ABSTRACT
Background: Irreversible pulpitis is a painful and debilitating condition. Root canal treatment (RCT) provides prompt relief and salvages the affected tooth/teeth. It has classically been performed as a multivisit procedure. A relatively newer approach constitutes performing all the steps in one single visit. This study was designed to explore if single-visit RCT could be confidently used as an effective and preferred treatment modality for irreversible pulpitis in the Indian Armed forces. Methods: The study compared the incidence of postoperative pain, tenderness on percussion (TOP), flare-ups, and the analgesic drug use in 60 cases of acute irreversible pulpitis who were treated by either single or multiple visit root canal therapy. Each treatment group included 30 patients who were evaluated preoperatively and postoperatively at 24 h, one week and one month. Results: The study found statistically higher incidence of postoperative pain (mild variant) and TOP in single visit therapy, 24 h after the obturation while the difference was insignificant at one week and one month after therapy. Analgesic use was significantly higher after the single visit therapy in the first 24 h. No flare-ups were recorded in either group. Significant pain and tenderness was observed after chemo-mechanical preparation (appointment 2) in multivisit regimen. Conclusion: Single visit therapy is a safe, practical, and effective approach. The treatment results are similar to the multivisit regimen. It should therefore be considered for wider adoption and application.
ABSTRACT
Endodontic procedures are associated with various mishaps, one of which is instrument breakage. It can act as an obstruction to mechanical and chemical cleaning of an infected root canal, thereby hampering the prognosis of treatment. Instrument retrieval must be performed with minimum damage to a tooth and surrounding tissues, minimal loss of radicular dentine and simultaneously maintaining the original canal shape as much as possible. This case report represents successful retrieval of a separated K file fragment from the distobuccal canal of the right mandibular primary second molar 85 with ultrasonic energy application under the dental operating microscope. How to cite this article: Kaul R, Gupta R, Chhabra S, et al. Dental Operating Microscope-guided Retrieval of Broken Instrument from a Deciduous Molar Using Ultrasonics. Int J Clin Pediatr Dent 2022;15(S-1):S114-S118.
ABSTRACT
Methylmalonic acidemia (MMA) is most common inherited type of organic acidemia. It has diverse presentation in older infants without any initial apparent symptoms. MMA sometimes present with sudden metabolic decompensation, which may mimics common emergencies like septic shock and diabetic ketoacidosis (DKA) without early recognition can be fatal. In born error of metabolism especially organic acidemia should be suspected in any infant presented with severe high anion gap metabolic acidosis. We report two cases of MMA in infants presented acutely mimicking DKA and septic shock.
ABSTRACT
AIMS: The study was aimed to acquire better understanding of C-shaped canal systems in mandibular second molar teeth through a clinical approach using sophisticated techniques such as surgical operating microscope and cone beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 42 extracted mandibular second molar teeth with fused roots and longitudinal grooves were collected randomly from native Indian population. Pulp chamber floors of all specimens were examined under surgical operating microscope and classified into four types (Min's method). Subsequently, samples were subjected to CBCT scan after insertion of K-files size #10 or 15 into each canal orifice and evaluated using the cross-sectional and 3-dimensional images in consultation with dental radiologist so as to obtain more accurate results. Minimum distance between the external root surface on the groove and initial file placed in the canal was also measured at different levels and statistically analyzed. RESULTS: Out of 42 teeth, maximum number of samples (15) belonged to Type-II category. A total of 100 files were inserted in 86 orifices of various types of specimens. Evaluation of the CBCT scan images of the teeth revealed that a total of 21 canals were missing completely or partially at different levels. The mean values for the minimum thickness were highest at coronal followed by middle and apical third levels in all the categories. Lowest values were obtained for teeth with Type-III category at all three levels. CONCLUSIONS: The present study revealed anatomical variations of C-shaped canal system in mandibular second molars. The prognosis of such complex canal anatomies can be improved by simultaneous employment of modern techniques such as surgical operating microscope and CBCT.
