Conservative Dentistry Research Articles

The 39th Indian Association of Conservative Dentistry and Endodontics National Conference

The 39th Indian Association of Conservative Dentistry and Endodontics National Conference

Reasons for Patients Preferring Extraction over Root Canal Treatment in a Tertiary Care Hospital

Introduction: Dental caries is a major global oral health issue, potentially progressing to irreversible pulpitis and causing substantial discomfort. Although advancements in materials, instruments and knowledge have improved the success rates of root canal procedures, some patients opt for tooth extraction instead of root canal treatment. This choice can result in tooth loss, necessitating costly prosthetic replacements. Objective: The objective of this study was to determine the reasons for patients choosing extraction over root canal treatment. Methods: A descriptive cross-sectional study was conducted among 205 patients visiting the Department of Conservative Dentistry and Endodontics at Kathmandu Medical College for the treatment of irreversible pulpitis, who ultimately opted for extraction. A structured questionnaire was utilized, and responses were recorded and analyzed using the Statistical Package for the Social Sciences. Mean, standard deviation, frequency and percentage were calculated depending upon the nature of data. Results: The study found that the primary reason for patients not undergoing root canal treatment (RCT) was the high cost of RCT and crown, accounting for 42.9% (88 patients), followed by the need for more appointments with pain, at 31.2% (64 patients). Conclusions: This study revealed the cost of RCT and crown to be the major factor for patients opting out from RCT. The study provides valuable insights into the psychology of patients regarding RCT, highlighting reasons for its rejection. Such understanding assists dentists and specialists in tailoring treatment plans that align with patient preferences and needs.

Patient’s Perceptions and Experiences about the Root Canal Treatment: A Survey among Patients Visiting Nobel Medical College

Introduction: One major drawback of root canal therapy (RCT) is that most people don't know enough about it. To effectively address the issue, it is imperative to comprehend and identify the elements that impede or discourage patients from undergoing Root Canal Treatment. A survey of the literature reveals a dearth of information regarding patients' understanding and acceptability of root canal treatment (RCT) in the Nepali community. Objective: The objective of the study was to determine how well-informed patients were about root canal treatment at Nobel Medical College and Teaching Hospital in Biratnagar. A wide-ranging patient viewpoint on the matter was sought by means of a patient survey. Methods: This survey was conducted with the help of prestructured questionnaire consisting of 15 questions, distributed to random 250 patients coming to the outpatient department of Conservative dentistry and Endodontics at Nobel Medical College and Teaching Hospital. The completed questionnaires were then analyzed to assess patients’ experiences, concerns, and perceptions about RCT. Results: There is a lack of awareness among patients regarding RCT. Conclusion: The people need to be made more aware of the importance of maintaining a healthy dentition and the consequences that follow if this isn't done. If patients were fully informed about endodontic procedures, more might consider having them.

Teaching posterior composite restorations: A survey of dental schools in Palestine

AimThis study aimed to assess different aspects of teaching posterior composite restorations in two dental schools in Palestine. Materials and methodsA questionnaire was emailed to the heads of the operative and conservative dentistry departments to collect detailed information on the teaching practices related to posterior composite restorations. The questionnaire comprised 22 questions structured to collect information on the time dedicated to teaching the topic, competency assessments, future plans for allocating time for each restoration type, relevant indications and contraindications, specific materials and techniques utilized in the application, and fees charged for posterior restorations. The gathered responses were collated in Excel and analyzed. ResultsBoth dental schools allocated similar teaching times to posterior composites and amalgam in their preclinical operative dentistry courses. However, there was a greater emphasis on composites in the clinical course than in the preclinical course at both institutions. Despite these differences, both institutions expressed a shared intention to allocate more time to teaching posterior composites while reducing the emphasis on teaching amalgam procedures. Consistency was observed across competency testing, cavity design preferences, and contraindications, with both schools favoring slot-type cavities. Furthermore, uniformity was noted in the management of operatively exposed dentin and matrix techniques, although variations existed in moisture isolation. Notably, both schools taught circumferential and sectional metal matrices but did not teach clear sectional matrices or use of bulk-fill composites. Additionally, the adhesive and light-curing practices remained consistent across both institutions. ConclusionThe findings of this study indicate that the teaching of posterior composite restorations is consistent across both Palestinian dental schools. Their curricula are aligned with contemporary international practices, demonstrating a strong commitment to modern operative dentistry and adherence to global standards. These findings offer valuable insights for educators and researchers and emphasize the need for ongoing adaptations to maintain high clinical standards.

