Comparison of obturation quality, instrumentation time and post-operative pain using manual K-files and pediatric rotary files in primary molars ­ a double blinded randomised clinical trial / Comparação da qualidade de obturação, tempo de instrumentação e dor pós-operatória usando Limas manuais K e Limas rotativas pediátricas em molares decíduos ­ um estudo clínico randomizado duplo-cego

Objective: to compare the quality of obturation, instrumentation time and post-operative pain after pulpectomy in primary molars using manual K-files, Kedo-S and Kedo-S Square rotary file systems. Material and Methods: a double blinded randomized control trial was conducted in 45 children, who were indicated for pulpectomy in any one of the primary mandibular molars. The canal preparation was done using either hand K-files, Kedo-S files, or Kedo-S Square files based on the groups assigned. The time taken for instrumentation was recorded using a stopwatch. The quality of obturation was evaluated using post-operative radiograph and post-operative pain was assessed with modified Wong-Baker Faces Pain scale. Results: instrumentation time was minimum in rotary Kedo-S Square files (53.23 ± 9.60 seconds) followed by Kedo-S files (82.70 ± 11.86 seconds). The preparation time was maximum with manual K-files (121.43 ± 20.18 seconds). Kedo-S square files provided a higher number of optimally filled canals (66.4%). All the three instrumentations equally showed the tendency to produce voids in the obturation. Rotary files Kedo-S Square followed by Kedo-S showed less post-operative pain compared to K-files. Conclusion: the use of pediatric rotary instruments for canal preparation during pulpectomy will result in better quality of obturation in reduced time with least post-operative pain (AU)

Objetivo: comparar a qualidade de obturação, tempo de instrumentação e dor pós-operatória após pulpectomia em molares decíduos usando limas manuais K, limas rotatórias Kedo-S e limas rotatórias Kedo-S Square. Material e Métodos: um estudo clínico randomizado duplo-cego foi conduzido com 45 crianças que foram submetidas à pulpectomia de algum molar decíduo indicado. A preparação do canal foi feita usando limas manuais K, ou limas Kedo-S, ou ainda Limas Kedo-S Square, com base nos grupos que foram selecionados. O tempo para a instrumentação foi registrado com um cronômetro. A qualidade de obturação foi avaliada por meio de uma radiografia após o procedimento e a dor pós-operatória foi avaliada com a escala de dor Wong-Baker Faces modificada. Resultados: o tempo de instrumentação foi mínimo para as limas rotatórias Kedo-S Square (53,23 ± 9,60 segundos) seguido pelas limas Kedo-S (82,70 ± 11,86 segundos). O tempo de preparação foi maior com as limas manuais K (121,43 ± 20,18 segundos). As limas Kedo-S Square promoveram um maior número de canais otimamente obturados (66,4%). Todas as três instrumentações mostraram igualmente a tendência em seproduzir vazios na obturação. As limas rotatórias Kedo-S Square seguidas pelas limas Kedo-S produziram menos dor pós-operatória comparadas às limas manuais K. Conclusão: o uso de instrumentos rotatórios pediátricos para a preparação do canal durante a pulpectomia resultará em melhor qualidade de obturação em tempo reduzido e com menos dor pós-operatória. (AU)

Fracture Incidence of Kedo-S Square Pediatric Rotary Files: A Prospective Clinical Study.

OBJECTIVE: The primary focus of this clinical study was to analyze the probability of occurrence of instrument fracture after root canal preparation of primary molars with the help of Kedo-S Square pediatric rotary file. MATERIALS AND METHODS: Three experienced specialists treated 100 primary maxillary and mandibular molars (335 root canals) using a standardized protocol over 2 months. Biomechanical preparations were carried out using Kedo-S Square file, as per the suggestions given by the manufacturer. Every instrument in Group A helped handle three clinical cases, while for groups B, C and D, they helped in handling 5, 9, and 12 cases, respectively. Making use of an operational microscope, the rotary files, after being pulled out from the canal, were observed. The values were tabulated, and descriptive statistics were performed. RESULTS: There were two fractures (2%), of which 1 occurred in group C in the apical 1/3rd of distobuccal canal of maxillary molar, and the other occurred in group D in the apical 1/3rd of mesiobuccal canal of maxillary molar. CONCLUSIONS: The fracture rate of Kedo-S Square rotary file is quite low. It is primarily in the buccal canals of the maxillary molars and the apical third of the root canal that the instrument has a greater probability of separation.

