ABSTRACT
Introduction: The root canal system in primary molars is considered to be complex. The aim of the present study was to assess the morphology of roots and root canals of primary maxillary and mandibular second molars using the cone-beam computed tomography (CBCT). Materials and Methods: From a total of 104 collected primary maxillary and mandibular molars (51 maxillary second molars and 53 mandibular second molars), 60 teeth (30 each of maxillary and mandibular second molars) were selected randomly and accordingly assigned into two groups: MAX2M (primary maxillary second molars) and MAN2M (primary mandibular second molars). CBCT was used to assess the number of roots and root canals, length of root, mesiodistal and buccolingual width of the canal, shape of the canal, and intercanal communications. Descriptive statistical analysis was performed using the SPSS software version 17.0. Results: The mandibular second molars showed the presence of two roots in 27 sample molars while the presence of three roots was observed in three MAN2M group. In these molars, all three roots exhibited Type I root canal configuration. The maxillary second molars exhibited three roots. A total of nine intercanal communications were seen in MAX2M group, whereas two communications were seen in MAN2M group. The palatal root in MAX2M group was more angulated (mean value: 127.21 ± 9.10) as compared to mesial (mean value: 95.39 ± 8.64) and distal roots (114 ± 11.24). Conclusion: The comprehensive knowledge of root and canal morphology of primary molars and anatomic variations is essential for successful endodontic therapy.
ABSTRACT
Context: Control of pain during dental treatment is an essential aspect of pediatric dentistry. Aims: This study was conducted to evaluate and compare the anesthetic efficacy of 4% articaine buccal infiltration with 2% lignocaine inferior alveolar nerve block (IANB) for primary mandibular molar extractions. Settings and Design: The study was a prospective, split-mouth, randomized controlled trial. Methods: Bilateral symmetrical carious primary mandibular molar (n = 92) extractions in 46 healthy children aged 5–10 years were included in this randomized controlled trial. Extraction was performed on one side using 4% of articaine buccal infiltration and on the contralateral side using 2% lignocaine IANB in two subsequent appointments. Pain and behavior were assessed at baseline, during injection and extraction using Wong–Baker Faces Pain Rating Scale, Modified Behavior Pain Scale (MBPS), and Frankl Behavior Rating Scale. Statistical Analysis Used: Values thus obtained were statistically analyzed by one-way analysis of variance test and compared using independent samples test. Results: According to MBPS, the mean value of pain experienced in the form of cry during injection was reported to be more for 2% lignocaine IANB (1.76) as compared to 4% articaine buccal infiltration (1.30), which was statistically significant (P = 0.024). Comparison of behavior depicted showed no statistically significant difference between the groups. Conclusion: Buccal infiltration with 4% articaine can be utilized as an effective alternative to 2% lignocaine IANB for primary mandibular molar extractions.
ABSTRACT
Aim: To compare the accuracy and repeatability of three diagnostic systems; visual inspection, bitewing radiography, and CarieScan PRO for occlusal caries diagnosis in primary molars. Materials and Methods: 216 occlusal surfaces of primary molars examined in turn by two examiners using each of three diagnostic systems (visual inspection, bitewing radiography, and CarieScan PRO). Examiners indicated operative intervention (validation method) for 104 teeth which were used for statistical analysis. The validation method was cavity preparation when the two examiners agreed about the presence of dentinal caries. Sensitivity, specificity, likelihood ratio, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each diagnostic technique. Inter‑ and intra‑examiner repeatability was calculated for each diagnostic system using the Cohen’s kappa statistics. Results: Visual inspection showed the highest sensitivity (0.93). The highest sensitivity and NPVs were provided by CarieScan PRO (0.97 and 0.95, respectively) however this was offset by a lower specificity (0.82) compared to other techniques. The CarieScan PRO gave the highest values of Cohen’s kappa statistics. Conclusion: This study showed low sensitivity but substantial specificity with visual inspection. Bitewing radiography performed poorly overall when compared with the other two systems. The CarieScan PRO technique gave the highest overall combination of sensitivity and specificity for detection of occlusal caries.