Influence of Academic Training and Professional Experience on the Management of Deep Caries Lesions.

Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor's degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master's degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16-30 years. Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions.

Fracture resistance and fractographic analysis of pressable glass-ceramics with different partial coverage designs for maxillary premolars

BackgroundPartial coverage concepts have met the main goal of conservative dentistry. Vonlays, which combine features of veneers and onlays, are a recent alternative to full coverage designs and overlay partial coverage restorations. This in vitro study was conducted to compare the fracture resistance of the newly introduced pressable zirconia-reinforced lithium silicate with pressable lithium disilicate ceramic and to determine the optimal preparation design for partial coverage on upper premolars.MethodsFifty-two duplicated epoxy resin dies were prepared following vonlay and overlay preparation guidelines. For each preparation (n = 26), the specimens were divided into two subgroups to be restored with lithium disilicate (IPS e.max Press) or zirconia-reinforced lithium silicate (Vita Ambria) (n = 13 each). Ceramic vonlays and overlays were bonded using dual cure resin cement, subjected to thermomechanical fatigue, and the load to fracture was tested by using a universal testing machine. The specimens were fractographically analyzed via scanning electron microscopy (SEM). The normality of the fracture resistance data was checked using the Shapiro‒Wilk test and Q‒Q plots, and two-way ANOVA was used to assess the effect of the type of preparation and ceramic material on the fracture resistance.ResultsThe group of overlays restored with zirconia-reinforced lithium silicate showed the highest mean fracture load (1218.69 N), while the group of vonlays restored with lithium disilicate had the lowest mean fracture resistance (967.15 N). The effect of preparation design and material type on fracture resistance was significant for both factors, p = 0.003 and p < 0.0001, respectively. Different features of the fracture surfaces, such as arrest lines, hackles, and directions of crack propagation, were observed.ConclusionsZirconia-reinforced lithium silicate exhibited greater resistance to fracture compared to lithium disilicate, making it a potential substitute for partial coverage restorations. Additionally, the overlay showed superior fracture resistance when compared to the vonlay preparation design.

GPT-4o vs. Human Candidates: Performance Analysis in the Polish Final Dentistry Examination.

Background This study aims to evaluate the performance of OpenAI's GPT-4o in the Polish Final Dentistry Examination (LDEK) and compare it with human candidates' results. The LDEK is a standardized test essential for dental graduates in Poland to obtain their professional license. With artificial intelligence (AI) becoming increasingly integrated into medical and dental education, it is important to assess AI's capabilities in such high-stakes examinations. Materials and methods The study was conducted from August 1 to August 15, 2024, using the Spring 2023 LDEK exam. The exam comprised 200 multiple-choice questions, each with one correct answer among five options. Questions spanned various dental disciplines, including Conservative Dentistry with Endodontics, Pediatric Dentistry, Dental Surgery, Prosthetic Dentistry, Periodontology, Orthodontics, Emergency Medicine, Bioethics and Medical Law, Medical Certification, and Public Health. The exam organizers withdrew one question. GPT-4o was tested on these questions without access to the publicly available question bank. The AI model's responses were recorded, and each answer's confidence level was assessed. Correct answers were determined based on the official key provided by the Center for Medical Education (CEM) in Łódź, Poland. Statistical analyses, including Pearson's chi-square test and the Mann-Whitney U test, were performed to evaluate the accuracy and confidence of ChatGPT's answers across different dental fields. Results GPT-4o correctly answered 141 out of 199 valid questions (70.85%) and incorrectly answered 58 (29.15%). The AI performed better in fields like Conservative Dentistry with Endodontics (71.74%) and Prosthetic Dentistry (80%) but showed lower accuracy in Pediatric Dentistry (62.07%) and Orthodontics (52.63%). A statistically significant difference was observed between ChatGPT's performance on clinical case-based questions (36.36% accuracy) and other factual questions (72.87% accuracy), with a p-value of 0.025. Confidence levels also varied significantly between correct and incorrect answers, with a p-value of 0.0208. Conclusions GPT-4o's performance in the LDEK suggests it has potential as a supplementary educational tool in dentistry. However, the AI's limited clinical reasoning abilities, especially in complex scenarios, reveal a substantial gap between AI and human expertise. While ChatGPT demonstrates strong performance in factual recall, it cannot yet match the critical thinking and clinical judgment exhibited by human candidates.