Microbial Evaluation of Root Canals after Biomechanical Preparation with Manual K-files, Manual H-files, and Kedo-SG Blue Rotary Files: An In Vivo Study.

Aim: The purpose of the present study was to comparatively evaluate the efficacy of Kedo-SG blue rotary files, manual K-files, and manual H-files in eliminating the root canal microflora of primary molars. Materials and methods: Forty-five primary molars requiring pulpectomy were included in the study. Based on type of instrumentation, the teeth were randomly assigned to one of the three groups: group A: Kedo-SG blue rotary files, group B: manual H-files, and group C: manual K-files. Sterile absorbent paper points were used for sample collection and stored in sterile Eppendorf tubes containing saline as transport medium. Culturing was done on thioglycolate agar and blood agar media for the cultivation of anaerobic and aerobic microbes, respectively, and recorded as colony-forming units (CFU) using digital colony counter. Wilcoxon signed-rank test and one-way analysis of variance (ANOVA) test were performed for statistical analysis. Results: Postinstrumentation, 93-96% reduction of aerobic and anaerobic microbial count was recorded in group A. Whereas, it was 87-91% reduction in group B and 90-91% reduction in group C. No statistically significant difference was noted between the three groups. Conclusion: Kedo-SG blue rotary files showed a better reduction of microbes in root canals when compared to manual instrumentation. However, there was no significant difference between manual and rotary instrumentation in microbial reduction of primary root canals. How to cite this article: Lakshmanan L, Jeevanandan G. Microbial Evaluation of Root Canals after Biomechanical Preparation with Manual K-files, Manual H-files, and Kedo-SG Blue Rotary Files: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(6):687-690.

Association of Ellis Class 2 fracture in 13-17 years old children.

The objective of the study is to evaluate the association of Ellis Class 2 fracture in children aged between 13 and 17 years. This is a descriptive study that was carried out in a university context, using data from patients with Ellis Class 2 fractures between 13 and 17 years from June 2019 to February 2021, which were obtained by analyzing patient records. The records were transferred to the SPSS software for statistical analysis. The association of Ellis Class 2 fracture is common in relation to 11 which is about 29.41% and more common among the age group of 14 years and had a more male prediction. The knowledge of Ellis Class 2 fracture and its association with several parameters are essential in dentistry for various clinical performances. This can be accomplished by increasing awareness through Continuing Dental Education (CDE) programs, demonstrations, and seminars on the clinical regime of Ellis Class 2 fracture.

Evaluation of quality of obturation in 6-9-year-old children.

The effectiveness of root canal therapy is dependent on the quality of obturation. The objective of the current study was to evaluate the obturation quality in pediatric patients of age 6-9 years reporting for pulpectomy treatment. Among the comprehensive data of patients attending Saveetha Dental College, a retrospective analysis of all the patients referred for pulpectomy was extracted. SPSS software version 19 was used to analyze the data gathered. Data were statistically evaluated using the Chi-square test. RESULTS: In the present study carried out, it was observed that the most frequent quality of obturation was normal (12.36%) and it is higher in the 7-year-old age category. The second frequent quality of obturation was voids (6.55%) and its higher in the 9-year-old age category. The results obtained were positively significant (P < 0.05). The most frequent quality of obturation was normal and it is higher in the 7 years category. The second frequent quality of obturation was voids with higher level in the 9 years category.

Association of Ellis class 1 fracture in children of age 6-12 years.

