Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT.

AIM AND BACKGROUND: To compare the root canal volume in primary teeth using hand and rotary instruments and to evaluate root canal filling techniques and flow of root canal obturation materials in the postinstrumented root canal volume using spiral computed tomography (SCT). MATERIALS AND METHODS: Freshly extracted 16 primary molars were randomly divided into two groups and subjected to SCT analysis before and after instrumentation. For the manual technique (group I) with eight teeth were prepared using K files, and rotary (group II) eight teeth preparation was performed with ProTaper files. The filled volume in each canal was measured using SCT, and the percentage of obturated volume was calculated. The data were statistically analyzed using the Mann-Whitney U test. RESULTS: There was a statistically significant difference in both groups' volume of root canals enlarged. Even though both K files and the ProTaper system brought about enlarged canals after instrumentation, there was a statistically significant increase in volume after using K files in two canals. In three canals, there was a statistically significant increase in volume after using ProTaper. Irrespective of the obturation technique and materials used, there is no statistically significant difference in the volume after obturation. CONCLUSION: From the results of this study, the ProTaper file system shows suitable volumetric enlargement up to an optimum level, which is needed in primary root canal walls, and is better in canal shaping, as evidenced by good postobturation volume. CLINICAL SIGNIFICANCE: The traditional method of cleaning and shaping the root canals in permanent teeth using manual stainless-steel files can lead to undesirable curvatures in root canal morphology, making correctly filling the root canals difficult. It is also time-consuming and sometimes leads to iatrogenic errors. Rotary nickel-titanium (Ni-Ti) instrumentation techniques have been developed to overcome these problems. How to cite this article: Yadav DBUC, Varma RB, Kumar JS, et al. Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT. J Contemp Dent Pract 2024;25(3):250-259.

Effect of Prolonged Water Aging on the Bond Strength and Marginal Seal of Three Novel Restorative Materials.

AIM: To assess and contrast the shear bond strength (SBS) and microbial leakage of Cention-N, Fuji IX, and nanohybrid composite restorative materials after being exposed to prolonged water aging. MATERIALS AND METHODS: A total of 30 self-curing acrylic blocks were prepared for SBS analysis. Extracted teeth were affixed on the acrylic resin to incorporate the root section. To expose the occlusal dentin, 3 mm of the midcoronal portion was sectioned. The sectioned samples were allocated into the following three groups: Group I: Fuji IX; group II: Filtek Z350; and group III: Cention-N. Cylindrical plastic tubing was used to place each material as directed by the manufacturer and water aging for 7, 14, and 28 days at 37°C. Also, a universal testing machine (UTM) was utilized for testing followed by a scanning electron microscope (SEM). For microleakage analysis, a total of 30 class-V cavities were prepared. The prepared samples were allotted to respective groups; Later, 200 thermocycles at 5°C and 55°C were applied for 30 seconds to mimic the oral environment. The root apices sealed with sticky wax and the exception of a 1-mm around the edges of the restorations were then painted twice with clear nail varnish and submerged in 0.5% basic fuchsin dye at 37°C. Samples were washed, dried, and sectioned longitudinally followed by stereomicroscopic evaluation. RESULTS: Groups I (0.083), group II (0.083), and group III (0.102) did not show significant variation in the SBS after water degradation. At the end of 28 days of water aging, group III showed 33.3% adhesive failure and 66.7% mixed failure mode. For marginal leakage in group III, the mean and standard deviation (SD) were 334.90 ± 418.454 with the p = 0.001 showing a significant difference compared to groups I and II. CONCLUSION: Compared to nanohybrid composite and Fuji IX, Cention-N showed a superior SBS after being exposed to water aging and exhibited lesser marginal leakage. CLINICAL SIGNIFICANCE: Cention-N outperformed in its marginal adaptation with superior shear resistance and can be considered as an alternative bulk filling material.

Comparative Evaluation of Compressive Strength and Flexural Strength of Self-cured Cention N with Dual-cured Cention N: An In Vitro Study.

