Capturing the art and science of dentistry in a lens: Digital dental photography.

Dental photography is now an excellent tool that plays a crucial role in dentistry as it helps in documenting and analyzing the oral conditions of patients. Photography provides a visual representation of the teeth, gums, and other oral structures, which aids in diagnosis, treatment planning, and monitoring the progress of treatment. Therefore, it is essential for dental professionals to understand the importance of dental photography and incorporate photography it into regular practice. The purpose of this paper is to provide emphasis and elucidate the path of dental photography easier for dental student and practitioner.

Comparative Evaluation of Penetration Depth of Irrigants into Root Dentin after Manual Sonic and Ultrasonic Activation using Dye Penetration Method under Light Microscope: An In Vitro Study.

Aim: To evaluate the penetration depth of irrigants into root dentin after manual, ultrasonic, and sonic activation using the dye penetration method under light microscope. Materials and methods: Ninety-two extracted single-rooted human teeth were used in the age range of 14-18 years. After access opening, root canals were instrumented. Canals were irrigated with preheated 5% sodium hypochlorite (NaOCl). Teeth were divided into four groups-group I, control group without activation; group II, manual dynamic activation; group III, ultrasonic activation; and group IV, sonic activation. About 1% methylene blue dye was used, which was activated for 30 seconds using the respective activation method. Cross sections of apical 1 mm were prepared from the apical third. Each section was examined under a light microscope to check the penetration depth of dye in a micrometer at the apical third level. Results: There was a statistically highly significant difference seen for the values between the groups (p < 0.01) with higher values in group IV and least in group I, revealing that group IV had higher penetration depth compared to other groups. Conclusion: The use of needle irrigation with the use of EndoActivator (sonic agitation method) has enhanced irrigation in the apical third. Clinical significance: As during biomechanical preparation and irrigation with the traditional method of needle and syringe, canals remain inadequately disinfected at the apical third level. So, this study was done to assess whether the advanced methods of activation are more effective than commonly used techniques in their ability to penetrate dentinal tubules. How to cite this article: Dadhich S, Srivastava H, Raisingani D, et al. Comparative Evaluation of Penetration Depth of Irrigants into Root Dentin after Manual Sonic and Ultrasonic Activation using Dye Penetration Method under Light Microscope: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-3):S253-S257.

Evaluation of calcium ion release from apical plugs formed by Biodentine and MTA with and without incorporation of triple antibiotic powder and modified triple antibiotic powder (cefaclor) using atomic absorption spectrophotometry - An in vitro study.

Introduction: Apexification procedure with Mineral trioxide aggregate (MTA) and Biodentine as apical plugs along with the incorporation of medicaments such as silver zeolite, chlorhexidine, and triple antibiotic powder (TAP) is a new area of research that is gradually gaining momentum in dentistry. Aim: The study aimed to evaluate and compare the calcium released from the apical plugs formed by MTA and Biodentine with and without incorporation of 2% TAP and 2% modified triple antibiotic powder (mTAP). Materials and Methods: Ninety single-rooted teeth were randomly divided (n = 15) into two experimental groups with three subgroups (n = 5) each based on the composition of apical plugs (4 mm) as follows: Group A: Biodentine - Subgroup 1: Biodentine, Subgroup 2: Biodentine + 2% TAP, and Subgroup 3: Biodentine + 2% modified TAP and Group B: MTA - Subgroup 1: MTA, Subgroup 2: MTA + 2% TAP, and Subgroup 3: MTA + 2% modified TAP. Each sample tooth was then immersed in 10 mL of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using a one-way analysis of variance and a Tukey's post hoc test. Results: Calcium ion release was maximum for Biodentine compared to MTA and was greater with materials incorporated with TAP and mTAP than materials alone at days 7, 15, and 30. Conclusion: The incorporation of 2% TAP and 2% mTAP resulted in increased calcium ions released from MTA and Biodentine which helps in faster apexification.

Comparison of Ribbond and Everstick Post in Reinforcing the Re-attached Maxillary Incisors Having Two Oblique Fracture Patterns: An In Vitro Study.

