Quandary in Diagnosing Peripheral Ossifying Fibroma and Pyogenic Granuloma: A Case Report with Mini Review.

The soft tissues of the oral cavity are constantly subjected to microtrauma due to various factors. The gingiva in particular reacts to these beyond a point resulting in reactive hyperplastic lesions. Amongst these, the pyogenic granuloma and the peripheral ossifying fibroma are the most common clinical entities. Since they have a similar clinical presentation but diverse histomorphologic illustrations, it was advocated that there exists an interrelation between these two reactive fibrous overgrowths. Hence, this paper is intended to abolish the quandary in diagnosing peripheral ossifying fibroma and pyogenic granuloma.

Comparative Study of Antifungal Efficacy of Various Endodontic Irrigants with and without Clotrimazole in Extracted Teeth Inoculated with Candida albicans.

AIM AND OBJECTIVE: To assess the application of clotrimazole (1%) as a complementary antifungal agent along with sodium hypochlorite (5.25%), chlorhexidine gluconate (2%), and doxycycline hydrochloride (5%) against Candida albicans. MATERIALS AND METHODS: Seventy freshly extracted single-rooted premolars with matured apices were collected, stored, and handled according to the Occupational Safety and Health Administration (OSHA) and the Center for Disease Control and Prevention (CDC) guidelines and recommendations. These were divided into three groups (two tests and one control group) depending on irrigants used. The efficacy of each irrigant group was compared. The observations were statistically analyzed by the multiple intergroup comparisons using ANOVA and Scheffe multiple comparisons (p < 0.001). RESULTS: The sodium hypochlorite (group IA-mean 129.6) has shown a statistically significant decrease in colony-forming units (CFUs) (p < 0.01) on comparison with chlorhexidine [(IB) mean 190.2]. A similar result was obtained in comparison with the sodium hypochlorite group (IA) and doxycycline HCl group [(IC) mean 318.4] and also between the sodium hypochlorite group (IA) and the control group [(III) mean 554.2]. The intragroup comparison of group II, group IIA (mean 63.3), and group IIB (mean 73.8) showed no statistically significant difference. Group III (mean 554.2) was the least effective of all the subgroups. CONCLUSION: Sodium hypochlorite showed better antifungal efficacy than chlorhexidine and doxycycline when used alone. The addition of clotrimazole increased the efficiency of doxycycline also, but it was less compared to sodium hypochlorite and chlorhexidine. Within the limitations of this study, the inclusion of 1% clotrimazole increased the antifungal efficacy of all the three irrigants. CLINICAL SIGNIFICANCE: Our study compared the efficacy of the various endodontic irrigants and also determined their efficiency with the addition of the antifungal agent. Clotrimazole (1%) addition in irrigating solutions showed better results and promoted faster healing.