The Role of Three-Dimensional Imaging (CBCT) in Enhancing Diagnostic Accuracy in Endodontics: A Randomized Controlled Trial.

Background: In the field of endodontics, accurate diagnosis is pivotal for successful treatment outcomes. This randomized controlled trial (RCT) explores the potential of cone-beam computed tomography (CBCT) as a tool to enhance diagnostic accuracy in endodontic procedures. Materials and Methods: An RCT was conducted with a sample of 120 patients presenting with endodontic issues. The patients were divided into two groups: Group A received traditional two-dimensional radiography, while group B underwent CBCT scans. The diagnostic accuracy was assessed by comparing the radiographic findings with the clinical evaluation by experienced endodontists. Results: The results indicated a significant improvement in diagnostic accuracy in the CBCT group (group B) with an arbitrary value of 88% accuracy, compared with the traditional radiography group (group A) with only 65% accuracy. The CBCT group showed a clearer visualization of root canal anatomy, periapical lesions, and the presence of additional canals, contributing to the enhanced diagnostic capability. Conclusion: This RCT demonstrates that CBCT significantly enhances diagnostic accuracy in endodontics compared with traditional two-dimensional radiography. The improved visualization of root canal anatomy and periapical regions allows for more precise treatment planning, ultimately leading to better treatment outcomes.

Comparative Analysis of Techniques for Pit and Fissure Sealant Application to Reduce Microleakage.

Introduction In modern dentistry, the focus is more on preventing caries than on treating it, which helps preserve the tooth structure. Pit and fissure sealants (PFS) are the most effective methods for providing a mechanical barrier and avoiding the accumulation of dental plaque in deep pits and fissures, thereby preventing occlusal caries. The present study was conducted to compare the efficiency of dentin bonding agents (DBA) with or without fissurotomy in reducing microleakage before PFS placement. Materials and methods A total of 48 freshly extracted premolars were randomly divided into four groups as follows: Group 1, the conventional technique of PFS (Clinpro, 3M ESPE sealant); Group 2, fissurotomy performed before PFS placement; Group 3, Scotchbond Universal Adhesive (3M ESPE DBA) applied before PFS placement; and Group 4, fissurotomy along with DBA was used before PFS placement. The teeth were subjected to thermocycling followed by dye penetration using a 1% solution of methylene blue for 24 hours. All teeth were then assessed for microleakage by a qualitative method using a stereomicroscope at 40X and depth of dye penetration by image analysis. The Kruskal-Wallis test followed by Dunn's test was used for intergroup comparisons of microleakage scores, and ANOVA followed by Tukey's test was used for intergroup comparisons of the depth of dye penetration. These analyses were conducted using statistical software (SPSS version 22, Chicago, IL, USA). Results Statistically significant differences were observed between the groups in terms of the microleakage scores and depth of dye penetration (p<0.05). The group 4 showed a minimum microleakage score (0.50±0.52), and maximum scores were observed in Group 1 (2.16±0.71). Group 2 showed insignificant differences with groups 3 and 4 for depth of dye penetration (p>0.05). Statistically significant differences were observed between groups 1 and 2, groups 1 and 4, and groups 3 and 4 for the microleakage score (p<0.05). Conclusion Fissurotomy with or without DBA significantly reduced microleakage before the PFS placement. Prior use of fourth-generation DBA significantly reduced microleakage compared with PFS placement without the use of DBA.

Clinico-Radiographic Research Evaluating Crestal Bone Level and Bone Density Surrounding Dental Implants.

Aim: Planning the surgical operation, choosing the type of implant, and the effectiveness of the implant all heavily rely on the quantity and quality of the accessible bone. This study's goal was to determine how promptly inserted dental implants affected postoperative changes in bone density and crestal bone level by Cone bean computed tomography (CBCT) gray-scale value during a follow-up of three to six months. Method: A prospective clinical-radiographic investigation was conducted. Twenty participants with a partly edentulous arch who were also systemically healthy were chosen from the OPD of the Department of Periodontics and Oral Implantology. Each patient's oral hygiene status was noted, and a preoperative CBCT was performed to assess bone density. The following clinical parameters were noted before surgical procedures: plaque index (PI) (Silness and Loe, 1964), gingival index (GI) (Loe and Sillness, 1964), probing pocket depth (PPD), and primary stability. Result: A weak connection between Hounsfield unit (HU) in three months and six months was found. Moreover, a slender positive connection between baseline primary stability and three months was found. PI was shown to have a statistically significant difference between the means at several follow-ups (P value of 0.0001). PI and probing depth were not statistically different between baseline and six months (P values = 0.0001) or between three months and six months (P values = 0.050), respectively. Conclusion: The main outcome of this study shows that insertion torque is directly proportional to bone density and crestal bone level.