AIM AND OBJECTIVE: This study aims to compare the resistance to fracture in maxillary incisors which were fractured in two different oblique patterns and then were re-attached and reinforced using anatomic fiber-reinforced composite (FRC) post. MATERIALS AND METHODS: Sixty extracted and intact human maxillary incisors were obtained and divided into two groups (A and B; n = 30). "Labiopalatal" and "palatolabial" fractures were induced in group A and group B, respectively. These two groups were further subdivided into two subgroups (n = 15). In subgroup I Ribbond fiber (Ribbond Inc., Seattle, WA, USA) and in subgroup II Everstick post (everStick Post™, GC Corporation, Tokyo, Japan) were used. Fractured fragments were re-attached using resin and tested for fracture resistance in universal testing machine. Statistical analysis was done with ANOVA one-way test and post hoc test. RESULTS: The labiopalatal fracture pattern of group A showed significantly increased resistance to fracture than the palatolabial fracture pattern of group B in both the subgroups. Similarly, subgroup II with Everstick post exhibited significantly higher fracture resistance than subgroup I with Ribbond in both groups A and B (p value < 0.05). CLINICAL SIGNIFICANCE: The study simulates a clinical scenario of coronal fracture of a tooth and focuses on the techniques and materials which can be used for successful management of such cases. HOW TO CITE THIS ARTICLE: Khurana D, Prasad AB, Raisingani D, et al. Comparison of Ribbond and Everstick Post in Reinforcing the Re-attached Maxillary Incisors Having Two Oblique Fracture Patterns: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(5):689-692.

Effect of Saliva Contamination on Shear Bond Strength of Self-etch Adhesive System to Dentin: An In Vitro Study.

AIM AND OBJECTIVE: This study aimed to evaluate the outcome of saliva contamination on shear bond strength (SBS) of a self-etch adhesive system to dentin. MATERIALS AND METHODS: A total of 60 premolars were selected. Occlusal surfaces of the teeth were severed off. Three groups of 20 teeth in each were formed after the samples were randomly divided. Group I: Not subjected to any contamination (control group). Group II: Contamination with saliva occurred before coating the teeth with a self-etch adhesive system. Group III: Contamination with saliva occurred after coating the teeth with a self-etch adhesive system. After the contamination, the composite was placed with the help of a Teflon tube. Under the universal testing machine, the SBS of these samples was then tested. RESULTS: The data obtained after testing were analyzed using SPSS software. Statistical difference was seen between all the three groups. Group II projected the least SBS. CONCLUSION: Contamination with saliva has a deleterious effect on the SBS. Contamination that occurs before the application of adhesive systems has shown considerably reduced SBS. CLINICAL SIGNIFICANCE: This study successfully established that saliva contamination acts as a major factor in reducing the SBS of the bonding agent. Hence, in clinical situations, it is necessary to ensure sufficient steps are taken to eliminate or reduce the chances of contamination with saliva to aid in the success of the restoration. HOW TO CITE THIS ARTICLE: Chaudhari RR, Srivastava HR, Raisingani D, et al. Effect of Saliva Contamination on Shear Bond Strength of Self-etch Adhesive System to Dentin: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(4):443-446.

Volumetric analysis of root filling with cold lateral compaction, Obtura II, Thermafil, and Calamus using spiral computerized tomography: An In vitro Study.

AIM: The aim of the present study is volumetric analysis of root canal filling with cold lateral compaction, Obtura II, Thermafil, and Calamus using spiral computerized tomography (SCT). MATERIALS AND METHODS: Root canals of eighty mandibular premolars were instrumented using rotary ProTaper, and the volume of the canal space was measured using spiral computerized tomography (SCT). The teeth were divided into four groups of twenty teeth each, and root canals filled by lateral compaction technique, Thermafil carriers, Obtura II, and Calamus techniques, respectively. AH Plus was used as a sealer with all techniques. The filled volume in each canal was measured using SCT, and the percentage of obturated volume (POV) was calculated. The data were statistically analyzed using ANOVA, Kruskal-Wallis test, and Mann-Whitney U-test. RESULTS: The four groups were comparable in canal volume. The overall POV was 78.11%, 85.72%, 82.50%, and 87.89% for lateral compaction, Thermafil, Obtura II, and Calamus, respectively (P Conclusion: The greatest POV was obtained with Calamus and Thermafil. Voids were seen in all root fillings.

