Prevalence of Traumatic Dental Injury in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Traumatic dental injury is an injury inflicted on the dentoalveolar system. It has a physical as well as a psychological impact. Despite this concern, epidemiological data regarding its prevalence is insufficient in the literature of Nepal. Hence, this study's objective was to investigate the prevalence of traumatic dental injuries for the patients visiting Universal College of Medical Sciences, Bhairahawa, Nepal, over five years. METHODS: A descriptive cross-sectional study was conducted using records from the medical record section for the patients presenting at the dental emergency outpatient department of the Universal College of Medical Sciences, Bhairahawa, Nepal, between April 2014 and April 2019. Ethical approval was taken from the Institutional Review Committee of the Universal College of Medical Sciences. Patient demographic data, type of traumatic dental injuries, and etiologies were evaluated from the record section. RESULTS: Out of 10,080 patients registered during the study period, 793 patients (7.86%) were due to traumatic dental injury, out of which 628 (79.2%) were male, and 165 (20.8%) were female. The most vulnerable age group was 20-29 years (42.4%). Most frequently, injuries occurred in June (16%). Road traffic accidents (57.8 %) were the most common mode, and complicated crown-root fracture (23.3%) was the most common type of traumatic dental injury. CONCLUSIONS: The frequency of 7.86% of traumatic dental injury indicates that dental traumatology needs special attention for policy planning and professional training.

Endodontic Indications among Patients Visiting a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Endodontics is the study of prevention, diagnosis and treatment of diseases or injuries to the dental pulp. The ultimate goal of modern dental care is tooth preservation and root canal therapy/treatment is an available therapeutic strategy to retain teeth. The aim of the study is to find the prevalence of patients visiting a tertiary care center who had endodontic indications. METHODS: The descriptive cross-sectional study included 516 patients accepted for endodontic treatment, between August 2019 and December 2019 in a tertiary care center. Ethical approval was taken from the ethical review board of Nepal Health Research Council (reference number: 425-2019). Convenience sampling method was used. The data were entered in Statistical Package for Social Sciences version 20 software and analysed using descriptive statistics. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 1740 patients, 516 (29.66%) (95% Confidence Interval= 21.46% - 27.51%) had endodontic indications. Symptomatic irreversible pulpitis 306 (59.30%) was the most prevalent pulpal disease. Maxillary teeth 300 (58.13%) had more endodontic diseases. While in individual dental elements most affected by endodontic diseases was the mandibular molar teeth 149 (28.87%). Females 348 (67.44%) were predominant for demanding endodontic management than males 168 (32.5%). CONCLUSIONS: More female patients and of younger age group in this study population demanded endodontic treatment. Irreversible pulpitis was responsible for the majority of the cases treated and more affected were the posterior teeth.

Influence of maintaining apical patency in post-endodontic pain.

BACKGROUND: The concept of instrumentation beyond the apical foramen by small flexible file to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain. METHODS: Preselected (n = 178) patients based on group of teeth and status of pulp were randomly divided into 2 groups, apical patency and non-patency which was further treated in either single or multiple visits. After exclusion, 160 patients were included. Each group (n = 80) was subdivided in single visit (n = 40) and multiple visits (n = 40), including vital (n = 20) and non-vital teeth (n = 20) and single-rooted (n = 10) and multiple-rooted teeth (n = 10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann-Whitney U test, Spearman correlation and Multiple linear regression analysis. RESULTS: The primary outcome of this study showed statistically significant difference (p < 0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1st, 2nd and 7th day follow up. The secondary outcome showed postoperative pain in patency-maintained group was influenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically significant (p = 0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically significant difference. CONCLUSIONS: Our study concluded that maintenance of apical patency increased postoperative pain. Evaluation of influence of number of visits, status of pulp, group of tooth and preoperative pain revealed status of pulp and preoperative pain as influencing factors for postoperative pain in patency group.

Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study.

BACKGROUND: The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs. METHODS: Eighty extracted single rooted maxillary and mandibular premolars were taken. Root canal treatment was completed. Apical 3 mm of all the teeth were resected with diamond disk. The tooth were divided into four groups with two subgroups for each group containing 10 tooth (N = 10) as: Group IA (Negative Control and IB (Positive Control); Group IIA and IIB: Prepared with round carbide bur and round diamond bur respectively, filled with GIC; Group IIIA and IIIB: Prepared with round carbide bur and round diamond bur respectively, filled with MTA; Group IVA and IVB: Prepared with round carbide bur and round diamond bur, filled with Biodentine. After applying two coats of nail varnish leaving apical 3 mm (except for negative control group) all teeth were immersed in 2% methylene blue for 3 days and again in 65% nitric acid for next 3 days for extraction of dye. The obtained solution was then transferred to eppendorf tube and centrifuged in microcentrifuges at 14,000 revolution per minutes (RPM) for 5 min. Optical density or absorbance of the supernatant solution was measured with UV spectrophotometer at 550 nm. RESULTS: The absorbance of the supernatant solution after dye extraction is decreasing in the order of positive control> GIC > MTA > Biodentine> negative control group. The significant difference was observed between GIC and MTA (p = 0.0001) and GIC and Biodentine (p = 0.0001) with two different burs but statistically non-significant difference was observed between MTA and Biodentine with Carbide bur (p = 0.127) and Diamond bur (p = 0.496) respectively. CONCLUSIONS: Within the limitations of the present study, it can be concluded that Biodentine and MTA showed less microleakage as compared to GIC. There is no significant difference between mean microleakage of MTA and Biodentine. However, the mean OD of the Biodentine was least of all evaluated materials. Preparation of the root-end using round carbide bur as well as round diamond burs showed comparable microleakage for all three filling materials.