit root canal treatment and were written in the questionnaire. The participants were informed to tick their response as agree, neutral and disagree as given in the questionnaire. The data collected were analyzed by the SPSS version 16. Frequency and percentages of variable like practice experience, current method of RCT and preference to the method of RCT were calculated. Chi-square tests were used to evaluate the differences in preference and current method of practice between both the groups of study. The level of statistical significance was set at 0.05

Results: Response rate was 100% in this study. Amongst all participants 29.4% have experience of less than 10 years and 70.6% have experience of more than 10 years. Generally all participants were practicing 72.4% multi-visit RCT and 27.6% single visit RCT. When both groups were compared by using chi-square test, GDPs preferred multiple-visit endodontic treatment and specialist Endodontist preferred single visit treatment. Also current method of performing root canal treatment by specialist endodontists is single visit procedure as compared to the GDPs, who performed mostly by multi-visit. Most important factor to be considered for multi-visit root canal treatment were outstanding effects of intracanalmedication, reduction of postoperative pain and easy collection of fees for multiple visit were 66.3%, 62.9% and 64.7% respectively.as compared to single visit root canal treatment, the most important factor considered were low risk and complication of local anesthetics 62.4, treatment can be completed in one visit 52.4%, patient's time limitation68.6%, dentist time limitation68.0% and patient preference 60.6%

Conclusion: In conclusion, most specialist endodontists perform and prefer single visit root canal treatment and GDPs preferred multi-visit root canal treatment

Frequency of C-shaped canals in mandibular permanent second molar among Hyderabad population

The objectives of this study were to assess the frequency and configuration of C-shapedcanal in mandibular second molar teeth. Descriptive type of study. This study was performed at the Dental OPD, Department of Operative Dentistry, Liaquat University Hospital, Hyderabad / Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro from June 2010 to December 2010. A total of 100 extracted mandibular second molars were collected. The teeth were stored in 0.9% physiological solution [Otsuka Pakistan Ltd:] after extraction. Calculus and the remainder of periodontal tissue were thoroughly removed by a curette. All the samples were then rinsed with tap water and dried with air. Each tooth was opened to gain access of the pulp chamber by a small round bur [Mani, Japan]. The pulp chamber was injected with the 0.5% methylene blue [BDH Gurrcertistan chemical Ltd: Poole England]. The contrast color penetrated through pulp-down to the pulp orifice of the root canal. All the teeth were resected transversally at the cemento-enamel junction by a thin diamond disc [Mani, Japan] and the crowns were discarded. The canal orifices were located by DG-16 endodontic explorer. The same diamond disc were used for cutting roots transversally into two more sections at middle 3[rd] and 2mm above the root apex. All these three section were studied under operating microscope [66 vision tech: Co. Ltd: Sozhou, China] for anatomical properties mentioned in objectives. Thirteen C-shaped canals were found out of 100 mandibular second molars. 03 were of category I and II respectively and 07 were of category III. The present study demonstrated that mandibular second molar teeth have variations in terms of number of roots, number of canal orifices and canal morphology. Therefore it cannot be assumed that these teeth always have two-roots and three canals. The overall prevalence of C-shaped canal was found 13% in the local population. The difference to other studies may be attributable to racial differences and study model

Frequency of fourth canal in permanent mandibular first molars

This study was carried out to investigate the frequency of fourth [distolingual] canal in the permanent mandibular first molars and to determine the effect of modified access cavity preparation for endodontic treatment. It was an observational study. The study was conducted at the Department of Operative Dentistry, Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad from September 2009 to February 2010. Two hundred permanent mandibular first molars were selected from male and female patients presenting for endodontic treatment. The method used for exploring the fourth canal was the modified access cavity preparation which involved changing the triangular access cavity shape to a quadrangular shape. The study involved careful selection criteria, pre-operative radiological examination and then triangular access cavity preparation. The number of canals found by triangular access cavity preparation was noted on the proforma before extending the shape to a quadrangular shape and then a thorough exploration of the floor of the pulp chamber was done. Finally, if fourth canal was present, the presence of the fourth canal was confirmed by taking two periapical radiographs at two different angles with 15 # K files in the root canals. The data collected were analyzed using the chi square test. The results showed that fourth canal was found in 36% of permanent mandibular first molars. The effect of modified access cavity preparation was significantly higher [P= 0.0001] in cases with a fourth canal than in teeth with three canals [P= 0.05]. Statistically there was insignificant difference [P= 0.7] between the genders for the occurrence of fourth canal. This study demonstrates that there is a greater frequency of fourth canal in the permanent mandibular first molar teeth than previously thought. Also changing the shape of access cavity from a triangular outline to a quadrangular outline facilitates in locating the fourth canal

Frequency of three canals in permanent maxillary second premolars [in vitro]

The objective of this study was to determine the frequency of three canals in extracted permanent maxillary second premolars. This was an in vitro study conducted at the Dental Outpatient's Department of Liaquat University of Medical and Health Sciences Hospital, Hyderabad/Jamshoro from January 2007 to June 2007. This study included one hundred and fifty extracted permanent maxillary second premolars. Pulp chambers were accessed using round bur in a high speed hand piece. The pulp chambers were irrigated with 2.5% sodium hypochlorite solution for 12 hours to dissolve pulp tissues, then rinsed under running tap water for 2 hours and dried overnight. The dye was introduced coronally and flooded throughout the pulp space by vacuum suction apically. Teeth were then decalcified in 5% nitric acid solution for five days. Eventually teeth were made clear by dipping in methyl salicylate and examined under operating microscope under 7.5 x magnification for frequency of the three canals. Results showed that three canals were found in 2% of the permanent maxillary second premolars. Chi-square test was used to evaluate the results. It was concluded that an accurate clinical as well as radiographic diagnosis based on knowledge of root canal morphology and critical interpretation of radiographs is essential for achieving better outcome of endodontic treatment of the permanent maxillary second premolars