Impact of the COVID-19 Pandemic on Self-Confidence in Patient Treatment in the Endodontic and Restorative Procedures of Dentistry Students at the University of Novi Sad.

(1) Background: The COVID-19 pandemic has brought about a change in the concept of teaching with the introduction of online lectures and "distance learning." The aim of this study was to determine the impact of the COVID-19 pandemic on the confidence and both theoretical and practical knowledge of dental students regarding the courses in conservative dentistry and endodontics. (2) Methods: The study was conducted using an originally created online questionnaire consisting of 30 questions that the students used to make a subjective assessment of their confidence in performing both endodontic and conservative procedures using numerical scales. They were divided into two groups, a non-COVID group of students, who attended classes before the outbreak of the pandemic, and a COVID group, whose classes were suspended due to the lockdown. The data were processed in the SPSS statistic 25 program, with statistical significance p < 0.05. (3) Results: The comparison of the self-assessment of 96 students from the COVID group and 91 students from the non-COVID group revealed significant results. Compared with the COVID group, the non-COVID students felt more confident in the application of anesthesia in both the maxilla and mandible, in the initial treatment of patients in pain, as well as in all the steps of the endodontic treatment. Both groups felt equally confident in diagnostic and conservative procedures, and the level of theoretical knowledge acquired in the courses. (4) Conclusions: Changes in teaching due to the COVID-19 pandemic had an unfavorable effect on students' self-confidence in performing routine dental interventions, especially in the endodontic field. The lack of confidence in the COVID group regarding the anesthetic and endodontic procedures appears due to their inability to do any of these procedures during the COVID period; we organized summer practical school under the supervision of teachers, and they gained the necessary knowledge and self-confidence for these procedures.

A Review on Carbon-Based Nanoporous Materials and Their Applications in Conservative Dentistry.

A Review on Carbon-Based Nanoporous Materials and Their Applications in Conservative Dentistry.

Revolutionising Dental Care: The Multifaceted Role of Ozone Therapy

The antibacterial, anti-inflammatory, and tissue-regenerative qualities of ozone therapy have attracted a great deal of interest in the dental community. The history, workings and uses of ozone treatment in the fields of oral pathology, conservative dentistry and endodontics, periodontics, pedodontics, oral surgery, oral medicine, and temporomandibular joint (TMJ) problems are all covered in length in this comprehensive overview. To establish the long-term advantages of ozone therapy in dentistry and standardize treatment regimens, this review highlights the need for advanced research in this field. Key Words - Antimicrobial Treatment, Dental Applications, Minimally Invasive Dentistry, Oral Health, Ozone Therapy

THE EXPERIENCE OF USING A NEW PHARMACOLOGICALLY ACTIVE COMPOSITION OF NANOSTRUCTURED FLUORAPATITE IN THE TREATMENT OF EARLY MANIFESTATIONS OF INCREASED TOOTH ABRASION

