An In vivo Study to Compare Anti Microbial Activity of Triantibiotic Paste, 2% Chlorhexidine Gel, and Calcium Hydroxide on Microorganisms in the Root Canal of Immature Teeth.

AIMS AND OBJECTIVES: Intracanal medication plays an important role in disinfecting the root canal from various microorganisms. There are various intracanal medication frequently used by practitioners based on the efficacy of the same, therefore to compare antimicrobial activity of a triple antibiotic paste with chlorhexidine gel and calcium hydroxide against microorganisms in the root canal used as irrigating solution. MATERIALS AND METHODS: The present study was conducted on 88 single rooted (central and lateral incisors), asymptomatic, nonvital, and necrotic teeth. Individuals included were between the ages of 12-15 years with no systemic complications. Overall, 88 teeth were divided randomly into four groups on the basis of treatment they were given, with each group having 22 teeth. Each group was assigned to one intervention group namely 2% chlorhexidine gel group, calcium hydroxide group, triantibiotic paste group, and the normal saline group. Triantibiotic paste was prepared from ciprofloxacin Hydrochloride 500 mg+ Metronidazole 400 mg+ Tetracycline 500 mg. Two samples were collected from individual tooth to assess the change in the extent of total colony forming units. RESULTS: Mean log10 bacterial count among the triantibiotic paste was 5.222 preirrigation which was decreased to 0.653. Maximum percentage of log10 bacterial count was decreased among triantibiotic paste group of 87.20% while control group of normal saline has recorded a decrease of 54.65% in bacterial count. Among all the four groups, there was a decrease of 73.51% of bacterial count. CONCLUSION: From the above results, it was concluded that triantibiotic paste demonstrated the highest efficacy against bacterial pathogen when used as irrigating solution.

Implementation of Game-based Oral Health Education vs Conventional Oral Health Education on Children's Oral Health-related Knowledge and Oral Hygiene Status.

INTRODUCTION: For the prevention of oral health problems, health education of schoolchildren has a vital role. The oral health status of the children can be improved if health promotion in schools is conducted in a comprehensive and interesting manner. OBJECTIVE: Effectivity of game-based oral health education over conventional on the oral health-related knowledge and oral hygiene status among 8- to 12-year-old schoolchildren. MATERIALS AND METHODS: A total of 150 children aged 8 to 12 years were divided into two groups. A pretest evaluation of their knowledge regarding oral health and the estimation of plaque index was carried out. Children in group I were given oral health education through PowerPoint presentation once daily for 7 days. Children in group II were educated through the play method (i.e., crosswords and quiz with PowerPoint presentation). The evaluations regarding oral health-related knowledge and plaque scores were recorded on postintervention 1 and 3 months. RESULTS: In group II, high knowledge scores of 10.32 and 9.98 were obtained by the on postintervention 1 and 3 months respectively. In both the groups, there was a significant increase in good oral hygiene scores and a significant decrease in plaque scores on postintervention 1 and 3 months follow-up, but much better scores were seen in group II compared to group I at both the follow-ups. CONCLUSION: Implementation of crossword game-based oral health education program is an easy and effective aid for teaching oral health instructions and preventing oral diseases in children as the knowledge scores of children increased considerably when the game-based teaching intervention was used. HOW TO CITE THIS ARTICLE: Malik A, Sabharwal S, Kumar A, Samant PS, Singh A, Pandey VK. Implementation of Game-based Oral Health Education vs Conventional Oral Health Education on Children's Oral Health-related Knowledge and Oral Hygiene Status. Int J Clin Pediatr Dent 2017;10(3):257-260.

Enhancing the antibacterial activity of the gold standard intracanal medicament with incorporation of silver zeolite: An in vitro study.

BACKGROUND: Enterococcus faecalis is a persistent organism that plays a major role in the etiology of persistent periradicular lesions after root canal treatment has been associated with different forms of periradicular disease including primary endodontic infections and persistent infections. The present study compares the antibacterial activities of calcium hydroxide, calcium hydroxide mixed with silver zeolite, and calcium hydroxide mixed with 2% chlorhexidine against E. faecalis using direct contact test. MATERIALS AND METHODS: The test materials of the in vitro experimental study were grouped as group 1-calcium hydroxide mixed with sterile water, group 2-2% silver zeolite added in calcium hydroxide mixed with sterile water, and group 3-calcium hydroxide mixed with 2% chlorhexidine. The bottom of microtiter plate were coated with freshly mixed tested material and a 10 µL of bacterial suspension was placed. After 1 h of incubation at 37°C, brain-heart infusion (BHI) broth (245 µL) was added and mixed for 2 min. These were designated as "subgroup 1" wells. A volume of 15 µL of broth then transferred from subgroup 1 wells to an adjacent set of four wells containing fresh BHI medium (215 µL); these wells were designated as "subgroup 2"' wells. The optical density was measured by a spectrophotometer after the first day, third day, and seventh day. One-way analysis of variance (ANOVA) and Tukey tests were performed for the analysis. RESULTS: Calcium hydroxide mixed with silver zeolite showed maximum antibacterial activity. CONCLUSION: Silver zeolite can be added in calcium hydroxide to enhance the latter's antibacterial activity against E. faecalis.