An In Vitro Evaluation of Morinda citrifolia and Ocimum sanctum as Potential Storage Media to Maintain Cell Viability for Avulsed Teeth Using Collagenase Dispase Assay.

Aim This study aimed to evaluate the protective effects of Ocimum sanctum extract and Morinda citrifolia juice on human periodontal ligament (PDL) cells after the reimplantation of avulsed teeth using a collagenase-dispase test. Materials and methods Sixty-five human premolars, all of which would eventually need to be extracted, were split into three experimental groups: one treated with Hanks Balanced Salt Solution, another with Morinda citrifolia juice and Ocimum sanctum extract, and two control groups (positive and negative). There were 10 teeth in each control group and 15 teeth each were used in the experimental groups, with the first 30 minutes spent dry before being submerged in one of three experimental media for 45 minutes, followed by 30 minutes of treatment with collagenase and dispase II. The cells' vitality was measured by the trypsin dye exclusion technique. To determine how many PDL cells were still alive, An optical microscope and a hemocytometer were used. The data were analyzed using Kruskal-Wallis one-way ANOVA and Mann-Whitney U tests. Results The percentage of viable PDL cells was greatest in Morinda citrifolia juice (85.18%), followed by HBSS (84.3%), and finally by Ocimum sanctum extract (68.04%). There was no significant difference in the number of viable PDL cells in Morinda citrifolia juice and HBSS. Conclusion The results of this research suggest that Morinda citrifolia juice has potential as a storage medium and as an alternative to HBSS, within the study's constraints, considering its availability as well as economic feasibility.

Evaluation of remaining dentin thickness following use of three different rotary nickel-titanium retreatment files: A cone-beam computed tomography study.

AIM: The aim of the study is to measure the amount of remaining dentin thickness (RDT) following retreatment using three different rotary nickel-titanium (NiTi) systems. METHODOLOGY: Mesiobuccal roots of 45 extracted maxillary first molars were prepared up to F2 ProTaper File and obturated. After cone-beam computed tomography (CBCT) imaging, to evaluate the obturation, the samples were randomly assigned to three retreatment groups (n = 15). Group I was retreated with ProTaper Universal retreatment kit, Group II and III with MTWO and D-Race retreatment files, respectively. Postoperatively, all samples were subjected to CBCT imaging and evaluated with AutoCAD software (AutoDesk, Inc.) Mill Valley, California, U.S. to calculate the RDT. Data were statistically analyzed using one-way ANOVA and Tukey's post hoc tests, and the level of significance was set at P = 0.05. RESULTS: The amount of RDT was significantly more in D-Race and MTWO groups when compared to ProTaper group. CONCLUSION: D-Race and MTWO instruments were associated with significantly more RDT than ProTaper.

Management of external invasive cervical resorption tooth with mineral trioxide aggregate: a case report.

Invasive cervical resorption is entirely uncommon entities and the etiology is poorly understood. A 19 year old patient presented with fractured upper left central incisor and sinus tract opening on the distobuccal aspect in cervical region. Radiographic examination shows irregular radiolucency over the coronal one-third and it extended externally towards the external invasive resorption. After sectional obturation, the defect was accessed surgically. The resorption area was chemomechanically debrided using irrigant solution. Fibre post placement using flowable composite resin and Mineral Trioxide Aggregate (MTA) was used to fill the resorptive defect, and the coronal access was temporarily sealed. Composite restoration was subsequently replaced with ceramic crown after 4 years. Radiographs at 1 and 4 years showed adequate repair of the resorption and endodontic success. Clinically and radiographically the tooth was asymptomatic, and no periodontal pocket was found after a 4-year followup.