Evaluation of anesthetic efficacy of 4% articaine as buccal infiltration vs 2% lidocaine as IANB in the mandibular 1st molar with irreversible pulpitis

The purpose of this prospective, randomized, study was to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:200,000 epinephrine for buccal infiltration and inferior alveolar nerve block respectively in patients experiencing irreversible pulpitis in permanent mandibular first molars. Sixty emergency patients diagnosed with irreversible pulpitis of a mandibular first molar ran-domly divided into two groups. Thirty patients received buccal infiltration of 1.7 ml of 4% articaine with 1:100,000 epinephrine and thirty patients received standard inferior alveolar nerve block with 1.8 ml of 2% lidocaine with 1:200,000 epinephrine. Endodontic access was begun 10 minutes after solution deposition, success [anesthetic efficacy] was defined as none or mild pain [Visual Analogue Scale recordings] on endodontic access preparation or pulp extirpation. Twenty-two patients out of 30 did not experience pain with 4% articaine [success = 52.4%] and 20 out of 30 patients did not experience pain in 2% lignocaine group [success = 47.6%]. There was no statistically significant difference between the articaine formulation as buccal infiltration and lidocaine formulation as IANB with regard to anesthetic success [p value =0.220]. Even though buccal infiltration of 4% articaine and IANB of 2% lidocaine were equally effective, buccal infiltration can be considered a viable substitute in IANB for anesthetizing mandibular first molar with irreversible pulpitis

Etiology and incidence of maxillofacial skeletal injuries at tertiary care hospital, Larkana, Pakistan

The objective of this study was to determine the causes, incidence and distribution of maxillofacial injuries. This was a descriptive study performed at the tertiary care hospital of Larkana [Accident and Emergency Department of Chandka Medical College, Hospital and Outpatient's Department of Bibi Aseefa Dental College Hospital, Larkana] from 1st February 2011 to 30th August 2013. Two hundred and eighty eight patients of maxillofacial injuries were included in this study patients less than 11 years of age, suffering from neurological disorders and patients with isolated cases of dental and nasal injuries or only with facial lacerations were excluded. Information and data were collected from history, clinical examination and surgical preoperative records of each patient. Results showed that the most common etiology was road traffic accident [170] 59%, interpersonal violence [31] 10.76%, gunshot injuries [28] 9.7%, falls [19] 6.5% and others [40] 13.88%. The mandible was the most frequent bone fractured, which accounted for [148] 50.38% followed by zygomatic complex [52] 18% and [24] 8.3% maxillary bone. Fracture in combination form involved [64] 22%. It was concluded that road traffic accident was the most common etiological factor of maxillofacial skeletal trauma, while second most common cause was the interpersonal violence. Mandible was the most commonly fractured bone

Prevalence of dental caries in Bibi Aseefa Dental College, Larkana areas

The study was conducted for the first time in Bibi Aseefa Dental College [BADC], Larkana from April 2012 to March 2013 to evaluate the prevalence of dental caries in Larkana city and its adjoining areas, and to know the effect of age, gender, socioeconomic status, oral hygiene status and attitude towards dental awareness to caries prevalence. It was a Cross-sectional study. Six hundred patients between 13-20 and 21-30 years of age were selected from dental OPD, BADC, Larkana. The dentition was examined using WHO 1997 guidelines. The results were tabulated and statistically analyzed. Chi-square test was used to evaluate results. The overall caries prevalence in 13-20 years and 21-30 years old groups in Larkana city and adjoining areas determined was 100%.The mean DMFT value was higher i.e. 3.42 in age group 13-20 years. Besides age, the gender, socioeconomic status, oral hygiene status and attitude towards dental awareness were significantly related to dental caries prevalence. It was concluded that prevalence of dental caries in Larkana city and its adjoining areas was found considerably higher, and it was significantly related to bad oral hygiene and socioeconomically deprived patients which indicates lack of awareness and motivation. Prevalence of dental caries decreased with increasing age

Frequency of fourth canal in permanent mandibular first molars

This study was carried out to investigate the frequency of fourth [distolingual] canal in the permanent mandibular first molars and to determine the effect of modified access cavity preparation for endodontic treatment. It was an observational study. The study was conducted at the Department of Operative Dentistry, Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad from September 2009 to February 2010. Two hundred permanent mandibular first molars were selected from male and female patients presenting for endodontic treatment. The method used for exploring the fourth canal was the modified access cavity preparation which involved changing the triangular access cavity shape to a quadrangular shape. The study involved careful selection criteria, pre-operative radiological examination and then triangular access cavity preparation. The number of canals found by triangular access cavity preparation was noted on the proforma before extending the shape to a quadrangular shape and then a thorough exploration of the floor of the pulp chamber was done. Finally, if fourth canal was present, the presence of the fourth canal was confirmed by taking two periapical radiographs at two different angles with 15 # K files in the root canals. The data collected were analyzed using the chi square test. The results showed that fourth canal was found in 36% of permanent mandibular first molars. The effect of modified access cavity preparation was significantly higher [P= 0.0001] in cases with a fourth canal than in teeth with three canals [P= 0.05]. Statistically there was insignificant difference [P= 0.7] between the genders for the occurrence of fourth canal. This study demonstrates that there is a greater frequency of fourth canal in the permanent mandibular first molar teeth than previously thought. Also changing the shape of access cavity from a triangular outline to a quadrangular outline facilitates in locating the fourth canal

Validity of different methods for MB-2 canal location in permanent maxillary molars

The purpose of this study was to evaluate the effectiveness of naked eye examination and Dental-operating microscope [DOM] examination for the location of second mesiobuccal canal [MB-2] in extracted maxillary first and second molars, considering the sectioning of the tooth as gold standard for the location of MB-2. This was a cross-sectional comparative study. One hundred extracted permanent maxillary first and second molars [50 of each] were stored in 10% neutral formalin. Using high speed headpiece standard endodontic access cavities were prepared. Initially, the mesiobuccal, distobuccal and palatal canals were located. Subsequently, the location of MB-2 canal was attempted by examining the pulp chamber floor with naked eye using only an endodontic explorer and canal confirmed with 10# K-file. MB-2 canal orifice was either located or not located with this method. Teeth in which MB-2 canal was not located were further explored under DOM. Yet again MB-2 canal orifice was either located or not located. Finally the mesiobuccal roots of each tooth were sectioned. The sections were explored with endodontic explorer and 10# K file with the adjunctive use of DOM at a magnification of 12x to decide the real presence of MB-2 canal. 42% and 60% of MB-2 canals in maxillary first molar, 20% and 38% of MB-2 canals in maxillary second molar were detected with naked eye and with DOM examination respectively. While 66% and 42% of MB-2 canals were actually present in maxillary first and second molar respectively as confirmed by gold standard [sectioning of teeth]. It is concluded that DOM examination may be more effective for location of the MB-2 canal than naked eye examination