Aim and objective: This study aimed to investigate and compare compressive strength and flexural strength of self-cured Cention N with dual-cured Cention N. Materials and methods: Cention N is mixed according to the proportions, as mentioned by the manufacturer. Dual cured samples are cured using a diode that emits blue light. Cylindrical plexiglass split mold of dimension 6 mm height, and 4 mm diameter used to fabricate samples for compressive strength. Compressive strength tested using Instron universal testing machine. Rectangular plexiglass split mold of dimension 25 mm length, 2 mm height, and 2 mm width were used to fabricate samples for flexural strength. Flexural strength tested using Instron universal testing machine. To compare the mean values independent t-test was used and the significance of the study was measured by calculating a p-value. Result: There is no statistically significant difference between compressive strength and flexural strength of self-cured Cention N with dual-cured Cention N. Conclusion: The type of polymerization does not affect flexural strength and compressive strength of Cention N. Clinical Significance: Self-curing polymerization alone is sufficient for Cention N to achieve adequate compressive strength and flexural strength. So it can be inserted as a single layer on a prepared cavity and to fasten curing additional light curing can be used. How to cite this article: Fousiya Ks, Balagopal VR, Suresh KJ, et al. Comparative Evaluation of Compressive Strength and Flexural Strength of Self-cured Cention N with Dual-cured Cention N: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(2):210-214.

CBCT evaluation and surgical management of an unusual cystic lesion: A case report.

This is a case of swelling originating from dens invaginatus associated with lateral incisor, misdiagnosed as a globulomaxillary cyst. The initial diagnosis of globulomaxillary cyst was made solely from radiographs by observing a reverse pear-shaped radiolucency between the lateral incisor and cuspid. The results following pulp testing and Cone Beam Computed Tomography (CBCT) evaluation revealed the endodontic origin of the lesion, which entailed the treatment carried out by surgical enucleation and apicoectomy. This also details the clinical and diagnostic dilemma as well as conflicts associated with the diagnosis and management of the cystic lesion.

Comparison of cytotoxicity and smear layer removal efficacy of triphala (an Indian ayurvedic herbal formulation) and 5.25% sodium hypochlorite as root canal irrigants: An in vitro study.

INTRODUCTIO: Healing potential of plants is an age-old idea that has recently attained renewed interest. Considering the ineffectiveness, potentially harmful effects, and safety concerns of commonly used synthetic irrigants, the herbal alternatives for endodontic usage might prove to be advantageous. AIM: The aim of this study was to evaluate the adequacy of smear layer removal and cytotoxicity potential of triphala in comparison to sodium hypochlorite. MATERIALS AND METHODS: The study was conducted in two parts: the first part of the study was cytotoxicity assessment studied using Alamar blue assay. L929 mouse fibroblasts were seeded in 96-well plates at a density of 5000 cells/well and treated with different concentrations of triphala and NaOCl for a period of 24 and 48 h. The percentage of cell viability was then quantified using an Alamar blue assay. The optical density was measured at 570 nm and compared with 620 nm, which was considered as a reference wavelength. The second part of the study was smear layer assessment at the coronal, middle, and apical third of twenty human premolar teeth using scanning electron microscope. RESULTS: The Alamar blue reagent cytotoxicity study suggested that triphala showed no cytotoxic properties against the normal mouse fibroblast cells whereas sodium hypochlorite showed a significant cytotoxic effect against the L929 cell lines with the IC50 concentration at 1.8%, respectively, after the treatment of 24 h of incubation at 37°C temperature. Triphala was as effective as sodium hypochlorite in smear layer removal in the coronal and middle third of the root, but sodium hypochlorite showed better smear layer removal in the apical third. CONCLUSION: Triphala can be considered as a superior irrigant with good antibacterial efficacy and least cytotoxicity potential compared to conventional hypochlorite irrigating agent and provide adequate clearing of smear layer in the coronal and middle third, and further studies are warranted to alter the properties of liquid to make it more cleansable in the apical third of the root.

Assessment of Salivary Flow Rate and Antioxidant Levels in Ectodermal Dysplasia Patients: An In vivo Study.

