Emergency management of avulsion injuries: from home to clinic: A multicentre cross-sectional survey among medical doctors and general public.

The objective of this multi-centre study was to analyse the knowledge of parents as compared to medical-doctors regarding avulsion-injuries. A validated and piloted questionnaire was circulated among two equal groups (130 participants each) of medical-doctors and the general public. Data was analysed using SPSS version 19. A total of 131 (89%) participants had a university degree and 185 (71%) had a full time employment. One hundred and eighty-seven (72%) participants reported having no previous information regarding avulsion injuries, 195 (75%) considered their level of knowledge inadequate, and 63 (24%) had a previous history of dental trauma. A statistically significant number had information regarding avulsed permanent-teeth replantation (p=0.02) but not deciduous-teeth (p=0.26), whereas only 39 (15%) were aware of the right medium for tooth storage. Having seen or sustained an avulsion-injury and a higher qualification were statistically related to correct responses for some questions. A total of 106 (41%) of the participants wanted to be educated through written-material. In conclusion, the first-aid knowledge regarding tooth avulsion injuries in our population, irrespective of their level of academic education, is poor and needs supervised training.

Effect of Apical Patency on Postoperative Pain after Single-visit Endodontic Treatment in Necrotic Teeth with Asymptomatic Apical Periodontitis: A Randomised Control Trial.

OBJECTIVE: To find out the effect of apical patency on postoperative pain after single-visit endodontic treatment in necrotic teeth with asymptomatic apical periodontitis. STUDY DESIGN: Single blind randomised clinical trial. PLACE AND DURATION OF STUDY: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from June to December 2020. METHODOLOGY: A total of 240 patients with good general health presenting with asymptomatic apical periodontitis in their mandibular first molar teeth were selected and randomly divided into two equal groups with the help of scientific number table. Endodontic therapy was initiated and root canals were prepared with ProTaper Next system. In the Patency group, a size 10 K-file was used as patency file and carried 01mm beyond working length between successive files. In the non-patency group, the file was carried till the working length. Obturation was done with cold lateral condensation using Pro Taper Next GP points, and permanent restoration was done with composite. The patients were informed to record pain scores after 24 and 48 hours and bring the VAS after one week. The data was analysed using SPSS version 22. RESULTS: There were 137 (57.08%) female and 103 (42.92%) male patients; 78 (65%) of patients in Patency group and 67 (55.83%) in Non-patency group, had no pain after 24 hours (p=0.345). In Patency group, 101 (84.17%) patients had no pain after 48 hours as compared to 98 (81.67%) patients of Non-patency group (p = 0.649). So apical patency reduced pain, but not in statistically significant proportion. CONCLUSION: Maintaining apical patency in necrosed teeth with asymptomatic apical periodontitis does not significantly reduce postoperative pain after single visit endodontic treatment. Key Words: Apical patency, Postoperative pain, Asymptomatic apical periodontitis.

Comparison Of Two Intra-Canal Medicaments On The Incidence Of Post-Operative Endodontic Pain.

BACKGROUND: Post-operative pain is the most annoying factor for the patients for which different intra-canal medicaments are used. The aim of this study was to compare calcium hydroxide mixed with dexamethasone and triple antibiotic paste as intra-canal medicaments on the incidence of post-operative endodontic pain. METHODS: This was a randomized controlled trail in which a total of 120 patients presenting to the department of Operative Dentistry AFID, Rawalpindi from 20-50 years of age from both gender presenting with acute apical periodontitis in their maxillary and mandibular central incisors were selected and randomly divided into three equal groups of 40 patients with the help of scientific random number table. Group A patients were given calcium hydroxide mixed with dexamethasone, group B patients were given triple antibiotic paste and in group C patients only cotton pellet was placed in the pulp chamber as a placebo. Endodontic therapy was initiated, following pulpectomy and disinfection, canals were prepared and intra-canal dressings were placed according to the allotted group and restored with cavit. Pain was recorded at 24, 48 and 72 hours using the visual analogue scale. Data was analysed using SPSS 21. RESULTS: After 72 hours, 55% of group A patients had no pain, 47.5% patients in group B while in group C 17.5% of the patients reported no pain. CONCLUSIONS: Both calcium hydroxide combined with dexamethasone and triple antibiotic paste are effective in reducing post-operative pain in teeth with symptomatic irreversible pulpitis while placebo showed little reduction in pain.

Postoperative sensitivity of self etch versus total etch adhesive.

OBJECTIVE: To compare postoperative sensitivity following composite restoration placed in supra gingival class-V cavities using self etch adhesive and total etch adhesive. STUDY DESIGN: A randomized clinical trial. PLACE AND DURATION OF STUDY: Operative Dentistry Department of Armed Forces Institute of Dentistry, Rawalpindi, from July to December 2009. METHODOLOGY: A total of 70 patients having class-V supra gingival carious lesions were divided into two groups. Classes-V cavities not exceeding 3 mm were prepared. One treatment group was treated with self etch adhesive (adhe SE one Ivoclar) and the control group was treated with total-etch adhesive (Eco-Etch Ivoclar) after acid etching with 37% phosphoric acid. Light cured composite (Te-Econom Ivoclar) restoration was placed for both groups and evaluated for postoperative sensitivity immediately after restoration, after 24 hours and after one week. Data was recorded on visual analogue scale. RESULTS: Comparison of sensitivity between the two treatment groups on application cold stimulus after 24 hours of restoration showed significant difference; however, no statistically significant difference was observed at baseline, immediately after restoration and at 1 week follow-up with cold stimulus or compressed air application. CONCLUSION: Less postoperative sensitivity was observed at postoperative 24 hours assessment in restoration placed using SE adhesives compared to TE adhesives. Thus, the use of SE adhesives may be helpful in reducing postoperative sensitivity during 24 hours after restoration placement.