Trauma is a well-known issue in children, and its prevalence is on the rise more than that of dental caries in children. The objective of the study is to evaluate the association of Ellis class 1 fracture in children between 6 and 12 years. This study includes 45 males and 55 female patients of age 6-12 years. All the data regarding the study population was extracted from Dental Information Archiving Software-all patient records from management. The data collected were tabulated and imported to SPSS software. Statistical analysis was done using Chi-square tests. Ellis class 1 fracture ordinarily is observed to affect the central incisors. Majority of school children of 6-12 years of age were more vulnerable to dental trauma. There is a strong association between Ellis class 1 fracture in children of 6-12 years of age.

Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial.

BACKGROUND: Profound local anesthetic delivery promotes successful treatment for children in terms of easing their fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the utmost anticipated or anxious stimuli in the dental operatory. Precooling the oral mucosa by application of cryotherapy before local anesthetic injections can alter the pain perception in children. AIM AND OBJECTIVES: To compare the efficacy of cryotherapy application and 20% benzocaine gel at reducing pain perception during buccal infiltration in pediatric patients. MATERIALS AND METHODS: In this split-mouth study, 30 pediatric patients between 7 years and 10 years of age who needed maxillary buccal infiltration of local anesthetics bilaterally for dental treatment were selected. They received cryotherapy (ice pack) on one quadrant (test group) for 2 minutes and 20% benzocaine topical gel on the contralateral quadrant (control group). A pediatric dentist blinded to the study assessed sound, eye, motor (SEM) scale based on patients' reaction during injection (objective method), and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection (subjective method). Statistical analyses were performed using Wilcoxon and Mann-Whitney U tests. RESULTS: The cryotherapy group had significantly reduced pain scores on the VAS scale (40.66 ± 14.60) when compared with the topical anesthetic gel group (61.33 ± 9.73). The cryotherapy group had reduced pain scores on the SEM scale as well (1.2 ± 0.1) when compared with the topical anesthetic gel group (1.6 ± 0.1), which was not statistically significant. CONCLUSION: When compared with topical anesthetic gel, precooling the injection site with cryotherapy is beneficial in reducing pain before local anesthesia injection in pediatric patients. CLINICAL SIGNIFICANCE: Cryotherapy application eliminates the fear of pain ascribed to injection of local anesthesia and assists in providing pertinent dental care. HOW TO CITE THIS ARTICLE: Lakshmanan L, Ravindran V. Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial 2021;14(5):616-620.

Evaluation of Postoperative Pain after Pulpectomy using Different File Systems in Primary Teeth: A Systematic Review.

OBJECTIVE: The purpose of this systematic review was to compare the incidence and intensity of postoperative pain after pulpectomy using different instrumentations in primary teeth. MATERIALS AND METHODS: An extensive literature search in PubMed, Cochrane Library, Science Direct, LILAC, SIGLE, and Google Scholar was performed to identify English language articles with human subjects that evaluated the effects of different instruments on postoperative pain after pulpectomy. RESULTS: The search retrieved 187 references. After screening of the abstracts and articles, based on the inclusion and exclusion criteria, a total of three articles were included in the systematic review. Of the three included studies, two of them had a moderate risk of bias and one showed a high risk of bias. CONCLUSION: The use of rotary instruments contributed to a lower incidence and intensity of postoperative pain than did the hand instruments in all the three studies. More high-quality randomized clinical trials are needed in this field in future studies to support the evidence.

Parents' knowledge, attitude, and practice regarding the pit and fissure sealant therapy.

CONTEXT: Parents' interpretation on children's oral health care practices plays a vital role in improving children's oral health. AIM: This study sought to evaluate parents' knowledge, attitude, and practice regarding dental sealants. MATERIALS AND METHODS: A cross-sectional study was conducted among parents of school-going children in Chennai, India. Knowledge, attitude, and practice toward sealant therapy were assessed through a questionnaire survey among 250 parents (45% fathers and 55% mothers). RESULTS: A statistically significant difference was noted in the knowledge and attitude scores at various age groups; 71% of the participants agreed that pit and fissure sealants are effective in preventing dental caries. Only 34% of the study participants' children had received dental sealants. CONCLUSION: The parental knowledge and awareness of preventive practices appear to support dental sealants as a preventive strategy for dental caries. But most parents did not practice the preventive measures despite knowing its effectiveness and benefits. Greater efforts should be made to encourage the parents to provide their children with primary care.

