Comparison of effectiveness of mineral trioxide aggregate and calcium hydroxide in apexification procedure

An incompletely formed apex [open apex] is one of the most common features seen in immature permanent teeth after dental trauma. Endodontic treatment of open apex teeth presents with problems of overfilling and poor apical seal, thus it is imperative to create an artificial apical barrier or to induce apical closure with calcified tissue. Different materials have been tried for Apexification procedure, the most common are calcium hydroxide and mineral trioxide aggregate [MTA]. The objective of this article was to compare the effectiveness of Mineral Trioxide Aggregate and Calcium hydroxide in creating apical closure.This is a comparative study of 80 patients with Open Apex teeth. They were randomly allotted into two groups [Group A and Group B]. In Group A[ 40 patients], calcium hydroxide was used as an apexification material, While in Group B [ 40 patients] apical plugs were produced with mineral trioxide aggregates [MTA] followed by obturation. In Group A,30 patients showed complete absence of lesion while in Group B, 37 patients showed complete healing. Ten patients showed no healing in Group A, because of improper packing of mate-rial into the canal, while only three patients showed no healing in Group B because of poor delivery of MTA to the apex. The results showed that 75% teeth had complete healing in Group A and 92.5 % had complete healing in Group B. The results of the study concluded that MTA is significantly better than Ca [OH]2 in Apexification of non- vital immature permanent teeth

Prevalence of taurodontism in mandibular second molars

The study was undertaken to assess the prevalence of taurodontism and gender differences in mandibular permanent second molars of patients who visited Punjab Dental Hospital. Taurodontism is the morpho-anatomical change in the shape of a tooth, and it is a rare dental anomaly which involves enlargement of the body of the tooth and shortening of the roots. Endodontic treatment of a taurodont tooth is challenging and requires special handling because of the proximity and apical displacement of the roots It has been reported in permanent and deciduous teeth, in premolars and molars and are associated with certain syndromes, particularly in those involving an ectodermal defect. It has clinical implications which are relevant to both the general dental practitioner and the orthodontist. The prevalence of taurodontism was12% in this study

comparison of thermafil and lateral condensation techniques in obturation of root canal systems

The aim of this study was to compare quality of thermafil obturation technique with cold Lateral Condensation technique in the management of root canal therapy. In this quasi experimental study, a total of 60 patients with symptomatic irreversible pulpitis were selected. They were randomly allocated to two groups, Group A and Group B, each comprising of 30patients. In both groups chemo-mechanical preparation was done in first visit and in the second visit group A was obturated by thermafil technique and group B was obturated by cold lateral condensation technique. Post-operative evaluations of patients were based on peri-apical radiograph. Teeth obturated with Thermafil showed fewer voids and more radiodensity. Hence in terms of quality, obturation by thermafil technique was considered better

Prevalence of palato gingival groove in maxillary lateral incisors

Palato gingival grooves, also called palatoradicular grooves or radicular lingual grooves are developmental anomalies in which an infolding of the inner enamel epithelium and Hertwig's epithelial root sheath create a groove that passes from the cingulam and extend varying distances apically on to the root. The purpose of this study was to determine the prevalence of palato gingival groove in maxillary lateral incisors, and prevalence of caries in the groove. 200 patients of age ranged between 15-40 years, attending the Punjab Dental Hospital, Lahore were randomly selected for examination. Patients with missing or crowned lateral incisors were excluded from the study. All lateral incisors were carefully examined for the presence, extension of palato gingival and caries development in groove. The prevalence of palato gingival groove was 10%. They were found to be 6.75% as coronal groove and 3.25% as an apical groove. Bilateralism was found to be 57.5%, 63% for coronal and 46.15% for apical grooves. In male patients the prevalence was 65% and in female patients 35%. Caries prevalence was 35%, 18.5% for coronal groove and 69% for apical groove. It was concluded that prevalence of palato gingival groove is high in this community and show increased caries incidence

