Reliability of Caries Assessment Spectrum and Treatment Tool in the Indian Subcontinent.

BACKGROUND: Accurate diagnosis, reporting of caries and its consequences, is absolute mandate for planning an efficient, effective community health-care program. Literature reports indicate shortcomings of existing caries assessment tools. Caries assessment spectrum and treatment (CAST) is novice caries quantification tool, which quantifies the entire spectrum of carious lesions. This tool records give an insight into the status of restorations along with various progressive developmental stages of dental caries. This instrument has been validated for face, content, and construct by an expert group, and currently, its usage is on the rise. AIM: The aim of this study was to report the reliability of this assessment tool with regard to the primary and permanent dentition of school children and adults belonging to a south Indian district. MATERIALS AND METHODS: A cross-sectional study was carried out by two trained and calibrated examiners by examining 192 school children in the age-group between 4 and 6 years and 262 adults between 19 and 69 years. The study sample was reexamined by the same examiners after a gap of 4 weeks. The κ coefficient values and percent of agreement were calculated for the data recorded from the study subjects. RESULTS: The analyzed data showed moderate intra-examiner and inter-examiner reproducibility for either of the dentition as revealed by κ coefficient values (0.80-0.89). Inter- or intra-examiner agreement was found to be substantial to almost perfect (percent agreement above 90%) with respect to both the age-groups. CONCLUSION: The CAST tool seems quite promising to be the future for quantifying caries spectrum for a community or an individual.

Molecular Detection of Porphyromonas gingivalis in Chronic Periodontitis Patients.

AIM: In the current study, Porphyromonas gingivalis was identified in chronic periodontitis patients and healthy subjects by polymerase chain reaction (PCR) and its presence correlated with the severity of clinical periodontal parameters. MATERIALS AND METHODS: Subgingival plaque samples were collected with sterile curette and subjected to deoxyribonucleic acid (DNA) extraction and subsequent PCR for detection of P. gingivalis. RESULTS: Porphyromonas gingivalis was detected in 60% of patients of group II (pocket depth up to 5 mm), and in 93.33% of patients of group III (pocket depth more than 5 mm). One periodontally healthy subject in group I (probing depth < 3 mm) showed the presence of P. gingivalis. CONCLUSION: Detection frequency of bacterium increased significantly with increase in probing pocket depth (PPD), loss of attachment (LOA), and gingival index (GI). CLINICAL SIGNIFICANCE: Porphyromonas gingivalis is strongly associated with chronic periodontitis and its detection frequency positively correlates with the severity of periodontal destruction.

Evaluation of Effectiveness of Two Different Endodontic Retreatment Systems in Removal of Gutta-percha: An in vitro Study.

AIM: To determine the effectiveness of two different endodontic retreatment systems for the removal of laterally compacted gutta-percha (GP). MATERIALS AND METHODS: Sixty-three freshly extracted human maxillary central incisors were used for the study. The teeth were instrumented with K-flex files and obturated using lateral condensation technique with GP and AH Plus sealer. The teeth were divided into three retreatment groups, each group consisting of 21 teeth. Group I: D-RaCe desobturation files (D-RaCe); group II: ProTaper Universal retreatment files (PTUR); group III: Hedstrom files (H-file). After removal of GP, the teeth were split longitudinally and divided into three equal parts: Cervical, middle, and apical third. The middle and apical thirds of all root halves were examined using scanning electron microscope (SEM). The total surface area covered by the residual debris was evaluated using Motic Image plus 2.0 software. Statistical analysis was done by one-way analysis of variance (ANOVA) test with a p-value <0.05 used to determine significance and Tukey's multiple post hoc tests used for comparison between the groups, and 't' test was done for comparison between the thirds within the same group. RESULTS: The PTUR retreatment files showed overall better performance compared with D-RaCe files and H-files. The PTUR files performed better at middle third compared with others. The PTUR files and D-RaCe files performed equally at apical third better than H-files. CONCLUSION: ProTaper retreatment files are better compared with D-RaCe files and H-files for the retreatment of the previously endodontically treated teeth. CLINICAL SIGNIFICANCE: Highest efficacy for the removal of GP was shown by ProTaper Universal System followed by D-RaCe and H-file.