Assessing the quality of root canal filling and instrumentation time using kedo-s files, reciprocating files and k-files / Avaliando a qualidade de obturação e tempo instrumentação usando limas kedo-s, limas reciprocantes e limas k manuais

Objective: Pulpectomy is the conservative treatment approach that retains and preserves the primary tooth in the dental arch in its normal function and non-pathologic state until its exfoliation. Over the years, pulpectomy has been performed using various instrumentation techniques. The aim of this study was to compare the quality of root filing and instrumentation time using Kedo-S files, Reciprocating files and K-files in primary teeth. Material And Methods: A randomized clinical trial was performed on 45 primary molars equally distributed for instrumentation with Kedo-S files, reciprocating files and K-Files. Immediate post-operative digital radiographs were taken to evaluate the quality of root filing and root canal instrumentation time was also recorded. Results: Mean instrumentation time with Kedo-S was 75.6 seconds, reciprocating file was 190.6 seconds and K-file was 95.4 seconds. Highest optimal fill was obtained with Kedo-S file group, highest overfill was obtained with Kedo-S group and highest under fill was obtained with reciprocating file group. Conclusion: Kedo-S rotary system provides better quality of root canal filling in minimum instrumentation time. (AU)

Objetivo: A pulpectomia é o tratamento conservador que retém e preserva o dente decíduo na arcada dentária em sua função normal e estado não patológico até sua esfoliação. Ao longo dos anos, a pulpectomia foi realizada usando várias técnicas de instrumentação. O objetivo deste estudo foi comparar a qualidade da obturação do canal radicular e do tempo de instrumentação usando limas Kedo-S, limas reciprocantes e limas K em dentes decíduos. Material e Métodos: Foi realizado um ensaio clínico randomizado em 45 molares decíduos distribuídos igualmente para instrumentação com limas Kedo-S, limas reciprocantes e limas K. Radiografias digitais pós-operatórias imediatas foram realizadas para avaliar a qualidade da obturação e também foi registrado o tempo de instrumentação do canal radicular. Resultados: O tempo médio de instrumentação com Kedo-S foi de 75,6 segundos, com limas reciprocantes foi de 190,6 segundos e com limas K foi de 95,4 segundos. O maior índice de obturação ideal foi obtido com o grupo de limas Kedo-S, o maior índice de sobreobturação foi obtido com o grupo Kedo-S e o maior índice de infraobturação foi obtido com o grupo de limas reciprocantes. Conclusão: O sistema rotatório Kedo-S fornece melhor qualidade de obturação do canal radicular em tempo mínimo de instrumentação.(AU)

Prevalence of congenitally missing second premolar teeth in the Dravidian population.

INTRODUCTION: In the practice of dentistry, one of the most common dental anomalies encountered is the congenitally missing teeth (CMT) with dierent prevalence in each region. CMT are those that fail to erupt in the oral cavity and remain invisible in radiographs. The aim of this study was to evaluate the prevalence of congenitally missing second premolar teeth in the Dravidian population that can be used in forensic research. MATERIALS AND METHODS: In this retrospective study, a total of 4600 panoramic radiographs of Dravidian children (2580 girls and 2020 boys) with an age group of 9-17 years were viewed for congenitally missing second premolar teeth. RESULTS: The total number of congenitally missing second premolars was 80 (1.73%). The prevalence was seen more in girls (60%) than boys (40%). Mandibular second premolar was the most commonly missing teeth. Bilateral agenesis (66%) was more prevalent than the unilateral agenesis (34%). CONCLUSION: The prevalence of congenitally missing second premolar teeth in the Dravidian population was 1.02%. The study of CMT is important in performing dental treatments and also in the field of forensic research as it can provide knowledge on the diversities among populations.