Evaluation of proximity of mandibular molars and second premolar to inferior alveolar nerve canal among central Indians: A cone‑beam computed tomographic retrospective study.

Context: A study was done to assess the average distances of root apices of mandibular first molar, second molar, and second premolar to inferior alveolar nerve canal (IANC), among males and females in central India. Materials and Methods: High‑resolution full‑volume cone‑beam computed tomography (CBCT) scans were obtained from the radiology database at the Sri Aurobindo College of Dentistry, Indore. After scrutinizing the database, CBCT of 40 males and 40 females that conformed to the inclusion and exclusion criteria were selected for the study. Results: All the data were analyzed using SPSS, Version 16. Descriptive statistics of the variables and measurements are presented using Students t‑test (paired and unpaired), and correlation between age was tabled by Karl Pearson’s correlation coefficient method. Conclusion: For the second premolar, the average distance to the IANC was 0.88–13.03 mm for males and 0.00–5.49 mm for females. The average distance of IANC to the mesial root apex of first molar was 1.46–13.23 mm for males and 0.93–8.03 mm for females. For the second molar, the average distance was 1.31–14.71 mm for males and 0.00–6.91 mm for females (values on left side were shorter as compared to right side). In the overall population, only second molar exhibited significant difference in the distance from root apex to IANC when compared bilaterally. In addition to gender differences, age‑related differences were found to be significant for the first molar on left side and second molar on the right side of the population (P < 0.05).

Use of second-generation platelet concentrate (platelet-rich fibrin) and hydroxyapatite in the management of large periapical inflammatory lesion: A computed tomography scan analysis.

Periapical surgery is required when periradicular pathosis associated with endodontically treated teeth cannot be resolved by nonsurgical root canal therapy (retreatment), or when retreatment was unsuccessful, not feasible or contraindicated. Endodontic failures can occur when irritants remain within the confines of the root canal, or when an extraradicular infection cannot be eradicated by orthograde root canal treatment. Foreign‑body responses toward filling materials, toward cholesterol crystals or radicular cysts, might prevent complete periapical healing. We present here a case report wherein, combination of platelet‑rich fibrin (PRF) and the hydroxyapatite graft was used to achieve faster healing of the large periapical lesion. Healing was observed within 8 months, which were confirmed by computed tomography, following improved bone density. PRF has many advantages over platelet‑rich plasma. It provides a physiologic architecture that is very favorable to the healing process, which is obtained due to the slow polymerization process.

A comparative evaluation of fracture resistance of endodontically treated teeth, with variable marginal ridge thicknesses, restored with composite resin and composite resin reinforced with Ribbond: An in vitro study.

Background: The anatomic shape of maxillary premolars show a tendency towards separation of their cusps during mastication after endodontic treatment. Preservation of the marginal ridge of endodontically treated and restored premolars can act as a strengthening factor and improve the fracture resistance. Objectives: To evaluate the effect of varying thickness of marginal ridge on the fracture resistance of endodontically treated maxillary premolars restored with composite and Ribbond reinforced composites. Materials and Methods: One hundred and twenty, freshly extracted, non carious human mature maxillary premolars were selected for this experimental in vitro study. The teeth were randomly assigned in to twelve groups ( n = 10). Group 1 received no preparation. All the premolars in other groups were root canal treated. In subgroups of 3 and 4, DO cavities were prepared while MOD cavities were prepared for all subgroups of group 2, the dimensions of the proximal boxes were kept uniform. In group 3 and 4 the dimensions of the mesial marginal ridge were measured using a digital Vernier caliper as 2 mm, 1.5 mm, 1 mm and 0.5 mm in the respective subgroups. All samples in groups 2.2 and all the subgroups of 3 were restored with a dentin bonding agent and resin composite. The teeth in group 2.3 and all subgroups of 4 were restored with composite reinforced with Ribbond fibers. The premolars were submitted to axial compression up to failure at 45 degree angle to a palatal cusp in universal testing machine. The mean load necessary to fracture was recorded in Newtons and the data was analysed. Results: There was a highly significant difference between mean values of force required to fracture teeth in group 1 and all subgroups of group 2, 3 and 4 (i.e., P < 0.01) Conclusion: On the basis of static loading, preserving the mesial marginal ridge with thicknesses of mm, 1.5 mm, 1 mm and 0.5 mm, composite restored and Ribbond reinforced composite restored maxillary premolars can help preserve the fracture resistance of teeth.