Bone healing of cyst-like periapical lesion following surgical endodontics: a case report

This article presents a case report of endodontic treatment and apicectomy as well as enucleation of large radicular cyst associated with maxillary right central, lateral and canine teeth accompanying labial expansion. Cystic lesion was removed surgically under local anesthesia and apicectomies were done after the completion of root canal treatment

Dens invaginatus: aetiology, classification, prevalence, diagnosis and treatment considerations

Dens invaginatus is a developmental malformation of teeth.Affected teeth show a deep infolding of enamel and dentine starting from the foramen caecum or even the tip of the cusps and which may extend deep into the root. Teeth most affected are maxillary lateral incisors. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of complex anatomy of teeth. Aetiology, classification, prevalence, diagnosis and treatment considerations are reviewed

Management of crown-root fracture - a case report

This case report describes the management of an oblique crown-root fracture of maxillary left lateral incisor. After removal of the fractured fragment, endodontic treatment, the remaining tooth was provisionally restored. The tooth was then orthodontically extruded by 3 mm to raise the defect supraginigivally. Periondontal fibres were cut with a surgical blade. A metallic screw type post was inserted in the root and core was built with composite restoration. Porcelain fused to metal crown was fitted over the core built up. This case report demonstrates that a multidisciplinary treatment approach to an oblique subgingival crown-root fracture is a reliable and predictable option to save a tooth

Incidence of caries in 6-12 years children visiting Punjab Dental Hospital, Lahore and Sardar Begum dental college and hospital, Peshawar

This study was conducted on 1146 patients having age of 6-12 years visiting two dental hospitals of NWFP and Punjab, Pakistan. The aim of this study was to determine the incidence of caries in 6-12 years children. G.V.Black's classification of dental caries was used. 516 cases were studied in Lahore while 630 in Peshawar during the period from January to December 2006. Class I and II carious lesions were included. Among 516 cases studied in Lahore, total of 938 carious lesions were detected on various surfaces. Class I caries on buccal surface was found in 40 [4.3%] teeth, on palatal/ lingual surfaces 4 [0.4%], occlusal surface caries, 503 [53.6%]. Class II caries on mesial surface 77 [8.2%] were detected while on distal surface 91 [9.7%] were seen. Other details were; mesio-occlusal [M-O] caries 109 [11.6%], disto-occlusal [D-O] caries 85 [91.1%], mesio-occluso-distal [MOD] caries were 29 [3.1%]. 630 patients were examined at Sardar Bengum dental College and Hospital, Peshawar. A total of 1838 carious lesions were detected on various surfaces. Class I caries on buccal surface 01 [0.1%], palatal/ lingual surfaces 19 [1.0%], occlusal surface caries 665 [36.2%]. Class II caries on mesial surface 200 [10.9%], on distal surface 173 [9.4%], mesio-occlusal [M-O] caries 384 [20.9%], disto-oocclusal [D-O] caries 328 [17.8%], mesio-occluso-distal [MOD] caries 68 [3.7%]. A high significance level [p<0.05] was compounded by poor knowledge of preventive and restorative oral health care services was contributory to the current trend

Relationship of intracanal irrigants to inter-appointment pain in endodontics

The purpose of this study was to compare levels of postoperative pain after cleaning and shaping of root canals using three different root canal irrigants for debridement. Sixty patients with irreversible pulpitis and acute apical periodontitis requiring root canal treatment were included. They were divided into three study groups. Canals were cleaned and shaped with one of the following protocols. In group 1, 17% EDTA was used as the root canal irrigant. In group II, canals were irrigated with 2% Chlorhexidine. In group III, 5.25% sodium hypochlorite was used as root canal irrigant. Access cavities were closed with a sterile cotton pellet and Cavit. The patients recorded degree of pain at various tune intervals afterconclusion of the first appointment on a visual analogue scale for 72 hours. A significant statistical difference was found in the degree of pain between the three groups [p = 0.0001]