Despite the obvious successes in the field of preventive and conservative dentistry, the prevalence of abrasion of teeth (ITP) continues to grow: during the period 1992-2004, the proportion of diseases of hard tissues of teeth with elimination properties increased from 30.9 ± 1.8% to 38.2 ± 1.3%, i.e. increased by 7.3% [1, 7-10]. Many issues related to the diagnosis and planning of an integrated approach to the provision of dental care to patients with moderate CAH have not yet been sufficiently studied and covered [2]. Biologically active calcium phosphate in gel or colloidal state is currently of increasing interest in many areas of clinical medicine related to the problem of regeneration of soft and hard tissues of the body. It has been established that the biological activity of apatite largely depends on the size of its particles or grains, and the higher the dispersion of the substance, the more pronounced it is [3]. The use of pure compounds, as well as various combinations of bioactive substances to improve properties such as adhesion, bioactivity and biocompatibility, is also very promising [4]. A promising direction of modification of calcium hydroxyapatite (HCA) from the point of view of obtaining materials with improved properties is the introduction of fluorine and silicon atoms into the structure of HCA. This transformation increases the stability of the material in the chemically active environment of the human body (due to the presence of fluoride ions) and increases its biological activity (due to the presence of silicate ions), while maintaining the inherent biocompatibility of HAP [5]. Nanotechnology is used in the study, production and use of nanostructures, devices and systems, including targeted control and modification of the shape, size, interaction and integration of their constituent nanoscale elements (1-100 nm) to obtain objects with new chemical, physical and biological properties. A number of technologies and methods. Direct transport of medicines to the focus of the pathological process can increase the effectiveness of existing drug therapies [6]. A promising direction in modern dentistry is the creation of new pharmacological agents with particle sizes of the order of 10-9 (nanoparticles) for noninvasive treatment and early prevention of dental diseases. The aim of the study was to study the effectiveness of new pharmacologically active compositions of nanostructured fluorohydroxyapatite in the treatment of early symptoms of dental hyperextension.

Use of optical see-through head-mounted devices in dentistry - a scoping review.

The aim of this scoping review was to identify the scientific evidence related to the utilization of Optical See- Through Head-Mounted Display (OST-HMD) in dentistry, and to determine future research needs. The research question was formulated using the "Population" (P), "Concept" (Cpt), and "Context" (Cxt) framework for scoping reviews. Existing literature was designated as P, OST-HMD as Cpt, and Dentistry as Cxt. An electronic search was conducted in PubMed, Embase, Web of Science, and CENTRAL. Two authors independently screened titles and abstracts and performed the full-text analysis. The search identified 286 titles after removing duplicates. Nine studies, involving 138 participants and 1760 performed tests were included in this scoping review. Seven of the articles were preclinical studies, one was a survey, and one was a clinical trial. The included manuscripts covered various dental fields: three studies in orthodontics, two in oral surgery, two in conservative dentistry, one in general dentistry, and the remaining one in prosthodontics. Five articles focused on educational purposes. Two brands of OST-HMD were used: in eight studies HoloLens Microsoft was used, while Google Glass was utilized in one article. The overall number of included studies was low; therefore, the available data from this review cannot yet support an evidence-based recommendation for the clinical use of OST-HMDs. However, the existing preclinical data indicate a significant capacity for clinical and educational implementation. Further adoption of these devices will facilitate more reliable and objective quality and performance assessments, as well as more direct comparisons with conventional workflows. More clinical studies must be conducted to substantiate the potential benefits and reliability for patients and clinicians.

Can a Novel Device with Pure Dry Air Increase the Shear Bond Strength of Dental Composites to Dentin? An Experimental Study.