A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study.

The continuous development of esthetically acceptable adhesive restorative material has made a variety of tooth-colored materials available for clinical use. The advent of visible light polymerizing resin and the use of finer filler particles permit resin composites to be polished to higher degree. The effect of polishing systems on surface finish has been reported to be material-dependent, and the effectiveness of these systems was mostly product-dependent. Hence, the purpose of this study was to evaluate the efficiency of finishing and polishing systems on the surface roughness of nanofilled, microfilled, and hybrid composite restorative materials available in the market. HOW TO CITE THIS ARTICLE: Yadav RD, Raisingani D, Jindal D, Mathur R. A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study. Int J Clin Pediatr Dent 2016;9(3):201-208.

Effect of Calcium Hydroxide, Chlorhexidine Digluconate and Camphorated Monochlorophenol on the Sealing Ability of Biodentine Apical Plug.

INTRODUCTION: Teeth with immature apex are managed by establishing an apical plug using various materials and techniques. However, the use of previously placed intracanal medicament may affect the sealing ability of permanent filling material used as an apical plug. AIM: To evaluate the effect of removal of previously placed Calcium Hydroxide, Chlorhexidine Digluconate and Camphorated Monochlorophenol as an intracanal medicament on the sealing ability of the Biodentine as an apical plug. MATERIALS AND METHODS: A total of 72 recently extracted human permanent teeth with single root were selected and stored in saline at room temperature. The crown portion of each tooth was removed at the level of cemento enamel junction; 14mm root length was taken as standard length. All the roots were submerged in 20% sulphuric acid up to 3 mm from the apex, for four days for root resorption. One sample was cut longitudinally to look for root resorption under stereo microscope. The canal preparation was done; the roots were kept in moist gauze after instrumentation. A total of 71 roots were randomly divided into three groups. GROUP 1:Calcium hydroxide paste, GROUP 2: Chlorhexidine digluconate, GROUP 3: Camphorated Monochlorophenol (CMCP). The medicaments were removed with stainless steel hand files and 0.5% sodium hypochlorite irrigation. After removal of medicament Biodentine was placed in apical third of resorbed roots and the remaining portion of the canals was filled with gutta-percha. All the 71 roots were analysed with fluid filtration method for evaluating microleakage. RESULTS: Comparing all the three groups statistically there was no significant difference. The mean values were found more for group 1 followed by group 2 & 3. CONCLUSION: All the groups showed microleakage. Calcium hydroxide showed the maximum microleakage followed by Chlorhexidine digluconate and least with CMCP.

Information regarding use of rotary nickel- titanium endodontic instruments among general dental practitioners: a questionnaire survey

Aim: A cross-sectional questionnaire survey was conducted to obtain information on the use of rotary nickel ­titanium endodontic instruments was conducted among General Dental Practioner A two sectioned questionnaire was mailed to 200 randomly general practioners to obtain information on usage of Nickel ­Titanium endodontic instrument and data was collected. Results: Forty-six percent of the general practioners had used rotary NiTi instruments. 76% dentists use NiTi files for five or more times a week. Most of the dentist used NiTi file coronally &apically. General dentists experienced more file fracture at size 20 and 25 with 0.02 and 0.04 taper. Conclusions: Dentists are familiar with limitations of NiTi instruments and techniques. Current study showed the awareness of dentists about benefits of NiTi rotary instruments application comparing to traditional techniques and also the high percent usage of these instruments among general dentists.

Incidence of Apical Crack Initiation during Canal Preparation using Hand Stainless Steel (K-File) and Hand NiTi (Protaper) Files.

