3P's in Retreatment Endodontics-An Often Forgotten Virtue.

Separation of instrument in the root canal is a common mishap that occurs during the cleaning and shaping procedure. So many different methods have been developed to retrieve fractured instruments from root canal. Separated instrument leads to incomplete cleaning of root canal and eventually causes posttreatment disease. For successful completion of treatment, a separated instrument must be retrieved and if not, a bypass must be attempted. This article presents four cases requiring removal of separated instruments from the root canal. All four cases were successfully treated by conservative means of instrument retrieval by using two different techniques.

Evaluation of Antibacterial Activity of Three Selected Fruit Juices on Clinical Endodontic Bacterial Strains.

INTRODUCTION: The increasing problem of antibiotic drug resistance by pathogenic microorganisms in the past few decades has recently led to the continuous exploration of natural plant products for new antibiotic agents. Many consumable food materials have good as well as their bad effects, good effect includes their antibacterial effects on different microorganisms present in the oral cavity. Recently, natural products have been evaluated as source of antimicrobial agent with efficacies against a variety of microorganisms. METHODOLOGY: The present study describes the antibacterial activity of three selected fruit juices (Apple, Pomegranate and Grape) on endodontic bacterial strains. Antimicrobial activity of fruit juices were tested by wel l diffusion assay by an inhibition zone surrounding the well. The aim of the study was to evaluate the antibacterial activity of three fruit juises on different endodontic strains. RESULT: Agar well diffusion method was adopted for determining antibacterial potency. Antibacterial activity present on the plates was indicated by an inhibition zone surrounding the well containing the fruit juice. The zone of inhibition was measured by measuring scale in millimeter. Comparision between antibacterial efficacy of all three fruit juices against Enterococcus feacalis and Streptococcus mutans was observed with significant value of P ≤ 0.05. CONCLUSION: The results obtained in this study clearly demonstrated a significant antimicrobial effect of apple fruit juice against Enterococcus fecalis and Streptococcus mutans. However, preclinical and clinical trials are needed to evaluate biocompatibility & safety before apple can conclusively be recommended in endodontic therapy, but in vitro observation of apple effectiveness appears promising.

Comparative evaluation of demineralization of radicular dentin with 17% ethylenediaminetetraacetic acid, 10% citric acid, and MTAD at different time intervals: An in vitro study.

BACKGROUND: The smear layer has the capability to protect the bacteria within the dentinal tubules from intracanal medicament. After removal of the smear layer from infected root canals, it allows disinfection of the entire root canal. The smear layer compromising the seal between the root canal sealer and root canal wall also decreases the penetration of irrigants into dentinal tubules. AIMS: This study compares the amount of phosphorous liberated and demineralization of the radicular dentin with 17% ethylenediaminetetraacetic acid, 10% citric acid and mixture of doxycycline, citric acid, and a detergent at different time intervals. MATERIALS AND METHODS: Extracted maxillary single-rooted teeth were prepared by using a combination of passive step-back and rotary 0.04 taper nickel-titanium files. Sodium hypochlorite 5.25% and sterile distilled water were used as an intracanal irrigant. The canals were then treated with 5 mL of one of the following solutions such as final rinse sterile distilled water, 5.25% sodium hypochlorite, 17% ethylenediaminetetraacetic acid (EDTA) or mixture of doxycycline, citric acid, and a detergent. The presence or absence of smear layer and the amount of erosion on the surface of the root canal walls at the coronal, middle, and apical portions of each canal were examined under a scanning electron microscope. STATISTICAL ANALYSIS: Data were analyzed by one-way analysis of variance (ANOVA) to determine whether there were significant differences between the groups. RESULTS: The results show that mixture of doxycycline, citric acid, and a detergent is an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules. CONCLUSIONS: In this study, 10% citric acid shows the maximum amount of dimeneralization of radicular dentine followed by mixture of doxycycline, citric acid, and a detergent, and 17% ethylenediaminetetraacetic acid. When all the subgroups were compared, it was seen that the maximum amount of phosphorus liberation was performed by 10% citric acid >mixture of doxycycline, citric acid, and a detergent >17% EDTA at a different time interval.