Comparison of anaesthetic efficacy of 4% articaine primary buccal infiltration versus 2% lidocaine inferior alveolar nerve block in symptomatic mandibular first molar teeth

Objective: To evaluate success of pulpal anaesthesia of mandibular 1st molar by using 4% articaine in buccal infiltration versus 2% lidocaine in inferior alveolar nerve block

Study Design: Randomized control trial

Place and Duration of Study: Department of Operative Dentistry, Sardar Begum Dental College, Gandhara University, Peshawar, from March to August 2014

Methodology: One hundred and fifty-six emergency patients, who had 1st molar diagnosed with irreversible pulpitis, participated in the study. Subjects were divided into two groups by random allocation. One group received 4% articaine buccal infiltration and the other group received inferior alveolar nerve block of 2% lidocaine. Subjects' self-reported pain response was recorded on Heft Parker Visual Analogue Scale after local anaesthetic administration during access cavity preparation and pulp extirpation

Results: Mean age of subjects was 31.46 +/- 10.994 years. The success rate of 4% buccal infiltration was 76.9%; whereas the success rate of 2% lidocaine inferior alveolar nerve block was 62.8%. There was no statistically significant difference between the two groups

Conclusion: 4% articaine buccal infiltration can be considered a viable alternative to 2% lidocaine inferior alveolar nerve block in securing successful pulpal anaesthesia for endodontic therapy

Comparison of effectiveness of 4% articaine buccal infiltration versus inferior alveolar nerve block in symptomatic mandibular 1[st] molar tooth

Objective: to evaluate the pulpal anaesthesia of mandibular 1st molar by using 4% articaine in two different techniques i-e buccal infiltration and inferior alveolar nerve block

Methodology: ninty emergency patients who had 1st molar diagnosed with irreversible pulpitis participated in the study. Subjects were randomly allo-cated into two groups One group received 4% articaine buccal infiltration and the other group received inferior alveolar nerve block of 4% articaine. Subjects' self reported pain response was recorded on Heft Parker Visual Analogue Scale after local anesthetic administration during access cavity preparation and pulp extirpation

Results: mean age of subjects was 32.96 years +/- 10.105 years. The success rate of 4% articaine buccal infiltration was 71.11% whereas the success rate of 4% articaine inferior alveolar nerve block was 64.4%. There was no statistically significant difference between two groups

Conclusion: since there was no difference between the two procedures 4% articaine buccal infiltration can be considered a viable alternative to inferior alveolar nerve block in securing successful pulpal anesthesia for endodontic therapy

Comparison of inter appointment pain between calcium hydroxide mixed with 2% chlorhexidine and calcium hydroxide mixed with normal saline; a randomized controlled trail

The objective of this study were to determine which medium [normal saline or 2% chlorhexidine] is more efficient when mixed with calcium hydroxide in reduction of interappointment pain. Eighty subjects from Department of Operative and Endodontics, Sardar Begum Dental College were randomly divided into two groups; Group 1 had 40 subjects who received calcium hydroxide mixed with 2% Chlorhexidine while in group 2, the subjects received calcium hydroxide mixed with 0.9% normal saline after chemomechanical preparation. The mean pain experienced by the subjects was less in group 1 after 6, 12, 24 and 48 hours of the preparation. As intra canal dressing, combination of calcium hydroxide and chlorhexidine was more effective than that of calcium hydroxide and saline, in reducing interappointment pain

Prophylactic use of antibiotics to prevent flare-up in endodontic treatment

The aim of this study was to assess the effectiveness of giving antibiotics during root canal treatment to reduce pain. Sixty patients with asymptomatic necrotic teeth were included in the study, which was carried out at the Department of Operative Dentistry, Altamash Institute of Dental Medicine, Karachi and was spread over one year. Two groups, A and B, were formed. Thirty patients in group A were given prophylactic antibiotics. Patients in group B formed the study group. Postoperative flare-up pain recorded at 4, 12, 24 and 48 hours was not statistically significant between the two groups. It was concluded that there was no statistical significance of giving prophylactic antibiotics to prevent inter-appointment flare-up. The risk of inappropriate use of antibiotics and widespread antibiotic resistance appear to be far more important than any possible perceived benefits

Incidence of endodontic flare-ups using either calcium hydroxide or creosote as intracanal medicament in symptomatic teeth

To enhance our knowledge about the superior intracanal medicament available for reducing the interappointmentpain in endodontic treatment. Hundred symptomatic teeth presenting to the Department of Operative Dentistry, Khyber College of Dentistry were included in this study. All teeth underwent conventional root canal treatment. The canals were dried and one of the following two medicaments was inserted into the canal in random sequence: Group 1: Calcium Hydroxide paste; Group 2: Creosote. Before dismissal, the preoperative pain experienced on the previous night was recorded using a visual analogue pain scale. Patients were instructed to record the degree of pain experienced 4 hours, 12 hours, 24 hours and 48 hours after the treatment. Patients who received Calcium hydroxide have a lower incidence of flare-up when compared to Creosote. Based on this study, Calcium Hydroxide is the superior intracanal medicament in terms of postoperative pain

role of factors contributing to oral and dental health status

The objective of the present study was to find various reasons or factors which contribute to poor oral and dental health. This study was carried out in three months from Sept to Nov 2009. One hundred and thirty five subjects were included in this study by convenience sampling method. A proforma was made to record the information. One hundred and five subjects [77.8%] were educated while 22.2% were uneducated. The participants belonged to good, satisfactory and poor socioeconomic classes [12.6%, 51.9% and 35.6% respectively. Negligence was the main reason for poor oral and dental health [44.4%] followed by unawareness [26%]. Education and socioeconomic condition had no significant effect on the oral and dental health [P-value 0.713 and 0.061 respectively]

Replacements of amalgam restorations - a study

The aim of this study was to register various reasons for replacement or repair of amalgam restorations of patients visiting a dental institution hospital in Peshawar, Pakistan, and to compare the results of the present study with the international studies carried out on this subject. A cross sectional study on 123 patients, aged 10-60 years, visiting for the replacement or repair of their 210 amalgam restorations was carried out over a period of 10 months. These patients were examined clinically and radiographically to find out the reasons of the failed amalgam restorations which needed replacement or repair while the teeth were still vital and restorable. In 123 patients, 210 amalgam restorations were examined. Seven reasons were found responsible for replacement or repair of restorations; Secondary caries [37.61%], marginal degradation [22.38%], dislodgment of fillings [20.47%], poor anatomy restored [14.76%], fracture of filling's material [11.42%], macroleakage gap [5.71%] and fracture of teeth [3.80%] were found in 210 restorations. The failed restorations with single reason [85.72%] and combined reasons [14.28%] were also assessed in this study. Secondary caries was the most prevalent reason for replacement or repair, followed by marginal degradation. The results also showed that the failed restorations with one reason were dominant over the restorations with multiple reasons in this study