AIM: To evaluate the incidence of apical crack initiation during canal preparation with stainless steel K-files and hand protaper files (in vitro study). MATERIALS AND METHODS: Sixty extracted mandibular premo-lar teeth are randomly selected and embedded in an acrylic tube filled with autopolymerizing resin. A baseline image of the apical surface of each specimen was recorded under a digital microscope (80×). The cervical and middle thirds of all samples were flared with #2 and #1 Gates-Glidden (GG) drills, and a second image was recorded. The teeth were randomly divided into four groups of 15 teeth each according to the file type (hand K-file and hand-protaper) and working length (WL) (instrumented at WL and 1 mm less than WL). Final image after dye penetration and photomicrograph of the apical root surface were digitally recorded. RESULTS: Maximum numbers of cracks were observed with hand protaper files compared with hand K-file at the WL and 1 mm short of WL. Chi-square testing revealed a highly significant effect of WL on crack formation at WL and 1 mm short of WL (p = 0.000). CONCLUSION: Minimum numbers of cracks at WL and 1 mm short of WL were observed with hand K-file and maximum with hand protaper files. HOW TO CITE THIS ARTICLE: Soni D, Raisingani D, Mathur R, Madan N, Visnoi S. Incidence of Apical Crack Initiation during Canal Preparation using Hand Stainless Steel (K-File) and Hand NiTi (Protaper) Files. Int J Clin Pediatr Dent 2016;9(4):303-307.

Evaluation of Coronal Leakage Following Different Obturation Techniques and in-vitro Evalution Using Methylene Blue Dye Preparation.

INTRODUCTION: Coronal and apical leakage still remains one of the most important cause for endodontic failure in spite of the presence of advanced endodontic materials. The cause may attribute to different filling techniques, physical and chemical properties of sealers and presence or absence of smear layer assessment of coronal or apical leakage is used as a research method to compare the sealing ability of different techniques and endodontic materials. AIM: To compare the coronal bacterial leakage using methylene blue in four different obturation techniques after protaper hand instrumentation. MATERIALS AND METHODS: Ninety extracted single-rooted teeth were instrumented to an apical preparation size F3 Protaper hand files. Twenty teeth were randomly obturated with lateral compaction, 20 with vertical compaction, 20 with combination of vertical and lateral compaction and 20 with Thermafil. Ten teeth were used for positive and negative controls (five teeth in each group). Teeth were kept in 100% humidity for 90 days, and then subjected coronally to Proteus vulgaris for 21 days to assess bacterial leakage. After bacterial challenge, methylene blue was placed coronally for another 21 days, and then scoring was done according to depth of dye leakage. Chi-square test was done for statistical analysis. RESULTS: Leakage as observed with combination of vertical and lateral compaction was significantly less than vertical compaction, lateral compaction and thermafil carriers during bacterial challenge. However, when dye was used it also showed statistically significant results with thermafil carriers showing the least leakage in comparison to vertical condensation, lateral condensation and combined groups. CONCLUSION: The study concludes that two different methods i.e. bacterial and dye leakage revealed considerable variation on the same substrate Thus, due to the presence of variability among the results obtained by two different analytical methods used in the present study, the study emphasizes the need for standardization of methods as the lack of standardization hinders the comparison of different endodontic filling techniques.

Anatomic and diagnostic challenges of C-shaped root canal system.

Successful root canal treatment depends on the thorough management of the canal anatomy. The use of periapical radiographs is essential to identify and monitor the canal's morphological variations. The C-shaped single canaled man-dibular 2nd molar probably requires a different regimen of treatment from the two rooted, three canaled version, as it is rare. Because of the importance of its true diagnosis and treatment, a comprehensive review of published information and investigations about it in addition to approaches for its treatment is necessary. In this article, a detailed review and three case reports with different C-shaped canal configurations have been described which were successfully negotiated, pre-pared and obturated. How to cite this article: Raisingani D, Gupta S, Mital P, Khullar P. Anatomic and Diagnostic Challenges of C-Shaped Root Canal System. Int J Clin Pediatr Dent 2014;7(1):35-39.