Modern conservative dentistry is taking the lead in daily clinical practice and is relying on adhesion. Whether it is a simple composite, ceramic inlays, onlays, veneers or crowns, the common factor for a successful outcome is a good bonding of these elements to dental structures. Thus, the purpose of this study was to evaluate the bond strength of resin composite to dentin when using a new device, the DENTIPURE KM™ (KM, Beirut, Lebanon), which provides a pure air flow, free of any contaminants and without humidity, when compared to other dental equipment. One hundred and eighty extracted human molars were equally divided into three groups according to the device used, the DENTIPURE KM™ (KM, Beirut, Lebanon), the KAVO™ (ESTETICA E30/E70/E80 Vision, KAVO, Biberach, Germany), or the ADEC™ (A-dec Performer 200, Newberg, OR, USA). The shear bond strength (SBS) was evaluated after 24 h of storage in distilled water on a universal testing machine. Statistical analysis was set with a level of significance at p ≤ 0.05. The results revealed that significantly different bond strength was imparted by the DENTIPURE KM™ device and the ADEC™ dental unit (p = 0.042). In conclusion, while the DENTIPURE KM™ device shows promise in providing contaminant-free air during bonding, its impact on dentin bond strength compared to devices like the KAVO™ appears minimal. Further research is needed to fully assess its potential in enhancing dentinal adhesion procedures.

Impact of self-assessment on dental student’s performance in pre-clinical conservative dentistry course

BackgroundSelf-assessment (SA) is an interactive course that endorses the accomplishment of learning objectives through learners’ identification of insufficiencies in their didactic knowledge and pre-clinical skills. This study was planned to determine whether there is any improvement in the faculty assessment (FA) score following the implementation of SA in the Pre-clinical Conservative Dentistry Course.MethodsFifty-four first-semester dental students were given an introductory lecture followed by a demonstration for Class I Cavity Preparation in typhodont mandibular first molar. At the end of the demonstration, the Scoring Rubric (SR) was explained point-wise in the prepared cavities. During the next session, all students performed Class I cavity preparation and they were given an assessment sheet to enter their scores (SA1). All teeth were evaluated by the Grading Faculties in a blinded manner (FA1). Each participant was explained the difference in their respective SA1 from FA1 and their queries were resolved individually. During the next sessions, Students and Grading Faculties followed the same protocol and scores were recorded as SA2, FA2, SA3 and FA3.ResultsThe mean score of SA1 was significantly higher than that of FA1 (p < 0.001). However, no significant difference was obtained between SA and FA in the second (p = 0.352) and third (p = 0.434) assessments. In contrast with first assessment, mean marks obtained in FA were higher compared to SA in both second and third assessments. There was a statistically significant improvement in mean marks obtained by the students over time (p < 0.001).ConclusionSA endorsed student-faculty communication and enhanced student’s poise and technical skills in operative pre-clinical dentistry.

Assessment of anxiety in patient’s undergone surgical extraction and root canal treatment – A comparative study

: To quantitate and compare the anxiety level associated with patients who have undergone surgical extraction of teeth and root canal treatment.: This study was conducted on 100 patients who reported to the Department of Oral and Maxillofacial Surgery (50) requiring surgical extraction of teeth and Department of Conservative Dentistry and Endodontics (50) requiring root canal treatment. Patients were randomly enrolled for the study and were given a questionnaire after the completion treatment (extraction and root canal treatment). The anxiety levels were evaluated based on the scores of the Corah's Dental Anxiety Scale. : The results of the present study showed that the dental anxiety was higher among subjects who have undergone surgical extraction of teeth when compared to the patients undergone root canal treatment. : In conclusion, maxillofacial surgeons should consider that patients initially visit dental office for treatment of surgical extraction of teeth with severe anxiety which could be due to conditioning or learned responses which these patients might have experienced or first visit. Thus a prior awareness of the patient's predisposition to dental anxiety may be of value, enabling to take appropriate measures pre-operatively. Thus our aim is to give anxiety free dental treatment to the patients and better postoperative recovery.

Orthodontic diagnosis rates based on panoramic radiographs in children aged 6-8 years: A retrospective study.

