Optimizing Root Canal Therapy: An In Vitro Comparative Study of Innovative File Systems on Mandibular Premolar Fracture Resistance.

INTRODUCTION AND AIM:  Root canal therapy is a vital procedure for saving teeth by removing infection and cleaning the complex root canal system. However, a delicate balance exists between thorough cleaning and preserving tooth strength. The study aims to evaluate the instrumentation effect of three innovative file systems, XP-endo® shaper, Reciproc®, and Self-adjusting file (SAF) on fracture resistance of mandibular premolars. MATERIALS AND METHODS: Thirty single-rooted mandibular premolars were collected; a standard access cavity was prepared and the working length was established 1 mm short of the apex. The teeth were randomly divided into three groups(n=10). In Group 1, the shaping of the specimens was achieved using XP-endo® shaper; in Group 2, it was instrumented using Reciproc® file; and in Group 3, it was instrumented using SAF. All samples were decoronated and the roots were mounted vertically in acrylic resin and subjected to fracture resistance under a universal testing machine. RESULTS: Intergroup analysis was done by one-way ANOVA followed by Bonferroni post hoc test, which did not report a statistically significant difference (p>0.05). CONCLUSION: All three tested file systems were similar in fracture resistance. XP-endo® shaper exhibited better fracture resistance on root canal instrumentation when compared to Reciproc® and SAF although they are not statistically significant.

Comparative assessment of titanium-prepared platelet-rich fibrin, EndoSequence root repair material, and calcium hydroxide as pulpotomy agents in permanent teeth with irreversible pulpitis: A randomized controlled trial.

Context: Pulpotomy is a procedure in which part of an exposed vital pulp is removed, usually as a means of preserving the vitality and function of the remaining part. Aim: The aim is to compare the effectiveness of Dycal (CH), EndoSequence, and Titanium-prepared platelet-rich fibrin with EndoSequence (T-PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis. Settings and Design: Sixty permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups. Subjects and Methods: Full pulpotomy was performed using Dycal, EndoSequence, and T-PRF with EndoSequence as pulpotomy agents. Pain intensity was analyzed using a Numeric Rating Scale score at baseline 24 h, 7 days, 6 months, and 1 year. The clinical and radiographic evaluations were done at 6 months and 1 year. Statistical Analysis: Nonparametric tests (Kruskal-Wallis, Chi-square) were applied to analyze the data as the normality test does not follow a normal distribution. Results: T-PRF and EndoSequence showed effective results when compared clinically, and there was no significant difference between radiographic success rates among the three groups at (P = 0.325 at 6 months, 0.466 at 12 months) follow-up. Conclusion: T-PRF and EndoSequence showed higher success rates among Dycal, EndoSequence as pulpotomy agents in teeth with irreversible pulpitis.

Evaluation of threshold response and appropriate electrode placement site for electric pulp testing in fluorosed anterior teeth: An in vivo study.

BACKGROUND: Accurate diagnosis is key to success. Diagnosing the pulpal status in varied clinical situations poses a challenge to the clinician. Electric pulp test (EPT) is one of the valuable attempts in evaluating the sensibility of pulp tissue. The aim of this study was to find out and compare the threshold levels and optimal electrode placement site for EPT in fluorosed and nonfluorosed anterior teeth. MATERIALS AND METHODOLOGY: Eighty volunteers recruited for this study were divided into two groups based on the incidence of dental fluorosis. Electric pulp testing was done on either of the central incisors in fluorosed and nonfluorosed group. Four sites on each crown were tested 4 times with digitest electric pulp tester, and the mean of the threshold responses was recorded. The data were analyzed with SPSS, version 11. Means of variables from each location were compared using one-way ANOVA and Tukey's post-hoc test while the critical level of significance was set at P < 0.05. RESULTS: The mean and standard deviation of threshold levels in fluorosed teeth were greater when compared to that of nonfluorosed teeth at all sites with incisal edge showing the least mean threshold levels for both the groups (P > 0.05). CONCLUSION: Within the limitations of this study, it can be concluded that fluorosed teeth respond to higher threshold levels than the non-fluorosed teeth, and incisal edge was the optimal electrode placement site.

Comparative Evaluation of Antimicrobial Effect of Three Endodontic Sealers with and Without Antibiotics - An In-vitro Study.

INTRODUCTION: Root canal sealers with good sealing ability and antimicrobial activity are desired to entomb the surviving microorganisms. AIM: Aim of the present study is to evaluate the antimicrobial effect of different sealers mixed with antibiotics. MATERIALS AND METHODS: Sixty extracted premolars were taken and were cut coronally & apically such that 7mm of tooth specimen was prepared. They were sterilized by autoclaving, inoculated with E.faecalis and incubated for three weeks. The specimens were divided into six groups of 10 each. Group 1 - ZnOE, Group 2 - ZnOE +TAM, Group 3 - Apexit Plus, Group 4 - Apexit Plus +TAM, Group 5 - AH Plus, Group 6 - AH Plus + TAM. Bacterial growth in the each specimen was calculated before & after sealer application and noted as initial & final colony count. Antimicrobial effect of each sealer was measured by calculating the Percentage Reduction in Colony Count (%RCC). One way analysis of variance and post hoc tests were used for statistical analysis. RESULTS: ZnOE + TAM group showed maximum antibacterial effect among the sealers tested and AH Plus sealer showed least antimicrobial effect. CONCLUSION: When the sealers were mixed with triple antibiotic mixture the antimicrobial effect was increased significantly.

Management of an Unusual Maxillary Canine: A Rare Entity.

Clinicians need to have intimate knowledge and thorough understanding of both pulp chamber and root canal anatomy. They should be aware of possibility of anatomical variations in the root canal system during endodontic treatment. Maxillary canines usually have single root and root canal but rarely may have single root with two root canals. This case describes a lengthier maxillary canine with two root canals.