AIMS: To assess the salivary flow rate levels and total antioxidant levels in ectodermal dysplasia (ED) patients and to compare with normal individuals. MATERIALS AND METHODS: Unstimulated saliva sample of control and case were collected from the mouth to a pre-weighed Eppendorf tube using a Pasteur pipette for 4 min. Stimulated saliva of case and control was also collected after chewing paraffin wax for 30 s. Both the Eppendorf tubes were weighed again after collection of both the saliva samples. The flow rate was calculated as difference of weight of the tube divided by time (4 min). Both unstimulated and stimulated saliva was also separately collected for estimation for total antioxidant levels. STATISTICAL ANALYSIS: For intergroup comparison, Mann-Whitney test was used, and for intragroup comparison, Wilcoxon signed-rank test was used. RESULTS: In the intergroup comparison of both the salivary flow rate and total antioxidant levels, there was no statistically significant difference; however, there was statistically significant difference in the intragroup comparison of salivary flow rate and total antioxidant levels in case group. CONCLUSIONS: There was a diminished unstimulated salivary flow rate in ED group, but stimulated salivary flow rate was significantly high and the total antioxidant levels in unstimulated saliva of the case group were significantly higher than the stimulated antioxidant levels.

Feeding Difficulty in an Infant with Stickler's Syndrome.

Stickler syndrome or hereditary progressive arthro-ophthalmopathy is an autosomal dominant condition characterized by ocular manifestations, arthritic changes, orofacial features, and deafness, in variable degrees. This is a case report of a 48-day-old infant who presented with severe feeding difficulty. It also details the clinical, diagnostic features, and management of an infant with Stickler syndrome.

Salivary interleukin-6 levels in children with early childhood caries and ventricular septal defect.

BACKGROUND: The efficacy of dental treatment on the levels of inflammatory markers in ventricular septal defect (VSD) has not been fully explored. AIMS: The aim of this study was to assess the level of salivary interleukin-6 (IL-6) in children with early childhood caries (ECC) and VSD and to compare its levels before and after comprehensive full mouth rehabilitation. METHODS: Saliva samples were collected from children with ECC and VSD before dental treatment and 1-month posttreatment. The salivary IL-6 levels were analyzed using the enzyme-linked immunosorbent assay method. Gingival index (GI) was also timely recorded during the study period. Oral health awareness sessions were conducted for children and their parents. The Fisher's Least Significant Difference test was used for intergroup comparison of salivary IL-6 levels, while the paired t-test compared the values of GI before and after treatment. RESULTS: The mean salivary IL-6 levels 1 month after treatment had reduced (P < 0.000). There was a reduction in GI score (P = 0.002). CONCLUSIONS: When children having VSD and ECC are dentally rehabilitated and followed up periodically, the level of IL-6 is minimized, hence improving the quality of life of the affected children.

Efficacy of a Calcium Sucrose Phosphate Based Toothpaste in Elevating the Level of Calcium, Phosphate Ions in Saliva and Reducing Plaque: A Clinical Trial.

AIM: To evaluate and compare the efficacy of "calcium sucrose phosphate" (CaSP) toothpaste (Enafix 5%) with ordinarily used calcium, phosphate-containing toothpaste in elevating the level of calcium, phosphate ions in saliva. Secondary aims were to evaluate substantivity and plaque-reducing ability of CaSP toothpaste. MATERIALS AND METHODS: Thirty study participants of age group 6-13 years were divided into two groups: Group X (Control group) was made to continue brushing with their regularly used calcium, phosphate-containing toothpaste and Group Y (Test group) was allotted CaSP toothpaste. 1 ml of unstimulated saliva was periodically collected from both groups to determine any alteration in the salivary calcium, phosphate level. Parameters such as substantivity and plaque-reducing ability of CaSP toothpaste were also evaluated. Salivary mineral's intergroup comparison was evaluated by Student's t-test while its intragroup comparison along with the plaque amount variation in Group Y was evaluated by ANOVA and Tukey's post hoc test. RESULTS: Group Y showed an increase in the salivary calcium level though not statistically significant. The increase was pronounced in samples collected on day 1. Group Y showed a consistent level of calcium, phosphate in samples collected immediately and 6 h postbrushing, indicating its substantivity. In addition, Group Y had an impact in reducing the plaque level when the 1st-month plaque score was compared with the 12th-month score. CONCLUSION: CaSP leads to an increase in the salivary calcium level though it was not statistically significant. Supervised brushing and dietary habits showed a positive effect on both the groups. CaSP toothpaste also showed substantivity and plaque-reducing ability.

Unique Approach to Dental Management of Children with Hearing Impairment.

