ABSTRACT
rrigation is one the most important aspects during root canal treatment of the teeth which can be achieved by mechanical cleaning and shaping with the aid of irrigants. However, the irrigant does not travel to all the places of the root canal especially the apical third. Hence, to make this irrigant reach the apical third, we need irrigant activation methods which will agitate the irrigant and help in accessing the places which are difficult to reach in the root canal system. The objective of this research was to check the canal cleanliness and the removal of the debris after irrigant activation using manual dynamic agitation (MDA), plastic F file, sonic irrigation (SI) and conventional syringe irrigation (CSI). METHODSSixty single rooted teeth were chosen for this study which were biomechanically prepared using ProTaper system (Dentsply Maillefer, USA) up to a preparation of F2 and 3 % NaOCl and 17 % EDTA were used as irrigants. All the samples were equally divided into groups of fifteen each depending on the mode of irrigant activation method used - Group 1, Manual Dynamic Agitation (MDA); Group 2, plastic F file; Group 3, EndoActivator (SI); and Group 4, control group (C). These teeth were then split along the long axis and were observed under the SEM for any debris and to determine the degree of canal cleanliness. RESULTSGroup 4 (control group) showed the maximum debris under SEM with a statistically significant difference with a P value less than 0.05; next was the manual dynamic agitation group. Plastic F file group and sonic irrigation groups showed almost similar results in terms of debris. CONCLUSIONSIrrigant activated using sonic mode and plastic F file efficiently removed the debris in comparison to the other two groups of syringe irrigation and manual dynamic agitation.
ABSTRACT
A successful endodontic therapy depends on resolution of all the clinical signs and symptoms with complete periapical repair or regeneration. Sometimes conventional root canal therapy fails because of which we have to resort to periapical surgery.1 Periapical surgery removes the pathological tissue and leads to healing of the periapical lesion.2,3 Periapical surgery accounts for 3 % - 10 % in endodontic practice.4Platelet‐Rich Fibrin (PRF) is a platelet concentrate with specific composition, three‐dimensional architecture, and has characteristics with all the constituents of a blood sample to favour wound healing.5 PRF contains numerous growth factors such as platelet-derived growth factor (PDGF), transforming growth factor β1 (TGF β1), insulin-like growth factor (IGF) and exhibits numerous properties such as cell migration, cell attachment, cell proliferation, and differentiation6 facilitating the regenerative process of human body by utilizing the patient’s own blood is a novel concept in dentistry. These blood clots initiate the process of healing and regeneration of the hard and soft tissues.7,8PRF is like an interpositional biomaterial. It accelerates wound healing due to growth factor release. It is an easy and cost-effective way to obtain high concentrations of growth factors for tissue healing and regeneration.5 Any periapical lesion is a type of response of the bone around the apex of tooth that develops due to pulpal necrosis or extensive periodontal disease. Following endodontic treatment, repair or regeneration can occur depending on the microenvironmental causes. This case report exemplifies the use of platelet rich fibrin (PRF) and bone graft for the management of a large periapical lesion. Following endodontic treatment, periapical endodontic surgery was performed on a 41 year old male patient having a swelling in the buccal region of lower front teeth with a large defect evidenced radiographically. The surgical defect after curettage was filled with PRF, bone graft and guided tissue membrane and sutured. PRF along with bone graft accelerated the wound healing and induced bone formation.
ABSTRACT
The ideal management of a severely damaged tooth structure with any sort of periapical or pulpal pathology is dependent on a definitive and careful endodontic treatment as well as on a good and strong prosthodontic management which should be tried to be accomplished by all clinicians. Majority of the teeth which have undergone pulp extirpation and subsequent treatment are weak structurally and require an endodontic post and core build system for adequate functionality as well as aesthetics. Amongst all the available options for post and core systems, the decision to select an appropriate one can be challenging to the clinicians. If a tooth has lost significant coronal structure due to underlying caries or any sort of pulpal pathology, it is important to treat it endodontically also equal attention should be paid to its restoration to its anatomic form and function. However when sufficient remaining tooth substance is present, there no need of a post and the tooth can be endodontically treated with a prosthetic crown for its restoration. If a tooth has lost most of its tooth structure, it definitely necessitates the use of a post. The function of a post is to help retain a core which will provide structure and support to the future crown. An endodontic post not only provides strength and support to the remaining crown structure by retaining the core but also to the radicular part of the tooth. The more the tooth structure is preserved, the lower is the risk of catastrophic failures for that tooth. Posts which are pre - fabricated have numerous options from material aspect. This review article emphasizes on the various parameters to be considered before planning an endodontic post for a tooth.