Comparative Evaluation of the Percentage of Gutta-percha Filled Areas in Canals Obturated with Different Obturation Techniques.

AIM: To evaluate the percentage of gutta-percha filled areas (PGFA) in canals obturated with guttacore system, single cone, and lateral compaction techniques. MATERIALS AND METHODS: A total of 60 single-rooted mandibular premolars were selected and randomly divided into three equal groups depending on the type of obturation technique used. After the obturation, the samples were marked at 2, 4, 6, and 8 mm distance from the apex and sectioned horizontally, and viewed under a stereomicroscope at 25×. The area of the canal and of the filling material was recorded, and the percentage of filling material on the canal wall was calculated. RESULTS: Guttacore showed the highest percentage of root-filled areas followed by single cone and lateral compaction techniques at 2, 4, 6, and 8 mm from the apex. CONCLUSION: None of the filling techniques used in the study was completely able to fill the root canals with gutta-percha and sealer. The guttacore system had a maximum area of root canals filled as compared to the single cone and lateral compaction system. CLINICAL SIGNIFICANCE: Root canals are mostly oval, elongated, or irregularly shaped rather than being completely round. Hence, the obturation technique that fills the maximum area of the root canal must be selected according to the given clinical circumstances.

Evaluation of Cyclic Fatigue of Hyflex EDM, Twisted Files, and ProTaper Gold Manufactured with Different Processes: An In Vitro Study.

INTRODUCTION: The main aims of root canal instrumentation are to provide an environment that will lead to healing and to provide a root canal shape that is comfortable to clean and seal. When working with rotary endodontic instruments, the most significant concerns are that the instrument might fracture in the root canal, thus affecting the treatment outcome. Hence, it is of immense importance to know which file systems have more cyclic fatigue resistance. Methodology. This study evaluated the effect of the curved segment length of the artificial canal (the arch), and the number of cycles necessary in fracture of Hyflex EDM, Twisted files, and ProTaper Gold were recorded. Sixty NiTi rotary instruments of 25 mm length (Hyflex EDM (20), Twisted files (20), and ProTaper Gold (20)) were tested in a metal block with simulated canal having 90° angle of curvature. The study was performed with a specific radius and degree of curvature, i.e., 8 mm radius and 90° angle of curvature, and data obtained were subsequently subjected to statistical evaluation using one-way analysis of variance and Tukey's post hoc test. RESULT: The Hyflex EDM (774.29) exhibited the maximum cyclic fatigue resistance compared to Twisted files (654.875) and ProTaper Gold (375.575). A statistically significant difference was observed between the tested groups. CONCLUSION: The Hyflex EDM files showed the highest cyclic fatigue resistance, followed by Twisted files and ProTaper Gold files.

Comparative evaluation of the compressive, tensile, and flexural strengths of paracore®, flourocore®2+, and multicore® resin-based core build-up materials - An in vitro study.

Aims: The study was aimed to evaluate and compare the compressive, diametral tensile, and flexural strengths of three different commercial resin based core materials and to single out the best resin-based core build-up material with respect to their physical properties among ParaCore® (Coltene Whaledent, USA), FlouroCore® 2+ (Dentsply International, USA), MultiCore® (Ivoclar Vivadent, Liechtenstein) with Miracle Mix® (GC America) core used as control. Materials and Methods: One hundred and twenty samples were prepared, of which forty samples (10 of each material) were prepared in cylindrical stainless steel molds (height 6 mm, diameter 4 mm) for compressive strength measurements. Other forty samples (10 of each material) were prepared in cylindrical molds (diameter 6 mm, height 2 mm) for diametral tensile strength measurements. Forty samples (10 of each material) were prepared in stainless steel molds cuboidal in shape (length 25 mm, thickness 2 mm, and width 2 mm) for flexural strength measurements. The samples were tested on a Universal testing machine (Instron Machine 3366, made in the USA). Statistical Analysis Used: One-way analysis of variance was performed to determine any statistically significant differences (P < 0.05) among the resin-based core build-up materials with respect to their three respective strengths. Further, the statistical comparison was made among the four materials using Student's t-test at a significance level of 5%. Results: Based on the results obtained it can be summarized that the ParaCore is the strongest material among all the four materials, followed by MultiCore, FlouroCore2+, and Miracle Mix. The Miracle mix is the weakest among all the materials owing to its inferior strength values. Conclusion: The results of the present study imply that, in consideration of their superior strength values, resin-based core build-up materials, ParaCore, MultiCore, and FlouroCore2+ should be a preferred for use as core build-up material over Miracle Mix in specific clinical situations, in the same order of preference.

