Comparative Evaluation of the Efficacy of Two Modes of Delivery of Diclofenac for the Management of Post-Endodontic Pain: A Randomized Controlled Clinical Trial.

Background: This study aimed to compare the efficacy of two modes of delivery of diclofenac for the management of post-endodontic pain. Materials and Methods: This study comprised 30 patients reporting to the department with pain in their teeth. Pain was assessed using the visual analog scale (VAS): group A (control group), group B (oral diclofenac), and group C (transdermal patch). A VAS was given to the patients in each group, and the severity of any pain was self-assessed by patients after 4 hrs, 8 hrs, 12 hrs, 24 hrs, and 48 hrs following the completion of treatment. Results: A comparison between group oral and diclofenac transdermal patch was carried out. The pain frequency was measured at 4 hrs, 8 hrs, 12 hrs, 24 hrs, and 48 hrs postoperatively with P values of 0.744, 0.035, 0.570, 0.060, and 0.508 and was statistically insignificant. Conclusion: Preoperative analgesics play an important role in reducing post-endodontic pain. Transdermal patches containing diclofenac show a promising analgesic modality in managing endodontic pain.

Prevalence of Tobacco Use and Oral Mucosal Lesions among Nicobarese Tribal Population in Andaman and Nicobar Islands.

AIM: To determine the prevalence of tobacco use and oral mucosal lesions among Nicobarese tribal populations in Andaman and Nicobar Islands, India. MATERIALS AND METHODS: Cross-sectional survey and oral examination were done in 400 Nicobari populations in Car Nicobar using the World Health Organization (WHO) format of Oral Health Questionnaire and Assessment forms. The data were then entered and statistical analysis was done using SPSS Inc.; Chicago, Illinois, USA, Version 20.0. RESULTS: There is high prevalence of tobacco consumption (88.25%), especially the smokeless form of tobacco. Oral mucosal lesions were present in 25.75% of the total population, and keratosis was the most prevalent among oral mucosal lesions which was 56.3%. CONCLUSION: There is a statistical significance in the presence of oral mucosal lesions who consumes smokeless form of tobacco every day. There is no significance observed between male and female Nicobari tribes. CLINICAL SIGNIFICANCE: This high consumption of smokeless form of tobacco puts both genders in Nicobari tribal population equally at risk of developing precancerous and cancerous lesions. Early intervention and oral health education should be done frequently to prevent the development of oral cancer at early stages in tribal population.

Assessment of Constant Periapical Lesions and Their Connection with Endodontic Failures after Apical Microsurgery.

BACKGROUND: Periapical lesions can be appreciated in the teeth that have underwent root canal treatment leading to more complications. Radiographic as well as histological evaluation is important for definitive diagnosis. AIM: The aim of this study was to examine the histology of constant periapical radiolucent lesions that are associated with root canal treated teeth and also to find association between histological findings and radiographic size of lesion as well as existence or nonappearance of a radiopaque lamina. MATERIALS AND METHODS: The study included 60 incisors and canines allotted for apical microsurgery. Two observers studied the diameter of periapical radiolucent lesions and the existence or nonappearance of radiopaque lamina. During apical microsurgery, biopsy specimens were collected and after tissue processing oral pathologist examined the specimen under a light microscope. Histological features of the specimen were taken into consideration, and the diagnosis of abscess, cyst, granuloma, and scar tissue were given. Pearson's chi-square test was used to study the established relationship between histological diagnosis and lesion size. RESULTS: Results indicated that 68.33% of lesions were granulomas, 23.33% were cysts, 5% were abscesses, and 3.33% were scar tissue. CONCLUSION: According to histological results, most of the lesions in this study were granulomas, followed by cysts. Abscesses and scar tissues were rare.

Impact of Root Dentin Thickness on the in vitro Compressive Strength of Teeth treated with Recent Post and Core Systems.

INTRODUCTION: Endodontically treated teeth dry with time, and its dentin undergoes changes making the teeth brittle and friable. The main function of a post is to strengthen or reinforce a weakened root. However, doing a post and core frequently requires the removal of sound tooth tissue. Recent materials introduced in the market for post and cores have been promising. AIM: The aim of this study is to evaluate the fracture resistance of endodontically treated extracted permanent teeth with variable remaining root dentin thickness after post space preparation. MATERIALS AND METHODS: A total of 270 freshly extracted permanent maxillary central incisors with fully formed apices were selected, decoronated at cementoenamel junction, and divided into three main groups according to remaining root dentin thickness, determined using a Vernier caliper into 0.5, 1, and 1.50 mm after post space preparation. Each group was further divided into three subgroups (subgroup a: Custom-made cobalt-chromium alloy post and core; subgroup b: Prefabricated glass fiber post and composite core; and subgroup c: EverStick fiber post). Each specimen was subjected to compressive load using universal testing machine. The force required to fracture was recorded and data were analyzed using analysis of variance (ANOVA) test. RESULTS: Analysis of variance revealed that compressive strength of the tooth is significantly affected by the increase in the remaining dentin thickness after post space preparation (p < 0.05). Furthermore, teeth with custom fabricated posts showed a significantly higher compressive strength (p < 0.05) than prefabricated glass fiber post and EverStick fiber post groups except the group with minimum remaining dentin thickness. CONCLUSION: The present in vitro study revealed that compressive strength of the post and core systems is directly related to the amount of healthy remaining dentin thickness. Hence, efforts to maximize the preservation of natural dentin should be taken during post space preparation.