This study aimed to retrospectively analyze the prevalence of orthodontic problems and the proportion of patients who underwent orthodontic diagnosis among children aged 6 (n = 300), 7 (n = 400), and 8 (n = 400) years who had undergone panoramic radiography. Children were divided into five groups according to their chief complaint and consultation: conservative dentistry, oral and maxillofacial surgery, orthodontics, periodontics, and prosthodontics). Chief complaints investigated included first molar eruption, lack of space for incisor eruption, frequency of eruption problems, lack of space, impaction, supernumerary teeth (SNT), missing teeth, and ectropion eruption. The number of patients whose chief complaint was not related to orthodontics but had dental problems requiring orthodontic treatment was counted. The proportion of patients with orthodontic problems who received an orthodontic diagnosis was also examined. Dental trauma and SNT were the most frequent chief complaints among the children. The proportion of patients with orthodontic problems increased with age. However, the orthodontic diagnosis rates based on panoramic radiographs among children aged 6, 7, 8 years were only 1.5% (6 years) and 23% (7 and 8 years). Accurate information should be provided to patient caregivers to correct misconceptions regarding the appropriateness of delaying orthodontic examination until permanent dentition is established.

The role of developmental factors in hypoplasia of deciduous teeth and treatment specifics in pediatric dental practice

Relevance. Congenital and systemic diseases can lead to developmental errors in the enamel organ, resulting in anomalies such as enamel hypoplasia. The high prevalence of these defects illustrates the vulnerability of teeth to changes in the intrauterine and postnatal environments. Enamel hypoplasia contributes to the development of caries and tooth wear by making enamel thinner, more retentive to dental plaque, and less resistant to acid degradation compared to normal enamel. Surfaces of the affected hard tissues are smooth and exhibit a symmetric distribution pattern. The occurrence of enamel hypoplasia in children is a significant factor in the development of caries; thus, they require comprehensive treatment and ongoing preventive care by a pediatric dentist.Purpose. To analyze the impact of factors contributing to the development of deciduous teeth hypoplasia in children, on the frequency of this condition and the specifics of its treatment by a pediatric dentist.Materials and Methods. The study involved the examination and treatment of children aged 4-12 at the Dental and Implantology Department of Kazan (Volga Region) Federal University over a 12-month period. Out of 972 children, 67 were diagnosed with systemic enamel hypoplasia. A questionnaire was developed for statistical research, and data were processed using Statistica 7.0 software Statistica 7.0 (StatSoft, США).Results. The survey revealed chronic diseases in 16.42% of mothers. During pregnancy, 68.6% of the mothers visited a dentist once, and 31.3% visited two to three times. Most mothers experienced early pregnancy toxemia—67% in the first half and 58.2% in the second half of the pregnancy. Additionally, 50.7% suffered from acute respiratory viral infections and influenza, and 25.4% had gastrointestinal diseases. Feeding practices involved breastfeeding in 68.7% of cases and artificial feeding in 31.3% (up to 3 months – 16.4%, up to 1 year – 64.1%, up to 2 years – 19.4%). Examination of the oral cavity in 67 children with systemic hypoplasia revealed a spotted form in 79.1% of cases and a purely destructive form in 20.9% of cases. Contemporary conservative dentistry emphasizes minimally invasive approaches to the treatment of such dental defects.Conclusion. The study of deciduous tooth hypoplasia in children highlighted the importance of the health status of the expectant mother and timely sanitation of the oral cavity. Particular attention should be paid to maternal infectious diseases, specifically influenza and ARVI. The findings underscore the need for preventive measures against temporary tooth hypoplasia from the onset of pregnancy planning to enhance the dental well-being of children.