Maxillary first molar with two palatal roots located under dental operating microscope.

An awareness and understanding of the presence of an additional root and unusual root canal morphology is essential as it determines the successful outcome of endodontic treatment. A thorough knowledge of basic root canal anatomy and its variation is necessary for successful completion of endodontic treatment. This report points to the importance of looking for additional roots and canals with the help of operating microscope. Finding additional roots and canals would enable clinician to successfully treat a case that would otherwise not be successful.

A conservative single visit reattachment of fractured crown fragment.

Injury of anterior teeth is a relatively common event that mainly affects children and adolescents. Dentists are confronted with managing dental trauma and restoring fractured teeth on a regular basis. Hence the techniques that speed and simplify the treatment, restore esthetics and improve long term success rate are considered of potential value. If an intact tooth fragment is present after trauma, immediate attachment of the incisal edge is a conservative yet, simple and aesthetic alternative. Fracture reattachment possesses challenging conservative and economically viable procedure within a single visit. The authors wuld report a case of fractured maxillary central incisor using fragment reattachment.

Adult cerebral malaria: prognostic importance of imaging findings and correlation with postmortem findings.

PURPOSE: To correlate imaging abnormalities, clinical features, and postmortem findings in patients with proved cerebral malaria. MATERIALS AND METHODS: Twenty-one patients aged 17-50 years with cerebral malaria consented to undergo transverse nonenhanced (10-mm sections) and contrast material-enhanced (8-mm sections in posterior fossa and 10-mm sections in supratentorial region) CT on admission (n = 21) and on day 10 (n = 6), with thin sections (5 mm) obtained in the area of abnormality. All CT scans were evaluated for diffuse cerebral edema, focal parenchymal abnormalities, and hemorrhage. CT findings were categorized as normal, diffuse cerebral edema, and edema with thalamic hypoattenuation without or with cerebellar hypoattenuation. Spearman rank correlation test was performed. RESULTS: Initial scans were normal in seven patients with mild disease (median Acute Physiology and Chronic Health Evaluation [APACHE] II score of 7, median Glasgow Coma Scale [GCS] score of 10), and all survived. Of eight patients with diffuse cerebral edema (GCS > or = 8; median APACHE II, 21), six survived. Cerebral edema with thalamic and cerebellar white matter hypoattenuation was seen in five patients. All had GCS score of 6 or less, median APACHE II score of 26, and multiorgan failure; none survived. One patient (GCS = 6) had thalamic hypoattenuation without cerebellar lesions. He survived with mild residual hemiparesis. Diffuse petechial hemorrhages were seen in the cerebrum and cerebellum at autopsy in all seven patients who died. These petechial hemorrhages were not visualized on CT scans. CT findings did not correlate with degree of parasitemia. CONCLUSION: CT findings correlate well with level of consciousness and severity of disease but underestimate the extent of disease at pathologic examination. A normal CT scan indicates a favorable outcome, whereas cerebellar hypoattenuation portends a poor outcome.

Massive pleural effusion as the presenting feature of a subarachnoid-pleural fistula.

A 14-year-old boy presented with a large symptomatic transudative pleural effusion 4 months after spinal surgery for kyphoscoliosis. Computed tomography myelography confirmed a subarachnoid-pleural fistula (SPF) with a pseudo-meningocele communicating with the left pleural space. A review of the literature indicates this to be a rare finding. The possibility of SPF should be entertained in patients who present with a pleural effusion following transthoracic spinal surgeries.