A comparison of four gutta-percha filling techniques in simulated C-shaped canals.

AIM: To compare four gutta-percha filling techniques in simulated C-shaped canals based on filling quality at three cross-sectional levels, filling time and the apical extrusion of gutta-percha. METHODOLOGY: Forty resin simulated C-shaped canals were constructed and filled using one of four techniques: cold lateral compaction (LC), ultrasonic compaction (UC), single cone with injectable gutta-percha (Obtura II(™) ) (IT) and core-carrier (Thermafil(®) ) (CC). Cross sections were made at 1 (L1), 3 (L3) and 6 (L6) mm from the canal terminus. Areas of gutta-percha, sealer and voids in each cross section were measured using an image analysis system. Data were analysed using a univariate general linear model and post hoc test (Dunnett's T3). Data on time taken to fill canals was evaluated using the Bonferroni post hoc test. RESULTS: CC had more gutta-percha and less sealer compared with IT at L1 (P < 0.05). LC had marginally significantly less gutta-percha than CC at this level (P = 0.049). At level 3 mm, significantly more gutta-percha and less sealer were present in IT compared with LC (P < 0.05). The techniques showed no difference in quality at L6. The time for LC (20.72 min) was three times longer than for both IT (6.11 min) and CC (6.67 min), whereas for UC (26.92 min), it was four times longer (P < 0.001). Finally, the four techniques were not different in the occurrence of apical extrusion of gutta-percha. CONCLUSIONS: The core-carrier technique was the most effective technique when assessed by gutta-percha area in this simulated C-shaped canal.

Pairing as an instructional strategy to promote soft skills amongst clinical dental students.

Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.

Periodontal response to two intracanal medicaments in replanted monkey incisors.

Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent) and a corticosteroid-antibiotic paste (Ledermix) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response.

Gaining access through a calcified pulp chamber: a clinical challenge.

Dental pulp is prone to dystrophic mineralization; this mineralization can be so extensive that the entire root canal system is obliterated. As a result, root canal treatment can become a difficult if not impossible task. This article presents the endodontic management of a tooth with an obliterated pulp chamber and associated with a discharging sinus in a teenage patient. The role of a calcium hydroxide lining to induce mineralization and cause the obliteration of the pulpal space is also discussed.

A multidisciplinary approach in achieving aesthetics and function.

This case report illustrates the successful management of a case of mutilated maxillary incisors in a 13 year old patient through a sequence of therapy designed to closely coordinate the various disciplines, endodontics, restorative dentistry and orthodontics, involved. Endodontics was directed towards the control of the infected pulp, restorative treatment was to reconstruct the broken down teeth in stages which were essential in the sequence of treatment, and orthodontics was involved in the achievement of functional occlusion and alignment. The comprehensive treatment approach combined to achieve satisfactory aesthetics and function.

Transpositions of maxillary teeth.

Transposition of teeth is a rare and special type of ectopic eruption where two contiguous teeth are found occupying each other's respective normal positions. Nine patients with transposed maxillary teeth are reported. The literature on transpositions, especially on the theories regarding the aetiology, is reviewed.

Extreme distal migration of a maxillary canine.

A case of extreme distal migration of the left maxillary canine is reported. The canine had erupted buccal to the contact area between the left second premolar and first molar. Past reports of similar ectopia are reviewed.

Permanent dentition occlusion in Chinese, Indian and Malay groups in Malaysia.

This survey outlines the proportion of the various features of occlusion in the permanent dentition of the three ethnic races, Chinese, Malay and Indian in Malaysia. The mean age of the high school children surveyed was 16.4 years. The Chinese and Malays had almost similar distribution of the different types of occlusion. There was a significantly higher prevalence of Class III occlusion among the Chinese and Malays as compared to the Indians. In addition, an edge to edge incisor relationship seemed to be a norm in the Chinese (54%) and Malays (50%) whilst the overjet of between 2-4 mm and the overbite of between 1/3 to 2/3 was more normal to Indians (50%). A crowded dentition was also a norm for the three races.