Frequency of Second Mesiobuccal Canal in Permanent Maxillary Molars: An Observational Study

Background: The success of root canal therapy in endodontics is heavily dependent on identifying a second mesiobuccal canal (MB2) in permanent maxillary molars. A comprehensive understanding of internal anatomy, particularly the recognition of MB2, is crucial for the effective treatment of this commonly encountered tooth. This study aimed to investigate the prevalence and occurrence of the second mesiobuccal canal in permanent maxillary first and second molars. Methods: This cross-sectional study that was conducted at the Department of Conservative Dentistry &amp; Endodontics, Military Dental Centre Dhaka, Bangladesh from January 2018 to December 2018. The analysis involved a total of 200 maxillary first molars and 200 maxillary second molars. In the initial phase for both groups, teeth were examined with the naked eye followed by microscopic assessment. Data analysis was conducted with MS Office tools. Results: In naked eye observation, the frequency of MB2 canals in the first molar teeth was found 64%, and in the second molar teeth it was found 56%. On the other hand, by microscopic assessment, the frequency of MB2 canals in the first molar teeth was found 96%, and in the second molar teeth, it was found 84%. Conclusion: The occurrence of the second mesiobuccal canal (MB2) in permanent maxillary first molars is more common than in the second molars. Microscopic assessment proves to be more effective than naked eye assessment for detecting the presence of MB2 in both maxillary first and second molars. J Bangladesh Coll Phys Surg 2024; 42: 133-138

Undergraduates' comparative assessment, utilizing a structured rubric, of hands-on versus video-supported presentation in class II cavity preparation.

Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an important step in many health professions to become a successful professional. During under graduation, class II cavity preparation exercise is of utmost important in dentistry. To compare class II cavities prepared by students after hands-on live demonstration and pre-recorded video demonstration using well-organised evaluation rubrics. Preclinical dental students (n= 50) were divided into two groups. The students in group I (n= 25) attended a hands-on live demonstration performed by one faculty while students in group II (n= 25) watched a 15-minute pre-recorded procedural video on the projector. Both groups were appealed to prepare class II cavity for amalgam involving disto-occlusal surface of mandibular second molar articulated on jaw model (TRU LON study model, Jayna industries, Ghaziabad U.P., India). Following completion of the preparations, all teeth were collected, and labelled grades of prepared cavities were given according to prespecified rubrics. The data of scores were presented as means and standard deviation. Statistical analysis of data was executed using SPSS software. A paired t-test was used to compare scores between groups. The study shows that the video-supported demonstration of a cavity preparation was better than the live hands-on demonstration. A higher mean response for the procedural video group was found compared to the live demonstration group (p= 0.000133). Pre-recorded video-supported demonstration along with guidance by a tutor may be a viable alternative to hands-on live demonstration in cavity preparation procedures during undergraduate dental training. Moreover, rubric methods can be implemented in the teaching of various preclinical exercises for conservative dentistry and endodontics.

FUNCTIONAL CROWN LENGTHENING AS A PRE-RESTORATIVE PROCEDURE IN THE AESTHETIC ZONE

Introduction: Crown lengthening is a surgical procedure to increase the height of the clinical crown for aesthetic and restorative purposes, or combination. The indications include treatment of subgingival caries and altered passive eruption. Functional crown lengthening for restorative purposes in the esthetic zone should consider the concept of biologic width and the ideal proportion of the dentogingival complex. Case: A 39-year-old male patient was referred from the Department of Conservative Dentistry, RSGM UGM Prof. Soedomo to expose the maxillary anterior teeth crowns for full crown and veneer restorations. Clinical examination showed 11, 12, and 12 post root canal treatment with 3-4 mm remaining crowns. Teeth 13, 21, 22, and 23 appear short, excessive gingival display of 3 mm, with a diagnosis of altered passive eruption type 1B. Treatment: Functional crown lengthening was performed by gingivectomy followed by flap elevation, ostectomy, and osteoplasty. A fenestration was found at the apical of 22 and treated with regenerative procedure. Full crowns and veneers insertion was done 3 months after surgery. Crown lengthening as a pre-restorative procedure is a multidisciplinary treatment that considers the need for restoration by re-establishing the biologic width, to prevent inflammation and bone loss. In addition, adequate post- surgical tissue healing time prior to restoration is necessary to avoid gingival margin rebound and to assure long-term success of the restoration. Conclusionn : Functional crown lengthening as a pre-restorative procedure in the esthetic zone can gives satisfactory and stable results, with careful examination and correct surgical procedure.