The number of deaf children has dramatically increased in the past few decades. These children present to the pediatric dentist a unique set of challenges mostly pertaining to the establishment of communication with them. There have been very few attempts in the past to break down these challenges and formulate a strategy on how to manage them effectively. This is a case report of a child who was successfully managed using two different modes of communication. Finally, the advantages and disadvantages are mentioned, and a common strategy incorporating the positives of both the methods has been devised. HOW TO CITE THIS ARTICLE: Renahan N, Varma RB, Kumaran P, Xavier AM. Unique Approach to Dental Management of Children with Hearing Impairment. Int J Clin Pediatr Dent 2017;10(1):107-110.

Clinical and radiographic comparison of indirect pulp treatment using light-cured calcium silicate and mineral trioxide aggregate in primary molars: A randomized clinical trial.

AIM: To clinically and radiographically evaluate the reparative dentin formation in indirect pulp treatment (IPT) using mineral trioxide aggregate (MTA) and light cured calcium silicate (TheraCal) in primary molars over a period of 6 months. MATERIALS AND METHODS: A clinical trial on IPT on 43 primary molars in 21 patients between the age of 4-7 years, divided into two groups: 22 teeth in MTA group and 21 in TheraCal group. Measurement of the variation in dentin thickness was done on the digitalized radiograph at baseline, 3 months and 6 months using CorelDRAW X3 software. RESULTS: Statistical analysis using an independent t-test for intragroup and intergroup comparison showed a significant increase in dentin thickness in both the MTA and TheraCal group (intragroup comparison [P < 0.05]). However, intergroup comparison between MTA and TheraCal showed no statistical difference in reparative dentin formation (P > 0.05). CONCLUSION: Clinically and radiographically, both MTA and TheraCal are good IPT materials. The better handling characteristics and comparable reparative dentin-forming ability of TheraCal make this material an alternative to MTA in pediatric restorative procedures.

Clinical and radiographic evaluation of indirect pulp treatment with MTA and calcium hydroxide in primary teeth (in-vivo study).

OBJECTIVES: Clinical and radiographic effects of mineral trioxide aggregate (white MTA) and calcium hydroxide (Dycal) in indirect pulp treatment (IPT) of primary teeth over a period of 6 months. MATERIALS AND METHODS: A clinical trial with sample size of 40 primary molars between the age group of 5-9 years, of which, 20 teeth were considered, each for MTA and Dycal. Measurements on the digitized radiographs were performed at baseline, third and sixth month, increase in dentin was then measured using Corel Draw software. RESULT: Independent t-test had indicated that at the end of 3 months and 6 months, a statistically significant increase in dentin thickness with both MTA and Dycal (P-value ≤ 0.001) was found. Within the MTA group, the thickness of dentin formed was 0.089 mm ± 0.031 mm at first 3 months and 0.055 ± 0.022 mm at the second 3 months, (P ≤ 0.001) evaluated using paired t-test. In the Dycal group, increment in dentin deposited was 0.068 mm at the first 3 months and second 3 months, it was 0.030 mm (P-value ≤ 0.001). CONCLUSION: Clinically and radiographically, MTA is superior to Dycal as a good IPT medicament in primary teeth.

Mandibulofacial dysostosis (Treacher Collins syndrome): A case report and review of literature.

Treacher Collins syndrome (TCS) or Franceschetti syndrome is an autosomal dominant disorder of craniofacial development with variable phenotypic expression. It presents with characteristic facial appearance enabling it to be easily recognizable. A case of a 10-year-old girl having TCS is briefly described in this article. A review of the etiology, clinical features, differential diagnosis, and treatment options are also discussed.

Clinical evaluation of the retention of different pit and fissure sealants: a 1-year study.

OBJECTIVE: The aim of this study was to evaluate the retention of different pit and fissure sealants on the first permanent molars over a period of one year . MATERIALS AND METHODS: In this study, a total of 40 children with all first permanent molars erupted received four different pit and fissure sealants. The children were evaluated at 6 and 12 months. RESULTS: The data was subjected to Chi-square test and Kaplan Meier survival analysis. The p-value was calculated using Wilcoxon matched-pairs signed-rank test. CONCLUSION: The retention rates of resin-based sealants were superior to that of glass ionomer sealant. How to cite this article: Kumaran P. Clinical Evaluation of the Retention of Different Pit and Fissure Sealants: A 1-Year Study. Int J Clin Pediatr Dent 2013;6(3):183-187.