ABSTRACT
Background The aim of the present investigation was to evaluate and compare the efficacy of frequently used chemical agents in terms of their capacity to eliminate the smear layer after instrumentation, as observed via scanning electron microscopy (SEM). Materials and methods Sixty extracted single-rooted mandibular premolar teeth, each with roots 15 mm in length, were used in this study. The teeth were divided into one control group and four study groups, each containing 12 teeth. In Control Group 0, teeth were irrigated with 3 ml of saline only. In Group 1, teeth were irrigated initially with 3% sodium hypochlorite (NaOCl) and then given a final rinse with 3 ml of 17% ethylenediaminetetraacetic acid (EDTA) for one minute. In Group 2, teeth were irrigated with 3% NaOCl and given a final rinse with 3 ml of a mixture of tetracycline, acid, and detergent (MTAD, BIOPURE) for one minute. In Group 3, teeth were irrigated with saline and given a final rinse with 3 ml of 17% EDTA for one minute. In Group 4, teeth were irrigated with saline and given a final rinse with 3 ml of MTAD for one minute. One-half of each tooth was chosen and prepared for scanning electron microscopic (SEM) examination at the cervical, middle, and apical thirds. These were observed at magnifications of up to 1,000 times to check for the presence or absence of a smear layer. The data were analyzed using the Kruskal-Wallis test and post-hoc Dunn's test. Results All of the root canal irrigation protocols exhibited superior efficacy compared to the control group in the elimination of the smear layer. Group 2 (3% NaOCl with MTAD) showed the lowest mean scores, compared to all the groups, followed by Group 1 (3% NaOCl with 17% EDTA). MTAD was more effective than EDTA. The smear layer was effectively removed from the apical third, followed by the middle and coronal thirds of the root. Conclusion Initial irrigation with 3% NaOCl and one-minute final irrigation with 3 ml MTAD was the most effective root irrigant, and particularly indicated in teeth with infection of the apical third.
ABSTRACT
INTRODUCTION: Assessing bone condition holds significant value in the diagnosis, treatment planning, and prognosing the periodontal disease; its importance is undeniable. The main aim of the present study was to evaluate the accuracy of alveolar bone measurements due to periodontal disease using cone-beam computed tomography (CBCT), by comparing with surgical measurements, considered as the gold standard. MATERIALS AND METHODS: A prospective cross-sectional study included a sample of 40 individuals diagnosed with chronic periodontitis who required periodontal surgery. A total of 202 sites were assessed for vertical and horizontal bone loss in the anterior (76 sites) and posterior (126 sites) teeth. Bone loss was measured using CBCT and a UNC 15 periodontal probe during the surgical intervention, and then compared. The statistical analysis involved employing a Student's t-test to compare measurements. Unpaired t-tests and correlation analyses were conducted using Pearson's correlation coefficient test. To establish statistical significance, a threshold of p<0.05 was considered appropriate. RESULTS: The statistical analysis carried out on the mean values of CBCT and direct surgical measurements for vertical bone loss demonstrated a significant difference (p<0.01). However, the values obtained for horizontal bone loss did not display statistical significance. A strong correlation of 0.94-0.99 existed between surgical and CBCT measurements. A statistically significant distinction was observed between the two methods in measuring bone loss at the distal and palatal sites of the anterior teeth. CONCLUSION: Both CBCT and direct surgical measurement exhibit comparable accuracy potential in assessing alveolar bone loss. CBCT provides an accessibility advantage by enhancing visual access to challenging sites during surgical interventions, including palatal and distal areas of the teeth.
ABSTRACT
INTRODUCTION: Periapical infection of primary molars affects the development of permanent teeth (premolars). Therefore, the present study was conducted to test the null hypothesis in children aged 4-10 years with chronic apical periodontitis (CAP) of the primary molars. MATERIALS AND METHODS: A retrospective, cross-sectional study was conducted on 185 panoramic radiographs of healthy children aged 4-10 years with CAP in the primary molars. A total of 256 infected primary molars (144 teeth in females, 112 teeth in males) were analyzed, radiographically, and compared with 245 healthy primary molars on the contralateral side. Permanent successors were evaluated for follicular damage, maturation, morphology, and deviation in the eruption path. Primary molars were evaluated for root resorption. Sixteen permanent teeth on the affected side and five teeth on the control side were excluded due to abnormal development. Student's t-test and the chi-square test were used to analyze the data. RESULTS: The null hypothesis is rejected. There were significant differences in the developmental status of permanent successors on the affected side, compared to the normal side at four to seven years (p<0.05). There were no significant sex differences in the abnormalities of permanent successors on the affected side (p>0.05). As the root resorption of the primary molars increased, the follicular damage observed in the permanent successors also increased (p<0.05), which suggests that, as the infection of primary molars increases, more damage is caused to underlying permanent successors (premolars). CONCLUSION: Apical periodontitis of the primary molars retards the development of permanent successors (premolars), affects their shape, causes follicular damage, and alters the eruption path.