Attitude among dental practioners towards use of rotary instruments and hand instruments for root canal treatment: a comparative study

Aim: The purpose of present study is to assess the attitude of general dental practioners towards use rotary instruments and hand instruments for root canal treatment. Material and Methods: It was a cross-sectional questionnaire study conducted in the private clinics in Lucknow city, Uttar Pradesh. A total of 400 clinics were visited and face to face interview schedule was conducted. Questionnaire consists of demographic details of dental professionals. Information regarding the years of experience, OPD details and number of root canal treatment done per week by dental professionals was obtained. Use of rotary and hand instruments by dental professionals was inquired. Years of experience with Rotary instruments, procedural problems with rotary instruments faced by dental professionals and reasons for not using the rotary instruments if any was also recorded. Results: 102 (33%) of the total study samples were using rotary instruments for root canal treatment and 100 (32%) using both rotary and hand instruments for root canal treatment. Dentists who are using rotary instruments are facing the procedural problem of file breakage {70 (36%)}. And those dental professionals using hand instruments are facing the problem of ledge formation {82(40%)}. Conclusions: The main procedural failure of the rotary instruments in root canal treatment, faced by dental professionals was file breakage and with hand instrument is ledge formation. Lack of expertise is the main reason which restricts dental professionals from using rotary instruments.

Study of root canal morphology of mandibular premolars in an indian population

AIM: The purpose of this study was to describe the external and internal anatomy of the mandibular premolars. MATERIAL AND METHODS: 100 extracted human permanent mandibular first and second premolars teeth were collected. The length of the tooth from the cusp tip to root apex was measured with the help of Vernier calliper. In case of curved roots, ligature wire was adapted to the root and then straightened and measured. Each tooth was examined for the number of roots, curvature of root, presence of root canal invagination. India ink was injected into the pulp chamber through the access opening with a no.27 gauge needle mounted on a disposable syringe. The ink was then drawn through the root canal system by applying negative pressure to the apical end of tooth with the use of central suction system. RESULTS: The average (mean) length of mandibular first premolar was 22.25 mm. Average (mean) length of mandibular second premolar was 21.90 mm. Mandibular first premolar had a ribbon shaped root canal orifice in 35% of teeth. Mandibular second premolar had a ribbon shaped of root canal orifice in 44% teeth. Mesial invagination of the root was found in 18% of first and 8% second mandibular premolar teeth. 78% had a Type I canal pattern with Type II, Type IV, Type V, Type VI and Type VII canals being identified in 1%, 2%, 13%, 2% and 1% of the teeth respectively. CONCLUSIONS: Complex root canal anatomy frequently found with mandibular premolars among which more common with mandibular first premolars in Indian population.

An in vitro Comparison of Endodontic Medicaments Propolis and Calcium Hydroxide alone and in Combination with Ciprofloxacin and Moxifloxacin against Enterococcus Faecalis.

AIM: To evaluate and compare the antimicrobial properties of propolis and calcium hydroxide alone and in combination with ciprofloxacin and moxifloxacin against Enterococcus faecalis (E. Faecalis). MATERIALS AND METHODS: The laboratory study was carried out to test the effectiveness of propolis and calcium hydroxidealone as well as in combination with the established endodontic medicaments (moxifloxacin and ciprofloxacin). The various combinations were-group 1: propolis, group 2: calcium hydroxide, group 3: moxifloxacin, group 4: ciprofoxacin, group 5: propolis + moxifloxacin, group 6: propolis + Ciprofloxacin, group 7: calcium hydroxide + ciprofloxacin, group 8: calcium hydroxide + moxifloxacin. The efficacy of these medicaments was tested by checking for the zone of inhibition for the specific strain (ATCC 29212) of E. faecalis at different time intervals, i.e. 24, 48 and 72 hours. RESULTS: Mean zone of inhibition was maximum in group V (21.94 ± 4.26) followed by group VI (18.80 ± 1.93), group I (18.71 ± 4.26), group VIII (15.88 ± 2.59), group III (14.91 ± 1.00), group VII (14.57 ± 2.17), group IV (13.91 ± 1.00) and minimum in group II (12.89 ± 2.14). Mean zone of inhibition was found to be maximum at 72 hours and minimum at 24 hours. At all time intervals, the combination of Propalis with Moxifocacin showed the maximum antimicrobial efficacy. CONCLUSION: On the basis of the results of the present study, it can be concluded that propolis and calcium hydroxide show synergistic effect with moxifloxacin and ciprofloxacin against E. Faecalis. Propolis in combination with antibiotics and alone is more effective than calcium hydroxide. CLINICAL SIGNIFICANCE: Since propolis alone and in combination with antibiotics was observed to be more effective than calcium hydroxide, propolis can be considered as an intracanal medicament when compared to traditional calcium hydroxide.

A stereomicroscopic in- vitro study to investigate the root canal morphology of mandibular third molars using clearing technique

AIM: To analyse the root canal morphology of mandibular third molars using clearing technique. MATERIAL AND METHODS: Ninety permanent extracted mandibular third molar teeth were collected based on inclusion and exclusion criteria. Teeth were then decalcified and were made transparent Methylene Blue Dye was injected to color the pulp space. These teeth were then observed under sterio Microscope and root canal systems were identified according to Vertucci's Classification. RESULTS: The most common anatomical morphology found was having two roots. Overall type I Vertucci's configuration was the most common pattern of canals. Other canal patterns that were found included type II, III, IV and V. In this study no canal of type VI, VII or VIII were found. CONCLUSION: The morphological variations in root patterns and canal configuration of mandibular third molar should be given consideration for successful endodontic treatment.