A survey report on effect of root canal fillings and coronal restorations on the periapical status of endodontically treated teeth in a selected group of population.

AIM: A cross-sectional radiographic orthopantomogram (OPG) survey was done to determine the prevalence of apical periodontitis (AP) in root canal-treated teeth in a selected population, and to evaluate the influence of the coronal restorations (CR) and root canal fillings on the periapical status. MATERIALS AND METHODS: A total of 250 OPGs were evaluated out of which root canal treatment (RCT) had been performed in 438 teeth which was taken as the sample size. STATISTICAL ANALYSIS USED: Chi-square test, odds ratio and p-values were recorded. RESULTS: The results showed that 53.1% of the endodontically treated teeth presented with AP radiographically. Incidence of AP among teeth with acceptable RCT (32.3%) was significantly lower than those suffering from unacceptable RCT (92.7%). Moreover, adequate CR demonstrated a significantly better periapical status (83.2%) compared to teeth with inadequate CR (37.2%). Also, the combination of adequate CR and adequate root filling resulted in significantly reduced incidence of AP (21.6%) compared to the presence of AP (97%) when both parameters scored as inadequate. CONCLUSION: RESULTS hence demonstrated that a well-performed RCT and well-sealing CR are both essential for the overall success of endodontic treatment. Therefore, a considerable improvement in the quality of RCT and CR in general dental practice is required to promote oral/periapical health. How to cite this article: Khullar P, Raisingani D, Gupta S, Khatri RK. A Survey Report on Effect of Root Canal Fillings and Coronal Restorations on the Periapical Status of Endodontically Treated Teeth in a Selected Group of Population. Int J Clin Pediatr Dent 2013;6(2):89-94.

Apexum: A Minimum Invasive Procedure.

The new Apexum procedure (Apexum Ltd, Or-Yehuda, Israel) is based on a minimally invasive removal of periapical chronically inflamed tissues through a root canal access. Apexum procedure (a novel method that allows for the removal or debulking of periapical tissues without using scalpels, periosteal elevators, or sutures) results in significant less postoperative discomfort or pain than conventional root canal treatment or than reported for conventional apical surgery. The removal or debulking of the periapical inflamed tissues, using the Apexum procedure, seems to enhance healing kinetics with no adverse events.

Cleanliness in the Root Canal System: An Scanning Electron Microscopic Evaluation of Manual and Automated Instrumentation using 4% Sodium Hypochlorite and EDTA (Glyde File Prep)-An in vitro Study.

Aim : To assess the cleaning efficacy of manual and automated instrumentation using 4% sodium hypochlorite singly and in combination with Glyde file Prep as root canal irrigant. Methodology : The study utilized 40 extracted human permanent premolars with single, straight and fully formed root. The teeth were then divided into four groups of ten each, Group I and II were prepared by manual instruments with 4% sodium hypochlorite used as irrigant singly [Group I] or in combination with Glyde file prep. Group III and IV were prepared by automated instruments at 250 rpm with 4% sodium hypochlorite as irrigant singly [Group III] and in combination with glyde file prep [Group IV] automated instrumentation. After completion of the root canal preparation the canal, teeth were prepared for SEM examination. These photomicrographs were qualitatively evaluated using criteria. Overall cleanliness, presence or absence of the smear layer, presence or absence of the debris, patency of the opening of dentinal tubules. Results : When comparing the cleansing efficacy of manual and automated instrumentation using 4% sodium hypochlorite better cleansing was there with manual instrumentation. When comparing the cleansing efficacy of manual and automated instrumentation using combination regime cleansing is better with automated instrumentation. When comparing the cleansing efficacy of manual instrumentation using 4% sodium hypochlorite singly and in combination with EDTA, the combination regime led to better cleansing. When comparing the cleansing efficacy of automated instrumentation using 4% sodium hypochlorite singly and in combination regime lead to better cleansing. Conclusion : Neither of instrumentation technique, nor irrigating regimes were capable of providing a completely clean canal. Automated instrumentation with a combination of sodium hypochlorite & EDTA resulted the best cleansing efficacy.