Evaluation of Bacteriological Profile in the Apical Root Segment of the Patients with Primary Apical Periodontitis.

INTRODUCTION: Apical periodontitis usually results from bacterial accumulation and contamination occurring in the root-canal system, and extending beyond the apical foramen to involve the periapical tissues. Literature has a paucity of the studies that stress on the division and analysis of the pulp canal segments. The reason for this disparity might be the technique used for collecting the samples from the pulp canals. Hence, we carried out the present study to evaluate the microbial flora in the apical part of the roots with necrotic pulp canals. MATERIALS AND METHODS: The present study included the assessment of 40 freshly extracted teeth that had necrotized pulpal tissue along with the presence of periapical periodontal lesions. Removal of the soft tissue lesions attached to the root portion of the teeth along with apical periodontal lesions was done with the help of scalpel blade, after rinsing them with a sterile solution of saline. Thorough cleaning of the root surfaces was done with hydrogen peroxide followed by rapid disinfection with the help of sodium hypochlorite at varying concentrations. Sectioning of the root portion of all the specimens with the help of a disk was done perpendicular to the long axis of the teeth at a distance of roughly 5 to 6 mm from the teeth's apicalmost point. Cryotubes were used for transferring the specimens of apical portions containing 1 mL of buffer and were subjected to immediate frozen processing at a temperature of -20°C. A 10 K-type file was used for the initial collection of the samples followed by subsequent incubation of the files and paper pints in the incubation cabinet. Subsequent deoxyribonucleic acid (DNA) extraction from the samples was done following the procedure described by Siqueira et al. Paster et al's modification of the reverse-capture checkerboard assay was used in the present study. Semiquantitative data were used for overcoming the difficulties arising due to obtaining the counts of the polymerase chain reaction (PCR)-based analysis of specimens. RESULTS: A positive result for the 16S ribosomal ribonucleic acid (rRNA) gene primer was observed only in two examined specimens of all the samples of the apical portion of the root canals in the present study. Negative result was shown by all the control group specimens, which were sterile samples. Presence of bacteria was confirmed by PCR in 38 out of 40 examined specimens. Amount of bacterial taxa, out of these 24 samples, ranged up to 6. Pseudoramibacter alactolyticus, Porphyromonas endodontalis, Dialister oral species, Bacteroidetes species, Streptococcus species, Olsenella uli, Synergistes species, Fusobacterium nucleatum, Parvimonas micra, Treponema denticola, and Filifactor alocis were the specific species detected. Bacteroidetes species was the only species that were detected at levels at or above 105. Heavy bacterial infections were noticed in more than 45% of the cases at the periradicular part of the root canals. CONCLUSION: Microbial flora of the apical segment of the root with necrotized pulp tissue comprises a vast variety of pathogenic bacteria. CLINICAL SIGNIFICANCE: For better prognosis of the treatment of such cases, adequate knowledge of the microbial flora of the root, especially the apical portion is necessary.

In vitro Evaluation of the Accuracy of Seating Cast Metal Fixed Partial Denture on the Abutment Teeth with Varying Degree of Convergence Angle.

BACKGROUND: The prime goal of a diligent prosthodontist is to obtain adequate marginal fit while restoring lost tooth structure. The marginal fit of the restoration, in turn depends upon the geometrical morphology of the tooth preparation. OBJECTIVE: To determine the effect of varying degree of convergence angle on the marginal seating of the single crown, three-unit fixed partial denture and multiple-unit fixed partial denture with pier abutment. MATERIALS AND METHODS: Three dies, of same convergence angle, were placed in an arch form on a base. In this way, four arch forms were prepared for four different convergence angles i.e. 0°, 6°, 12°, and 20°. Five castings each were made for single crown, 3-unit fixed partial denture and multiple-unit fixed partial denture (FPD) with pier abutment for each convergence angle. The castings were seated on their respective dies and vertical marginal discrepancy was measured at four points for each casting with the help of an optical microscope. RESULTS: The results showed that 200 convergence angle showed better marginal seating of the single crown, 3-unit FPD as well as for the multiple unit FPD. CONCLUSION: There was a possibility that the retention and resistance may be compromised with 200 taper. Hence 120 taper is suggested for crowns and fixed partial denture retainers as the marginal discrepancy is reasonable and retention and resistance is optimum. There was a high statistical significant difference in the values obtained for the different convergence angles.

Multidrug resistance 1 gene polymorphism in amlodipine-induced gingival enlargement.

Gingival enlargement comprises any clinical condition in which an increase in the size of the gingiva is observed. It is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Among calcium channel blockers, nifedipine causes gingival enlargement in about 10% of patients, whereas the incidence of amlodipine, a third-generation calcium channel blocker, induced gingival enlargement is very limited. Because the calcium antagonists, albeit to a variable degree, act as inhibitors of P-glycoprotein (P-gp), the gene product of multidrug resistance 1 (MDR1), and inflammation may modify P-gp expression. We hereby, report a case of amlodipine-induced gingival enlargement with MDR1 3435C/T polymorphism, associated with inflammatory changes due to plaque accumulation, in a 50-year-old hypertensive male patient. The genotype obtained for the polymorphism was a heteromutant genotype, thus supporting the contention that the MDR1 polymorphism may alter the inflammatory response to the drug.

Effects of herbal and non-herbal toothpastes on plaque and gingivitis: A clinical comparative study.

BACKGROUND: Presence of plaque may be the culprit for dental caries, gingivitis, periodontal problems, and halitosis. Many mechanical aids are practiced worldwide to remove or control plaque, including tooth brushes, dental floss, mouth rinses, and dentifrices. The objective of this clinical study was to investigate the effectiveness of herbal toothpaste (Dabur Red) in controlling plaque and gingivitis, as compared to conventional (non-herbal) dentifrice (Pepsodent). MATERIALS AND METHODS: In this study, 30 subjects aged 35-43 years with established gingivitis and at least 20 natural teeth, and having a probing depth <3 mm were investigated. After the washout period, plaque and gingival index (PI and GI, respectively) scores were assessed at days 0 and 30. Differences between groups were compared with Mann-Whitney U test and the mean scores of PI and GI by Wilcoxon test. Statistical difference between the weights of dentifrices tubes on days 0 and 30 was evaluated by Student's t-test. RESULTS: At the end of 30 days of the study, there was statistically significant difference between both the groups for plaque and gingival scores. CONCLUSION: After 30 days of trial, both test and control groups showed effective reduction of plaque and gingivitis, which was statistically significant. No adverse reactions to dentifrices products were observed during the trial. It was concluded that herbal dentifrice was as effective as non-herbal dentifrices in the control of plaque and gingivitis.